Nineteen female and @ male subjects were lost to follow-up .


Among the remaining @ female and @ male subjects in the efficacy analysis , the mean terminal hair count at @ weeks increased from baseline by @ , @ , @ , @ , and @ per cm@ in @-beam lasercomb-treated female subjects , @-beam lasercomb-treated female subjects , @-beam lasercomb-treated male subjects , and @ - and @-beam lasercomb-treated male subjects , respectively , compared with @ ( p < @ ) , @ ( p < @ ) , @ ( p = @ ) , @ ( p = @ ) , and @ ( p = @ ) in sham-treated subjects ( @ % confidence interval ) .


The increase in terminal hair density was independent of the age and sex of the subject and the lasercomb model .


Additionally , a higher percentage of lasercomb-treated subjects reported overall improvement of hair loss condition and thickness and fullness of hair in self-assessment , compared with sham-treated subjects .


No serious adverse events were reported in any subject receiving the lasercomb in any of the four trials .


We observed a statistically significant difference in the increase in terminal hair density between lasercomb - and sham-treated subjects .


No serious adverse events were reported .


Our results suggest that low-level laser treatment may be an effective option to treat pattern hair loss in both men and women .


Additional studies should be considered to determine the long-term effects of low-level laser treatment on hair growth and maintenance , and to optimize laser modality .


Primary-care ( PC ) settings may be an opportune place to deliver obesity interventions .


Scalable interventions utilizing motivational interviewing ( MI ) , supported by Internet resources , may overcome obstacles to effective obesity treatment dissemination .


This study was a randomized controlled trial testing two Web-supported interventions , motivational interviewing ( MIC ) and nutrition psychoeducation ( NPC ) , an attention-control intervention , in comparison with usual care ( UC ) .


Eighty-nine overweight/obese patients , with and without binge eating disorder ( BED ) , were randomly assigned to MIC , NPC , or UC for @ months in PC .


Patients were assessed independently at post-treatment and at @-month follow-up .


Weight , triglyceride levels , and depression scores decreased significantly in NPC when compared to UC but not MIC ; UC and MIC did not differ significantly .


Weight loss results maintained at @-month follow-up : approximately @ % MIC and NPC patients achieved at least @ % weight loss which did not differ by BED status .


Fidelity ratings were high and treatment adherence was associated with weight loss .


This is the first randomized controlled trial in PC testing MI for weight loss to include an attention-control intervention ( NPC ) .


NPC , but not MIC , showed a consistent pattern of superior benefits relative to UC .


BED status was not associated , but treatment adherence was associated , with weight loss outcomes .


Miller laryngoscope blades are preferred for laryngoscopy in infants and children < @ yr of age .


Despite their long history , the laryngeal view with the Miller blade size @ has never been compared with that with the Macintosh ( MAC ) blade in children .


This prospective , single-blinded , randomized study was designed to compare the laryngeal views with the size @ Miller and MAC blades in children < @ yr .


With IRB approval , @ ASA I and II children < @ yr undergoing elective surgery were enrolled .


After an inhalation induction and neuromuscular block with i.v. rocuronium @ mg kg ( -@ ) , two laryngeal views were obtained with a single blade ( Miller or MAC ) in each child : one lifting the epiglottis and another lifting the tongue base .


The best laryngeal views in each blade position were photographed with a SONY ( ) Cyber-shot camera and rated by a blinded anaesthesiologist using the percentage of glottic opening scale .


The scores with the Miller blade lifting the epiglottis and the MAC blade lifting the tongue base were similar .


The scores with the Miller blade lifting the epiglottis and the tongue base were similar .


The scores for the MAC blade lifting the tongue base were greater than those lifting the epiglottis ( @ % confidence interval : @-@ @ ) ( P = @ ) .


In infants and children < @ yr of age , optimal laryngeal views may be obtained with either the Miller size @ blade lifting the epiglottis or with the Miller or MAC blades lifting the tongue base .


To study the predictive value of biphasic ST-events for interventions for suspected fetal distress and adverse neonatal outcome , when using ST-analysis of the fetal electrocardiogram ( FECG ) for intrapartum fetal monitoring .


Prospective cohort study .


Three academic hospitals in Sweden .


Women in labor with a high-risk singleton fetus in cephalic position beyond @weeks of gestation .


In women in labor who were monitored with conventional cardiotocography , ST-waveform analysis was recorded and concealed .


Traces with biphasic ST-events of the FECG ( index ) were compared with traces without biphasic events of the FECG .


The ability of biphasic events to predict interventions for suspected fetal distress and adverse outcome was assessed using univariable and multivariable logistic regression analyses .


Interventions for suspected fetal distress and adverse outcome ( defined as presence of metabolic acidosis ( i.e. umbilical cord pH < @ and base deficit in extracellular fluid > @mmol ) , umbilical cord pH < @ , @-min Apgar score < @ , admittance to neonatal intensive care unit or perinatal death ) .


Although the presence of biphasic events of the FECG was associated with more interventions for fetal distress and an increased risk of adverse outcome compared with cases with no biphasic events , the presence of significant ( i.e. intervention advised according to cardiotocography interpretation ) biphasic events showed no independent association with interventions for fetal distress -LSB- odds ratio ( OR ) @ , @ % confidence interval ( CI ) @-@ @ -RSB- or adverse outcome ( OR @ , @ % CI @-@ @ ) .


The presence of significant biphasic events did not discriminate in the prediction of interventions for fetal distress or adverse outcome .


Therefore , biphasic events in relation to ST-analysis monitoring during birth should be omitted if future studies confirm our findings .


In HIV-infected children , viral diversity tends to increase with age in the absence of antiretroviral treatment ( ART ) .


We measured HIV diversity in African children ( ages @-@ months ) enrolled in a randomized clinical trial comparing two ART regimens ( Cohort I of the P@ trial ) .


Children in this cohort were exposed to single dose nevirapine ( sdNVP ) at birth .


HIV diversity was measured retrospectively using a high resolution melting ( HRM ) diversity assay .


Samples were obtained from @ children at the enrollment visit prior to ART initiation .


Six regions of the HIV genome were analyzed : two in gag , one in pol , and three in env .


A single numeric HRM score that reflects HIV diversity was generated for each region ; composite HRM scores were also calculated ( mean and median for all six regions ) .


In multivariable median regression models using backwards selection that started with demographic and clinical variables , older age was associated with higher HRM scores ( higher HIV diversity ) in pol ( P = @ ) and with higher mean ( P = @ ) and median ( P < @ ) HRM scores .


In multivariable models adjusted for age , pre-treatment HIV viral load , pre-treatment CD@ % , and randomized treatment regimen , higher HRM scores in pol were associated with shorter time to virologic suppression ( P = @ ) and longer time to study endpoints ( virologic failure -LSB- VF -RSB- , VF/death , and VF/off study treatment ; P < @ for all measures ) .


In this cohort of sdNVP-exposed , ART-nave African children , higher levels of HIV diversity in the HIV pol region prior to ART initiation were associated with better treatment outcomes .


Asymmetric dimethylarginine ( ADMA ) , an endogenous inhibitor of nitric oxide synthase , increase with advancing age and menopausal status .


ADMA plays a role in endothelial dysfunction and increasing arterial stiffness .


Regular aerobic exercise has a positive effect on arterial function ( i.e. , arterial compliance ) .


This study investigated the effects of aerobic exercise training on plasma ADMA concentrations and arterial compliance in postmenopausal women .


Thirty postmenopausal women were divided into @ groups : an exercise group ( n = @ ) and a control group ( n = @ ) .


Subjects in the exercise group completed @ weeks of aerobic exercise training ( @ % -@ % of maximal heart rate , @-@ min/day , @-@ days/week ) .


Before and after each intervention , plasma ADMA concentrations and carotid arterial compliance were measured in all participants .


The baseline plasma ADMA concentrations , carotid arterial compliance , and most other key dependent variables did not differ between the @ groups .


In the exercise group , carotid arterial compliance significantly increased after exercise intervention ( P < @ ) , and plasma ADMA concentrations significantly decreased ( P < @ ) .


In addition , changes in carotid arterial compliance after the exercise intervention were inversely correlated with changes in plasma ADMA concentrations ( r = -@ ; P < @ ) .


We demonstrated that aerobic exercise training significantly decreased plasma ADMA concentrations with increase in carotid arterial compliance in postmenopausal women .


These results suggest that reduction in ADMA may play an important role in the aerobic exercise training-induced increase in arterial compliance .


Persistent disparities in access and quality of mental health care for Latinos indicate a need for evidence-based , culturally adapted , and outside-the-clinic-walls treatments .


Evaluate treatment effectiveness of telephone ( ECLA-T ) or face-to-face ( ECLA-F ) delivery of a @-@ session cognitive behavioral therapy and care management intervention for low-income Latinos , as compared to usual care for depression .


Multisite randomized controlled trial .


Eight community health clinics in Boston , Massachusetts and San Juan , Puerto Rico .


@ Latino patients recruited from primary care between May @ and September @ .


The primary outcome was severity of depression , assessed with the Patient Health Questionnaire-@ and the Hopkins Symptom Checklist-@ .


The secondary outcome was functioning over the previous @ days , measured using the World Health Organization Disability Assessment Schedule ( WHO-DAS @ ) .


Both telephone and face-to-face versions of the Engagement and Counseling for Latinos ( ECLA ) were more effective than usual care .


The effect sizes of both intervention conditions on Patient Health Questionnaire-@ were moderate when combined data from both sites are analyzed ( @ and @ for face-to-face and telephone , respectively ) .


Similarly , effect sizes of ECLA-F and ECLA-T on the Hopkins Symptom Checklist were quite large in the Boston site ( @ and @ .


respectively ) but not in Puerto Rico ( @ and @ ) .


The intervention appears to help Latino patients reduce depressive symptoms and improve functioning .


Of particular importance is the higher treatment initiation for the telephone versus face-to-face intervention ( @ % vs. @ % ) , which suggests that telephone-based care may improve access and quality of care .


Vomiting is a common complication associated with the use of hydromorphine for pre-emptive analgesia in dogs .


The ideal anti-emetic protocol for prevention of this complication has not been established .


Maropitant administered concurrently or before hydromorphone would reduce the incidence of vomiting , signs of nausea , ptyalism , and increased panting compared to administration of acepromazine or a @ % saline control .


Sixty mixed-breed female dogs scheduled for ovariohysterectomy .


Randomized , blinded , placebo-controlled experimental study .


Dogs were assigned to @ experimental groups with @ dogs per group .


All groups received @ mg/kg of hydromorphone IM .


Group `` Control '' received @ mL/kg saline SC @-@ minutes before hydromorphone , group `` Marop@ '' received @ mg/kg maropitant SC @-@ minutes before hydromorphone , group `` Ace '' received @ mg/kg IM acepromazine @-@ minutes before hydromorphone , and group `` Marop@ '' received @ mg/kg SC maropitant concurrently with hydromorphone .


