The Prevalence Ratio was @ ( @-@ @ ) for males and @ ( @-@ @ ) for females .


There was no significant effect of VAS in infancy on atopy later in childhood .


The role of infant VAS in the development of atopy is still unclear .


Dupilumab , a fully human monoclonal antibody that blocks interleukin-@ and interleukin-@ , has shown efficacy in patients with asthma and elevated eosinophil levels .


The blockade by dupilumab of these key drivers of type @ helper T-cell ( Th@ ) - mediated inflammation could help in the treatment of related diseases , including atopic dermatitis .


We performed randomized , double-blind , placebo-controlled trials involving adults who had moderate-to-severe atopic dermatitis despite treatment with topical glucocorticoids and calcineurin inhibitors .


Dupilumab was evaluated as monotherapy in two @-week trials and in one @-week trial and in combination with topical glucocorticoids in another @-week study .


End points included the Eczema Area and Severity Index ( EASI ) score , the investigator 's global assessment score , pruritus , safety assessments , serum biomarker levels , and disease transcriptome .


In the @-week monotherapy studies , dupilumab resulted in rapid and dose-dependent improvements in clinical indexes , biomarker levels , and the transcriptome .


The results of the @-week study of dupilumab monotherapy reproduced and extended the @-week findings : @ % of patients in the dupilumab group , as compared with @ % of those in the placebo group , had a @ % reduction in the EASI score ( EASI-@ , with higher scores in the EASI indicating greater severity of eczema ) ( P < @ ) ; @ % of patients in the dupilumab group , as compared with @ % in the placebo group , had a score of @ to @ ( indicating clearing or near-clearing of skin lesions ) on the investigator 's global assessment ( P < @ ) ; and pruritus scores decreased ( indicating a reduction in itch ) by @ % in the dupilumab group versus @ % in the placebo group ( P < @ ) .


In the combination study , @ % of the patients in the dupilumab group , as compared with @ % of those who received topical glucocorticoids with placebo injection , met the criterion for EASI-@ ( P = @ ) , despite the fact that patients who received dupilumab plus glucocorticoids used less than half the amount of topical glucocorticoids used by those who received placebo plus the topical medication ( P = @ ) .


Adverse events , such as skin infection , occurred more frequently with placebo ; nasopharyngitis and headache were the most frequent adverse events with dupilumab .


Patients treated with dupilumab had marked and rapid improvement in all the evaluated measures of atopic dermatitis disease activity .


Side-effect profiles were not dose-limiting .


( Funded by Regeneron Pharmaceuticals and Sanofi ; ClinicalTrials.gov numbers , NCT@ , NCT@ , NCT@ , and NCT@ . )


To determine whether a @-year family-based intervention using frequent contact and limited expert involvement was effective in reducing excessive weight compared with usual care .


Two hundred and six overweight and obese ( BMI @th percentile ) children aged @ to @ years were randomized to usual care ( UC ) or tailored package ( TP ) sessions at university research rooms .


UC families received personalized feedback and generalized advice regarding healthy lifestyles at baseline and @ months .


TP families attended a single multidisciplinary session to develop specific goals suitable for each family , then met with a mentor each month for @ months , and every third month for another @ months to discuss progress and provide support .


Outcome measurements ( anthropometry , questionnaires , dietary intake , accelerometry ) were obtained at @ , @ , and @ months .


BMI at @ months was significantly lower in TP compared with UC children ( difference , @ % confidence interval : -@ , -@ to -@ ) , as was BMI z score ( -@ , -@ to -@ ) and waist circumference ( -@ , -@ to -@ cm ) .


TP children consumed more fruit and vegetables ( P = @ ) and fewer noncore foods ( P = @ ) than UC children , and fewer noncore foods were available in the home ( P = @ ) .


TP children were also more physically active ( P = @ ) .


No differences in parental feeding practices , parenting , quality of life , child sleep , or behavior were observed .


Frequent , low-dose support was effective for reducing excessive weight in predominantly mild to moderately overweight children over a @-year period .


Such initiatives could feasibly be incorporated into primary care .


Inhaled allergen challenge is a standard method to study airway responses to inflammatory provocation and evaluate the therapeutic potential of novel anti-inflammatory compounds in asthma .


MEM @ is a novel oral PDE@ inhibitor with high affinity and selectivity creating the potential for an improved side effect profile vs non-selective PDE inhibitors .


We evaluated the tolerability and effect of MEM @ on airway responses in mild asthmatics .


A randomised double blind placebo controlled cross over study in two centres , in which sixteen steroid nave atopic asthmatics were challenged with inhaled allergen .


Subjects were dosed with MEM @ ( @mg ) or placebo , twice daily orally for @days .


Allergen challenge was performed on day @ ( @hours post-dose ) , and methacholine responsiveness was measured @hours post allergen ( day @ ) .


Biomarkers of drug effects using ex vivo LPS stimulation of whole blood production of interleukin ( IL ) -@ and leukotriene ( LT ) - B@ and fractional exhaled nitric oxide ( FeNO ) were measured on day @ ( @ , @ and @hours post-dose ) .


Plasma pharmacokinetics were measured on days @ , @ and @ .


The primary endpoint was the effect on late asthmatic response to allergen .


Treatment with MEM @ abrogated the late phase response with a mean difference in FEV@ ( LAR @-@ hours ) of @ml ( @ % ) vs placebo ( p < @ ) , with no effect on the early response .


Biomarker responses were also attenuated with MEM @ treatment with reductions in LPS-stimulated whole blood assays for TNF at @hours ( p < @ ) and LTB@ at @hours ( p = @ ) with no change in the IL-@ response .


The MEM @ treatment phase was associated with higher incidence of nausea ( @/@ MEM @ vs @/@ placebo ) and vomiting ( @/@ vs @/@ placebo ) .


Oral MEM @ , a novel PDE@ inhibitor , significantly reduces the late response following inhaled allergen challenge .


MEM @ also inhibited whole blood assays of cytokine production from inflammatory cells .


MEM @ was associated with a typical adverse event profile of PDE@ inhibitors , namely nausea and vomiting although these were mild side effects .


