Associations of inhaled corticosteroids ( ICS ) with bone mineral density ( BMD ) loss have not been characterized consistently .


This randomized , double-blind study assessed effects of mometasone furoate ( MF ) administered via dry powder inhaler on BMD of patients with persistent asthma .


Adults with mild-moderate persistent asthma who did not receive ICS for @ months were randomized to MF @ g once daily ( QD ) in the evening ( pm ) , MF @ g QD pm , montelukast sodium ( ML ) @ mg QD pm , or fluticasone propionate ( FP ) @ g twice daily .


Included patients had @-hydroxy vitamin D levels @ ng/mL at baseline .


All the patients received calcium and vitamin D supplements for daily use during the trial .


Duplicate BMD scans were done at baseline , @ months , and @ year .


The mean percentage change in lumbar spine ( LS ) BMD from baseline to end point for MF @ g versus ML @ mg was the primary analysis .


Changes from baseline in left total femur BMD and femoral neck BMD were secondary assessments .


At the end point , mean LS BMD increased @ % ( MF @ g ) , @ % ( ML ) , @ % ( MF @ g ) , and @ % ( FP ) , with no significant differences for MF @ g versus ML ( -@ % -LSB- @ % CI , -@ to @ -RSB- ) for LS BMD .


No significant differences among treatments occurred for changes in left total femur BMD ; all were slight increases .


Changes in femoral neck BMD were @ % ( MF @ g ) , -@ % ( ML ) , -@ % ( MF @ g ) , and -@ % ( FP ) ; only the difference between MF @ g and FP was statistically significant ( P = @ ) .


No detrimental effects on lumbar BMD were observed after up to @ year of treatment with MF in comparison with ML for patients who received calcium and vitamin D supplements .


The efficacy and safety of axitinib , a potent and selective second-generation inhibitor of vascular endothelial growth factor receptors @ , @ , and @ in combination with pemetrexed and cisplatin was evaluated in patients with advanced non-squamous non-small-cell lung cancer ( NSCLC ) .


Overall , @ patients were randomly assigned to receive axitinib at a starting dose of @-mg twice daily continuously plus pemetrexed @ mg/m ( @ ) and cisplatin @ mg/m ( @ ) on day @ of up to six @-day cycles ( arm I ) ; axitinib on days @ through @ of each cycle plus pemetrexed/cisplatin ( arm II ) ; or pemetrexed/cisplatin alone ( arm III ) .


The primary endpoint was progression-free survival ( PFS ) .


Median PFS was @ , @ , and @ months in arms I , II , and III , respectively ( hazard ratio : arms I vs. III , @ -LSB- P = @ -RSB- and arms II vs. III , @ -LSB- P = @ -RSB- ) .


Median overall survival was @ months ( arm I ) , @ months ( arm II ) , and @ months ( arm III ) .


Objective response rates ( ORRs ) for axitinib-containing arms were @ % ( arm I ) and @ % ( arm II ) compared with @ % for pemetrexed/cisplatin alone ( arm III ) .


Gastrointestinal disorders and fatigue were frequently reported across all treatment arms .


The most common all-causality grade @ adverse events were hypertension in axitinib-containing arms ( @ % and @ % , arms I and II , respectively ) and fatigue with pemetrexed/cisplatin alone ( @ % ) .


Axitinib in combination with pemetrexed/cisplatin was generally well tolerated .


Axitinib combinations resulted in non-significant differences in PFS and numerically higher ORR compared with chemotherapy alone in advanced NSCLC .


The use of a balloon-expandable transcatheter heart valve previously resulted in a greater rate of device success compared with a self-expandable transcatheter heart valve .


The aim of this study was to evaluate clinical and echocardiographic outcome data at longer term follow-up .


The investigator-initiated trial randomized @ high-risk patients with symptomatic severe aortic stenosis and anatomy suitable for treatment with both balloon - and self-expandable transcatheter heart valves to transfemoral transcatheter aortic valve replacement with either device .


Patients were followed-up for @ year , with assessment of clinical outcomes and echocardiographic evaluation of valve function .


At @ year , the rates of death of any cause ( @ % vs. @ % ; relative risk -LSB- RR -RSB- : @ ; @ % confidence interval -LSB- CI -RSB- : @ to @ ; p = @ ) and of cardiovascular causes ( @ % vs. @ % ; RR : @ ; @ % CI : @ to @ ; p = @ ) were not statistically significantly different in the balloon - and self-expandable groups , respectively .


The frequencies of all strokes ( @ % vs. @ % ; RR : @ ; @ % CI : @ to @ ; p = @ ) and repeat hospitalization for heart failure ( @ % vs. @ % ; RR : @ ; @ % CI : @ to @ ; p = @ ) did not statistically significantly differ between the @ groups .


Elevated transvalvular gradients during follow-up were observed in @ patients in the balloon-expandable group ( @ % vs. @ % ; p = @ ) ; all were resolved with anticoagulant therapy , suggesting a thrombotic etiology .


More than mild paravalvular regurgitation was more frequent in the self-expandable group ( @ % vs. @ % ; p = @ ) .


Despite the higher device success rate with the balloon-expandable valve , @-year follow-up of patients in CHOICE ( Randomized Comparison of Transcatheter Heart Valves in High Risk Patients With Severe Aortic Stenosis : Medtronic CoreValve Versus Edwards SAPIEN XT Trial ) , with limited statistical power , revealed clinical outcomes after transfemoral transcatheter aortic valve replacement with both balloon - and self-expandable prostheses that were not statistically significantly different .


( A Comparison of Transcatheter Heart Valves in High Risk Patients With Severe Aortic Stenosis : The CHOICE Trial ; NCT@ ) .


We aimed to compare the effect and feasibility of a combined therapy with tamsulosin hydrochloride plus meloxicam , and tamsulosin hydrochloride alone in patients with benign prostate hyperplasia symptoms and impact on nocturia and sleep quality .


Four hundred male patients were included in this study between @ and @ .


Patients were randomly divided into two groups : one received tamsulosin hydrochloride @ mg ( Group @ , @ patients ) and the other tamsulosin hydrochloride @ mg plus meloxicam @ mg ( Group @ , @ patients ) prospectively .


Patients were evaluated for benign prostate hyperplasia ( BPH ) symptoms according to the American Urological Association clinical guidelines and sleep quality according to Pittsburgh Sleep Quality Index ( PSQI ) .


Patients were reevaluated after three months of treatment .


The International Prostatic Symptom Score ( IPSS ) , IPSS-Quality of Life ( IPSS-QoL ) , maximal urinary flow rates ( Qmax ) , average urinary flow rates ( AFR ) , post void residual urine volumes ( PVR ) , nocturia and Pittsburgh Sleep Quality Score ( PSQS ) were recorded at baseline and after three months .


Mean age was @ @ and @ @ years in groups @ and @ , respectively ( p = @ ) .


There were no statistically significant differences between both groups .


Also , baseline prostate specific antigen ( PSA ) , prostate volume , creatinine , International Prostatic Symptom Score ( IPSS ) , IPSS-Quality of Life ( IPSS-QoL ) , maximal urinary flow rates ( Qmax ) , average urinary flow rates ( AFR ) , post void residual urine volumes ( PVR ) , nocturia and Pittsburgh Sleep Quality Score ( PSQS ) were similar in both groups .


In addition , the total IPSS , IPSS-QoL , PVR , nocturia , and PSQS were significantly lower in Group @ compared with Group @ after treatment ( p < @ ) .


Qmax and AFR were higher significantly in Group @ compared with Group @ after treatment ( p < @ ) .


Cyclooxygenase ( COX ) -@ inhibitors in combination with an alpha blocker may decrease benign prostatic hyperplasia symptoms and increase sleep quality without serious side effects .


To evaluate the efficacy and safety of patient-controlled intravenous analgesia ( PCIA ) of dezocine combined with sufentanil in burn patients after escharectomy or tangential excision followed by autologous skin grafting .


Sixty burn patients hospitalized in Department of Burns and Plastic Surgery of our hospital from February @ to December @ , conforming to the study criteria and going to have escharectomy or tangential excision followed by autologous skin grafting , were divided into sufentanil group ( S , n = @ ) and dezocine + sufentanil group ( DS , n = @ ) according to the random number table .


Patients in group S were given @ mL normal saline containing @ g/kg sufentanil citrate and @ mg tropisetron after skin grafting for @ hours .


Patients in group DS were given @ mL normal saline containing @ mg/kg dezocine , @ g/kg sufentanil citrate , and @ mg tropisetron for @ hours .


Visual Analog Scale ( VAS ) , Bruggrmann Comfort Scale ( BCS ) , and Ramsay Sedation Scale were used to evaluate the sedative effect or analgesic effect , and their scores were recorded at administration hour ( AH ) @ , @ , @ , @ , and @ .


The times of efficient injection and incidence of adverse effect within the @ AH were recorded .


Data were processed with analysis of variance for repeated measurement , t test , chi-square test , and Fisher 's exact test .


There were no obvious differences in the scores of VAS and BCS between two groups at each time point ( with t values from -@ to @ , P values above @ ) .


The scores of Ramsay Sedation Scale in group S at AH @ , @ , @ , @ , and @ were respectively ( @ @ ) , ( @ @ ) , ( @ @ ) , ( @ @ ) , and ( @ @ ) points , which were higher than those in group DS -LSB- ( @ @ ) , ( @ @ ) , ( @ @ ) , ( @ @ ) , and ( @ @ ) points , with t values from @ to @ , P values below @ -RSB- .


The times of efficient injection within the @ AH was @ @ in group S and @ @ in group DS , showing no significantly statistical difference ( t = @ , P > @ ) .


Respiratory depression was not observed in both groups ; the incidence of pruritus was the same , and that of urine retention was similar between the @ groups within the @ AH ( with P values above @ ) .


Within the @ AH , the incidence of nausea and vomiting in group S was @ % ( @/@ ) , which was obviously higher than that in group DS ( @ % , @/@ , P < @ ) ; the incidence of drowsiness in group S was @ % ( @/@ ) , which was significantly higher than that in group DS ( no patient , P < @ ) .


Dezocine combined with sufentanil can provide effective postoperative analgesia with little adverse effect for PCIA in burn patients after escharectomy or tangential excision followed by autologous skin grafting , therefore it can be widely used .


To evaluate the efficacy of the use of oral Prednisolone and heparin versus the use of heparin alone in treatment of patients with unexplained recurrent miscarriage .


The study was a double-blind placebo randomized control trial conducted on @ patients with unexplained recurrent miscarriage .


Patients recruited were randomized into two groups .


The first group received oral Prednisolone in addition to low dose aspirin and heparin , while the other group received a placebo in addition to low dose aspirin and heparin .


A peripheral venous blood sample was taken from all included patients before starting treatment and collected in heparinized tubes .


Natural Killer ( NK ) cells were checked in each sample and then re-checked in another sample at @weeks of gestation .


We found that in the prednisolone group , @ % of women had successful outcome ( defined as an ongoing pregnancy beyond @weeks gestation ) , while @ % miscarried before this gestation .