A trained and blinded observer documented adverse events from the time hydromorphone was administered until the time dogs were induced for surgery .


Marop@ had significantly less vomiting ( @ % ) compared to Control ( @ % ; P < @ ) and Ace ( @ % ; P < @ ) .


Marop@ had significantly less vomiting ( @ % ) compared to Control ( P < @ ) .


Marop@ had significantly greater incidence of ptyalism ( @ % ) compared to Ace ( P < @ ; @ % ) .


Ace showed significantly less panting ( @ % ) compared to Marop@ ( @ % ; P < @ ) .


In healthy dogs , maropitant citrate administered before hydromorphone significantly decreases the incidence of vomiting in dogs but does not improve signs of nausea , ptyalism , or increased panting .


Sentinel lymph node biopsy alone has become an acceptable alternative to elective axillary lymph node dissection in patients with clinically node-negative early-stage breast cancer .


Approximately @ percent of the patients undergoing breast surgery develop side effects caused by the axillary lymph node dissection ( axillary pain , shoulder stiffness , lymphedema and paresthesias ) .


The current standard treatment is to perform completion axillary lymph node dissection in patients with positive sentinel lymph node biopsy .


However , randomized clinical trials of axillary dissection versus axillary irradiation failed to show survival differences between the two types of axillary treatment .


The National Institute of Oncology , Budapest conducted a single centre randomized clinical study .


The OTOASOR ( Optimal Treatment of the Axilla - Surgery or Radiotherapy ) trial compares completion axillary lymph node dissection to axillary nodal irradiation in patients with sentinel lymph node-positive primary invasive breast cancer .


Patients with primary invasive breast cancer ( clinically lymph node negative and less than or equal to @ cm in size ) were randomized before surgery for completion axillary lymph node dissection ( arm A-standard treatment ) or axillary nodal irradiation ( arm B-investigational treatment ) .


Sentinel lymph node biopsy was performed by the radio-guided method .


The use of blue-dye was optional .


Sentinel lymph nodes were investigated with serial sectioning at @ mm levels by haematoxylin and eosin staining .


In the investigational treatment arm patients received @Gy axillary nodal irradiation instead of completion axillary lymph node dissection .


Adjuvant treatment was recommended and patients were followed up according to the actual institutional guidelines .


Between August @ and June @ , @ patients were randomized for completion axillary lymph node dissection ( @ patients ) or axillary nodal irradiation ( @ patients ) .


The two arms were well balanced according to the majority of main prognostic factors .


Sentinel lymph node was identified in @ patients ( @ % ) and was positive in @ patients ( @ % ) .


Fifty-two sentinel lymph node-positive patients were excluded from the study ( protocol violation , patient 's preference ) .


Out of the remaining @ patients , @ underwent completion axillary lymph node dissection and @ received axillary nodal irradiation according to randomization .


The mean length of follow-up to the first event and the mean total length of follow-up were @ and @ months , respectively , and there were no significant differences between the two arms .


There was no significant difference in axillary recurrence between the two arms ( @ % in arm A and @ % in arm B ) .


There was also no significant difference in terms of overall survival between the arms at the early stage follow-up .


The authors conclude that after a mean follow-up of more than @ months axillary nodal irradiation may control the disease in the axilla as effectively as completion axillary lymph node dissection and there was also no difference in terms of overall survival .


There is no consensus concerning the most effective type of facilitator to promote healthy sexual behaviours in interventions targeting adolescents .


To evaluate the facilitator 's effect on the implementation of the COMPAS programme ( Spanish acronym for Skills for Adolescents with Healthy Sexuality ) , a school-based HIV prevention protocol .


Participants were @ Spanish scholars aged @ to @ .


Fifteen schools were randomly assigned to one of the three following schemes : COMPAS delivered by experts only ; the same programme administered by experts and peers ; or a control group , not exposed to any intervention .


The experts achieved an improvement in HIV knowledge and attitudes towards HIV and condom use ; however , experts associated to peers only succeeded in increasing HIV knowledge .


The effect size of the changes indicated a greater positive change in the programme when applied by experts than by experts and peers .


The participation of peers as co-facilitators did not increase the efficacy of a programme delivered by experts to Spanish adolescents .


Education delivered by experts was the most effective modality for reducing sexual risk .


COMPAS is the only Spanish programme targeting the promotion of safer sex behaviours in adolescents whose efficacy has been evaluated with different health agents in Spain .


To observe the therapeutic effect of a drug pair of Radix Astragali and Rehmanniae Radix combined with glucocorticoid ( GC ) in treating lupus nephritis ( LN ) patients and its influence on some experimental indices .


Totally @ LN patients were randomly assigned to the treatment group ( treated by routine Western medicine and a drug pair of Radix Astragali and Rehmanniae Radix , @ cases ) and the control group ( treated by Western medicine , mainly by GC and cyclophosphamide , @ cases ) .


All patients received @-month therapy .


The GC dosage , the withdrawal and reduction dosage of GC , clinical efficacy , systemic lupus erythematosus disease activity index ( SLEDAI ) score , adverse reactions , and laboratory indicators were recorded .


( @ ) All patients got relieved to some degree with the dosage of GC reduced .


The total withdrawal and reduction dosage of GC was slightly higher in the treatment group than in the control group -LSB- ( @ + / - @ ) mg vs ( @ + / - @ ) mg , P > @ -RSB- .


Besides , the prednisone dosage in the treatment group was lower than that in the control group , but without statistical difference ( P > @ ) .


The ratio of patients in need of adding prednisone for aggravating disease was @ % , significantly lower than that in the control group ( @ % , P < @ ) .


( @ ) There was no statistical difference in the SLEDAI score , inflammatory indicators , liver and renal functions , blood electrolytes , blood glucose , blood and urine routines between the two groups ( P > @ ) .


The @-h urinary protein count was ( @ + / - @ ) g/L in the treatment group , obviously lower than that in the control group ( @ + / - @ g/L , P < @ ) .


( @ ) There was no statistical difference in the incidence rate of infection , gastrointestinal hemorrhage , psychoneuroses , Cushing 's syndrome , cardiovascular anomalies , and femoral head necrosis between the two groups ( P > @ ) .


But the incidence of adverse reactions such as insomnia , tidal fever , spontaneous sweat , and obesity was less in the treatment group than in the control group ( P < @ ) .


Using a drug pair of Radix Astragali and Rehmanniae Radix combined with GC in treating LN could withdraw the dosage of GC and relieve symptoms it induced .


It was advantageous in reducing the dosage of GC and stabilizing patients ' conditions .


To evaluate the efficacy and side-effects of fentanyl and sufentanil combined with hyperbaric spinal bupivacaine in elective cesarean section .


A prospective , randomized , double-blind study with @ term parturients , distributed into @ groups according to the opioid combined with hyperbaric bupivacaine @ % ( @mg ) : GF - fentanyl ( @ g ) and GS - sufentanil ( @ g ) .


The latency and maximum sensory block level ; degree and duration of motor block ; duration and quality of analgesia ; maternal-fetal repercussions were evaluated .


This was an intention-to-treat analysis with a @ % significance level .


The latency period , maximum sensory block level , motor block degree and perioperative analgesia were similar in both groups .


Motor block and analgesia had a longer duration in the sufentanil group .


Maternal adverse effects and neonatal repercussions were similar .


The incidence of hypotension was higher in the fentanyl group .


In both groups , there was a predominance of patients who were awake and either calm or sleepy .


The addition of fentanyl and sufentanil to hyperbaric subarachnoid bupivacaine was shown to be effective for the performance of cesarean section , and safe for the mother and fetus .


Analgesia was more prolonged with sufentanil .


Figitumumab ( CP-@ ,@ ) , a fully human immunoglobulin G@ monoclonal antibody , inhibits the insulin-like growth factor @ receptor ( IGF-@R ) .


Our multicenter , randomized , phase III study compared figitumumab plus chemotherapy with chemotherapy alone as first-line treatment in patients with advanced non-small-cell lung cancer ( NSCLC ) .


Patients with stage IIIB/IV or recurrent NSCLC disease with nonadenocarcinoma histology received open-label figitumumab ( @ mg/kg ) plus paclitaxel ( @ mg/m ( @ ) ) and carboplatin ( area under the concentration-time curve , @ mg min/mL ) or paclitaxel and carboplatin alone once every @ weeks for up to six cycles .


The primary end point was overall survival ( OS ) .


Of @ randomly assigned patients , @ received treatment .


The study was closed early by an independent Data Safety Monitoring Committee because of futility and an increased incidence of serious adverse events ( SAEs ) and treatment-related deaths with figitumumab .


Median OS was @ months for figitumumab plus chemotherapy and @ months for chemotherapy alone ( hazard ratio -LSB- HR -RSB- , @ ; @ % CI , @ to @ ; P = @ ) ; median progression-free survival was @ months ( @ % CI , @ to @ ) and @ months ( @ % CI , @ to @ ) , respectively ( HR , @ ; P = @ ) ; the objective response rates were @ % and @ % , respectively .


The respective rates of all-causality SAEs were @ % and @ % ; P < @ ) .


Treatment-related grade @ adverse events were also more common with figitumumab ( @ % v @ % ; P < @ ) .


Adding figitumumab to standard chemotherapy failed to increase OS in patients with advanced nonadenocarcinoma NSCLC .


Further clinical development of figitumumab is not being pursued .


Postprandial hyperglycemia is a known risk factor for the development of several health disorders including type @ diabetes , obesity , oxidative stress , and cardiovascular diseases .


One encouraging approach for a better control of postprandial glycemia is to reduce carbohydrate digestion .


Cinnamon extracts have been known for managing blood glucose .


However , their effects on inhibiting digestion of carbohydrate have been poorly analyzed to date .


The aim of this study was to investigate the acute effect of a specific Ceylon cinnamon hydro-alcoholic extract ( CCE ) on carbohydrate digestion and post-meal blood glucose reduction .


In vitro enzymatic assays and in vivo starch tolerance tests in rats were designed as preclinical assays .


Then , a randomized , double-blind , placebo-controlled , cross-over clinical trial was conducted in @ healthy female and male volunteers .


Following the intake of @ g of CCE , the subjects ate a standardized meal .


Blood samples were collected during the @ hours following the meal to measure glucose and insulin concentrations .


Areas under the curves were calculated and statistical differences between the CCE and placebo groups were analyzed using the Mann Whitney-Wilcoxon test .


CCE has demonstrated in the in vitro study that it inhibited pancreatic alpha-amylase activity with an IC@ of @ g/mL .


In the in vivo study , CCE was shown to acutely reduce the glycemic response to starch in a dose-dependent manner in rats .