Incidence and severity of motion sickness ( MS ) in hot-humid environment are extremely high .


We tried to know the effect of two-stage training for reducing incidence and severity of ms.


Sixty male subjects were divided into experimental group and control group randomly .


Subjects in experimental group received : ( @ ) adaptation training including sitting , walking and running in hot lab .


After adaptation confirmation based on subjective feeling , rectal temperature , heart rate , blood Pressure , sweat rates and sweat salt concentration , we tested both groups by Coriolis acceleration revolving chair test and recorded Graybiel 's score and grading of severity to evaluate whether adaptation training was useful ; ( @ ) Anti-dizzy training @m later of deacclimatization contained revolving chair training for @ times .


Then we did the same test as mentioned above to evaluate effect of anti-dizzy training .


RESULST : Graybiel ' s score and grading of severity had no difference between two groups through acclimatization training ( P > @ ) .


While they had difference through anti-dizzy training ( P < @ ) .


Adaptation training seems useless for reducing incidence and severity of MS in hot-humid environment , but anti-dizzy training is useful .


Local infiltration analgesia ( LIA ) is well established for effective postoperative pain relief in total knee arthroplasty ( TKA ) .


To prolong the effect of LIA , infusion pumps with local intraarticular analgesia can be used .


We evaluated the effect of such an infusion pump for the first @ h postoperatively regarding pain , knee function , length of stay ( LOS ) in hospital , and complications .


@ patients received peroperative LIA and a continuous intraarticular elastomeric infusion pump set at @ mL/h .


The patients were randomized either to ropivacaine ( @ mg/mL ) or to NaCl ( @ mg/mL ) in the pump .


Visual analog scale ( VAS ) pain ( @-@ mm ) , analgesic consumption , side effects of medicine , range of motion ( ROM ) , leg-raising ability , LOS , and complications during the first @ months were recorded .


On the first postoperative day , the ropivacaine group had lower VAS pain ( @ vs. @ at @ noon and @ vs. @ at @ p.m. ; p = @ and @ , respectively ) , but after that all recorded variables were similar between the groups .


During the first @ months , the ropivacaine group had a greater number of superficial and deep surgical wound infections ( @ patients vs. @ patients , p = @ ) .


There were no other statistically significant differences between the groups .


Continuous intraarticular analgesia ( CIAA ) with ropivacaine after TKA has no relevant clinical effect on VAS pain and does not affect LOS , analgesic consumption , ROM , or leg-raising ability .


There may , however , be a higher risk of wound-healing complications including deep infections .


Metabolic syndrome ( MetS ) is associated with adverse cardiovascular events , and impaired vascular function .


In this study we evaluated the effects of omega-@ polyunsaturated fatty acids ( PUFAs ) supplementation on vascular function , inflammatory and fibrinolytic process in subjects with MetS .


We studied the effect of a @ weeks oral treatment with @ g/day of omega-@ PUFAs in @ ( @ male ) subjects ( mean age @ @ years ) with MetS on three occasions ( day@ : baseline , day @ and day @ ) .


The study was carried out on two separate arms ( PUFAs and placebo ) , according to a randomized , placebo-controlled , double-blind , cross-over design .


The diagnosis of MetS was based on the guidelines of Adult Treatment Panel III definition .


Endothelial function was evaluated by flow-mediated dilation ( FMD ) of the brachial artery .


Carotid-femoral pulse wave velocity ( PWV ) was measured as an index of aortic stiffness .


Serum levels of interleukin-@ ( IL-@ ) and plasminogen activator inhibitor-@ ( PAI-@ ) were measured by ELISA .


Treatment with PUFAs resulted in a significant improvement from day @ to @ and @ in FMD and PWV ( p < @ for all ) .


Nevertheless , treatment with placebo resulted in no significant changes in FMD ( p = @ ) and PWV ( p = @ ) .


Moreover , PUFAs treatment , compared to placebo , decreased IL-@ levels ( p = @ ) and increased PAI-@ levels ( p = @ ) .


Finally , treatment with PUFAs resulted in a significant decrease in fasting triglyceride levels from day @ to @ and @ ( p < @ ) and in serum total cholesterol levels ( p < @ ) .


In subjects with MetS , treatment with omega-@ PUFAs improved endothelial function and arterial stiffness with a parallel antiinflammatory effect .


The optimal management of treatment for patients at intermediate risk of a common duct stone ( including increased liver function tests but bilirubin < @ mg/dL and no cholangitis ) is a matter of debate .


Many stones migrate spontaneously into the duodenum , making preoperative common duct investigations unnecessary .


To compare strategies of cholecystectomy first vs a sequential endoscopic common duct assessment and cholecystectomy for the management of patients with an intermediate risk of a common duct stone .


The main objective was to reduce the length of stay and the secondary objectives were to reduce the number of common duct investigations , morbidity , and costs .


Interventional , randomized clinical trial with @ parallel groups performed between June @ and February @ , with a patient follow-up of @ months .


The trial comprised a random sample of @ adult patients admitted to Geneva University Hospital , Geneva , Switzerland , for acute gallstone-related conditions with an intermediate risk of a common duct stone .


Fifty patients were randomized to each group .


Cholecystectomy first with intraoperative cholangiogram for the study group and endoscopic common duct assessment and clearance followed by cholecystectomy for the control group .


Length of initial hospital stay ( primary end point ) , number of common duct investigations and morbidity and mortality within @ months after initial admission , and quality of life at @ and @ months after discharge ( EQ-@D-@L -LSB- EuroQol Group , @-level -RSB- questionnaire ) .


Patients who underwent cholecystectomy as a first step had a significantly shorter length of hospital stay ( median , @ days -LSB- interquartile range -LCB- IQR -RCB- , @-@ -RSB- vs median , @ days -LSB- IQR , @-@ -RSB- ; P < @ ) , with fewer common duct investigations ( @ vs @ ; P < @ ) , no significant difference in morbidity or quality of life .