On the contrary , among women in the placebo group , @ % had successful outcome while @ % miscarried before @weeks , which was statistically significant .


On the other hand , we found that there were no significant paired differences between initial serum levels of the NK cells markers CD@ and CD@ and their levels at @weeks gestation in both groups .


The addition of prednisolone to heparin and low dose aspirin might be beneficial in patients with unexplained recurrent miscarriage , and this effect might be due to a suppressive effect of steroids on the peripheral CD@ NK cells concentration .


The purpose of the current study was to test theory-based predictions of mediators and moderators of treatment effects of a pilot randomized controlled trial , which aimed to increase adherence to preventive medication in stroke survivors via addressing both automatic ( i.e. , habitual responses ) and reflective ( i.e. , beliefs and value systems ) aspects of medication-taking behavior .


Sixty-two stroke survivors were randomly allocated to either an intervention or control group .


Intervention participants received a brief @-session intervention aimed at increasing adherence via ( a ) helping patients establish better medication-taking routines using implementation intentions plans ( automatic ) , and ( b ) eliciting and modifying any mistaken patient beliefs regarding medication and/or stroke ( reflective ) .


The control group received similar levels of non-medication-related contact .


Primary outcome was adherence to antihypertensive medicine measured objectively over @ months using an electronic pill bottle .


Secondary outcome measures included self-reported adherence ( including forgetting ) and beliefs about medication .


Intervention participants had @ % greater adherence on doses taken on schedule ( intervention , @ % ; control , @ % ; @ % CI -LSB- @ , @ -RSB- , p = @ ) , as well as significantly greater increases in self-reported adherence and reductions in concerns about medication .


Treatment effects were mediated by reductions in both forgetting and concerns about medication , and moderated by the presence of preexisting medication-taking routines .


Addressing both automatic and reflective aspects of behavior via helping stroke survivors develop planned regular routines for medication-taking , and addressing any concerns or misconceptions about their medication , can improve adherence and thus potentially patient outcomes .


Drug related problem ( DRPs ) is a key factor which will affect the outcome of therapy and safety .


To assess the DRPs in type @ diabetes mellitus ( T@DM ) patients and psychological aspects of patients by community pharmacists to observe the rate of DRP .


Prospective randomized controlled intervention study involved T@DM patients and conducted in two community pharmacies at Kanpur from January @ to December @ .


The assessment of DRPs was based on the PCNE .


Changes in glycosylated hemoglobin ( HBA@c ) , low density lipoproteins ( LDL ) , blood pressure ( BP ) , foot examinations , changes medical and medication utilization were studied .


Using as control group , received usual care , and interventional group provided , intervened with use of the standard treatment guidelines ( STG ) .


Researcher provided the knowledge to community pharmacists and patients .


Baseline and interventional data were collected at @,@,@,@ and @ months .


Over the @ month study , participants ' average HBA@C reduced from @ % at initial visit to @ % .


During this time , the eye examination rate was raised from @ % to @ % , and the foot examination rate was raised from @ % to @ % .


The intervention of pharmacists showed little influence on any of the intermediate health outcomes in T@DM .


Abdominal adiposity may be an important risk factor for uncontrolled asthma in adults , controlling for general obesity .


Whether the relationship , if present , is explained by other factors ( e.g. , asthma onset age , sex , and/or coexisting conditions ) is unclear .


To examine whether clinically applicable anthropometric measures of abdominal adiposity -- waist circumference and waist-to-height ratio ( WHtR ) -- are related to poorer asthma control in adults with uncontrolled asthma controlling for body mass index ( BMI ) , and whether the relationship ( if present ) is explained by gastroesophageal reflux disorder ( GERD ) , sleep quality , or obstructive sleep apnea ( OSA ) or differs by age of asthma onset or sex .


Patients aged @ to @ years with uncontrolled asthma ( n = @ ) participated in a @-month randomized clinical trial .


Baseline measures included sociodemographics , standardized anthropometrics , Asthma Control Test ( ACT ) , GERD Symptom Assessment Scale , Pittsburgh Sleep Quality Index , and Berlin Questionnaire for Sleep Apnea .


Participants ( mean -LSB- SD -RSB- age , @ -LSB- @ -RSB- yr ) were racially and ethnically diverse , @ % women , and @ % overweight or obese , and @ % reported their age of asthma onset was @ years or older .


Participants had uncontrolled asthma ( mean -LSB- SD -RSB- ACT score , @ -LSB- @ -RSB- ) and low GERD symptoms score ( @ -LSB- @ -RSB- ) ; @ % reported poor sleep quality , and @ % had a high OSA risk .


General linear regression results showed that worse ACT scores were significantly associated with every SD increase in waist circumference ( = -@ ; @ % confidence interval -LSB- CI -RSB- , -@ to -@ ; P = @ ) and waist-to-height ratio ( = -@ ; @ % CI , -@ to -@ ; P = @ ) , controlling for sociodemographics .


Waist-to-height ratio remained correlated with ACT ( = -@ ; @ % CI , -@ to -@ ; P = @ ) after further adjusting for BMI .


The BMI-controlled relationship between WHtR and ACT did not differ by age of asthma onset or sex ( P > @ for interactions ) and persisted after additional adjustment for GERD , sleep quality , or OSA scores .


Poor sleep quality was associated with worse ACT scores ( = -@ ; @ % CI , -@ to -@ ; P = @ ) controlling for waist-to-height ratio , BMI , and sociodemographics .


Abdominal adiposity by waist-to-height ratio and poor sleep quality correlated with poorer asthma control in adults with uncontrolled asthma , after controlling for BMI and sociodemographics .


These results warrant replication in larger studies of diverse populations .


Clinical trial registered with www.clinicaltrials.gov ( NCT @ ) .


Vorapaxar , a novel thrombin receptor antagonist , reduces cardiovascular death and recurrent thrombotic events when added to standard antiplatelet therapy in patients with stable atherosclerotic vascular disease .


The goal of this study was to test the hypothesis that treatment with vorapaxar reduces the rate of coronary stent thrombosis ( ST ) in stable patients with a history of coronary stenting .


TRA @ P-TIMI @ ( Trial to Assess the Effects of Vorapaxar in Preventing Heart Attack and Stroke in Patients With Atherosclerosis-Thrombolysis In Myocardial Infarction @ ) was a multinational , randomized , double-blind , placebo-controlled trial of vorapaxar in stable patients with prior myocardial infarction , peripheral arterial disease , or stroke .


We evaluated the rates of definite ST as adjudicated by a central events committee using Academic Research Consortium ( ARC ) criteria .


A total of @,@ patients were randomized , with @,@ ( @ % ) having a history of a coronary stent implantation before randomization , and an additional @ patients receiving a coronary stent during the trial ( total @,@ ) .


During follow-up ( median @ years ) , there were @ definite ST events , with the majority ( @ % ) occurring late or very late .


Vorapaxar reduced ARC definite ST ( @ % vs. @ % , hazard ratio -LSB- HR -RSB- : @ , @ % confidence interval -LSB- CI -RSB- : @ to @ ; p = @ ) .


The reduction was consistent , regardless of time from percutaneous coronary intervention , history of diabetes , use of drug-eluting stents , and use of dual antiplatelet therapy ( DAPT ) at randomization .


Vorapaxar increased GUSTO moderate/severe bleeding ( HR : @ , @ % CI : @ to @ ; p < @ ) .


The rate of ARC definite ST in stable patients , the majority of whom were receiving DAPT , was approximately @ % at @ years .


In stable patients with coronary stenting receiving standard antiplatelet therapy , vorapaxar administered for long-term secondary prevention significantly reduced ARC definite ST , including very late ST. ( Trial to Assess the Effects of Vorapaxar -LSB- SCH @ ; MK-@ -RSB- in Preventing Heart Attack and Stroke in Patients With Atherosclerosis -LSB- TRA @ P-TIMI @ -RSB- -LSB- P@ -RSB- ; NCT@ ) .


To compare parenterally administered moderate sedation and paracervical block versus general anesthesia during day-case operative hysteroscopy for polypectomy in terms of patients ' postoperative pain perception , operating time , and postoperative drug administration .


A pilot study ( Canadian Task Force classification I ) .


A university hospital .


Women undergoing hysteroscopic polypectomy procedures ( N = @ ) .


Hysteroscopic polypectomy with general anesthesia or moderate parenteral sedation and paracervical block .


The patients were divided into @ groups : @ underwent general anesthesia ( group @ ) , and @ were submitted to moderate parenteral sedation and a paracervical block ( group @ ) .


General anesthesia was induced with the laryngeal mask airway with propofol ( @ % @-@ @ mg/kg ) and fentanyl ( @-@g / kg ) and maintained with an infusion of propofol ( @ % @-@mg / kg/h ) .


After the procedure , patients in the general anesthesia group received postoperative analgesic medication with paracetamol ( @mg/kg ) and ketorolac ( @ mg/kg ) or tramadol ( @-@mg / kg ) .


The group receiving moderate parenterally sedation and a paracervical block received a paracervical block with mepivacaine ( @ % @mL ) and lidocaine ( @ % @mL ) and received fentanyl ( @g/kg ) and propofol ( @ % @-@mg / kg/h ) maintaining spontaneous breathing .


A blind observer recorded the operative time and the discomfort of patients using a @-step scale ( @-@ ) .


The postoperative pain assessment was performed @hours after the procedure with a self-administered validated tool , the Brief Pain Inventory .


We found that women receiving moderate parenteral sedation and a paracervical block perceived significantly less pain in daily activity ( p < @ ) , walking ( p < @ ) , daily work ( p < @ ) , relations with others ( p = @ ) , sleep ( p < @ ) , and pain contrasting enjoyment of life ( p < @ ) .


The total amount of time spent in the operating room in group @ was significantly lower than in group @ ( p < @ ) .


Moderate sedation plus a paracervical block for operative hysteroscopy is associated with reduced pain perception and a shorter operative time .


To evaluate the long-term efficacy of the Epley manoeuvre as a therapeutic procedure for posterior canal benign paroxysmal positional vertigo .


Randomised , double-blind , sham-controlled trial .


A multidisciplinary dizziness unit in a non-academic Hospital .


Forty-four patients with posterior canal benign paroxysmal positional vertigo ( BPPV ) with a duration of at least @ month .


Participants were randomised in two groups of @ and treated with either the Epley manoeuvre or a sham manoeuvre and followed up for @ year after treatment .


Conversion of a ` positive ' Dix-Hallpike test to a ` negative ' Dix-Hallpike test , impairments perceived by the dizziness assessed by the Dizziness Handicap Inventory ( DHI ) .


Absolute and relative risks were computed , and Fisher 's exact test was used to compare the treatments .


Six patients were lost to follow up ( five in the sham group , one in the Epley group ) .


The Epley procedure resulted in a treatment success in @/@ patients ( @ % ) after @ months of follow-up , whereas the sham procedure had a positive effect in @/@ patients ( @ % ; P = @ ) .


The DHI was significantly lower in the Epley group at all follow-up assessments ( median scores @ months @ ( @-@ ) versus @ ( @-@ ) , P = @ ) .