This effect was significant from the dose of @ mg/kg of body weight .


In both , the in vitro and in vivo studies , the hydro-alcoholic extract has shown to be more efficacious than the aqueous extract .


In the human clinical trial , @ g of CCE lowered the area under the curve of glycemia between @ and @ min by @ % ( P = @ ) and between @ and @ min by @ % ( P < @ ) compared to the placebo .


This effect occurred without stimulating insulin secretion .


No adverse effects were reported .


These results suggest that Ceylon cinnamon hydro-alcoholic extract ( CCE ) may provide a natural and safe solution for the reduction of postprandial hyperglycemia and therefore help to reduce the risks of developing metabolic disorders .


To compare the performance of voluminous benign prostatic hyperplasia patients who have received laparoscopic simple prostatectomy ( LSP ) with the patients who have received bipolar transurethral resection of the prostate ( B-TURP ) in their perioperative and @-year follow-up period .


Ninety patients with prostate volumes > @mL ( range @-@mL ) were randomly assigned to either LSP or B-TURP surgery type .


The patients were followed up at @ , @ , @ , @ , @ , and @ months postoperatively .


Perioperative and follow-up characteristics were then recorded and compared .


More blood loss , greater resected adenoma volume , and shorter catheterization duration were recorded in LSP group than that of B-TURP group ( @ vs @ mL ; @ vs @ mL ; @ vs @ days ; p < @ ) .


None of the patients in LSP group reported complications out of @ days , while @ case of urethral stricture , @ cases of retrograde ejaculation , @ case of bladder neck contracture , and @ cases of recurrence were recorded in B-TURP group .


At @ , @ , @ , and @ months postoperatively , there were no significant differences in terms of postvoid residual urine volume , maximal urinary flow rate ( Qmax ) , and International Prostate Symptom Score between the two groups ( p > @ ) .


In contrast , the differences became significant at @ and @ months ( p < @ ) .


Compared with B-TURP , LSP with Madigan technique is accompanied by less residual adenoma , shorter catheterization time , and more blood loss .


Further , the risk of late complications is lower with LSP and , in terms of functional outcomes , LSP appears to be better than B-TURP beyond @ years .


Mind-body therapies such as Tai Chi are widely used by breast cancer survivors , yet effects on inflammation are not known .


This study hypothesized that Tai Chi Chih ( TCC ) would reduce systemic , cellular , and genomic markers of inflammation as compared with cognitive behavioral therapy for insomnia ( CBT-I ) .


In this randomized trial for the treatment of insomnia , @ breast cancer survivors with insomnia were assigned to TCC or CBT-I for @-hour sessions weekly for @ months .


At baseline and postintervention , blood samples were obtained for measurement of C-reactive protein and toll-like receptor-@-activated monocyte production of interleukin-@ ( IL-@ ) and tumor necrosis factor - ( TNF ) , with a random subsample ( n = @ ) analyzed by genome-wide transcriptional profiling .


Levels of C-reactive protein did not change in the TCC and CBT-I groups .


Levels of toll-like receptor-@-activated monocyte production of IL-@ and TNF combined showed an overall reduction in TCC versus CBT-I ( P < @ ) , with similar effects for IL-@ ( P = @ ) and TNF ( P < @ ) alone .


For genome-wide transcriptional profiling of circulating peripheral blood mononuclear cells , expression of genes encoding proinflammatory mediators showed an overall reduction in TCC versus CBT-I ( P = @ ) .


TELiS promoter-based bioinformatics analyses implicated a reduction of activity of the proinflammatory transcription factor , nuclear factor-B , in structuring these differences .


Among breast cancer survivors with insomnia , @ months of TCC reduced cellular inflammatory responses , and reduced expression of genes encoding proinflammatory mediators .


Given the link between inflammation and cancer , these findings provide an evidence-based molecular framework to understand the potential salutary effects of TCC on cancer survivorship .


Ecabet sodium ( ES ) is a new non-systemic anti-ulcer agent belonging to the category of gastroprotective agents .


In this study we aimed to compare the efficacy of a combination therapy with lansoprazole ( LS ) followed by ES with LS alone in treating endoscopic submucosal dissection ( ESD ) - induced iatrogenic gastric ulcers .


Patients diagnosed with gastric adenomas or early gastric cancer were randomly divided into either the LS group ( @mg once daily for @ weeks ; n = @ ) or the LS+ES group ( LS @mg once daily for one week followed byES @mg twice daily for @ weeks ; n = @ ) .


Four weeks after ESD , a follow-up endoscopy was conducted to evaluate the proportions of ulcer reduction and ulcer stages in the two groups .


In all , @ patients were included in the final analyses .


Both treatment modalities were well-tolerated in most patients , with a drug compliance of over @ % .


There were no significant differences between the two groups in terms of the proportions of ulcer reduction ( @ in the LS group vs @ in the LS+ES group , P = @ ) or ulcer stage ( P = @ ) .


The prevalence of adverse events related to drugs and bleeding were also similar between the two groups .


Sequential therapy with LS+ES is as effective as LS alone against ESD-induced gastric ulcers .


To investigate the efficacy and safety of the MGDRx EyeBag ( The Eyebag Company , Halifax , UK ) eyelid warming device .


Twenty-five patients with confirmed meibomian gland dysfunction ( MGD ) - related evaporative dry eye were enrolled into a randomised , single masked , contralateral clinical trial .


Test eyes received a heated device ; control eyes a non-heated device for @min twice a day for @weeks .


Efficacy ( ocular symptomology , non-invasive break-up time , lipid layer thickness , osmolarity , meibomian gland dropout and function ) and safety ( visual acuity , corneal topography , conjunctival hyperaemia and staining ) measurements were taken at baseline and follow-up .


Subsequent patient device usage and ocular comfort was ascertained at @months .


Differences between test and control eyes at baseline were not statistically significant for all measurements ( p > @ ) .


After @weeks , statistically significant improvements occurred in all efficacy measurements in test eyes ( p < @ ) .


Visual acuity and corneal topography were unaffected ( p > @ ) .


All patients maintained higher ocular comfort after @months ( p < @ ) , although the benefit was greater in those who continued usage @-@ times a month ( p < @ ) .


The MGDRx EyeBag is a safe and effective device for the treatment of MGD-related evaporative dry eye .


Subjective benefit lasts at least @months , aided by occasional retreatment .


Complex regional pain syndrome type I ( CPRS I ) , is a complex of symptoms characterized by diffuse pain usually with associated swelling , vasomotor instability , and severe functional impairment of the affected extremity in stroke patients .


Pain is a prominent feature and is often refractory to variety of treatment .


To investigate the clinical , functional , and psychosocial effects of upper extremity aerobic exercise ( UEAE ) and compare the effect of aerobic exercise with that of conventional physiotherapy in patients with CPRS type I following stroke as a randomized controlled assesor blinded @ week-study .


A total of @ inpatients with stroke -LSB- mean age : @ @ ( min .


= @ , max .


= @ ) years , and the mean age of the control group was @ years -RSB- , all within @ months post-stroke and diagnosed with CPRS I.


The UEAE program consisted of an arm crank ergometer ( @ W/min ) , in addition to a conventional physiotherapy ( whirlpool , TENS , retrograd massage ) .


Primary outcome measures were CPRS clinical determinants ( pain , hyperalgesia , allodynia , and autonomic abnormalities ) secondary outcome measures were functional independence measure ( FIM ) , Nottingham Health Profile ( NHP ) , and Beck Depression Scale scores that were performed at @ month ( baseline ) and @ weeks ( post-treatment ) .


In UEAE group , patients reported significant pain relief ( @ % ) and significant decline in CRPS signs and symptoms .


The mean change in pain at shoulder , pain at the hand as well as and NHP and BDS scores between groups were statistically significant ( P < @ ) .


UEAE made an excellent improvement in the symptoms and signs of CRPS I. Combined treatment of conventional physiotherapy and aerobic exercises may be an excellent synthesis for this syndrome in these patients .


to evaluate the efficacy of Berberis aristata/Silybum marianum ( Berberol ( ) ) in a sample of dyslipidemic patients intolerant to statins at high dosages in a randomized , double blind , placebo-controlled clinical trial .


we enrolled @ euglycemic , dyslipidemic subjects , intolerant to statins at high dosages .


During the run-in period , statins were stopped for @ month , then they were re-introduced at the half of the previously taken dose .


After that , patients were randomized to placebo or Berberol ( ) , @ tablet during the lunch and @ tablet during the dinner , for @ months .


Anthropometric , metabolic and inflammatory parameters were assessed at randomization , at @ and @ months .


fasting plasma glucose , insulin , and HOMA-index levels were reduced by Berberol ( ) , but not by placebo ; moreover they were lower than the ones recorded with placebo .


Total cholesterol , LDL-C , triglycerides , and myeloperoxidase did not change after @ months since the reduction of statin dosage and the introduction of Berberol ( ) , while they increased in the placebo group , and were higher compared to the ones obtained with active treatment .


No patients had serious adverse events in both groups .


our study displays the rationale of the combination of Berberol ( ) and a reduced dosage of statin for the treatment of hyperlipidemia in patients intolerant to statins at high dosage .


Postoperative ileus ( POI ) , a common postoperative complication , increases length of stay and costs .


Although bowel rest and delayed oral intake were once thought to help prevent POI , newer evidence shows that chewing gum can be beneficial .


METHODS -- LITERATURE SEARCH : The literature was searched for the terms ileus , gum , chewing , and gum chewing for @ to @ .


All prospective randomized controlled trials comparing gum chewing in adults with a control treatment after abdominal surgery ( except cesarean section ) were included ; an outcome measure was required as a dependent variable .


Seven primary research studies from around the world were gathered .


Across all studies , patients in the gum-chewing experimental group both passed flatus and defecated before those in the non-gum-chewing control group .


Where length of stay was studied , patients in all but one experimental group were in the hospital for less time .


These included small sample sizes , lack of blinding in all but one study , differences in standards of care among hospitals and countries represented , unspecified types of gum , and variable timing and frequency of gum chewing among studies .


Patients who chewed gum postoperatively had less POI , passed flatus sooner , had an earlier bowel movement and a shorter length of stay , and were more satisfied .


Gum chewing is recommended as adjunctive therapy to reduce postoperative POI .


Carpal tunnel syndrome is known as the most common entrapment neuropathy .


Conservative treatments can not reduce the symptomatic severity satisfactorily ; therefore , effectiveness of Linum usitatissimum L. ( linseed ) oil on carpal tunnel syndrome , as a complementary treatment , was evaluated in the current study .


Linseed oil is a well-known preparation in Iranian traditional medicine and its analgesic , anti-inflammatory and anti-oxidative effects have been shown in previous studies .


A randomized , double-blind , placebo-controlled clinical trial was conducted .