Among patients at intermediate risk of a common duct stone , initial cholecystectomy compared with sequential common duct endoscopy assessment and subsequent surgery resulted in a shorter length of stay without increased morbidity .


If these findings are confirmed , initial cholecystectomy with intraoperative cholangiogram may be a preferred approach .


To compare the safety of a single-piece , foldable intraocular lens ( IOL ) hydroimplantation with that of a standard implantation using an ophthalmic viscosurgical device ( OVD ) .


One hundred consecutive patients with bilateral age-related cataract surgery were enrolled into a prospective double-blind study .


Each patient 's first eye was randomly assigned to a standard implantation technique with an OVD or the hydroimplantation technique , while the fellow eye received the opposite technique .


The main outcomes measured were endothelial cell loss , postoperative changes of intraocular pressure ( IOP ) , and the frequency of complications .


The reduction of endothelial cell density @ month and @ months after the surgery was @ % @ % , @ % @ % , respectively , in group A ( OVD ) and @ % @ % , @ % @ % , respectively , in group B ( hydroimplantation ) .


The differences were not statistically significant .


The mean IOP @ hours after surgery was @ @ mm Hg in group A and @ @ mm Hg in group B. Twenty-four hours and @ month after surgery , the mean IOP was @ @ mm Hg and @ @ mm Hg , respectively , in group A , and @ @ mm Hg and @ @ mm Hg , respectively , in group B.


The differences between groups A and B were not statistically significant .


The hydroimplantation technique is a safe technique for single-piece foldable IOL implantation .


There was no increase in intraoperative and postoperative complications compared with the standard implantation technique using an OVD .


This study aimed to investigate how the organic cation transporter @ nucleotide polymorphism at site @ ( G T ) affects metformin pharmacokinetics and its long-term anti-diabetic effect .


A total of @ newly diagnosed type @ diabetes patients taking oral metformin were recruited , genotyped and then divided into three groups by SLC@A@ genotypes ( G/G , G/T , T/T ) .


Nine patients in the GG genotype group , five patients in the GT genotype group and four patients in the TT genotype group were randomly selected for the metformin pharmacokinetic study .


A randomized cohort study with @-year follow-up was performed to clarify the metformin pharmacodynamics .


After @ year , the decrease in glycosylated hemoglobin ( HbA@c ) levels in subjects with the heterozygous variant genotype ( GT ) was significantly greater than in those with the wild-type homozygote ( -@ % in GT vs. -@ % in GG , P < @ ) after adjustment for baseline HbA@c levels , exercise and diet in each group .


There were also differences in the pharmacokinetic parameters ( @ % confidence interval ) of metformin between these two groups -LSB- area under the concentration-time curve ( AUC ) @ - @ ( @-@ @ ) vs. @ ( @-@ @ ) g h/L ; renal clearance ( CLr ) @ ( @-@ @ ) vs. @ ( @-@ @ ) L/h ; tubular secretion clearance ( CLt ) @ ( @-@ @ ) vs. @ ( @-@ @ ) L/h ; all P < @ -RSB- .


Multivariate analysis further revealed that the presence of T alleles and gender were independent influencing factors of urine excretion of metformin ( P < @ ) .


As well as gender , the glucose-lowering efficiency of metformin can be enhanced by SLC@A@ @G > T variants through the delay of its transportation and CLr in Chinese type @ diabetes populations .


Electronic cigarettes ( e-cigarettes ) have been reported to reduce tobacco craving and withdrawal ; however , the mechanisms underlying these effects have not been elucidated .


This study examined the contributions of nicotine stimulus and response expectancies to responses to nicotine-free e-cigarettes in @ e-cigarette nave smokers ( @ male ) .


Participants completed two randomized experimental sessions in which they administered a nicotine-free e-cigarette .


During one session they were informed that the e-cigarette contained nicotine and during the other session they were informed that the e-cigarette was nicotine-free .


Participants completed subjective assessments before and immediately after sampling ten puffs from the e-cigarette and were then invited to earn additional puffs using a computerized progressive ratio task .


Prior to their enrolment in the study , participants provided an estimate of the relative importance of the nicotine content of e-cigarettes for craving relief .


Instructions that the e-cigarette contained nicotine were found to reduce both intention to smoke ( p = @ ) and withdrawal-related ( p = @ ) craving , regardless of a-priori reported beliefs regarding the relative importance of nicotine .


Nicotine content instructions were also found to be associated with a shorter latency to self-administration ( p = @ ) ; however , a SexInstructionsResponse Expectancy interaction ( p = @ ) revealed that this effect was specific to women who had strong a-priori nicotine content craving relief expectations .


Neither nicotine content instructions nor response expectancies impacted the number of puffs self-administered .


Findings suggest that nicotine content expectations contribute to smokers ' responses to e-cigarettes , and that a-priori beliefs about nicotine effects may be especially important in women .


Gastric intestinal metaplasia ( GIM ) is associated with a risk for development of intestinal-type gastric cancer .


This study aimed to compare the diagnostic yield of GIM from confocal laser endomicroscopy ( CLE ) and white light endoscopy ( WLE ) .


In a prospective , double-blind , randomized study , patients were randomly assigned to receive either CLE with targeted biopsies ( group A ) or WLE with a standard biopsy protocol ( group B ) .


A total of @ patients were finally analyzed ( group A @ , group B @ ) .


On a per-patient analysis , the diagnostic yields of GIM ( including GIM with gastric intraepithelial neoplasia -LSB- GIN -RSB- ) for groups A and B were @ % and @ % , respectively ( P = @ ) .


On a per-biopsy analysis , CLE-targeted biopsy gave a significantly higher diagnostic yield of GIM compared with WLE and standard biopsy , at @ % ( @/@ biopsies ) versus @ % ( @/@ biopsies ) ( P < @ ) .


Moreover , the diagnostic yield of the operative link on gastric intestinal metaplasia ( OLGIM ) assessment stages III and IV was higher at @ % ( @/@ biopsies ) in group A versus @ % ( @/@ biopsies ) in group B ( P < @ ) .


In addition , use of CLE-guided biopsy significantly decreased by @ % ( P < @ ) the mean number of biopsies required per patient .