The Epley manoeuvre provides long-term resolution of symptoms in patients with posterior canal BPPV .


The primary purpose of this study was to evaluate the detection rate of local radiorecurrent prostate cancer by using diffusion-weighted MR imaging ( DWI ) and targeted biopsies .


The secondary purpose was to assess the value of performing random biopsies .


This study included @ consecutive patients with biochemical recurrence after external beam radiation therapy ( EBRT ) .


At the time of biopsy , the mean ageSD was @ years , median serum prostate-specific antigen level was @ ng/mL , and mean elapsed time between EBRT and biopsy was @ years .


MRI examination included high-resolution axial T@-weighted and DWI sequences and was classified as either negative or positive .


Transrectal ultrasound-guided targeted biopsies were obtained from all patients with positive findings on MRI using a soft image fusion system .


Random sextant biopsies were obtained from both lobes in patients with negative findings on MRI and from the lobe contralateral to the MRI target in patients with positive findings on MRI .


The biopsy results were classified as negative or positive and defined as the criterion standard .


MRI findings were positive in @ of @ ( @ % ) patients , and the overall positive biopsy rate was @ % ( @ of @ patients ) .


Targeted biopsies were positive in @ of @ ( @ % ) patients .


Random biopsies were positive in @ of @ ( @ % ) patients , all of whom had positive targeted biopsies .


DWI is highly sensitive for detecting radiorecurrent prostate cancer , and a few targeted biopsies may confirm a positive diagnosis .


However , random biopsies may assess the tumor burden more exactly .


In this study we compared silver nitrate cautery with placebo to assess the effect of silver nitrate cautery in aphthous stomatitis for pain relief and healing time .


In this study , sixty-five patients with aphthous stomatitis were assessed .


Silver nitrate sticks were used in group A ( treatment group ) and placebo sticks were used for group B ( control group ) .


Change in the severity of pain , change in the size of the ulcers , healing time , side effects of the procedure were assessed .


Although the mean value of pain scores before the procedure was similar in both of the groups , there were statistically significant differences between two groups after the procedure on the first to the seventh day .


On the seventh day after the procedure , the ulcers were completely reepithelialized in @ patients ( @ % ) in the treatment group and in @ patients ( @ % ) in the placebo group .


The difference was statistically significant ( p < @ ) .


In the treatment group , the mean healing time of ulcers , reported by these @ patients , was @ days ( range @-@ ) after the procedure .


In the placebo group , the mean healing time of ulcers , reported by @ patients with healed ulcers , was @ days ( range @-@ ) after the procedure .


No side effects were recorded in either of the groups .


In conclusion , silver nitrate cautery appears to be an effective and rapid treatment option for pain relief in aphthous stomatitis .


Also this treatment shortens the healing time of ulcers .


The optimal fixation of the Rotaglide total knee arthroplasty 's ( TKA ) components is controversial .


It is hypothesized that the hybrid fixation ( cementless femoral component ) in a mobile-bearing TKA system might cause increased rate of loosening -- especially in the femoral part -- and finally failure of the arthroplasty .


Consequently , the aim of this study was to compare the survival and revision rates and also the clinical and radiological outcomes of the cemented and hybrid fixation of the Rotaglide TKA .


One hundred patients , who underwent TKA with the Rotaglide prosthesis , were randomly placed in two groups .


In the first group , the prosthesis was cemented , and in the second group , the hybrid technique was used .


Revision and mortality rates were compared after @-@ years of follow-up .


Knee and Osteoarthritis Outcome Score ( KOOS ) questionnaire and the Knee Society Roentgenographic Evaluation and Scoring System were used to demonstrate clinical and radiographic differences .


There were no statistically significant differences in revision ( n.s. ) or mortality ( n.s. ) rates between the two treatment arms .


The clinical outcome at the time of last follow-up ( mean @ years , SD @ ) ranged from very good to excellent ( @ @ for the cemented group and @ @ for the hybrid group ) .


No statistically significant differences in all KOOS subscales .


Radiographs showed no significant difference in prosthesis alignment and no evidence of loosening between groups .


The hypothesis that the hybrid fixation in a mobile-bearing TKA system might cause increased rate of loosening and finally failure of the arthroplasty was not confirmed .


The fixation technique ( cemented or hybrid ) had no influence on the prosthesis 's survivorship , and also on mortality rates , clinical and radiographic outcomes in a mean follow-up time of @ @ years .


The Rotaglide TKA is a safe and reliable prosthesis regardless the fixation technique .


To explore the relationship between worksite physical environment and employee dietary intake , physical activity behavior , and weight status .


Two trained research assistants completed audits ( Checklist of Health Promotion Environments at Worksites ) at each worksite ( n = @ ) .


Employees ( n = @ ) completed a brief health survey before participation in a weight loss program .


Employees ' access to outdoor areas was directly associated with lower body mass index ( BMI ) , whereas access to workout facilities within a worksite was associated with higher BMI .


The presence of a cafeteria and fewer vending machines was directly associated with better eating habits .


Better eating habits and meeting physical activity recommendations were both related to lower BMI .


Selected environmental factors in worksites were significantly associated with employee behaviors and weight status , providing additional intervention targets to change the worksite environment and promote employee weight loss .


As glioblastoma progresses , patients experience a decline in health-related quality of life ( HRQoL ) .


Delaying this decline is an important treatment goal .


In newly diagnosed glioblastoma , progression-free survival was prolonged when bevacizumab was added to radiotherapy plus temozolomide ( RT/TMZ ) versus placebo plus RT/TMZ ( phase III AVAglio study ; hazard ratio , @ ; @ % CI , @ to @ ; P < @ ) .


To ensure that addition of bevacizumab to standard-of-care therapy was not associated with HRQoL detriment , HRQoL assessment was a secondary objective .


Patients completed European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires C@ and BN@ at each tumor assessment ( Appendix Table A@ , online only ) .


Raw scores were converted to a @-point scale and mean changes from baseline scores were evaluated ( stable : < @-point change ; clinically relevant deterioration/improvement : @-point change ) .


Deterioration-free survival was the time to deterioration/progression/death ; time to deterioration was the time to deterioration/death .


Most evaluable patients who had not progressed ( > @ % ) completed all HRQoL assessments for at least @ year of treatment , and almost all completed at least one HRQoL assessment at baseline ( @ % and @ % , bevacizumab and placebo arms , respectively ) .


Mean changes from baseline did not reach a clinically relevant difference between arms for most items .


HRQoL declined at progression in both arms .


The addition of bevacizumab to RT/TMZ resulted in statistically longer ( P < @ ) deterioration-free survival across all items .


Time to deterioration was not statistically longer in the placebo plus RT/TMZ arm ( v bevacizumab ) for any HRQoL item .


The addition of bevacizumab to standard-of-care treatment for newly diagnosed glioblastoma had no impact on HRQoL during the progression-free period .


To examine the usefulness of an absorbable hemostatic gelatin sponge for hemostasis after transrectal prostate needle biopsy .


The subjects comprised @ participants who underwent transrectal prostate needle biopsy .


They were randomly allocated to the gelatin sponge insertion group ( group A : @ participants ) and to the non-insertion group ( group B : @ participants ) .


In group A , the gelatin sponge was inserted into the rectum immediately after biopsy .


A biopsy-induced hemorrhage was defined as a case in which a subject complained of bleeding from the rectum , and excretion of blood clots was confirmed .


A blood test was performed before and after biopsy , and a questionnaire survey was given after the biopsy .


Significantly fewer participants in group A required hemostasis after biopsy compared to group B ( @ ( @ % ) vs. @ ( @ % ) , P = @ ) .


The results of the blood tests and the responses from the questionnaire did not differ significantly between the two groups .


In multivariate analysis , only `` insertion of a gelatin sponge into the rectum '' emerged as a significant predictor of hemostasis .


Insertion of a gelatin sponge into the rectum after transrectal prostate needle biopsy significantly increases hemostasis without increasing patient symptoms , such as pain and a sense of discomfort .


The benefit of inducing deep neuromuscular block to improve laparoscopic surgical conditions is controversial .


The goal of this study was to determine the depth of neuromuscular block needed to guarantee excellent operating conditions during laparoscopic hysterectomy .


A randomised controlled trial .


A single-centre study performed between February @ and May @ .


One hundred and two women of ASA physical status @ or @ gave consent to participate and were allocated randomly to one of two groups .


Under desflurane general anaesthesia , patients in Group S ( shallow block ) , neuromuscular blockade was induced by administration of rocuronium @ mg kg-@ followed by spontaneous recovery or a rescue bolus dose of @ mg if surgical conditions were unacceptable .


In Group D ( deep block ) , neuromuscular block was induced by administration of rocuronium @ mg kg-@ and maintained by bolus doses of @ mg if the train-of-four count exceeded two , using adductor pollicis electromyography .


With a stable pneumoperitoneum ( @mmHg ) , the surgeon scored the quality of the surgical field every @ min as excellent ( @ ) , good but not optimal ( @ ) , poor but acceptable ( @ ) or unacceptable ( @ ) .


The groups were compared using the Cochran-Armitage trend test .


The level of neuromuscular blockade was recorded each time the surgical field score exceeded @ .


For groups S and D , respectively , the maximum surgical field scores were @ in @ and @ patients , @ in @ and @ patients , @ in @ and @ patients and @ in @ and @ patients .


A trend towards higher scores was demonstrated in group S ( P < @ ) .


Surgical field scores of @ , @ and @ occurred only when the train-of-four count was at least @ , @ and @ , respectively .


Inducing deep neuromuscular block ( train-of-four count < @ ) significantly improved surgical field scores and made it possible to completely prevent unacceptable surgical conditions .


Numerous studies have reported predictors of new-onset postoperative atrial fibrillation ( POAF ) following cardiac surgery , which is associated with increased length of stay , cost of care , morbidity , and mortality .


The purpose of this study was to examine the association between preoperative diastolic function and occurrence of new-onset POAF in patients undergoing a variety of cardiac surgeries at a single institution .


Using data from a prospective study from November @ to January @ , a retrospective review was conducted .


The diastolic function of each patient was determined from preoperative transthoracic echocardiograms .


Occurrence of new-onset POAF was prospectively noted for each patient in the original study .


Demographic and operative characteristics of the study population were analyzed to determine predictors of POAF .


Of @ patients , @ ( @ % ) experienced new-onset POAF .


Univariate predictors of POAF included increasing age , male gender , operations involving mitral valve repair/replacement , nonsmoking , hypertension , increased intraoperative pulmonary artery pressure , grade I diastolic dysfunction , abnormal diastolic function of any grade , decreased medial e ' , elevated medial E/e ' , and increased left atrial volume .


Multivariate predictors of POAF included increasing age , increased left atrial volume , and elevated initial intraoperative pulmonary artery pressure .


Even after exclusion of patients with hypertrophic obstructive cardiomyopathy or those undergoing mitral valve operations , diastolic dysfunction was not a multivariate predictor of POAF .


In the patient population studied here , preoperative diastolic dysfunction was not predictive of POAF .