One hundred patients ( @ hands ) with idiopathic mild to moderate carpal tunnel syndrome aged between @ and @years old were randomized in two parallel groups .


These two groups were treated during @weeks with topical placebo and linseed oil .


In addition , a night wrist splint was prescribed for both groups .


Symptomatic severity and functional status were measured using Boston Carpal Tunnel Questionnaire .


In addition , median sensory nerve conduction velocity , motor distal latency , sensory distal latency and compound latency as electrodiagnostic parameters were measured at baseline and after the intervention period .


After the intervention , significant improvement was observed regarding Boston Carpal Tunnel Questionnaire symptomatic severity and functional status mean differences ( p < @ ) in the linseed oil group compared with those in the placebo group .


Also , regarding the mean differences of both groups , significant improvement of nerve conduction velocity of the median nerve was seen in the linseed oil group by a value of @ m/sec ( p < @ ) .


However , motor distal latency and sensory distal latency of the median nerve showed no between-group significant changes ( p = @ for both items ) .


Finally , compound latency was improved slightly in the case group , comparing mean differences between the groups ( p < @ ) .


No significant adverse events were reported from using linseed oil .


It seems that linseed oil could be effective in the management of mild and moderate carpal tunnel syndrome , especially in improving the severity of symptoms and functional status .


In addition , its effect on electerodiagnostic parameters , especially on the nerve conduction velocity , can be considered as a valuable point .


This study examines the importance of work in life of people with disability and then focuses on employer attitudes towards these people .


In the light of Stone and Colella 's model , the study examines the employer attitudes and the role of variables such as type of disability , employer experience in the hiring of persons with disabilities , the description of hypothetical hirees with disabilities , the ways in which employers evaluate work performance and social acceptability , and the work tasks that they consider appropriate for workers with disability .


Eighty employers were randomly assigned to standard condition ( candidates with disability were presented by referring to the disability they presented ) or positive condition ( candidates were presented with reference to their strengths ) .


It was found that the type of disability and its presentation influence employer attitudes .


In addition , realistic and conventional tasks were considered appropriate for hirees with disabilities .


Implications were discussed .


Acute bouts of high-intensity exercise modulate peripheral appetite regulating hormones to transiently suppress hunger .


However , the effects of physical activity on central appetite regulation have yet to be fully investigated .


We used functional magnetic resonance imaging ( fMRI ) to compare neural responses to visual food stimuli after intense exercise and rest .


Fifteen lean healthy men -LSB- mean SD age : @ @ y ; mean SD body mass index ( in kg/m ( @ ) ) : @ @ -RSB- completed two @-min trials-exercise ( EX ; running at @ % maximum aerobic capacity ) and a resting control trial ( REST ) - in a counterbalanced order .


After each trial , an fMRI assessment was completed in which images of high - and low-calorie foods were viewed .


EX significantly suppressed subjective appetite responses while increasing thirst and core-body temperature .


Furthermore , EX significantly suppressed ghrelin concentrations and significantly enhanced peptide YY release .


Neural responses to images of high-calorie foods significantly increased dorsolateral prefrontal cortex activation and suppressed orbitofrontal cortex ( OFC ) and hippocampus activation after EX compared with REST .


After EX , low-calorie food images increased insula and putamen activation and reduced OFC activation compared with REST .


Furthermore , left pallidum activity was significantly elevated after EX when low-calorie images were viewed and was suppressed when high-calorie images were viewed , and these responses correlated significantly with thirst .


Exercise increases neural responses in reward-related regions of the brain in response to images of low-calorie foods and suppresses activation during the viewing of high-calorie foods .


These central responses are associated with exercise-induced changes in peripheral signals related to appetite-regulation and hydration status .


This trial was registered at www.clinicaltrials.gov as NCT@ .


The live , attenuated Japanese encephalitis ( JE ) chimeric virus vaccine ( JE-CV ) is licensed in Thailand and Australia for prophylaxis of JE in individuals at the age of @ months .


JE-CV has not yet been compared with the SA@-@-@ JE vaccine , which is also licensed in Thailand .


In this phase @ , observer-blinded trial , @ children at the age of @-@ months were randomized @:@ to receive @ dose of JE-CV or SA@-@-@ .


JE neutralizing antibody titers were assessed using PRNT@ .


The primary endpoint was the noninferiority of seroconversion against JE on Day @ after JE-CV compared with SA@-@-@ , as assessed using the @ % confidence interval of the difference between the groups .


Safety and reactogenicity were described in each group using conventional methods , including the reporting of solicited and unsolicited adverse events .


The seroconversion rate on Day @ was @ % in each group .


Noninferiority was demonstrated as the difference between the JE-CV and SA@-@-@ groups was -@ percentage points ( @ % confidence interval : -@ to @ ) , which was above the required -@ % .


The seroprotection rate remained very high at Month @ and comparable between groups , but a slight decrease was observed in the JE-CV group between Months @ and @ .


Current recommendations for both vaccines call for a booster dose @-@ months after primary immunization to maintain high seroprotection rates in the long term .


Geometric mean titers ( GMTs ) on Day @ after vaccination were @ ( @/dil ) in the JE-CV group and @ ( @/dil ) in the SA@-@-@ group , decreasing by @-fold and @-fold , respectively , to Month @ before remaining stable to Month @ and comparable between groups .


Solicited reactions were all reported at lower rates after vaccination with JE-CV compared with SA@-@-@ .


A single dose of JE-CV elicited a noninferior immune response compared with SA@-@-@ and had a satisfactory safety profile .


to analyze the efficiency and safety of Dexmedetomidine infusion for a short-term controlled sedation and treatment of delirium in the early postoperative period in patients after cardiac surgery .


open , randomized , prospective study of @ patients undergoing surgery on the heart or main blood vessels under general anaesthesia .


In the early postoperative period all patients received an infusion of Dexmedetomidine ( @-@ @ microg kg ( -@ ) per hour ) for sedation .


The analgesia was carried out with Ketoprofen according to the protocol and Trimeperidine if VAS was > or = @ .


Sedation and agitation levels were measured by Ramsay and RAAS scales , speed of awaking by Aldrete score .


Duration of mechanical ventilation , length of stay in ICU , need for analgesics ( VAS scale ) , type and frequency of side effects and vital signs ( Harward standart ) were recorded .


Type of delirium , time of onset ( days after surgery ) , dose and duration of psychomotor agitation were evaluated in patients with delirium ( n = @ ) .


Dexmedetomidine infusion in the medium therapeutic doses resulted mild or moderate sedation remaining up to @ hours after the infusion .


More than @ % of patients had retrograde amnesia .


The pain intensity did not exceed @ point on VAS scale in @ % of patients .


@ % of patients required an additional administration of Trimeperidine .


The most common side effects were bradycardia ( @ % ) and arterial hypotension ( @ % ) .


The therapy with Dexmedetomidine provided the most optimal level of sedation compared to other combinations of drugs ( haloperidol , midazolam , propofol ) in patients with delirium according to sedation-agitation and awaking scales .


Dexmedetomidine provides dose-dependent sedation and retrograde amnesia without altering the verbal contact , does not cause respiratory depression .


The drug has independent analgesic effect and proved to be effective in the treatment of delirium .


The most frequent side effects of Dexmedetomidine are bradycardia and arterial hypotension .


Fluid volume optimization guided by stroke volume measurements reduces complications of colorectal and high-risk surgeries .


We studied whether dehydration or a strong hemodynamic response to general anesthesia increases the probability of fluid responsiveness before surgery begins .


Cardiac output , stroke volume , central venous pressure and arterial pressures were measured in @ patients before general anesthesia ( baseline ) , after induction and stepwise after three bolus infusions of @ ml/kg of @ % hydroxyethyl starch @/@ @ ( n = @ ) or Ringer 's lactate ( n = @ ) .


A subgroup of @ patients who received starch were preloaded with @ ml of Ringer 's lactate .


Blood volume changes were estimated from the hemoglobin concentration and dehydration was estimated from evidence of renal water conservation in urine samples .


Induction of anesthesia decreased the stroke volume to @ % of baseline ( mean ) ; administration of fluids restored this value to @ % ( starch ) and @ % ( Ringer 's ) .


The optimized stroke volume index was clustered around @-@ ml/m@/beat .


Additional fluid boluses increased the stroke volume by @ % ( a sign of fluid responsiveness ) in patients with dehydration , as suggested by a low cardiac index and central venous pressure at baseline and by high urinary osmolality , creatinine concentration and specific gravity .


Preloading and the hemodynamic response to induction did not correlate with fluid responsiveness .


The blood volume expanded @ ( starch ) and @ ( Ringer 's ) times over the infused volume .


Fluid volume optimization did not induce a hyperkinetic state but ameliorated the decrease in stroke volume caused by anesthesia .


Dehydration , but not the hemodynamic response to the induction , was correlated with fluid responsiveness .


Colorectal cancer ( CRC ) screening rates are lower among Latinos and people living in poverty .


Fecal occult blood testing ( FOBT ) is one recommended screening modality that may overcome cost and access barriers .


However , the ability of FOBT to reduce CRC mortality depends on high rates of adherence to annual screening .


To determine whether a multifaceted intervention increases adherence to annual FOBT compared with usual care .


Patient-level randomized controlled trial conducted in a network of community health centers .


Included were @ patients who had previously completed a home FOBT from March @ through February @ and had a negative test result : @ % of participants were women ; @ % were Latino ; @ % stated that Spanish was their preferred language ; and @ % were uninsured .


Usual care at participating health centers included computerized reminders , standing orders for medical assistants to give patients home fecal immunochemical tests ( FIT ) , and clinician feedback on CRC screening rates .


The intervention group also received ( @ ) a mailed reminder letter , a free FIT with low-literacy instructions , and a postage-paid return envelope ; ( @ ) an automated telephone and text message reminding them that they were due for screening and that a FIT was being mailed to them ; ( @ ) an automated telephone and text reminder @ weeks later for those who did not return the FIT ; and ( @ ) personal telephone outreach by a CRC screening navigator after @ months .


Completion of FOBT within @ months of the date the patient was due for annual screening .


Intervention patients were much more likely than those in usual care to complete FOBT ( @ % vs @ % ; P < @ ) .


Of the @ intervention patients completing screening , @ % completed prior to their due date ( intervention was not given ) , @ % within @ weeks ( after initial intervention ) , @ % within @ to @ weeks ( after automated call/text reminder ) , and @ % between @ and @ weeks ( after personal call ) .


This intervention greatly increased adherence to annual CRC screening ; most screenings were achieved without personal calls .


It is possible to improve annual CRC screening for vulnerable populations with relatively low-cost strategies that are facilitated by health information technologies .


Lipoprotein-associated phospholipase A@ ( Lp-PLA@ ) has been hypothesized to be involved in atherogenesis through pathways related to inflammation .