CLE with targeted biopsies is superior to WLE with standard biopsies for the detection and surveillance of GIM .


The number of biopsies needed to confirm GIM is about one third of that needed with WLE with standard biopsies .


To assess whether outpatient cervical ripening at @@/@ weeks of gestation with the nitric oxide donor isosorbide mononitrate reduces cesarean delivery rates in nulliparous women with an unfavorable cervix .


We recruited nulliparous pregnant women with a Bishop score less than @ in a randomized , multicenter , double-blind , placebo-controlled trial .


Women received @ mg vaginal isosorbide mononitrate or a placebo at @@/@ , @@/@ , and @@/@ weeks of gestation .


They returned home between visits .


At @@/@ weeks of gestation , for women who had not yet given birth , labor was induced with oxytocin or prostaglandins , depending on cervical status .


We needed @ women per group to detect a @ % reduction in the cesarean delivery rate , the primary outcome measure , from @ % in the placebo group to @ % in the isosorbide mononitrate group ( @ - = @ , = @ , two-sided ) .


The NOCETER ( NO donors for reduction of CEsareans at TERm ) trial was a negative study .


The cesarean delivery rate was @ % ( @/@ ) in the isosorbide mononitrate group and @ % ( @/@ ) in the placebo group ( relative risk @ , @ % confidence interval -LSB- CI -RSB- @-@ @ ) .


None of the maternal secondary efficacy outcomes differed between groups .


Side effects were more common among women receiving isosorbide mononitrate than in the placebo group ( @ % -LSB- @/@ -RSB- compared with @ % -LSB- @/@ -RSB- , relative risk @ , @ % CI @-@ @ ) .


Composite perinatal morbidity did not differ between groups .


Outpatient cervical ripening with vaginal isosorbide mononitrate for prolonged pregnancy in nulliparous women does not reduce cesarean delivery rate .


Activated Protein C ( APC ) stimulates multiple cytoprotective pathways via the protease activated receptor-@ ( PAR-@ ) and promotes anticoagulation .


@K@A-APC was designed for preserved activity at PAR-@ with reduced anticoagulation .


This Phase @ trial characterized pharmacokinetics and anticoagulation effects of @K@A-APC .


Subjects ( n = @ ) were randomly assigned to receive @K@A-APC ( n = @ ) at @ , @ , @ , @ , @ , @ or @ g/kg or placebo ( n = @ ) and were observed for @ hr .


After safety review additional subjects received drug every @ hr for @ doses ( n = @ per group ) at @ , @ , @ , or @ g/kg or placebo ( n = @ ) and were observed for @ hr .


All subjects returned for safety assessments at @ hours and @ days .


We found few adverse events in all groups .


Systolic blood pressure increased in both active and placebo groups .


Moderately severe headache , nausea and vomiting were reported in one of two subjects treated with @ g/kg so @ g/kg was considered the highest tolerated dose .


Mean plasma concentrations increased in proportion to dose .


Clearance ranged from @,@ @ to @,@ @,@ mL/hr , volume of distribution ranged from @,@ to @,@ @,@ mL , and elimination half-life ranged from @ @ to @ @ hours .


Elevations in aPTT were minimal .


@K@A-APC was well tolerated at multiple doses as high as @ g/kg .


These results should be confirmed in stroke patients with relevant co-morbidities .


Clinical Trial Registration-URL : http://www.clinicaltrials.gov .


Unique identifier : NCT@ .


To evaluate the effect of warm ophthalmic viscosurgical devices ( OVDs ) on the unfolding time of prehydrated hydrophobic acrylic intraocular lenses ( IOLs ) .


Experimental study and human trial .


Three foldable hydrophobic acrylic IOLs ( enVista MX@ , AcrySof SN@AT , and Tecnis @ ZCB@ ) .


The unfolding times of @ kinds of IOLs were measured according to temperature from @C to @C in a transparent container filled with a mixture of OVDs and balanced salt solution .


The unfolding time of each IOL was measured @ times for each temperature .


Unfolding time was defined as the time required for the folded IOL to recover @ % of its overall optic diameter before folding .


In human trials , the unfolding time of the MX@ in a capsular bag filled with @C OVDs was compared with that filled with room temperature OVDs for @ cases in each group .


The unfolding time of the MX@ ( @ @ seconds ) was significantly longer than that of the SN@AT ( @ @ seconds ) and the ZCB@ ( @ @ seconds ) at @C ( p = @ ) .


However , there were no differences in the unfolding time of @ IOLs at @C .


In human trials , the unfolding time of the MX@ was shorter in a capsular bag filled with @C OVDs ( @ @ seconds ) than if filled with OVDs kept at room temperature ( @ @ seconds ; p = @ ) .


When fast and complete unfolding characteristics are needed , filling the anterior chamber and capsular bag with OVDs warmed to @C before IOL implantation is recommended .


Panic disorder with or without agoraphobia is a commonly occurring disorder affecting @ to @ % of the population in Sweden .


Untreated , panic disorder is a chronic condition that significantly increases the risk for psychiatric comorbidity , morbidity and mortality , employment difficulties , and healthcare utilization .


Cognitive behavioral approaches are the recommended first-line treatment for panic disorder ; however , many patients in routine care receive another evidence-based psychotherapy , including psychodynamic therapy .


Allowing patients to choose among evidence-based approaches to panic disorder may improve outcomes and reduce overall health costs .


Trials comparing the ` gold standard ' treatment for panic disorder to other evidence-based psychotherapies are needed , and also trials that can separate patient preferences for treatment from randomization effects on outcome , disability and healthcare utilization in the longer term .


A phase @/@ doubly-randomized controlled trial carried out in routine care with @ adults ( aged @ to @ years ) with a primary diagnosis of DSM-IV Panic Disorder ( with or without Agoraphobia ) .


Within each clinic , patients are randomized to self-selection , random assignment of treatment , or wait-list .


Patients choose or are randomly assigned to either Panic Control Treatment or Panic-Focused Psychodynamic Psychotherapy .