In addition to increasing age , initial intraoperative pulmonary artery systolic pressure and left atrial volume were both significant multivariate predictors of POAF .


Nintedanib is in clinical development as a treatment for idiopathic pulmonary fibrosis ( IPF ) .


Data from the Phase II TOMORROW study suggested that nintedanib @mg twice daily had clinical benefits with an acceptable safety profile .


The INPULSIS trials are replicate Phase III , randomized , double-blind , studies comparing the efficacy and safety of nintedanib @mg twice daily with placebo in patients with IPF .


Eligible patients were aged @ years with a diagnosis of IPF within @ years before randomization who had undergone a chest high-resolution computed tomography ( HRCT ) scan within @-year before screening , and who had a forced vital capacity ( FVC ) of @ % predicted and a diffusing capacity for carbon monoxide of @-@ % predicted .


Participants were randomized @:@ to receive nintedanib or placebo for @ weeks .


The primary endpoint is the annual rate of decline in FVC .


The key secondary endpoints are change from baseline in the total score on the St. George 's Respiratory Questionnaire ( a measure of health-related quality of life ) over @ weeks and time to first acute exacerbation .


Enrolment of @ patients in @ countries was completed in September @ .


Results will be reported in the first half of @ .


The INPULSIS trials will determine the efficacy of nintedanib in patients with IPF , including its impact on disease progression as defined by decline in FVC , acute exacerbations and health-related quality of life .


In addition , they will characterise the adverse event profile of nintedanib in this patient population .


To compare the maximum change in numeric rating scale ( NRS ) pain scores , in patients receiving low-dose ketamine ( LDK ) or morphine ( MOR ) for acute pain in the emergency department .


We performed an institutional review board-approved , randomized , prospective , double-blinded trial at a tertiary , level @ trauma center .


A convenience sample of patients aged @ to @ years with acute abdominal , flank , low back , or extremity pain were enrolled .


Subjects were consented and randomized to intravenous LDK ( @ mg/kg ) or intravenous MOR ( @ mg/kg ) .


Our primary outcome was the maximum change in NRS scores .


A sample size of @ subjects per group was calculated based on an @ % power to detect a @-point change in NRS scores between treatment groups with estimated SDs of @ and an of @ , using a repeated-measures linear model .


Forty-five subjects were enrolled ( MOR @ , LDK @ ) .


Demographic variables and baseline NRS scores ( @ vs @ ) were similar .


Ketamine was not superior to MOR in the maximum change of NRS pain scores , MOR = @ ( confidence interval , @-@ @ ) and LDK = @ ( confidence interval , @-@ ) .


The time to achieve maximum reduction in NRS pain scores was at @ minutes for LDK and @ minutes for MOR .


Vital signs , adverse events , provider , and nurse satisfaction scores were similar between groups .


Low-dose ketamine did not produce a greater reduction in NRS pain scores compared with MOR for acute pain in the emergency department .


However , LDK induced a significant analgesic effect within @ minutes and provided a moderate reduction in pain for @ hours .


To assess the effects of sodium pentosan polysulfate ( PPS ) , N-acetyl glucosamine ( NAG ) , and sodium hyaluronan ( HA ) in horses with induced osteoarthritis ( OA ) .


Experimental .


Adult Standard bred horses ( n = @ ) .


OA was induced arthroscopically in @ intercarpal joint ; @ horses were administered @mg/kg PPS , @ mg/kg NAG , and @ mg/kg HA ( PGH ) , intravenously ( IV ) , weekly and @ horses were administered an equivalent volume of saline IV until study completion ( day @ ) .


Horses underwent a standardized treadmill exercise program .


Clinical and radiographic findings and synovial fluid analysis were evaluated throughout the study .


Macroscopic , histologic , histochemical , and biochemical findings were evaluated after necropsy .


Comparisons of interest included OA and non-OA joints of saline treated horses and OA joints of PGH treated horses and OA joints of saline treated horses .


Results were statistically analyzed with significance set at P < @ .


OA caused increases in clinical assessment scores , synovial fluid variables , radiographic , macroscopic , and histologic cartilage scores , synovial fluid and cartilage chondroitin sulfate @-epitope and glycosaminoglycan concentration .


Total radiographic scores , total macroscopic joint pathology and macroscopic cartilage pathology scores were significantly reduced in horses treated with PGH compared with saline treated horses .


Synovial fluid total protein concentration and white blood cell count were higher in OA joints of PGH treated horses compared with saline treated horses .


There were no other significant differences between treatment groups .


Improvements in macroscopic variables were not supported by other outcomes .


Further evidence is needed before PGH can be recommended as a therapeutic option for osteoarthritis in horses .


The prevention of mother-to-child transmission of human immunodeficiency virus ( HIV ) is lauded as one of the more successful HIV prevention measures .


However , despite some gains in the prevention of mother-to-child transmission of HIV ( PMTCT ) in sub-Saharan Africa , mother-to-child transmission rates are still high .


In Kenya , mother-to-child transmission is considered one of the greatest health challenges and scaling up PMTCT services is crucial to its elimination by @ .


However , guideline implementation faces barriers that challenge scale-up of services .


The objective of this paper is to identify barriers to PMTCT implementation in the context of a randomized control trial on the use of structured mobile phone messages in PMTCT .


The preliminary analysis presented here is based on survey data collected during enrolment in PMTCT services at one of two health facilities in Nairobi , Kenya , with overall number of antenatal care ( ANC ) visits determined from @ hour follow up data .


Data was collected for @ women .


Despite significant differences in the type of facility and sample characteristics between sites , all women presented to care at @ weeks gestation or later and @ % attended less than four ANC visits .


PMTCT counselling at first visit had high coverage ( @ % ) , however less than a third of women ( @ % ) reported receiving contraception counselling .


Although @ % of women had reportedly disclosed their status to their partners , only @ % were aware of their partner 's status .


Very few women had been tested for TB ( @ % ) or received single dose nevirapine during their first antenatal care appointment ( @ % ) .


Revised PMTCT guidelines aim to reduce the inequity between PMTCT services in high and low resource settings in efforts to eliminate mother-to-child transmission .


However , guideline implementation in low resource settings continues to be confronted with challenges related to late presentation , less than four ANC visits , low screening rates for opportunistic infections , and limited contraception counselling .


These challenges are further complicated by lack of disclosure to partners .


Effective scale up and implementation of PMTCT services requires that such ongoing program challenges be identified and appropriately addressed within the local context .


This study examined whether the choice of pain-related outcome to represent opioid efficacy influenced findings in a genetic association study .


Data from the European Pharmacogenetic Opioid Study , which used opioid dose as the outcome , were analysed in respect of six alternative outcomes : average pain intensity , pain right now , worst pain intensity , pain at its least , pain relief and pain interference .


Cancer pain patients using an opioid for moderate or severe pain were included .


The pain outcomes were obtained using the Brief Pain Inventory .


Genetic variation was analysed for @ single nucleotide polymorphisms ( SNPs ) in @ candidate genes relevant for opioid efficacy .


The patients were randomly divided into a development and a validation sample and linear regression was used to compare the equality of means in the six outcomes .


The influence of non-genetic factors was controlled for , the regression analyses were stratified by country , and the results were corrected for multiple testing .


@ cancer pain patients were included .


Their mean age was @ years and mean average pain was @ .


None of the examined SNPs exceeded p values corrected for multiple testing for any of the outcomes .


None of the outcomes were associated with variation in the selected SNPs , as previously shown for opioid dose .


Thus , we observed that findings related to associations between genetic variability and opioid efficacy were consistent for several alternative outcomes .


Surgical treatment with open reduction and internal fixation ( ORIF ) of displaced middle-third clavicular fractures resulted in shorter complete return to work periods with earlier consolidation documented on computed tomography ( CT ) scans in this prospective , randomized controlled trial .


The study randomized @ consecutive patients with displaced fractures ( @B@-@B@ according to Robinson ) to conservative ( C , n = @ ) and surgical ( S , n = @ ) treatment with plates and screws .


Bone union was documented with CT scans at @ and @ weeks .


Risk factors known to increase the risk of nonunion were similar between groups .


Time until discharge for complete return to work was @ @ months for C and @ @ months for S ( P = @ ) .


On the CT scan at @ weeks , @ % of the patients presented advanced bone union in S vs @ % in C ( P = @ ) .


At @ weeks , @ % of the patients presented advanced bone union in S vs @ % in C ( P = @ ) .


At final follow-up , @ nonunions were present in the C group that required surgery ; in the S group , @ patients underwent revision surgery for plate removal .


At @ and @ months of follow-up , Constant scores were higher for the S group .


Surgical treatment with ORIF of displaced middle-third clavicular fractures achieved good and excellent functional results , shorter time to complete return to work , earlier bone union , and fewer cases of nonunions in a working population under injury compensation .


The objective of this study is to evaluate the auditory functions in chronic asthma patients with the use of pure tone high frequency audiometry .


Twenty-two healthy controls and @ adult patients were included as a prospective , randomized , and controlled study .


Pulmonary function tests and blood gas studies were completed on all subjects .


Asthma patients have divided into two groups -LSB- Group A : Arterial oxygen tension ( PaO@ ) > @ mmHg , Group B : PaO@ @ mmHg , Group C : Control group ) .


Acoustic assessments of patients were performed in @-@ ,@ Hz by using pure-tone audiometry ( PTA ) and tympanometry .


The mean value of air and bone conduction hearing threshold levels were in normal range for all groups .


All patients had normal peripheral hearing all threshold levels across @ Hz to @ Hz in the both ears .


Significant differences were observed between the chronic asthma patients and control group for the extended high frequencies ( @,@-@ ,@ Hz ) .


Group B had statistically more significant increased hearing threshold levels than Group A in frequencies higher than @,@ Hz .


There were no statistical differences between the hearing threshold levels and FEV@ , FVC , FEV@/FVC and tympanogram results in the groups .


This is the first study of evaluating the auditory functions in asthma patients .


Sensorineural hearing loss in high frequencies ( @,@ Hz-@ ,@ Hz ) is common in chronic asthma and is probably present more often than were formerly thought .


After the oral administration of iron , the production of circulating non-transferrin-bound iron may contribute to an increased risk of illness in malaria-endemic areas that lack effective medical services .


In healthy women with a range of body iron stores , we aimed to determine effects on the production of circulating non-transferrin-bound iron resulting from the oral administration of @ ) a supplemental dose of iron ( @ mg ) with water , @ ) a supplemental dose of iron ( @ mg ) with a standard test meal , and @ ) a fortification dose of iron ( @ mg ) with a standard test meal .


With the use of serum ferritin as the indicator , healthy women with replete iron stores ( ferritin concentration > @ g/L ; n = @ ) and reduced iron stores ( ferritin concentration @ g/L ; n = @ ) were enrolled in a prospective , randomized , crossover study .


After the oral administration of aqueous solutions of ferrous sulfate isotopically labeled with Fe , Fe , or Fe , blood samples were collected for @ h , and iron absorption was estimated by erythrocyte incorporation at @ d.