Darapladib is an oral , selective inhibitor of the Lp-PLA@ enzyme .


To evaluate the efficacy and safety of darapladib in patients after an acute coronary syndrome ( ACS ) event .


SOLID-TIMI @ was a multinational , double-blind , placebo-controlled trial that randomized @,@ participants within @ days of hospitalization with an ACS ( non-ST-elevation or ST-elevation myocardial infarction -LSB- MI -RSB- ) at @ sites in @ countries .


Patients were randomized to either once-daily darapladib ( @ mg ) or placebo on a background of guideline-recommended therapy .


Patients were followed up for a median of @ years between December @ , @ , and December @ , @ .


The primary end point ( major coronary events ) was the composite of coronary heart disease ( CHD ) death , MI , or urgent coronary revascularization for myocardial ischemia .


Kaplan-Meier event rates are reported at @ years .


During a median duration of @ years , the primary end point occurred in @ patients in the darapladib group and @ in the placebo group ( @ % vs @ % at @ years ; hazard ratio -LSB- HR -RSB- , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) .


The composite of cardiovascular death , MI , or stroke occurred in @ in the darapladib group and @ in the placebo group ( @ % vs @ % at @ years ; HR , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) .


There were no differences between the treatment groups for additional secondary end points , for individual components of the primary end point , or in all-cause mortality ( @ events in the darapladib group and @ in the placebo group -LSB- @ % vs @ % at @ years ; HR , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) .


Patients were more likely to report an odor-related concern in the darapladib group vs the placebo group ( @ % vs @ % ) and also more likely to report diarrhea ( @ % vs @ % ) .


In patients who experienced an ACS event , direct inhibition of Lp-PLA@ with darapladib added to optimal medical therapy and initiated within @ days of hospitalization did not reduce the risk of major coronary events .


Disruptions in calcium ( Ca ) homeostasis during exercise may influence skeletal adaptations to exercise training .


In young men , vigorous cycling causes increases in parathyroid hormone ( PTH ) and bone resorption ( C-terminal telopeptides of type I collagen -LSB- CTX -RSB- ) ; responses are attenuated by Ca supplementation .


The study aimed to determine whether vigorous walking causes similar increases in PTH and CTX in older women and how the timing of Ca supplementation before and during exercise influences these responses .


In experiment @ , @ women ( @ @ yr ) consumed @ mL of either a Ca-fortified ( @ gL ) or control beverage every @ min during exercise starting @ min before and continuing during @ min of exercise .


In experiment @ , @ women ( @ @ yr ) consumed @ mL of a Ca-fortified ( @ gL ) or control beverage every @ min starting @ min before and continuing during @ min of exercise .


The exercise was treadmill walking at @ % -@ % VO@peak .


In experiment @ , serum ionized Ca decreased in the control condition ( P < @ ) , but not with Ca supplementation .


PTH increased after exercise on both days ( Ca , P = @ ; control , P = @ ) but was attenuated by Ca supplementation ( @ vs @ pgmL ; P = @ ) .


CTX increased only on the control day ( P = @ ) .


In experiment @ , serum ionized Ca decreased on Ca and control days ( Ca and control , P < @ ) , but less so on the Ca day ( P = @ ) .


PTH ( Ca and control , P < @ ) and CTX ( Ca , P = @ ; control P = @ ) increased on the Ca and control day , and there were no differences in the changes .


The timing of Ca supplementation may be a key mediator of Ca homeostasis during acute exercise .


Further research is necessary to determine how this influences skeletal adaptations to training .


To determine the extent to which children 's mastery motivation predicts occupational performance outcomes following upper limb intervention ( ULI ) .


In this cohort study , participants received @ hours of ULI , either in an intensive group-based or distributed individualized model .


The Dimensions of Mastery Questionnaire ( DMQ ) measured mastery motivation at baseline .


Occupational performance outcomes were assessed at baseline and @ weeks ' post-intervention using the Canadian Occupational Performance Measure ( COPM ) .


Multivariable models determined the contribution of mastery motivation to COPM outcome irrespective of group membership .


Forty-two children with congenital hemiplegia ( @ males , @ females ; mean age @y @mo -LSB- SD @y @mo -RSB- ; range @y @mo-@y @mo ; Manual Ability Classification System -LSB- MACS -RSB- I = @ and II = @ ; predominant motor type unilateral spastic n = @ ) participated in the study .


Significant gains were seen in COPM performance and satisfaction scores ( p < @ ) post-intervention with no between group differences .


Children who had greater persistence with object-oriented tasks ( p = @ ) and better manual ability ( p = @ ) achieved higher COPM performance scores at @ weeks .


Children 's persistence on object-oriented tasks was the strongest predictor of COPM satisfaction ( p = @ ) .


Children 's persistence with object-oriented tasks as well as manual abilities needs to be considered when undertaking ULI .


Predetermining children 's motivational predispositions can assist clinicians to tailor therapy sessions individually based on children 's strengths , contributing to effective engagement in ULI .


Cardiovascular disease ( CVD ) is the leading cause of death and disability worldwide .


Despite the widespread availability of evidence-based clinical guidelines and validated risk predication equations for prevention and management of CVD , their translation into routine practice is limited .


We developed a multifaceted quality improvement intervention for CVD risk management which incorporates electronic decision support , patient risk communication tools , computerised audit and feedback tools , and monthly , peer-ranked performance feedback via a web portal .


The intervention was implemented in a cluster randomised controlled trial in @ primary healthcare services in Australia .


Overall , there were improvements in risk factor recording and in prescribing of recommended treatments among under-treated individuals , but it is unclear how this intervention was used in practice and what factors promoted or hindered its use .


This information is necessary to optimise intervention impact and maximally implement it in a post-trial context .


In this study protocol , we outline our methods to conduct a theory-based , process evaluation of the intervention .


Our aims are to understand how , why , and for whom the intervention produced the observed outcomes and to develop effective strategies for translation and dissemination .


We will conduct four discrete but inter-related studies taking a mixed methods approach .


Our quantitative studies will examine ( @ ) the longer term effectiveness of the intervention post-trial , ( @ ) patient and health service level correlates with trial outcomes , and ( @ ) the health economic impact of implementing the intervention at scale .


The qualitative studies will ( @ ) identify healthcare provider perspectives on implementation barriers and enablers and ( @ ) use video ethnography and patient semi-structured interviews to understand how cardiovascular risk is communicated in the doctor/patient interaction both with and without the use of intervention .


We will also assess the costs of implementing the intervention in Australian primary healthcare settings which will inform scale-up considerations .


This mixed methods evaluation will provide a detailed understanding of the process of implementing a quality improvement intervention and identify the factors that might influence scalability and sustainability .


Intensive glucose control with insulin in patients with an acute coronary syndrome reduces platelet reactivity during hospitalization , compared to conventional control .


However , the effect of strict , long-term glucose control on platelet reactivity in these patients remains uncertain .


This is a prospective , randomized trial evaluating the effects of optimized glucose control ( target glucose , @-@mg / dL ) with insulin , compared with conventional control ( target glucose , < @ mg/dL ) , on platelet reactivity after hospital discharge in patients with an acute coronary syndrome and hyperglycemia .


The primary endpoint was assessment of platelet aggregation after stimulation with adenosine diphosphate @ M at @-month follow-up .


One hundred four patients were randomized to optimized management ( n = @ ) or conventional management ( n = @ ) .


There were no differences between groups in baseline characteristics or platelet function .


After @ months of follow-up , blood glucose levels were significantly lower in the optimized treatment group ( @ vs @mg/dL ; P < @ ) .


However , platelet aggregation following adenosine diphosphate @ M stimulation showed no differences between the groups ( @ % -LSB- @ % -RSB- vs @ % -LSB- @ % -RSB- respectively ; P = @ ) .


There were no significant differences for other platelet function tests .


Long-term optimized glucose control with insulin in patients with an acute coronary syndrome did not result in a reduction in platelet reactivity compared to conventional control .


To detect a difference in ( @ ) intubation success and ( @ ) successful intubation times between novice physicians using a Macintosh-style or video-assisted laryngoscope on a difficult airway manikin .


Prospective randomized trial .


Academic , tertiary medical center .


Forty first-year residents across a variety of disciplines with fewer than @ total live intubations were recruited for the study .


Testing took place during orientation prior to commencement of clinical duties .


The entire group was provided training by faculty otolaryngologists and anesthesiologists using both laryngoscope types on a manikin airway simulator in a standard intubating scenario .


Subjects were then randomized into @ testing groups , using either a Macintosh laryngoscope or video-assisted laryngoscope in a difficult intubation scenario .


The difficult airway simulation entailed oral cavity/oropharyngeal obstruction using inflation of the tongue , as well as cervical spine immobilization with a rigid collar preventing extension and elevation of the head and limiting oral cavity opening .


Success was defined as a confirmed endotracheal intubation by the testing instructor in @ seconds or less .


The Macintosh laryngoscope group ( n = @ ) had an intubation success rate of @ % with a mean intubation time of @ seconds ( @ % confidence interval -LSB- CI -RSB- : @ , @ ) .


The video-assisted group ( n = @ ) demonstrated a significantly higher success rate of @ % ( P < @ ) and a decreased mean intubation time of @ seconds ( @ % CI : @ , @ ; P < @ ) .


The mean difference in success rate between groups was @ % ( @ % CI : @ % , @ % ) .


Novice physicians with little to no prior intubation experience showed significantly higher intubation success with lower intubation times using a video-assisted laryngoscope in a difficult airway manikin simulator .


To determine whether the addition of advanced-practice nurse ( APN ) telephone counseling to a printed survivorship care plan ( SCP ) significantly increases the proportion of at-risk survivors who complete cardiomyopathy screening .


Survivors age @ years participating in the Childhood Cancer Survivor Study who received cardiotoxic therapy and reported no history of cardiomyopathy screening in the previous @ years were eligible for enrollment .


The @ participants ( mean age , @ years ; range , @ to @ ; @ % women ) were randomly assigned to either standard care , consisting of an SCP summarizing cancer treatment and cardiac health screening recommendations ( n = @ ) , or standard care plus two APN telephone counseling sessions ( n = @ ) .


The primary outcome-completion of cardiomyopathy screening within @ year-was validated by medical records and compared between the two arms using adjusted relative risks ( RRs ) with @ % CIs .


Participants in the standard and APN counseling groups were not statistically different by demographic or clinical characteristics .


At the time of @-year follow-up , @ ( @ % ) of @ survivors in the APN group completed screening compared with @ ( @ % ) of @ survivors in the non-APN group ( P < @ ) .


With adjustment for sex , age ( < @ v @ years ) , and Children 's Oncology Group-recommended screening frequency group ( annual , @ years , or @ years ) , survivors in the APN group were > @ more likely than those in the control group to complete the recommended cardiomyopathy screening ( RR , @ ; @ % CI , @ to @ ) .