Primary outcomes are changes in panic symptom severity , occupational status , and sickness-related absences from work at post-treatment and @ , @ and @ months post-treatment .


Secondary outcomes include changes in agoraphobic avoidance , psychiatric comorbidity , disability , and healthcare utilization .


The study also employs elements of an effectiveness trial as therapist and service-related effects on outcome will be estimated .


Putative change mechanisms for the two treatments are also assessed .


Cognitive behavioral and psychodynamic therapies are both evidence-based approaches that are routinely offered to panic disordered patients in Sweden .


However , little is known about the relative effectiveness of these two approaches for panic/agoraphobia , work-related disability and healthcare utilization over the longer term .


The current trial ( POSE ) also addresses the important but understudied issue of whether patient preference for a particular psychotherapeutic approach moderates outcome .


The sympathetic nervous system plays an important role in the arousal response .


Recently , the stellate ganglion block ( SGB ) was found to effectively treat anxiety and night awakening in humans and decrease electroencephalogram ( EEG ) indices of arousal responses in rat .


But , the role of the sympathetic block in human arousal responses has not yet been studied .


We performed this prospective , double-blinded , controlled volunteer study to investigate the sedative effects and bispectral index ( BIS ) changes of SGB .


A randomized , double-blind trial .


Single academic medical center .


This study was approved by the Ethics Committee of Kyungpook National University Hospital ( ref : KNUH-@-@ ) and registered with CRiS ( Clinical Research Information Service , http://cris.cdc.go.kr , ref : KCT@ , @ ) .


Twenty healthy volunteers were enrolled in this study .


The volunteers were randomly assigned to one of @ groups : the SGB group ( n = @ ) and the sham group ( n = @ ) .


Volunteers in SGB group received SGB and volunteers in the sham group received a sham procedure .


BIS value , heart rate , and blood pressure were measured before and @ , @ , @ , and @ minutes after the procedure .


Observer 's Assessment of Alertness/Sedation ( OAA/S ) scores were assessed before and @ and @ minutes after the intervention .


In the SGB group , BIS values and OAA/S scores significantly decreased after the intervention as compared to baseline ( P < @ ) .


The values were also significantly decreased in the SGB group when compared to the values in sham group after the intervention ( P < @ ) .


There was a significant change of mean blood pressure @ to @ minutes after SGB ( P < @ ) .


There were no differences in heart rate during study period between groups .


This study is limited by a relatively small sample size .


This study showed that SGB has a sedative effect in normal healthy volunteers , as evidenced by decreased OAA/S scores and BIS values .


Despite the reported widespread use of herbal medicines globally and their benefits , they are not completely without potential to cause harm .


The haphazard , irresponsible or non-regulated use of several herbal medicines may put the health of their users at risk of toxicity .


This study aimed to assess the general perception of the safety and occurrence of adverse effects of herbal medicines among residents of Ikorodu in Lagos , Nigeria .


The study population included @ randomly selected and consented residents in Ikorodu .


Data was collected using a standard closed and open-ended structured questionnaire with three ( @ ) sections on socio-demography , safety and adverse effects of herbal medicines .


Associations between the variables were determined using Chi square analysis .


The results showed that @ respondents ( @ % ) believed that herbal medicines are safe for use and only @ ( @ % ) held the view that they may not be safe .


RESULTS also show that @ ( @ % ) of respondents had experienced adverse effects while @ ( @ % ) said they had never experienced adverse effects from the use of herbal medicines .


Herbal medicine is popular among the respondents but they appear to be ignorant of its potential toxicities .


It may be necessary to educate the consumers of herbal medicines on the potentials for herbs-drugs interaction and adverse effects specially as a result of indiscriminate and unguided use of herbal medicines .


To identify risk factors for early hospital readmission in low-income community-dwelling older adults .


Prospective cohort study .


University-affiliated urban safety-net healthcare system in Indianapolis , Indiana .


Community-dwelling adults aged @ and older with annual income less than @ % of the federal poverty level and enrolled in the Geriatric Resources for Assessment and Care of Elders ( GRACE ) randomized controlled trial ( N = @ ) .


Participant health and functional status at baseline and @ , @ , @ , and @ months .


Early readmission was defined as a repeat hospitalization occurring within @ days of a prior hospital discharge .


Candidate risk factors included sociodemographic characteristics , health and functional status , prior care , lifestyle , and satisfaction with care .


Of @ index admissions in @ participants , @ ( @ % ) were followed by an early readmission .


The independent risk factors for early readmission identified according to regression analysis were living alone ( odds ratio ( OR ) = @ , @ % confidence interval ( CI ) = @-@ @ ) , fair or poor satisfaction with primary care physician ( OR = @ , @ % CI = @-@ @ ) , not having Medicaid ( OR = @ , @ % CI = @-@ @ ) , receiving a new assistive device in the past @ months ( OR = @ , @ % CI = @-@ @ ) , and staying in a nursing home in the past @ months ( OR = @ , @ % CI = @-@ @ ) .


Age , race , sex , education , and chronic diseases were not associated with early readmission .


A broad range of nonmedical risk factors played a greater role than previously recognized in early hospital readmission of low-income seniors .


Gonadotropin therapy using a human chorionic gonadotropin ( hCG ) and FSH preparation is an effective regimen in inducing masculinization and spermatogenesis in men with idiopathic hypogonadotropic hypogonadism ( IHH ) .


However , the high cost of medication and frequent injections affect compliance .


The aim of this study was to determine the efficacy of sequential use of highly purified urinary FSH ( uFSH ) / hCG in men with IHH .


A randomized , open-label , prospective , controlled noninferiority trial with an @-month follow-up was conducted in @ tertiary hospitals .


A total of @ Chinese men with IHH were randomly allocated into group A receiving continual uFSH ( @ U , @ times a week ) and hCG ( @ U , twice a week ) injection and group B receiving sequential uFSH ( @ U , @ times a week every other @ months ) and hCG ( @ U , twice a week ) injection .


The primary outcome was the proportion of subjects with a sperm concentration of @ @ ( @ ) / mL during the @ months .