At @ h , serum non-transferrin-bound iron reached peaks with geometric mean ( @ % CI ) concentrations of @ mol/L ( @ , @ mol/L ) for @ mg Fe with water and @ mol/L ( @ , @ mol/L ) for @ mg Fe with food but was at assay limits of detection ( @ mol Fe/L ) for @ mg Fe with food .


For the @ mg Fe without food , the area under the curve over @ h for serum non-transferrin-bound iron was positively correlated with the amount of iron absorbed ( R = @ , P < @ ) and negatively correlated with serum ferritin ( R = -@ , P < @ ) .


In healthy women , the production of circulating non-transferrin-bound iron is determined by the rate and amount of iron absorbed .


The highest concentrations of non-transferrin-bound iron resulted from the administration of supplemental doses of iron without food .


Little or no circulating non-transferrin-bound iron resulted from the consumption of a meal with a fortification dose of iron .


To investigate the effect of perioperative restricted fluid therapy on circulating CD@ ( + ) / CD@ ( + ) T lymphocyte ratio , percentage of regulatory T cells ( Treg ) and postoperative complications in patients with colorectal cancer .


A total of @ patients met the inclusion criteria and were included in the randomized clinical trial .


These patients were divided into two groups according to receipt of either perioperative standard ( S , n = @ ) or restricted ( R , n = @ ) fluid therapy .


Clinical data of these patients were collected in this prospective study .


Perioperative complications and cellular immunity changes ( CD@ ( + ) / CD@ ( + ) and Treg ) were analyzed comparatively between the two groups .


Both during surgery and on postoperative days , the total volumes of fluids administered in the R group were significantly lower than those in the S group ( @ @ mL vs @ @ mL ; @ @ mL vs @ @ mL ; @ @ mL vs @ @ mL ; @ @ mL vs @ @ mL ; P < @ ) .


Decreased ratios of circulating CD@ ( + ) / CD@ ( + ) T lymphocytes ( @ @ vs @ @ ; @ @ vs @ @ ; P < @ ) and Treg percentage values ( @ @ vs @ @ ; @ @ vs @ @ ; P < @ ) were observed after surgery in both groups .


However , in the R group , these values restored more quickly starting from postoperative day @ ( @ @ vs @ @ ; @ @ vs @ @ ; P < @ ) .


The proportion of patients with complications was significantly lower in the restricted group ( @ of @ vs @ of @ , P < @ ) .


Perioperative restricted intravenous fluid regimen leads to a low postoperative complication rate and better cellular immunity preservation in patients with colorectal cancer .


During times of organ scarcity and extended use of liver grafts , protective strategies in transplantation are gaining importance .


We demonstrated in the past that volatile anesthetics such as sevoflurane attenuate ischemia-reperfusion injury during liver resection .


In this randomized study , we examined if volatile anesthetics have an effect on acute graft injury and clinical outcomes after liver transplantation .


Cadaveric liver transplant recipients were enrolled from January @ to September @ at @ University Centers ( Zurich/Sao Paulo/Ghent ) .


Recipients were randomly assigned to propofol ( control group ) or sevoflurane anesthesia .


Postoperative peak of aspartate transaminase was defined as primary endpoint , secondary endpoints were early allograft dysfunction , in-hospital complications , intensive care unit , and hospital stay .


Ninety-eight recipients were randomized to propofol ( n = @ ) or sevoflurane ( n = @ ) .


Median peak aspartate transaminase after transplantation was @ ( interquartile range , @-@ ) in the propofol and @ ( interquartile range , @-@ ) in the sevoflurane group .


In the propofol arm , @ patients ( @ % ) experienced early allograft dysfunction , @ ( @ % ) in the sevoflurane one ( odds ratio , @ ( @ to @ , P = @ ) .


There were @ mortalities ( @ % ) in the propofol and @ ( @ % ) in the sevoflurane group .


Overall and major complication rates were not different .


An effect on clinical outcomes was observed favoring the sevoflurane group ( less severe complications ) , but without significance .


This first multicenter trial comparing propofol with sevoflurane anesthesia in liver transplantation shows no difference in biochemical markers of acute organ injury and clinical outcomes between the @ regimens .


Sevoflurane has no significant added beneficial effect on ischemia-reperfusion injury compared to propofol .


Cardiorespiratory fitness , assessed during cardiopulmonary exercise tests by peak oxygen uptake ( Vo@pk ) , is an independent predictor of mortality in obesity .


We investigated whether Vo@pk and systemic responses measured during field walking tests were similar to those measured during an incremental treadmill test ( ITMT ) in obese individuals with treated OSA .


Individuals with treated OSA and a BMI > @ kg/m@ were recruited .


Participants completed an ITMT , two @-min walk tests ( @MWTs ) , and two incremental shuttle walk tests ( ISWTs ) on three separate days in a randomized order .


Expired gas analysis was performed during all tests .


The study was completed by @ patients ( nine men ) ( mean -LSB- SD -RSB- age , @ -LSB- @ -RSB- y ; BMI , @ -LSB- @ -RSB- kg/m@ ) .


There was no difference ( P = @ ) in Vo@pk assessed by the ITMT and the ISWT ( @,@ -LSB- @ -RSB- and @,@ -LSB- @ -RSB- mL/min , respectively ) .


The Vo@pk measured by the @MWT ( @,@ -LSB- @ -RSB- mL/min ) was lower than that measured by the ITMT ( P < @ ) .


The limits of agreement for Vo@pk between the ISWT and the ITM were @ mL/min .


Cardiorespiratory responses during the ISWT and the ITMT reflected a graded response to a peak , whereas the @MWT demonstrated a rapid rise to a plateau .


The ISWT can be used instead of an ITMT and in preference to the @MWT to assess cardiorespiratory fitness for a cohort of obese people with treated OSA .


However , the imprecision of the agreement in Vo@pk between the ITMT and ISWT means they can not be used interchangeably in an individual .


Surgical site infection ( SSI ) is a serious complication after pancreaticoduodenectomy ( PD ) .


To prevent microbial colonization of suture material in operative wounds , triclosan-coated polyglactin sutures with antibacterial activity have been developed recently .


Several clinical studies have shown that the use of such suture reduces SSIs in various operations , but its efficacy in PD has not been studied .


We evaluated whether the incidence of SSI can be reduced when triclosan-coated sutures are used for abdominal incision closure after PD .


This controlled clinical trial took place between December @ and February @ with a total of @ consecutive patients who had undergone PD .


The study group received triclosan-coated polyglactin @ antimicrobial sutures between March @ and February @ , and the control group received conventional wound closure between January @ and February @ .


We compared the rate and types of infections in the two groups .


In the study group , age , the incidence of diabetes mellitus , smoking history , and operating time were significantly greater than in the control group .


The rates of SSI were @ % in the study group and @ % in the control group ( p = @ ) .


The use of triclosan-coated sutures may help reduce the incidence of SSI after PD compared with conventional non-antibiotic sutures .


The aim of this study was to compare the results of ultrasonographically guided axillary nerve block ( ANB ) combined with suprascapular nerve block ( SSNB ) with those of SSNB alone on postoperative pain and satisfaction within the first @hours after arthroscopic rotator cuff repair .


Forty-two patients with rotator cuff tears who had undergone arthroscopic rotator cuff repair were enrolled in this study .


Among them , @ patients were randomly allocated to group @ and received both SSNB and ANB with @mL ropivacaine .


The other @ patients were allocated to group @ and received SSNB with @mL @ % ropivacaine and ANB with @mL saline .


Visual analog scale ( VAS ) pain score , patient satisfaction ( SAT ) , and lateral pain index ( LPI ) was checked at @ , @ , @ , @ , @ , @ , @ , and @hours postoperatively .


Group @ showed a significantly lower mean VAS score at postoperative @ , @ , @ , @ , @ , and @hours compared with group @ ( @ < @ , @ < @ , @ < @ , @ < @ , @ < @ , and @ < @ , respectively ) .


A significantly high mean SAT and low mean LPI was observed in group @ at postoperative @ , @ , @ , @ , @ , @ , and @hours ( @ > @ , @ > @ , @ > @ , @ > @ , @ > @ , @ > @ , and @ > @ , respectively ) , ( @ < @ , @ < @ , @ < @ , @ < @ , @ < @ , @ < @ , and @ < @ , respectively ) .


The frequency of rebound pain decreased in group @ compared with group @ ( P = @ ) .


In addition , rebound phenomenon showed a correlation with ANB on univariate logistic regression ( P = @ ; odds ratio , @ ) .


Ultrasonographically guided ANB combined with SSNB in arthroscopic rotator cuff repair showed an improved mean VAS in the first @hours after surgery compared with SSNB alone .


The mean SAT and LPI of the combined blocks were better than those of the single block within the first @hours .


Ultrasonographically guided ANB combined with SSNB also decreased the rebound phenomenon .


Level I , randomized controlled trial .


The aim of this study was to compare the effect of sevoflurane and propofol on cerebral oxygenation , using regional cerebral oxygen saturation ( SrO@ ) measured by near-infrared spectroscopy ( NIRS ) .


Prospective , randomized , controlled study .


Fifty-four patients aged between @ and @ years who underwent elective minor surgery ( tumorectomy for breast cancer or inguinal hernia repair ) were randomly assigned to receive sevoflurane or propofol anaesthesia .


Exclusion criteria included pre-existing cerebrovascular diseases , anaemia , ASA > III , blood loss @ mL , arterial hypotension , baseline pulse oximetry < @ % , sign of sensor low quality of SrO@ or bispectral index , and patients with a forehead area < @ cm .


SrO@ , bispectral index , haemodynamic data and anaesthetic doses were recorded during surgery .


A total of @ patients were included in the final analysis ( @ in each group ) .


There were no significant differences in mean , minimum and maximum SrO@ between sevoflurane and propofol groups .


The relative maximum decrease was higher in propofol anaesthesia than sevoflurane anaesthesia ( @ versus @ % ; P = @ ) .


Cerebral desaturation ( @ % reduction from SrO@ baseline during @ seconds ) occurred in @ patients in propofol group exclusively ( P = @ ) .


SrO@ adjusted for baseline was higher in the sevoflurane group than in the propofol group ( @ % versus @ % ; P = @ ) .


There were no significant differences in haemodynamic parameters between the two groups .


Cerebral cortical oxygenation measured by NIRS may be better preserved with sevoflurane than with propofol .


These findings suggest that sevoflurane anaesthesia could be a good option in patients with compromised cerebral oxygenation , given the absence of intracranial hypertension .


Further studies with larger sample sizes are required to support our results .


To assess long-term effects of laparoscopic electrocautery of the ovaries compared with ovulation induction with gonadotropins in women with clomiphene citrate ( CC ) - resistant polycystic ovary syndrome ( PCOS ) on the incidence of pregnancy complications like gestational diabetes , hypertensive disorders , and metabolic or cardiovascular disease .


Long-term follow-up study .


Twenty-eight hospitals within the Netherlands .


One hundred sixty-eight CC-resistant women who had participated in a randomized controlled trial between @ and @ comparing electrocautery and gonadotropins .


Postal questionnaire , search in medical files .