The addition of telephone counseling to an SCP with cardiac health screening recommendations increases cardiomyopathy screening in at-risk survivors .


The aim of this study was to evaluate the effect of dynamic bilateral postural stability on balance control and gait parameters in children with cerebral palsy .


Thirty children with spastic diplegia ( @-@ yrs ) were included in this study .


The children were randomly assigned into two groups : control group A and study group B.


The children in both groups received traditional physical therapy program , @ hrs per day for group A and @ hrs followed by @ mins of dynamic postural stability training program using the Biodex Stability System for group B.


The treatment frequency was three sessions per week for @ consecutive weeks on two stability levels ( @ and @ ) .


The participating children received pretreatment and posttreatment assessments using the Biodex Stability System to evaluate the stability indices ( anteroposterior , mediolateral , and overall ) at the two stability levels ( @ and @ ) and three-dimensional motion analysis system ( pro-reflex system ) to evaluate the spatiotemporal parameters including step length , velocity , cycle time , stance , and swing phase percentage .


The children in both groups showed significant improvements in the mean values of all measured variables after treatment indexed by a significant reduction in stability indices and improvement in gait parameters .


The results also showed significant differences in all measured parameters in favor of group B , when compared with those in group A ( P < @ ) .


Balance training on the Biodex Stability System could be a useful tool in conjunction with traditional physical therapy program for improving balance control and gait functions in children with spastic diplegic cerebral palsy .


This study investigated coronary artery remodeling patterns associated with clinical outcomes .


In the prospective , multicenter PROSPECT ( Providing Regional Observations to Study Predictors of Events in the Coronary Tree : An Imaging Study in Patients With Unstable Atherosclerotic Lesions ) study , reported predictors of nonculprit lesion ( NCL ) major adverse cardiac events ( MACE ) were an intravascular ultrasound ( IVUS ) minimal lumen area ( MLA ) @ mm ( @ ) , a plaque burden @ % , and a IVUS-virtual histology ( VH ) thin-cap fibroatheroma ( TCFA ) , but not lesion site remodeling .


Overall , @ consecutive patients with an acute coronary syndrome were enrolled and underwent @-vessel gray-scale and IVUS-VH ; @,@ NCLs were identified by IVUS .


The remodeling index ( RI ) was calculated as the external elastic membrane area at the MLA site divided by the average of the proximal and distal reference external elastic membrane areas .


First , one third of the patients were randomly selected to determine RI cutoffs related to NCL MACE ( development cohort ) .


Receiver-operating characteristic analysis showed that there were @ separate cut points that predicted NCL MACE : RI = @ and RI = @ ( area under the curve = @ ) .


These cut points were used to define negative remodeling as an RI < @ , intermediate remodeling as an RI of @ to @ , and positive remodeling as an RI > @ .


Second , we used the remaining two-thirds of patients to validate these cut points with respect to lesion morphology and clinical outcomes ( validation cohort ) .


Kaplan-Meier curve analysis in the validation cohort showed that NCL MACE occurred more frequent ( and equally ) in negative and positive remodeling lesions compared with intermediate remodeling lesions .


In this cohort , negative remodeling lesions had the smallest MLA , positive remodeling lesions had the largest plaque burden , and VH TCFA , especially VH TCFA with multiple necrotic cores , was most common in negatively remodeling lesions .


The present study showed the novel concept that positive and negative lesion site remodeling was associated with unanticipated NCL MACE in the PROSPECT study .


An Imaging Study in Patients With Unstable Atherosclerotic Lesions -LSB- PROSPECT -RSB- ; NCT@ ) .


Fixed-combination ocular hypotensives have multiple advantages , but triple-therapy dorzolamide/brimonidine/timolol ( dorz/brim/tim ) is only available in Latin and South America , and information on its relative efficacy is limited .


This study compares the efficacy and tolerability of fixed-combination bimatoprost/timolol ( bim/tim ) and dorz/brim/tim in Mexican patients with primary open-angle glaucoma or ocular hypertension .


In this investigator-masked , crossover study , patients with unmet target intraocular pressure ( IOP ) on once-daily bim/tim or twice-daily dorz/brim/tim received the opposite medication for @months before returning to their pre-baseline medication for @months .


IOP was evaluated before and after morning instillation at months @ , @ , @ and @ .


Primary endpoints were mean IOP change and Ocular Surface Disease Index ( OSDI ) score at each visit .


The intent-to-treat population was the a priori analysis population , but due to the number of discontinuations , the per-protocol and intent-to-treat populations were used for the primary efficacy and sensitivity analyses , respectively .


Seventy-eight and @ patients were included in the intent-to-treat and per-protocol populations , respectively .


At month @ , statistically significant IOP reductions from baseline were observed in the bim/tim ( P < @ ) and dorz/brim/tim ( P < @ ) groups , regardless of assessment time .


At month @ , patients returned to bim/tim exhibited no significant IOP increase ( regardless of assessment time ) , but patients returned to dorz/brim/tim exhibited a statistically significant IOP increase ( P < @ ) when assessed before instillation of study treatment .


Results were similar in both intent-to-treat and per-protocol analysis populations .


In the per-protocol analysis , @ % of patients on bim/tim at month @ had an IOP < @mm Hg , which declined to @ % ( P = @ ) at month @ ( ie , after @months of dorz/brim/tim treatment ) .


In patients receiving dorz/brim/tim at month @ , @ % had an IOP < @mm Hg , which remained comparable after return to bim/tim .


OSDI scores and incidence of adverse events were similar in both groups .


In this first direct comparison of the efficacy of dorz/brim/tim and bim/tim , patients switched from dorz/brim/tim to bim/tim demonstrated improved/lower IOP ; when returned to dorz/brim/tim , IOP increased to levels seen at study initiation , suggesting that once-daily bim/tim may have greater IOP-lowering efficacy .


Both bim/tim and dorz/brim/tim were well tolerated with minimal ocular surface damage .


Wound complications negatively affect outcomes of lower extremity arterial reconstruction .


By way of an investigator initiated clinical trial , we tested the hypothesis that a silver-eluting alginate topical surgical dressing would lower wound complication rates in patients undergoing open arterial procedures in the lower extremity .


The study block-randomized @ patients at three institutions to standard gauze or silver alginate dressings placed over incisions after leg arterial surgery .


This original operating room dressing remained until gross soiling , clinical need to remove , or postoperative day @ , whichever was first .


Subsequent care was at the provider 's discretion .


The primary end point was @-day wound complication incidence generally based on National Surgical Quality Improvement Program guidelines .


Demographic , clinical , quality of life , and economic end points were also collected .


Wound closure was at the surgeon 's discretion .


Participants ( @ % male ) were @ % white , @ % were diabetic , @ % had critical limb ischemia , and @ % had claudication ( with aneurysm , bypass revision , other ) .


The overall @-day wound complication incidence was @ % , with superficial surgical site infection as the most common .


In intent-to-treat analysis , silver alginate had no effect on wound complications .


Multivariable analysis showed that Coumadin ( Bristol-Myers Squibb , Princeton , NJ ; odds ratio -LSB- OR -RSB- , @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ; P = @ ) , higher body mass index ( OR , @ ; @ % CI , @-@ @ ; P = @ ) , and the use of no conduit/material ( OR , @ ; @ % CI , @-@ @ ; P < @ ) were independently associated with wound complications .


The incidence of wound complications remains high in contemporary open lower extremity arterial surgery .


Under the study conditions , a silver-eluting alginate dressing showed no effect on the incidence of wound complications .


Morbid obese ( MO ) population is increasing every year worldwide , and laparoscopic bariatric surgery ( LBS ) has a central role in their treatment .


The postoperative period of MO is not free from complications .


The introduction of sugammadex has brought huge developments in patient 's safety and nowadays LBS is performed with better care and quality .


However , the effect of this agent in postoperative pain is still unknown .


A controlled trial enrolling @ MO submitted to LBS under general anesthesia using muscle relaxation , randomly assigned into @ groups : one received sugammadex ( SUG group ) at the end of surgery and the other neostigmine ( NEO group ) .


In the postanesthetic care unit ( PACU ) , we evaluated pain using the visual analogue scale in @ different moments : arrival in the PACU , @ minutes after arrival , @ minutes after arrival , and immediately before leaving the PACU .


We also recorded the presence of postoperative nausea and vomits ( PONV ) and the duration of the PACU stay before discharge to the ward .


Forty-four patients received sugammadex and @ received neostigmine .


We found lower visual analogue scale pain scores in the SUG group at @ and @ minutes after arriving to the PACU ( P < @ ) .


We also had less PONV in the SUG group and these patients were also discharged earlier .


Sugammadex is associated with less pain felt in the PACU .


This `` opioid-sparing '' effect , combined with less PONV and a faster discharge from the PACU , makes sugammadex an indispensable drug in this type of patients and allows fast-track surgery in the MO. .


To explore the relationship between goal setting and fruit and vegetable ( FV ) consumption and physical activity ( PA ) in an intervention for college students .


Secondary data analysis of intervention group participants from a @-week online intervention with complete weekly data ( n = @ ) .


Outcomes ( cups of FV per day and minutes of PA per week ) and goals for both behaviors were reported online each week .


Weekly differences between goals and behaviors were calculated , as well as the proportion meeting individual goals and meeting recommendations for behaviors .


There were significant ( P < @ ) effects of goal setting on both behaviors and of goal group ( tertile of meeting weekly goals ) on behavior , as well as meeting recommendations for both behaviors .


There was an increase in FV consumption ( P < @ ) but no change in PA over time .


Goal setting as part of a Web-based intervention for college students was effective , but results differed for FV and PA. .


Goal setting for maintaining behavior may need to differ from goal setting for changing behavior .


To evaluate the push-out bond strengths of prefabricated glass-fiber posts ( Beijing Oya Biomaterials ) with polydopamine functionalized to root dentin using two different resin cements ( Paracore and RelyX Unicem ) in different root regions ( cervical , middle , and apical ) .


Forty extracted human , single-rooted teeth were endodontically treated and a @-mm post space was prepared in each tooth with post drills provided by the manufacturer .


Specimens were then randomly assigned into four groups ( n = @ per group ) , depending on the adhesive system and post surface treatment used : group IA ( Paracore + polydopamine ) ; group IB ( Paracore + control ) ; group IIA ( RelyX Unicem + polydopamine ) ; group IIB ( RelyX Unicem + control ) .


Following post cementation , the specimens were stored in distilled water at @C for @ days .


The push-out test was performed using a universal testing machine ( @ mm / min ) , and the failure modes were examined with a stereomicroscope .


Data were statistically analyzed using twoway ANOVA ( p = @ ) .