The efficacy between groups A and B was compared for noninferiority .


Of the patients , @/@ ( @ % ) receiving continual uFSH/hCG and @/@ ( @ % ) receiving sequential uFSH/hCG achieved sperm concentrations of @ @ ( @ ) / mL .


The efficacy in the sequential uFSH/hCG group was not inferior to that in the continual uFSH/hCG group ( noninferiority , P = @ ) by intention-to-treat analysis .


The efficacy of the sequential uFSH/hCG regimen is not inferior to that of the continual uFSH/hCG regimen in inducing spermatogenesis and masculinization of patients with IHH .


There was no standard treatment for hepatocellular carcinoma with portal vein tumour thrombosis ( PVTT ) .


This prospective , randomised , two-arm clinical trial aims to investigate the feasibility , safety and effectiveness of transarterial chemoembolisation ( TACE ) combined with the endovascular implantation of an iodine-@ seed strand for the treatment of hepatocellular carcinoma with portal vein tumour thrombosis versus conventional TACE .


Eighty-five patients who met the eligibility requirements were randomly assigned to receive the treatment of TACE combined with the endovascular implantation of an iodine-@ seed strand ( @ cases ) or conventional TACE ( @ cases ) .


The end points were survival time , complications related to the procedure and adverse events .


No significant differences in baseline characteristics were observed between groups .


The mean and median survival times were @ @ days -LSB- @ % confidence interval ( CI ) @-@ @ days -RSB- and @ @ days ( @ % CI @-@ @ days ) in group A and @ @ days ( @ % CI @-@ @ days ) and @ @ days ( @ % CI @-@ @ days ) in group B ( P = @ ) .


The @ - , @ - and @-day cumulative survival rates were @ , @ and @ % in group A and @ , @ and @ % in group B ( P = @ ) .


Transarterial chemoembolisation combined with the endovascular implantation of an iodine-@ seed strand is feasible , safe and effective in the treatment for hepatocellular carcinoma with PVTT .


To compare the effectiveness of two different techniques to lift the maxillary sinus via a crestal approach : the Summers versus the Cosci technique .


Fifteen partially edentulous patients missing bilaterally maxillary molars and / or premolars , having @ to @ mm of residual crestal height and at least @ mm thickness below the maxillary sinuses measured on CT scans , were randomised to have implants placed in sinuses crestally lifted according to the Cosci or the Summers techniques , with bone substitutes according to a split-mouth design .


Implants were left to heal submerged for @ months .


Implants were loaded with acrylic provisional crowns/prostheses .


Screw-retained definitive metal-ceramic prostheses were delivered @ months after provisional loading .


Outcome measures were : prosthesis and implant failures ; any complications ; operation time ; operator preference ; patient preference and peri-implant marginal bone level changes assessed by a blinded outcome assessor .


All patients were followed to @ years after implant loading .


Nineteen study implants were placed according to each technique .


Three years after loading , @ patients dropped out and no implant failed .


No discomfort/complications occurred at sites treated with the Cosci technique , whereas @ patients reported discomfort during the augmentation procedure at the side treated with the Summers technique ; this was statistically significant ( P = @ ) .


In one of these patients , a perforation of the sinus membrane occurred .


Postoperatively , headache was reported by @ patients and swelling occurred in @ of these patients at the Summers treated sides .


Statistically significant less time ( @ mins , SD = @ , P < @ , @ % CI -@ to -@ ) was required to place implants according to the Cosci technique ( @ versus @ mins on average ) .


The @ operators and @ out of @ patients preferred the Cosci technique @ month after surgery ( P = @ ) , and @ year after surgery ( @ out of @ patients , P = @ ) .


The ceramic layer of one prosthesis of the Summers ' group and one abutment screw of the Cosci 's group loosened between @ to @ years post-loading .


After @ years , implants inserted according to the Cosci technique lost @ mm of peri-implant bone versus @ mm for the implants placed with the Summers technique .


There were no statistically significant differences for marginal bone level changes between the two groups ( difference @ mm , @ % CI -@ to @ , P = @ ) .


Both crestal sinus lift techniques produced successful results over a @-year follow-up period , but the Cosci technique required less surgical time , determined less intra - and postoperative morbidity and was preferred by patients .


Conflict of interest statement : This was an investigator-initiated trial , however the trial was partially supported by Zimmer Dental Italy , Vittorio Veneto ( TV ) , Italy .


One of the authors ( Dr Cosci ) , who treated @ patients in this study , is the inventor of the Cosci technique and his partipation was a prerequisite of the sponsor to support the trial .


To study the effect of blood activating water relieving method ( BAWRM ) on heart functions and serum levels of NT-proBNP in patients with heart failure with normal ejection fraction ( HFNEF ) .


Sixty-four HFNEF patients were admitted to our hospital during January @ to June @ .


They were randomly assigned to the treatment group ( @ cases ) and the control group ( @ cases ) .


Patients in the control group received routine Western medical treatment , while those in the treatment group additionally took Chinese medical recipes for activating blood circulation and relieving water retention .


Changes of Chinese medical syndromes , E/E ' , serum NT-proBNP contents were observed between the two groups .


Compared with before treatment , their Chinese medical syndromes and E/E ' were significantly improved , and serum NT-proBNP contents decreased in the two groups ( P < @ ) .


Compared with the control group , Chinese medical syndromes , E/E ' , serum NT-proBNP contents obviously decreased in the treatment group , showing statistical difference ( P < @ ) .


BAWRM was an effective way to improve the diastolic function of HFNEF patients and lower the serum level of NT-proBNP with confirmative efficacy .


This study aimed to implement a point-of-care cluster randomized trial using electronic health records .


We evaluated the effectiveness of electronically delivered decision support tools at reducing antibiotic prescribing for respiratory tract infections in primary care .


Family practices from England and Scotland participating in the Clinical Practice Research Datalink ( CPRD ) were included in the trial ; @ family practices were allocated to intervention and @ practices were allocated to usual care .


Patients aged @ to @ years consulting for respiratory tract infections were eligible .