Pregnancy complications , metabolic or cardiovascular disease .


Eighty-two percent of follow-up data were obtained .


Thirteen of @ women ( @ % ) allocated to electrocautery , and @ of @ women ( @ % ) allocated to gonadotropins had evidence for pregnancy complications ( relative risk @ ; @ % confidence interval @-@ @ ) .


At follow-up , @ of @ ( @ % ) women allocated to electrocautery , and @ of @ ( @ % ) women allocated to gonadotropins had evidence for metabolic or cardiovascular disease ( relative risk @ ; @ % confidence interval @-@ @ ) .


The risk of these was modified by body mass index ( BMI ) , but not by female age or treatment allocation .


This study is based on questionnaires and data from medical files .


In the absence of routine screening , under-reporting in our follow-up study is likely .


Electrocautery in women with CC-resistant PCOS does not affect pregnancycomplications or metabolic or cardiovascular disease later in life compared with ovulation induction with gonadotropins .


To describe the current extent and type of pharmaceutical marketing in nursing homes ( NHs ) in one state and to provide preliminary evidence for the potential influence of pharmaceutical marketing on the use of atypical antipsychotics in NHs .


Nested mixed-methods , cross-sectional study of NHs in a cluster randomized trial .


Forty-one NHs in Connecticut .


NH administrators , directors of nursing , and medical directors ( n = @ , response rate @ % ) .


Quantitative data , including prescription drug dispensing data ( September @-August @ ) linked with Nursing Home Compare data ( April @ ) , were used to determine facility-level prevalence of atypical antipsychotic use , facility-level characteristics , NH staffing , and NH quality .


Qualitative data , including semistructured interviews and surveys of NH leaders conducted in the first quarter of @ , were used to determine encounters with pharmaceutical marketing .


Leadership at @ % of NHs ( n = @ ) reported pharmaceutical marketing encounters , consisting of educational training , written and Internet-based materials , and sponsored training .


No association was detected between level of atypical antipsychotic prescribing and reports of any pharmaceutical marketing by at least one NH leader .


NH leaders frequently encounter pharmaceutical marketing through a variety of ways , although the impact on atypical antipsychotic prescribing is unclear .


To evaluate anthropometric measures and serum markers of myostatin-pathway activity after different weight-reduction protocols in wrestlers .


Subjects were randomly assigned to a gradual-weight-reduction ( GWR ) or rapid-weight-reduction ( RWR ) group .


Food logs were collected for the duration of the study .


Anthropometric measurements and serum samples were collected after an @-h fast at baseline and after the weight-reduction intervention .


Subjects reduced body mass by @ % .


The GWR group restricted calories over @ d , while the RWR group restricted calories over @ d.


A series of @ repeated-measures ( RM ) ANOVAs was conducted to examine differences in nutrient consumption , while separate @ RM ANOVAs were conducted to examine differences in anthropometric measures and serum markers .


When applicable , Tukey post hoc comparisons were conducted .


Significance for all tests was set at P < @ .


There were no between-groups differences for any anthropometric measure ( P > @ ) .


Subjects in both groups experienced a significant reduction in body mass , fat mass , lean mass , and percent body fat ( P < @ ) .


There were no between-groups differences in serum markers of myostatin-pathway activity ( P > @ ) , but subjects in the RWR condition experienced a significant increase in serum myostatin ( P < @ ) , a decrease in follistatin ( P < @ ) , and an increase in myostatin-to-follistatin ratio ( P < @ ) .


Although there were no between-groups differences for any outcome variables , the serum myostatin-to-follistatin ratio was significantly increased in the RWR group , possibly signaling the early stages of skeletal-muscle catabolism .


Barrett 's oesophagus ( BE ) is a pre-malignant condition leading to oesophageal adenocarcinoma ( OAC ) .


Treatment of neoplasia at an early stage is desirable .


Combined endoscopic mucosal resection ( EMR ) followed by radiofrequency ablation ( RFA ) is an alternative to surgery for patients with BE-related neoplasia .


We examined prospective data from the UK registry of patients undergoing RFA/EMR for BE-related neoplasia from @ to @ .


Before RFA , visible lesions were removed by EMR .


Thereafter , patients had RFA @-monthly until all BE was ablated or cancer developed ( endpoints ) .


End of treatment biopsies were recommended at around @months from first RFA treatment or when endpoints were reached .


Outcomes for clearance of dysplasia ( CR-D ) and BE ( CR-IM ) at end of treatment were assessed over two time periods ( @-@ and @-@ ) .


Durability of successful treatment and progression to OAC were also evaluated .


@ patients have completed treatment .


CR-D and CR-IM improved significantly between the former and later time periods , from @ % and @ % to @ % and @ % , respectively ( p < @ ) .


EMR for visible lesions prior to RFA increased from @ % to @ % ( p = @ ) .


Rescue EMR after RFA decreased from @ % to @ % ( p < @ ) .


Progression to OAC at @months is not significantly different ( @ % vs @ % , p = @ ) .


Clinical outcomes for BE neoplasia have improved significantly over the past @years with improved lesion recognition and aggressive resection of visible lesions before RFA .


Despite advances in technique , the rate of cancer progression remains @-@ % at @year in these high-risk patients .


To compare maternal and neonatal oxygenation and acid-base status after elective cesarean section ( CS ) under different anesthetic techniques .


Three hundred and eighty parturients undergoing elective cesarean section were randomly assigned to receive general ( GA , n = @ ) , epidural ( EA , n = @ ) or subarachnoid anesthesia ( SA , n = @ ) .


Blood gases , oxygen content , and acid-base status parameters were measured in maternal artery and umbilical cord vessels .


Neonatal Apgar scores were also recorded .


Umbilical artery pH , HCO@ - , and actual base excess ( ABE ) were significantly higher in the GA compared to SA group ( p < @ , p < @ , andp < @ , respectively ) .


Umbilical vein ABE was lower in the SA compared to GA and EA groups ( p < @ ) .


Oxygen content in maternal artery was higher in the GA and EA groups compared to the SA group ( p < @ ) .


Neonatal oxygen content in both cord vessels was higher in the GA group compared to EA and SA groups ( p < @ ) .


Umbilical venous-arterial difference of PO@ , oxygen content , and Apgar scores did not differ significantly among groups .


Neonatal oxygenation and acid-base status values were better preserved when GA was administered for elective CS compared to regional modalities .


Apgar scores and neonatal outcomes were not affected by the anesthetic technique .


Early studies showed beneficial effects of phosphodiesterase @ inhibitors on cardiovascular function in heart failure ( HF ) patients , but the RELAX trial observed no improvement in exercise capacity with sildenafil treatment in subjects with HF and preserved ejection fraction .


A subgroup of participants in the RELAX trial ( n = @ ) underwent comprehensive noninvasive cardiovascular assessment before and after treatment with sildenafil or placebo in a prospective ancillary study .


Left ventricular contractility was assessed by peak power index and stroke work index .


Systemic arterial load was assessed by arterial elastance ( Ea ) and right ventricular afterload by pulmonary artery systolic pressure .


Endothelial function was assessed by reactive hyperemia index after upper arm cuff occlusion .


Compared with placebo ( n = @ ) , sildenafil ( n = @ ) decreased Ea ( -@ mm Hg/mL versus +@ , P = @ ) and tended to improve reactive hyperemia index ( +@ versus -@ , P = @ ) .


In contrast , left ventricular contractility was reduced by @ % to @ % with sildenafil compared with placebo ( PWR/EDV -@ versus +@ mm Hg/s , P = @ ; SW/EDV +@ versus -@ mm Hg , P = @ ) .


Sildenafil had no effect on pulmonary artery systolic pressure .


In subjects with HF and preserved ejection fraction , sildenafil displayed opposing effects on ventricular and vascular function .


We speculate that beneficial effects of phosphodiesterase @ inhibitors in the systemic vasculature and endothelium were insufficient to improve clinical status or that the deleterious effects on left ventricular function offset any salutary vascular effects , contributing to the absence of benefit observed with sildenafil in subjects with HF and preserved ejection fraction in the RELAX trial .


Evaluate the ability of clonidine to reduce pulmonary arterial pressure in patients with pulmonary hypertension undergoing heart surgery , either by reducing the pressure values from the direct measurement of pulmonary arterial pressure or by reducing or eliminating the need for intraoperative dobutamine and nitroprusside .


Randomized , double-blind , placebo-controlled , comparative study conducted in @ patients with pulmonary arterial hypertension type @ undergoing cardiac surgery .


Mean pulmonary arterial pressure and dosage of dobutamine and sodium nitroprusside were assessed four times : before intravenous administration of clonidine ( @ g/kg ) or placebo ( T@ ) , @ min after tested treatment and before cardiopulmonary bypass ( T@ ) , immediately after CPB ( T@ ) , @ min after protamine injection ( T@ ) .


There were no significant differences regarding mean pulmonary arterial pressure at any time of evaluation .


There was no significant difference between groups regarding other variables , such as mean systemic arterial pressure , heart rate , total dose of dobutamine , total dose of sodium nitroprusside , and need for fentanyl .


Data analysis from patients included in this study allows us to conclude that intravenous clonidine ( @ g/kg ) was not able to reduce the mean pulmonary arterial pressure in patients with pulmonary hypertension in group @ ( pulmonary venous hypertension ) , undergoing heart surgery , or reduce or eliminate the need for intraoperative administration of dobutamine and sodium nitroprusside .


The primary aim of this pilot study was to evaluate the possible therapeutic effects of a @-session humor intervention program in improving rehabilitative outcomes and the effects of the intervention on patients ' sense of humor among patients with schizophrenia .


Thirty subjects were randomly assigned into either the intervention ( humor skill training ) group ( n = @ ) or the control ( doing handwork ) group ( n = @ ) .


The results were analyzed using descriptive statistics , t-tests and ANOVA .


Repeated measures analysis of variance ( ANOVA ) tests were conducted to examine the differences across conditions and time .


A group by time interaction effect was observed on all of the outcomes , except positive symptoms of PANSS .


The time main effect was also significant on the total score ( p < @ ) and the negative symptoms score ( p < @ ) of the PANSS .


The implementation of humor skill training in a mental health service can improve rehabilitative outcomes and sense of humor for schizophrenia patients who were in the rehabilitation stage .


Levosimendan is a calcium sensitizer drug which has been used in cardiac surgery for the prevention of postoperative low cardiac output syndrome ( LCOS ) and in difficult weaning from cardiopulmonary bypass ( CPB ) .


This study aims to evaluate perioperative hemodynamic effects of levosimendan pretreatment in patients for off-pump coronary artery bypass graft ( OPCABG ) surgery with low left ventricular ejection fractions ( LVEF < @ % ) .


Fifty patients undergoing OPCABG surgery with low LVEF ( < @ % ) were enrolled in the study .


Patients were randomly divided in two groups : Levosimendan pretreatment ( Group L ) and placebo pretreatment ( Group C ) of @ each .


Group L , patients received levosimendan infusion @ g/kg over @ h and in Group C Patients received placebo .