Bond strengths ( mean SD ) were : @ @ MPa ( group IA ) , @ @ MPa ( group IB ) , @ @ MPa ( group IIA ) , @ @ MPa ( group IIB ) .


The bond strength of polydopamine groups was significantly higher than one of the control groups ( p < @ ) .


No significant difference was found in the micro push-out bond strengths between the two resin cement groups or the root regions ( p > @ ) .


Stereomicroscopic analysis showed a higher percentage of adhesive than cohesive failures in all groups .


Surface polydopamine functionalization was confirmed to be a reliable method for improving the bond strength of resin luting agents to fiber posts .


The bond strength of Paracore to fiber posts was not significantly different from that of RelyX Unicem , and considering its convenient application , Paracore can be recommended .


To evaluate the comparative efficacy and safety of artemether-lumefantrine ( AL ) , artesunate-amodiaquine ( ASAQ ) and artesunate-amodiaquine-chlorpheniramine ( AQC ) for the treatment of acute uncomplicated malaria among Southwest Nigerian children .


One hundred and sixty children aged @ months to @ years with acute uncomplicated malaria were randomized to AL ( n = @ ) , ASAQ ( n = @ ) , or AQC ( n = @ ) .


Enrollees were seen daily on days @-@ and then on days @ , @ , @ , @ and @ for clinical and parasitological evaluations .


Paired samples of genomic DNA at enrolment and at the time of recurrent parasitaemia were genotyped using nested PCR to distinguish between reinfection and recrudescence .


Detailed haematological and biochemical evaluations were carried out in a subset of enrollees on days @ , @ and @ as part of a safety evaluation .


Of the @ children , @ ( @ % ) completed the study .


The mean fever clearance times and parasite clearance times for AL , ASAQ and AQC were comparable ( p = @ and p = @ , respectively ) .


On day @ , the adequate clinical and parasitological response ( ACPR ) for AL and AQC was @ % and for ASAQ it was @ % ( p = @ ) .


The PCR-uncorrected results on days @ and @ and the ACPR-corrected results on day @ were similar for all drugs ( p = @ and p = @ , respectively ) .


AQC resulted in the best parasite clearance and haematological recovery on day @ ( p = @ and p = @ , respectively ) .


Biochemical parameters were not adversely affected by the three artemisinin-based combination therapies ( ACTs ) and these were well tolerated .


The three ACTs were efficacious and safe , but AQC resulted in a better haematological recovery on day @ and higher cure rates throughout the study period .


Prospective , randomized , controlled trial .


To compare arthrodesis rates between patients undergoing a primary single-level minimally invasive transforaminal lumbar interbody fusion ( MIS TLIF ) with either Actifuse or recombinant human bone morphogenetic protein-@ ( rhBMP-@ ) .


Preclinical animal studies suggest that silicate-substituted calcium phosphate ( Actifuse ) bone graft substitute offers equivalent or an increased fusion rate compared with other graft enhancers/extenders and rhBMP-@ .


Fifty-two patients undergoing a single-level unilateral MIS TLIF were evenly randomized into @ cohorts as follows : the Actifuse cohort received Actifuse combined with @ mL of bone marrow aspirate ( n = @ ; @ % ) , whereas the rhBMP cohort received @ mg of rhBMP-@ ( n = @ ; @ % ) .


A pre hoc G * Power analysis yielded a sample size of n = @ that was determined through a @-tailed distribution calculation .


Computed tomographic analysis was performed at @ months and @ year postoperatively .


Pre - and postoperative visual analogue scale scores were obtained to assess the clinical outcomes .


Arthrodesis was determined by @ separate , blinded orthopedic surgeons and a board certified radiologist .


At @-year follow-up , @ % ( @/@ ) of the Actifuse cohort and @ % ( @/@ ) of the rhBMP-@ cohort demonstrated a radiographical arthrodesis ( P = @ ) .


In both study cohorts , the @-year postoperative visual analogue scale scores significantly improved ( P < @ ) .


Pseudarthrosis rates at @ year were @ % ( @/@ ) and @ % ( @/@ ) for the Actifuse and rhBMP-@ groups , respectively ( P = @ , OR = @ , @ % CI = @-@ @ ) .


A greater reoperation rate was noted in the Actifuse cohort ( @ % , @/@ ) compared with the BMP-@ cohort ( @ % , @/@ ; P = @ ) .


One patient with BMP-@ also experienced symptomatic neuroforaminal bone growth ( @ % , n = @/@ ) .


Silicate-substituted calcium phosphate was associated with a significantly lower rate of arthrodesis than rhBMP-@ in a MIS TLIF .


The patients with pseudarthrosis in both cohorts were all clinically symptomatic with an unimproved visual analogue scale score .


Additional analysis of Actifuse and other graft enhancers/extenders are needed prior to the utilization for an MIS TLIF .


Elevated serum uric acid is detected in pulmonary arterial hypertension ( PAH ) and is associated with poor patient outcomes .


High serum uric acid is an independent risk factor for cardiovascular disease and renal impairment .


We analyzed the effects of endothelin receptor antagonism on serum uric acid in PAH patients participating in the Sitaxentan to Relieve Impaired Exercise ( STRIDE ) -@ / @X trial , and the impact of uric acid on @-minute walk distance ( @MWD ) , time to clinical worsening ( TtCW ) and survival .


In the @-week , double-blind , placebo-controlled STRIDE-@ trial , @ PAH patients were randomized and received matched placebo , sitaxentan @ or @ mg orally once daily , or open-label bosentan @ mg twice daily .


STRIDE-@X was a @-year , open-label extension of STRIDE-@ .


Baseline serum uric acid was similar between groups .


Increased serum uric acid was a significant risk factor for @-year mortality and TtCW .


Compared with placebo , sitaxentan @ and @ mg and bosentan all reduced serum uric acid ( p < @ ) .


Reduced serum uric acid correlated with increased @MWD ( p = @ ) .


Endothelin receptor antagonism reduces serum uric acid in PAH patients , and this reduction is associated with improved survival and longer TtCW .


Further prospective studies are needed to investigate the pathogenic role of serum uric acid in PAH and its prognostic potential .


Extending the time a parturient is left sitting after induction of spinal anesthesia ( i.e. , the seated time ) has had varying success in decreasing hypotension at Cesarean delivery .


This may be due to the current lack of information concerning the dose-response relationship of seated time and rates of hypotension .


Term parturients scheduled for Cesarean delivery were randomized to receive @ or @ mg of @ % intrathecal hyperbaric bupivacaine , and they remained seated after injection for a length of time determined by an up-down sequential method .


They were then placed in a wedged position and their blood pressure was measured every minute .


Pre-delivery hypotension was considered present if there was a > @ % from baseline drop in systolic blood pressure .


The seated time at which @ % of parturients avoided pre-delivery hypotension ( median effective seated time ) was determined with isotonic regression .


Fifty patients were studied .


For the @-mg and @-mg groups , the median effective seated time ( @ % confidence interval -LSB- CI -RSB- ) was @ sec ( @ % CI @ to @ ) and @ sec ( @ % CI @ to @ ) , respectively .


There exists a seated time after intrathecal injection of hyperbaric bupivacaine where @ % of parturients do not experience hypotension .


This seated time increases with an increased dose of bupivacaine .


Further work is required to determine the full relationship between seated time and hypotension for other doses of anesthetic and to investigate the clinical utility of this technique for prevention of hypotension .


This trial was registered at www.clinicaltrials.gov ( NCT@ ) .


Development of an incisional hernia is one of the most frequent complications of midline laparotomies requiring reoperation .


This paper presents the rationale , design , and study protocol for a randomized controlled trial , the aim of which is to evaluate the efficacy and safety of prophylactically placing a bioabsorbable synthetic mesh for reinforcement of a midline fascial closure .


The PREBIOUS trial ( PREventive midline laparotomy closure with a BIOabsorbable mesh ) is a multicenter randomized controlled trial in which adult patients undergoing elective or urgent open abdominal operations through a midline laparotomy incision are assigned to one of two groups based on the laparotomy closure procedure : an intervention group in which a continuous polydioxanone ( PDS ) suture is reinforced with a commercially available GORE BIO-A Tissue Reinforcement prosthesis ( W.L. Gore & Associates , Flagstaff , AZ , USA ) , or a control group with continuous PDS suture only .


Both groups are followed over @ months .


The primary outcome is the appearance of incisional hernias assessed by physical examination at clinical visits and radiologically ( CT scan ) performed at the end of follow-up .


Secondary outcomes are the rate of complications , mainly infection , hematoma , burst abdomen , pain , and reoperation .


The PREBIOUS trial has the potential to demonstrate that suture plus prosthetic mesh insertion for routine midline laparotomy closure is effective in preventing incisional hernias after open abdominal surgery , to avoid the effects on those affected , such as poor cosmesis , social embarrassment , or impaired quality of life , and to save costs potentially associated with incisional hernia surgical repair .


Prenatal genetic testing guidelines recommend providing patients with detailed information to allow informed , preference-based screening and diagnostic testing decisions .


The effect of implementing these guidelines is not well understood .


To analyze the effect of a decision-support guide and elimination of financial barriers to testing on use of prenatal genetic testing and decision making among pregnant women of varying literacy and numeracy levels .


Randomized trial conducted from @-@ at prenatal clinics at @ county hospitals , @ community clinic , @ academic center , and @ medical centers of an integrated health care delivery system in the San Francisco Bay area .


Participants were English - or Spanish-speaking women who had not yet undergone screening or diagnostic testing and remained pregnant at @ weeks ' gestation ( n = @ ) .


A computerized , interactive decision-support guide and access to prenatal testing with no out-of-pocket expense ( n = @ ) or usual care as per current guidelines ( n = @ ) .


The primary outcome was invasive diagnostic test use , obtained via medical record review .


Secondary outcomes included testing strategy undergone , and knowledge about testing , risk comprehension , and decisional conflict and regret at @ to @ weeks ' gestation .


Women randomized to the intervention group , compared with those randomized to the control group , were less likely to have invasive diagnostic testing ( @ % vs @ % ; odds ratio -LSB- OR -RSB- , @ -LSB- @ % CI , @-@ @ -RSB- ) and more likely to forgo testing altogether ( @ % vs @ % ; OR , @ -LSB- @ % CI , @-@ @ -RSB- , reference group screening followed by invasive testing ) .


Women randomized to the intervention group also had higher knowledge scores ( @ vs @ on a @-point scale ; mean group difference , @ -LSB- @ % CI , @-@ @ -RSB- ) and were more likely to correctly estimate the amniocentesis-related miscarriage risk ( @ % vs @ % ; OR , @ -LSB- @ % CI , @-@ @ -RSB- ) and their estimated age-adjusted chance of carrying a fetus with trisomy @ ( @ % vs @ % ; OR , @ -LSB- @ % CI , @-@ @ -RSB- ) .