The intervention was through remotely installed , computer-delivered decision support tools accessed during the consultations .


Control practices provided usual care .


The primary outcome was the proportion of consultations for respiratory tract infections with an antibiotic prescribed based on electronic health records .


Family practice-specific proportions were included in a cluster-level analysis .


Data were analyzed for @,@ patients : @,@ at intervention practices and @,@ at control practices .


Use of the intervention was less than anticipated , varying among practices .


There was a reduction in proportion of consultations with antibiotics prescribed of @ % ( @ % CI , @ % -@ % , P = @ ) and in the rate of antibiotic prescribing for respiratory tract infections ( @ % ; @ % CI , @ % -@ % , fewer prescriptions per @,@ patient-years , P = @ ) .


There were no adverse events .


Cluster randomized trials may be implemented efficiently in large samples from routine care settings by using primary care electronic health records .


Future studies should develop and test multicomponent methods for remotely delivered intervention .


to compare the biological efficacy of generic enoxaparin ( HeptronTM ) versus branded Sanofi-Aventis enoxaparin for prophylaxis and treatment of lower-extremity deep venous thrombosis ( DVT ) in a prospective , randomized , open-label study .


patients with diagnosed lower-extremity DVT ( therapeutic branch , n = @ ) and patients requiring venous thromboembolism ( VTE ) prophylaxis after arterial vascular surgery or major lower-extremity amputations ( prophylactic branch , n = @ ) were randomized to receive generic or branded enoxaparin for up to seven days .


Enoxaparin activity was measured by estimating blood anti-factor Xa levels at the peak plasma concentration .


As secondary outcomes , development or progression of VTE events , major adverse events and major bleeding events were considered for efficacy and safety comparisons .


DVT therapy : twenty-five patients received generic enoxaparin while @ received branded enoxaparin ( subcutaneous , @ mg/kg BID ) .


Mean percentages of anti-factor Xa levels within the target ranges were @ @ % and @ @ % , respectively ( p = @ for non-inferiority ) .


No patient presented DVT progression , clinically detectable pulmonary embolism , or major bleeding events in any subgroup .


DVT prophylaxis : Thirty patients received generic enoxaparin and @ received branded enoxaparin ( subcutaneous , @ mg/day ) .


There were no cases of VTE or major bleeding events in any subgroup .


generic and branded enoxaparins exhibited similar in vivo responses as measured by the anti-factor Xa activity , as well as similar clinical efficacy and safety outcomes .


Kidney function gradually decreases with age , and myocardial infarction accelerates this deterioration .


Omega-@ ( n-@ ) fatty acids may slow down the decline of kidney function .


The effect of marine and plant-derived n-@ fatty acids on kidney function in patients after myocardial infarction was examined .


In the Alpha Omega Trial , @ patients with history of myocardial infarction ages @-@ years old ( @ % men ) were randomized to one of four trial margarines .


The patients received an additional targeted amount of @ mg/d eicosapentaenoic acid and docosahexaenoic acid , @ g/d - linolenic acid , eicosapentaenoic acid-docosahexaenoic acid plus - linolenic acid , or placebo for @ months .


Serum cystatin C and serum creatinine were assessed at baseline and after @ months .


Creatinine-cystatin C-based GFR was estimated with the Chronic Kidney Disease Epidemiology Collaboration equation .


Patients consumed @ g margarine/d , providing an additional @ mg/d eicosapentaenoic acid with @ mg/d docosahexaenoic acid , @ g/d - linolenic acid , or both in the active treatment groups .


After @ months , compared with baseline , mean ( SD ) creatinine-cystatin C-based GFR was -@ ( @ ) , -@ ( @ ) , -@ ( @ ) , and -@ ( @ ) ml/min per @ m ( @ ) in the placebo , eicosapentaenoic acid-docosahexaenoic acid , - linolenic acid , and eicosapentaenoic acid-docosahexaenoic acid plus - linolenic acid groups , respectively .


After @ months , in patients receiving eicosapentaenoic acid-docosahexaenoic acid compared with placebo , the decline in creatinine-cystatin C-based GFR was @ less ( @ % confidence interval , @ to @ ; P < @ ) ml/min per @ m ( @ ) ; other comparisons were not statistical significant .


Odds ratios ( @ % confidence intervals ) of incident CKD ( < @ ml/min per @ m ( @ ) ) and rapid decline of kidney function ( @ ml/min per year ) for eicosapentaenoic acid-docosahexaenoic acid compared with placebo were @ ( @ to @ ) and @ ( @ to @ ) , respectively .


Long-term supplementation with @ mg/d eicosapentaenoic acid-docosahexaenoic acid provides a small beneficial effect on kidney function in patients with a history of myocardial infarction .


Many service members do not seek care for mental health and addiction problems , often with serious consequences for them , their families , and their communities .


This study tested the effectiveness of a brief , telephone-based , cognitive-behavioral intervention designed to improve treatment engagement among returning service members who screened positive for posttraumatic stress disorder ( PTSD ) .


Service members who had served in Operation Enduring Freedom or Operation Iraqi Freedom who screened positive for PTSD but had not engaged in PTSD treatment were recruited ( N = @ ) , randomly assigned to either control or intervention conditions , and administered a baseline interview .


Intervention participants received a brief cognitive-behavioral therapy intervention ; participants in the control condition had access to usual services .


All participants received follow-up phone calls at months @ , @ , and @ to assess symptoms and service utilization .


Participants in both conditions had comparable rates of treatment engagement and PTSD symptom reduction over the course of the six-month trial , but receiving the telephone-based intervention accelerated service utilization ( treatment engagement and number of sessions ) and PTSD symptom reduction .


A one-time brief telephone intervention can engage service members in PTSD treatment earlier than conventional methods and can lead to immediate symptom reduction .


There were no differences at longer-term follow-up , suggesting the need for additional intervention to build upon initial gains .


To evaluate whether dietary intake of luteiin/zeaxanthin and B vitamins is associated with cataract prevalence and incidence .


Clinic-based , baseline cross-sectional and prospective cohort study designs .