The clinical parameters measured before and after the drug administration up to @ h were heart rate ( HR ; for the hour after drug infusion ) , cardiac index ( CI ) , and pulmonary capillary wedge pressure ( PCWP ) .


The requirement of inotropes , intraaortic balloon pump ( IABP ) , CPB , intensive care unit ( ICU ) stay , and hospital stay were also measured .


The patients in group L exhibited higher CI and PCWP during operative in early postoperative period as compared to control group C. Group L also had a less requirement for inotropes , CPB support and IABP with shorter ICU stay as well as hospital stay .


Levosimendan pretreatment ( @ h infusion ) in patient for OPCABG with poor LVEF shows better outcomes and hemodynamics in terms of inotropes , CPB and IABP requirements .


It also reduces ICU stay .


Both @-L polyethylene glycol with ascorbic acid ( @-L PEG/Asc ) and sodium picosulfate with magnesium citrate ( SP/MC ) are low-volume combined agents for colonic preparation .


The aim of the current study was to compare the preparation adequacy and patient tolerability of @-L PEG/Asc and SP/MC .


We performed a prospective randomized controlled study in outpatients undergoing daytime colonoscopy at a tertiary academic hospital .


We compared preparation adequacy based on the Boston Bowel Preparation Scale ( BBPS ) , polyp and adenoma detection rate ( PDR and ADR ) , compliance , tolerability for ease and palatability , intention to reuse , and patient satisfaction using a questionnaire between @-L PEG/Asc and three sachets of SP/MC , both given in a split-dose method .


A total of @ patients were evaluated based on intention to treat ( ITT ) and @ patients per protocol ( PP ) .


No significant differences in preparation adequacy were observed in ITT and PP analyses , based on the BBPS ( p > @ ) .


The PDR and ADR were greater than @ and @ % in both groups , respectively ( p > @ ) .


Compliance levels were higher in the @-L PEG/Asc group than in the SP/MC group ( p < @ ) .


Satisfaction ( ITT , p = @ ; PP , p = @ ) and palatability ( ITT and PP , p < @ ) levels were higher in the SP/MC group than in the @-L PEG/Asc group , but values for tolerability for ease and intention to reuse were similar in both groups ( ITT and PP , p > @ ) .


Both @-L PEG/Asc and SP/MC had adequate bowel cleansing efficacy to satisfy PDR and ADR as quality indicator and had showed similar tolerability .


To determine the safety , pain intensity correlated with age and body mass index ( BMI ) , epidural anesthesia with ropivacaine and clonidine in hemorrhoidectomy .


Eighty patients , both genders , @-@ years old , ASA I or II , for hemorrhoidectomy were randomly divided into two groups : Control ( n = @ ) , epidural anesthesia with @ mL of ropivacaine @ % plus @ mL/kg of @ % saline solution ; Experimental ( n = @ ) epidural anesthesia with @ mL of @ % ropivacaine plus @ mcg/kg of clonidine .


In preoperative and postoperative period were evaluated : systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , heart rate ( HR ) , pulse oximetry ( SpO@ ) , electrocardiography ( ECG ) , pain intensity ( VAS ) in four , eight and , @ hours and analgesic consumption .


The VAS values differed between four , eight and @ hours in the Experimental Group , where correlation of VAS @h with age ( p < @ ) occurred and not with BMI and more patients ( p < @ ) did not receive analgesics .


SBP , DBP , HR changed similarly in both groups at @ , @ and @ min .


The ECG and SpO@ remained unchanged .


Clonidine ( @mcg/kg ) in epidural anesthesia with ropivacaine @ % in hemorrhoidectomy showed safety and greater analgesia within four hours .


The pain at @ hours showed correlation with age and not with body mass index .


High-concentration normobaric oxygen ( O ) administration is the first-aid priority in treating divers with suspected decompression illness .


The best O delivery device and flow rate are yet to be determined .


To determine whether administering O with a non-rebreather mask ( NRB ) at a flow rate of @ or @ Lmin or with a demand valve with oronasal mask significantly affects the tissue partial pressure of O ( PtcO ) in healthy volunteer scuba divers .


Fifteen certified scuba divers had PtcO measured at six positions on the arm and leg .


Measurements were taken with subjects lying supine whilst breathing O from a NRB at @ or @Lmin , a demand valve with an adult Tru-Fit oronasal mask and , as a reference standard , an oxygen ` head hood ' .


End-tidal carbon dioxide was also measured .


While none of the emergency delivery devices performed as well as the head hood , limb tissue oxygenation was greatest when O was delivered via the NRB at @ Lmin .


There were no clinically significant differences in end-tidal carbon dioxide regardless of the delivery device or flow rate .


Based on transcutaneous oximetry values , of the commonly available emergency O delivery devices , the NRB at @ Lmin is the device and flow rate that deliver the most O to body tissues and , therefore , should be considered as a first-line pre-hospital treatment in divers with suspected decompression illness .


Postmenopausal women with breast cancer receiving aromatase inhibitors are at an increased risk of bone loss .


The current study was undertaken to determine whether upfront versus delayed treatment with zoledronic acid ( ZA ) impacted bone loss .


This report described the @-year follow-up results .


A total of @ postmenopausal women with breast cancer who completed tamoxifen treatment and were undergoing daily letrozole treatment were randomized to either upfront ( @ patients ) or delayed ( @ patients ) ZA at a dose of @ mg intravenously every @ months .


In the patients on the delayed treatment arm , ZA was initiated for a postbaseline bone mineral density T-score of < -@ or fracture .


The incidence of a @ % decrease in the total lumbar spine bone mineral density at @ years was @ % in the upfront treatment arm versus @ % in the delayed treatment arm ( P < @ ) .


A total of @ patients in the delayed treatment arm were eventually started on ZA .


With the exception of increased NCI Common Toxicity Criteria ( CTC ) grade @/@ elevated creatinine and fever in the patients treated on the upfront arm and cerebrovascular ischemia among those in the delayed treatment arm , there were no significant differences observed between arms with respect to the most common adverse events of arthralgia and back pain .


Osteoporosis occurred less frequently in the upfront treatment arm ( @ vs @ cumulative cases ) , although this difference was not found to be statistically significant .


Bone fractures occurred in @ patients in the upfront treatment arm versus @ patients in the delayed treatment arm .


Immediate treatment with ZA prevented bone loss compared with delayed treatment in postmenopausal women receiving letrozole and these differences were maintained at @ years .


The incidence of osteoporosis or fractures was not found to be significantly different between treatment arms .


The Neonatal Resuscitation Program ( NRP ) has transitioned to a simulation-based format .


We hypothesized that immersive simulation differentially impacts similar trainee populations ' resuscitation knowledge , procedural skill and teamwork behavior .


Residents from NICU and non-NICU programs were randomized to either control or a booster simulation @ to @ months after NRP .


Procedural skill and teamwork behavior instruments were validated .


Individual resident 's resuscitation performance was assessed at @ to @ months .


Three reviewers rated videos .


Fifty residents were assessed .


Inter-rater reliability was good for procedural skills ( @ ) and team behavior ( @ ) instruments .


The intervention group demonstrated better procedural skills ( @ versus @ ) and teamwork behaviors ( @ versus @ ) .


The NICU program demonstrated better teamwork behaviors ( @ versus @ ) compared with non-NICU program .


A simulation-enhanced booster session @ months after NRP differentiates procedural skill and teamwork behavior at @ months .


Deliberate practice with simulation enhances teamwork behaviors additively with residents ' clinical resuscitation exposure .


Multifactor heart failure is a common life-threatening event in elderly patients and often complicated by concomitant hypertension and diabetes mellitus ( DM ) .


The aim of this study was to evaluate whether @-blocker , urapidil , provides additional therapeutic benefits compared to nitroglycerin ( NG ) in treatment of multifactor heart failure complicated by hypertension and DM in elderly patients .


Seventy-two elderly consecutive patients were randomized into @ groups that received treatment with urapidil or NG .


All patients were monitored for blood pressure ( BP ) and heart rate and received tests for metabolic activity and cardiovascular function .


Patients receiving urapidil had significantly lower systolic BP than their counterparts in NG group ( P < @ ) .


Moreover , patients in urapidil group showed lower N-terminal pro-B-type natriuretic peptide levels but higher ejection fraction ( t = @ , P < @ ) , cardiac index ( t = @ , P < @ ) and left end-diastolic volume ( t = -@ , P < @ ) compared to NG group .


Although both urapidil and NG decreased fasting plasma glucose ( FPG ) levels , there was no significant difference of FPG levels between these @ groups .


Urapidil demonstrated better efficacy than NG on lowering and stabilizing systolic BP , attenuating cardiac afterload and improving cardiac function .


Both NG and urapidil significantly reduced FPG levels in multifactor heart failure patients with DM .


Urapidil is a therapeutic option for the multifactor heart failure patients complicated with hypertension and DM .


Meta-analyses suggest that reboxetine may be less effective than other antidepressants .


Such comparisons may be biased by lower adherence to reboxetine and subsequent handling of missing outcome data .


This study illustrates how to adjust for differential non-adherence and hence derive an unbiased estimate of the efficacy of reboxetine compared with citalopram in primary care patients with depression .


A structural mean modelling ( SMM ) approach was used to generate adherence-adjusted estimates of the efficacy of reboxetine compared with citalopram using GENetic and clinical Predictors Of treatment response in Depression ( GENPOD ) trial data .


Intention-to-treat ( ITT ) analyses were performed to compare estimates of effectiveness with results from previous meta-analyses .


At @ weeks , @ % of those randomized to citalopram were still taking their medication , compared with @ % of those randomized to reboxetine .


In ITT analysis , there was only weak evidence that those on reboxetine had a slightly worse outcome than those on citalopram -LSB- adjusted difference in mean Beck Depression Inventory ( BDI ) scores : @ , @ % confidence interval ( CI ) -@ to @ , p = @ -RSB- .


There was no evidence of a difference in efficacy when differential non-adherence was accounted for using the SMM approach for mean BDI ( -@ , @ % CI -@ to @ , p = @ ) or the other mental health outcomes .


There was no evidence of a difference in the efficacy of reboxetine and citalopram when these drugs are taken and tolerated by depressed patients .


The SMM approach can be implemented in standard statistical software to adjust for differential non-adherence and generate unbiased estimates of treatment efficacy for comparisons of two ( or more ) active interventions .


Alcoholic hepatitis is a clinical syndrome characterized by jaundice and liver impairment that occurs in patients with a history of heavy and prolonged alcohol use .


The short-term mortality among patients with severe disease exceeds @ % .


Prednisolone and pentoxifylline are both recommended for the treatment of severe alcoholic hepatitis , but uncertainty about their benefit persists .


We conducted a multicenter , double-blind , randomized trial with a @-by-@ factorial design to evaluate the effect of treatment with prednisolone or pentoxifylline .


The primary end point was mortality at @ days .


Secondary end points included death or liver transplantation at @ days and at @ year .


Patients with a clinical diagnosis of alcoholic hepatitis and severe disease were randomly assigned to one of four groups : a group that received a pentoxifylline-matched placebo and a prednisolone-matched placebo , a group that received prednisolone and a pentoxifylline-matched placebo , a group that received pentoxifylline and a prednisolone-matched placebo , or a group that received both prednisolone and pentoxifylline .