Significant differences did not emerge in decisional conflict or regret .


Full implementation of prenatal testing guidelines using a computerized , interactive decision-support guide in the absence of financial barriers to testing resulted in less test use and more informed choices .


If validated in additional populations , this approach may result in more informed and preference-based prenatal testing decision making and fewer women undergoing testing .


Undernutrition in older age is associated with adverse clinical outcomes and high health care costs .


This study aimed to evaluate the cost-effectiveness of a dietetic treatment in primary care compared with usual care in older , undernourished , community-dwelling individuals .


A parallel randomized controlled trial .


Primary care .


A total of @ undernourished , independently living older ( @ years ) individuals .


Dietetic treatment .


Main outcomes were change in kilogram body weight compared with baseline and quality-adjusted life years ( QALYs ) after @ months .


Costs were measured from a societal perspective .


The main analysis was performed according to the intention-to-treat principle .


Multiple imputation was used to impute missing data and bootstrapping was used to estimate uncertainty surrounding cost differences and incremental cost-effectiveness ratios .


Cost-effectiveness planes and cost-effectiveness acceptability curves were estimated .


The participants were randomized to receive either dietetic treatment ( n = @ ) or usual care ( n = @ ) .


After @ months , no statistically significant differences were found between the dietetic treatment and usual care group in body weight change ( mean difference @ kg , @ % CI -@ -@ ) , QALYs ( mean difference @ , @ % CI -@ -@ ) and total costs ( mean difference @ , @ % CI -@ -@ ) .


The incremental cost-utility ratio ( ICUR ) for QALYs was not interpretable .


The incremental cost-effectiveness ratio ( ICER ) for body weight gain was @ .


The probability that dietetic treatment is cost-effective compared with usual care was @ for a ceiling ratio of @ for body weight and @ for a ceiling ratio of @ for QALY .


In this study , dietetic treatment in older , undernourished , community-dwelling individuals was not cost-effective compared with usual care .


Despite great need , the number of HIV prevention implementation studies remains limited .


The challenge for researchers , in this time of limited HIV services agency resources , is to conceptualize and test how to disseminate efficacious , practical , and sustainable prevention programs more rapidly , and to understand how to do so in the absence of additional agency resources .


We tested whether training and technical assistance ( TA ) in a couple-based HIV prevention program using a Web-based modality would yield greater program adoption of the program compared to training and TA in the same program in a manual-based modality among facilitators who delivered the interventions at @ agencies in New York State .


This study used a cluster randomized controlled design .


Participants were HIV services agencies ( N = @ ) and up to @ staff members at each agency ( N = @ ) .


Agencies were recruited , matched on key variables , and randomly assigned to two conditions .


Staff members participated in a four-day , face-to-face training session , followed by TA calls at two and four months , and follow-up assessments at @ , @ , and @ months post - training and TA .


The primary outcomes examined number of couples with whom staff implemented the program , mean number of sessions implemented , whether staff implemented at least one session or whether staff implemented a complete intervention ( all six sessions ) of the program .


Outcomes were measured at both the agency and participant level .


Over @ months following training and TA , at least one participant from @ ( @ % ) Web-based assigned agencies and @ ( @ % ) traditional agencies reported program use .


Longitudinal multilevel analysis found no differences between groups on any outcomes at the agency or participant level with one exception : Web-based agencies implemented the program with @ % fewer couples compared with staff at manual-based agencies ( IRR @ , CI , @-@ @ ) .


Greater implementation of a Web-based program may require more resources and staff exposure , especially when paired with a couple-based modality .


Manual-based and traditional programs may hold some advantage or ease for implementation , particularly at a time of low economic resources .


Chronic kidney disease ( CKD ) is highly prevalent in patients with diabetes or hypertension in primary care .


A shared care model could improve quality of care in these patients


To assess the effect of a shared care model in managing patients with CKD who also have diabetes or hypertension .


Design and setting A cluster randomised controlled trial in nine general practices in The Netherlands .


Five practices were allocated to the shared care model and four practices to usual care for @ year .


Primary outcome was the achievement of blood pressure targets ( @/@ mmHg ) and lowering of blood pressure in patients with diabetes mellitus or hypertension and an estimated glomerular filtration rate ( eGFR ) < @ ml/min/@ @ m ( @ ) .


Data of @ intervention and @ control patients could be analysed .


Blood pressure in the intervention group decreased with @ ( @ % CI = @ to @ ) / @ ( @ % CI = -@ to @ ) compared to -@ ( @ % CI = -@ to @ ) / -@ ( @ % CI = -@ to @ ) in the control group .


Use of lipid-lowering drugs , angiotensin-system inhibitors and vitamin D was higher in the intervention group than in the control group ( @ % versus @ % , @ % versus @ % , and @ % versus @ % , respectively , -LSB- P = @ , P = @ , and P = @ -RSB- ) .


A shared care model between GP , nurse practitioner and nephrologist is beneficial in reducing systolic blood pressure in patients with CKD in primary care .


The treatment of clubfoot by the Ponseti method requires the utilization of a foot abduction orthosis ( FAO ) after manipulation and casting .


Adherence to this protocol , specifically FAO wear rates , has been postulated to improve treatment outcomes .


Our hypothesis was that caregiver-reported wear rates were significantly less than actual wear rates in these braces .


A randomized prospective study of @ children , aged @ to @ years old with idiopathic clubfoot , treated using the Ponseti technique for idiopathic clubfoot , was undertaken after IRB approval .


Participants were randomized into @ groups : a functioning pressure-based sensor ( group FPS ) attached to the FAO ( @ patients ) , a nonfunctioning sensor ( NFPS group ) attached to the FAO ( @ patients ) , or no sensor ( NS group ) ( @ patients ) .


All caregivers filled out a diary of subjective wear rates .


Reported and actual wear rates were recorded as a percentage of the entire day and compared .


In the FPS group , the average actual wear rate for months @ , @ , and @ were @ % ( @ patients ; @ % to @ % ) , @ % ( @ patients ; @ % to @ % ) , and @ % ( @ patients ; @ % to @ % ) , respectively .


The average self-reported wear rate in the FPS group in months @ , @ , and @ were @ % ( @ patients ; @ % to @ % ) , @ % ( @ patients ; @ % to @ % ) , and @ % ( @ patients ; @ % to @ % ) , respectively .


The most predictive factor in determining a patient 's decrease in the overall wear rate was a drop in the wear rate between months @ and @ ( P < @ ) .


The reported wear rates were not statistically different between any of the @ groups ( P < @ ) .


By using a novel method of pressure measurement , which documented FAO wear , we have shown a significant decline in wear rates from months @ to @ .


These actual FAO wear rates did not match their reported rates , thus putting into question previous assumptions about reported brace compliance .


The largest drop in wear rates occurred from months @ to @ .


This study provides the first objective measurement of FAO brace wear in patients undergoing the Ponseti method of treatment .


Level II .


The purpose of this study was to compare secondary intention healing of oral soft tissues after laser surgery with and without the use of a compound containing amino acids and sodium hyaluronate .


Sodium hyaluronate has been successfully used in medicine to promote healing .


It has not been studied in the healing of laser-produced wounds .


Excisional biopsy was performed in oral soft tissues with a potassium-titanyl-phosphate ( KTP ) laser ( @ nm , SmartLite , DEKA , Florence , Italy ) in @ patients divided into two groups .


In the study group ( SG ) , @ patients received a compound gel containing four amino acids and sodium hyaluronate ( Aminogam ( ) , Errekappa , Italy ) after laser surgery ; in the control group ( CG ) , @ subjects received no treatment involving a drug or gel .


Numeric rating scale ( NRS ) was used to evaluate pain experienced after surgery -LSB- pain index ( PI ) -RSB- .


Using a grid as a benchmark and computer software , the lesion area was measured after surgery ( T@ ) and after @ days ( T@ ) .


A percentage healing index ( PHI ) was calculated indicating healing extension in @ days .


SG cases showed an average PHI of @ , whereas the average PHI in the CG was @ % @ .


Mean PI was @ for SG and @ for CG .


A statistically significant difference was detected between the groups for PHI ( p = @ ) , whereas no difference was detectable for PI ( p = @ ) .


The use of a gel containing amino acids and sodium hyaluronate can promote faster healing via secondary intention in laser-induced wounds , although it does not seem to affect pain perception .


To facilitate the transfer of exercise effects to older adults ' everyday life , essential daily life movements ( stair climbing and walking on different surfaces ) were embedded into the functional movement circle for older adults ( FuMoC ) -- a systematic balance and resistance training programme supplemented by functional movements .


This study 's aim was to consider the feasibility of the FuMoC and to evaluate the effects of this new training programme in a randomised controlled pilot study .


Twenty-one adults aged @years and older were randomised into one of two groups .


The intervention group ( IG ; n = @ ) trained for @weeks in the FuMoC , while the control group ( CG ; n = @ ) maintained their usual activities .


The evaluation of feasibility comprised training attendance , realised intensity of load , and perceived exertion .


Outcome variables included measures of strength and performance-based tests of mobility-related activities .


Training attendance was @ % and the prescribed intensity of load was realised by the participants in the IG .


Physical performance showed significant improvements in the IG in comparison to the CG : an increase of @ % in the One-Repetition Maximum test in the chest press ( p < @ ) , of @-@ % in the modified Timed Up and Go test ( p < @ ) , and of @ % in the Maximal Step Length test ( p < @ ) was identified .


In conclusion , the FuMoC study was feasible in terms of compliance ( training attendance ) and the planned exercise regimen ( suitable exercises , intensity , and exertion ) and showed positive effects on physical performance .


Patient-controlled epidural analgesia ( PCEA ) and continuous epidural infusion ( CEI ) are popular and effective methods for pain relief during labor ; however , there are concerns about increasing rates of cesarean section ( C/S ) and instrumental delivery .


This prospective study investigated the effect of PCEA and CEI with different formulas on labor and the mode of delivery in nulliparous women .


A total of @ nulliparous women were randomized into four groups , with @ in each .


Group A received a loading dose of @mL of @mg/mL ropivacaine with @g/mL fentanyl , then an intermittent bolus of @mL with a background infusion of @mL/hour by PCEA .


Group B received the same PCEA formula as Group A with @ mg/mL bupivacaine .


Group C received the same formula as Group A by CEI with @mg/mL ropivacaine at a rate of @mL/hour .


Group D received the same formula as Group C with @ mg/mL bupivacaine .


The rates of C/S and instrumental delivery and the incidence of side effects were recorded .


The rates of C/S were significantly different between Groups A and C , Groups A and D , and Groups B and D.


The rates of instrumental delivery for normal spontaneous delivery were significantly different between Groups A and B , A and D , B and C , and C and D.


The C/S rate was higher in Groups C and D ; however , the instrumental delivery rate was lower in Groups A and C.