A total of @ patients underwent randomization , and data from @ were available for the primary end-point analysis .


Mortality at @ days was @ % ( @ of @ patients ) in the placebo-placebo group , @ % ( @ of @ patients ) in the prednisolone-placebo group , @ % ( @ of @ patients ) in the pentoxifylline-placebo group , and @ % ( @ of @ patients ) in the prednisolone-pentoxifylline group .


The odds ratio for @-day mortality with pentoxifylline was @ ( @ % confidence interval -LSB- CI -RSB- , @ to @ ; P = @ ) , and that with prednisolone was @ ( @ % CI , @ to @ ; P = @ ) .


At @ days and at @ year , there were no significant between-group differences .


Serious infections occurred in @ % of the patients treated with prednisolone versus @ % of those who did not receive prednisolone ( P = @ ) .


Pentoxifylline did not improve survival in patients with alcoholic hepatitis .


Prednisolone was associated with a reduction in @-day mortality that did not reach significance and with no improvement in outcomes at @ days or @ year .


( Funded by the National Institute for Health Research Health Technology Assessment program ; STOPAH EudraCT number , @-@-@ , and Current Controlled Trials number , ISRCTN@ ) .


The combination of stent insertion and single high-dose brachytherapy is a feasible and safe palliative treatment regimen in patients with unresectable oesophageal cancer .


We aimed to further assess the efficacy of this treatment strategy compared to a conventional covered stent in patients with dysphagia caused by unresectable oesophageal cancer .


In this multicentre , single-blind , randomised , phase @ trial , we enrolled patients with unresectable oesophageal cancer from @ hospitals in China .


We included adult patients ( aged @ years ) with progressive dysphagia , unresectable tumours due to extensive lesions , metastases , or poor medical condition , and with clear consciousness , cooperation , and an Eastern Cooperative Oncology Group ( ECOG ) performance status score of @-@ .


Eligible patients were randomly assigned ( in @:@ ratio , no stratification ) to receive either a stent loaded with ( @ ) iodine radioactive seeds ( irradiation group ) or a conventional oesophageal stent ( control group ) .


The primary endpoint was overall survival .


Survival analyses were done in a modified intention-to-treat group .


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


Between Nov @ , @ , and Oct @ , @ , @ patients were randomly assigned to receive treatment with either an irradiation stent ( n = @ ) or a conventional stent ( n = @ ) .


During a median follow-up of @ days ( IQR @-@ ) , @ stents ( @ in the irradiation group and @ in the control group ) were successfully placed into the diseased oesophagus in @ participants .


Median overall survival was @ days ( @ % CI @-@ ) in the irradiation group versus @ days ( @-@ ) in the control group ( p = @ ) .


Major complications and side-effects of the treatment were severe chest pain ( @ -LSB- @ % -RSB- of @ patients in the irradiation group vs @ -LSB- @ % -RSB- of @ patents in the control group ) , fistula formation ( six -LSB- @ % -RSB- vs five -LSB- @ % -RSB- ) , aspiration pneumonia ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , haemorrhage ( five -LSB- @ % -RSB- vs five -LSB- @ % -RSB- ) , and recurrent dysphagia ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) .


In patients with unresectable oesophageal cancer , the insertion of an oesophageal stent loaded with ( @ ) iodine seeds prolonged survival when compared with the insertion of a conventional covered self-expandable metallic stent .


Participation in organised youth sports ( OYS ) has been recommended as an opportunity to increase young peoples ' moderate-to-vigorous physical activity ( MVPA ) levels .


Participants , however , spend a considerable proportion of time during OYS inactive .


The purpose of this study , therefore , was to investigate whether coaches who attended coach education sessions ( where education on increasing MVPA and decreasing inactivity during training was delivered ) can increase players ' MVPA during training sessions over a @-day basketball program compared to coaches who did not receive coach education sessions .


A convenience sample of @ female players and @ coaches were recruited into the UWS School Holiday Basketball Program in Greater Western Sydney , Australia .


A two-arm , parallel-group randomised controlled trial was employed to investigate whether coaches who attended @ coach education sessions ( compared with a no-treatment control ) can increase their players ' MVPA during training sessions over a @-day basketball program .


Objectively measured physical activity , directly observed lesson context and leader behaviour , player motivation , players ' perceived autonomy support , and coaching information ( regarding training session planning , estimations on player physical activity and lesson context during training , perceived ability to modify training sessions , perceived importance of physical activity during training , intention to increase physical activity/reduce inactivity , and likelihood of increasing physical activity/reducing inactivity ) were assessed at baseline ( day @ ) and at follow-up ( day @ ) .


Linear mixed models will be used to analyse between arm differences in changes from baseline to follow-up on all outcomes .


The current trial protocol describes , to our knowledge , the first trial conducted in an OYS context to investigate the efficacy of an intervention , relative to a control , in increasing MVPA .


This study 's findings will provide evidence to inform strategies targeting coaches to increase MVPA in OYS , which could have major public health implications , given the high proportion of children and adolescents who participate in OYS globally .


The beneficial effects of the Mediterranean diet have been amply proven in adults with cardiovascular risk factors .


The effects of this diet have not been extensively assessed in pediatric populations with obesity , insulin resistance ( IR ) and metabolic syndrome ( MetS ) .


The aim of this study was to assess the efficacy of the Mediterranean style diet ( MSD ) to decrease cardiovascular risk factors in children and adolescents with obesity .


Participants were randomly assigned to a MSD rich in polyunsaturated fatty acids , fiber , flavonoids and antioxidants ( @ % of energy from carbohydrate , @ % from fat , and @ % from protein , ( n = @ ) ; or a standard diet ( @ % of carbohydrate , @ % from fat and @ % from protein , ( n = @ ) , the caloric ingest was individualized .


At baseline and @-week of intervention , the glucose , triglycerides ( TG ) , total cholesterol ( TC ) , HDL-C , LDL-C were measured as well as the body composition and anthropometric data .


The diet compliance was determined by the @-hour recalls.Paired Student 's t and Macnemar 's test were used to compare effects in biochemical , body composition , anthropometric , and dietary variables .


The MSD group had a significantly decrease in BMI , lean mass , fat mass , glucose , TC , TG , HDL-C and LDL-C .


( p < @ ) ; the diet compliance increased consumption of omega @ fatty acids , zinc , vitamin E , selenium , and decreased consumption of saturated fatty acids ( p < @ ) .


The standard diet group decrease in glucose levels and frequency of glucose > @ mg/dL ( p < @ ) .


The MSD improves the BMI , glucose and lipid profile in children and adolescents with obesity and any MetS component .


We sought to characterize growth between birth and age @ years in infants with hypoplastic left heart syndrome who underwent the Norwood procedure .


We performed a secondary analysis using the Single Ventricle Reconstruction Trial database after excluding patients < @ weeks gestation ( N = @ ) .


We determined length-for-age z score ( LAZ ) and weight-for-age z score ( WAZ ) at birth and age @ years and change in WAZ over @ clinically relevant time periods .


We identified correlates of change in WAZ and LAZ using multivariable linear regression with bootstrapping .


Mean WAZ and LAZ were below average relative to the general population at birth ( P < @ , P = @ , respectively ) and age @ years ( P < @ each ) .


The largest decrease in WAZ occurred between birth and Norwood discharge ; the greatest gain occurred between stage II and @ months .


At age @ years , WAZ and LAZ were < -@ in @ % and @ % , respectively .


Factors associated with change in WAZ differed among time periods .


Shunt type was associated with change in WAZ only in the Norwood discharge to stage II period ; subjects with a Blalock-Taussig shunt had a greater decline in WAZ than those with a right ventricle-pulmonary artery shunt ( P = @ ) .


WAZ changed over time and the predictors of change in WAZ varied among time periods .


By age @ years , subjects remained small and three times as many children were short as were underweight ( > @ SD below normal ) .


Failure to find consistent risk factors supports the strategy of tailoring nutritional therapies to patient - and stage-specific targets .


Fingolimod , a sphingosine @-phosphate receptor modulator , is the first oral disease modifying therapy approved for the treatment of relapsing multiple sclerosis .


The aim of this double-blind , placebo-controlled study was to evaluate the effect of fingolimod on cerebral blood flow , platelet function and macular thickness in healthy volunteers .


The study included @ healthy volunteers who received fingolimod @ mg or @ mg or matched placebo over a period of @ weeks .


Transcranial colour coded sonography was performed to measure mean blood flow velocities , the platelet function was measured by the PFA-@ assay using a collagen/epinephrine cartridge and macular thickness was measured using optical coherence tomography .


An assessment of non-inferiority of fingolimod vs. placebo was performed against a reference value ( @ % of the overall baseline value ) .


All @ randomized participants completed the study .


At day @ compared with baseline value , for @ mg , @ mg and placebo treatments , the mean middle cerebral artery blood flow velocity decreased by @ , @ and @ cms ( -@ ) , respectively .


The platelet function analyzer closure time increase was not significant ( @ , @ and @ s , respectively ) .


The mean percentage change in the central foveal thickness from baseline for both eyes was below @ % for all groups .


The safety profile of fingolimod in this study was found consistent with the previous reports .


In healthy volunteers , the changes seen with both fingolimod doses were found to be within normal variability , non-inferior and comparable with those observed with placebo for all the pharmacodynamic parameters assessed .


Cancer survivors often experience decreased self-confidence which impacts negatively on their ability to self-manage the practical , social and emotional problems frequently faced as they emerge from end of treatment .


This was a feasibility study of a life-coaching intervention , designed to rebuild confidence of survivors and support transition to life after cancer treatment .


A one group pre-test , post-test design was used , recruiting participants from community organisations .


Eligibility criteria are as follows : < @ year of completion of primary cancer treatment , aged > @ , no metastases , and no mental health problems .


Participants received one individualised face-to-face and five telephone coaching sessions over @ months .


Outcome measures are as follows : New General Self-Efficacy Scale , Hope Scale , Personal Well-being Index , Assessment of Survivorship Concerns , Quality of Life in Adult Cancer Survivors , Hospital Anxiety and Depression Scale , Social Difficulties Index , and a goal attainment score .


Interviews explored feasibility , acceptability and impact of life-coaching and research design .


Nine women and two men were recruited , representing varying cancer diagnoses .


All outcome measures were sensitive to change and indicated positive trends post-intervention .


Participant interviews indicated the intervention was well received and had a positive impact .


Lessons were learnt about study design , recruitment and intervention delivery .


Life-coaching has a potential to enable cancer survivors to manage the transition to life beyond cancer and effect change on a range of outcomes .


The intervention was feasible to deliver and acceptable to survivors at a time when many struggle to make sense of life .


It merits further evaluation through a randomised controlled trial .


of the study was to assess efficacy of the use of fixed combination of nebivolol and amlodipine in patients with moderate and high degree of arterial hypertension ( AH ) .


Patients with diagnosis of primary AH ( n = @ ) were divided into @ groups by random sample method .