Three thousand one hundred fifteen patients ( @ eyes ) enrolled in the Age-Related Eye Disease Study @ to @ years of age followed up for mean of @ years .


Participants completed baseline food frequency questionnaires .


Baseline and annual lens photographs were graded centrally .


Multivariate models controlling for previously identified risk factors for cataracts tested for the association of cataracts with reported dietary intake , using the lowest quintile as reference .


Cataract surgery , cataract status ( type and severity ) at baseline , and development of cataracts .


At baseline , increased dietary riboflavin and B@ were associated inversely with nuclear and cortical lens opacities .


In comparisons of persons with and without cataract , persons with the highest riboflavin intake versus those with the lowest intake had the following associations : mild nuclear cataract : odds ratio ( OR ) , @ ; @ % confidence interval ( CI ) , @-@ @ ; moderate nuclear cataract : OR , @ ; @ % CI , @-@ @ ; and mild cortical cataract : OR , @ ; @ % CI , @-@ @ .


For B@ , the results were : mild nuclear cataract : OR , @ ; @ % CI , @-@ @ ; moderate nuclear cataract : OR , @ ; @ % CI , @-@ @ ; and mild cortical cataract : OR , @ ; @ % CI , @-@ @ .


Highest dietary B@ intake was associated with a decreased risk of moderate nuclear lens opacity developing compared with the lowest quintile ( OR , @ ; @ % CI , @-@ @ ) .


Highest dietary intake levels of niacin and B@ were associated with a decreased risk of development of mild nuclear or mild cortical cataracts in participants not taking Centrum ( Pfizer , New York , NY ) multivitamins .


For participants taking multivitamins during the study , the highest intake of dietary folate was associated with an increased risk of mild posterior subcapsular lens opacity development .


No statistically significant associations were found between lutein plus zeaxanthin intake and presence at baseline or development of nuclear or cortical lens opacity outcomes .


These findings are consistent with earlier studies suggesting that dietary intake of B vitamins may affect the occurrence of age-related lens opacities .


Further investigations are warranted .


Latrodectism is the most important spider envenomation syndrome worldwide .


There remains considerable controversy over antivenom treatment .


We aimed to investigate whether antivenom resulted in resolution of pain and systemic effects in patients with latrodectism who received standardized analgesia .


In a multicenter randomized placebo-controlled trial of redback spider antivenom for latrodectism , @ patients ( > @ years ) with a redback spider bite and severe pain , with or without systemic effects , were randomized to receive normal saline solution ( placebo ) or antivenom after receiving standardized analgesia .


The primary outcome was a clinically significant reduction in pain @ hours after trial medication compared with baseline .


A second primary outcome for the subgroup with systemic features of envenomation was resolution of systemic features at @ hours .


Secondary outcomes were improved pain at @ and @ hours , resolution of systemic features at @ hours , administration of opioid analgesics or unblinded antivenom after @ hours , and adverse reactions .


Two hours after treatment , @ of @ patients ( @ % ) from the placebo arm had a clinically significant improvement in pain versus @ of @ ( @ % ) from the antivenom arm ( difference in favor of antivenom @ % ; @ % confidence interval -@ % to @ % ; P = @ ) .


Systemic effects resolved after @ hours in @ of @ patients ( @ % ) in the placebo arm and @ of @ ( @ % ) in the antivenom arm ( difference @ % ; @ % confidence interval -@ % to @ % ; P = @ ) .


There was no significant difference in any secondary outcome between antivenom and placebo .


Acute systemic hypersensitivity reactions occurred in @ of @ patients ( @ % ) receiving antivenom .


The addition of antivenom to standardized analgesia in patients with latrodectism did not significantly improve pain or systemic effects .


Although screening colonoscopy is effective in preventing distal colon cancers , effectiveness in preventing right-sided colon cancers is less clear .


Previous studies have reported that retroflexion in the right colon improves adenoma detection .


We aimed to determine whether a second withdrawal from the right colon in retroflexion vs. forward view alone leads to the detection of additional adenomas .


Patients undergoing screening or surveillance colonoscopy were invited to participate in a parallel , randomized , controlled trial at two centers .


After cecal intubation , the colonoscope was withdrawn to the hepatic flexure , all visualized polyps removed , and endoscopist confidence recorded on a @-point Likert scale .


Patients were randomized to a second exam of the proximal colon in forward ( FV ) or retroflexion view ( RV ) , and adenoma detection rates ( ADRs ) compared .


Logistic regression analysis was used to evaluate predictors of identifying adenomas on the second withdrawal from the proximal colon .


A total of @ patients ( mean age @ years , @ % female ) were randomly assigned to FV ( N = @ ) or RV ( N = @ ) .


Retroflexion was successful in @ % .


The ADR ( @ % FV and @ % RV ) and numbers of adenomas per patient ( @ FV and @ RV ) were similar ( P = @ for both ) .


At least one additional adenoma was detected on second withdrawal in similar proportions ( @ % FV and @ % RV , P = @ ) .


Predictors of identifying adenomas on the second withdrawal included older age ( odds ratio ( OR ) = @ , @ % confidence interval ( CI ) = @-@ @ ) , adenomas seen on initial withdrawal ( OR = @ , @ % CI = @-@ @ ) , and low endoscopist confidence in quality of first examination of the right colon ( OR = @ , @ % CI = @-@ @ ) .


There were no adverse events .


Retroflexion in the right colon can be safely achieved in the majority of patients undergoing colonoscopy for colorectal cancer screening .


Reexamination of the right colon in either retroflexed or forward view yielded similar , incremental ADRs .


A second exam of the right colon should be strongly considered in patients who have adenomas discovered in the right colon , particularly when endoscopist confidence in the quality of initial examination is low .


Botulinum toxin type A ( BoNT-A ) has been used for almost @ years in cosmetic dermatology to reduce dynamic wrinkles on single or multiple facial areas .


To evaluate the safety and efficacy of full-face treatments with various total doses of abobotulinum toxin A ( ABO ) .


A total of @ participants were enrolled .


Subjects had at least two indications for BoNT-A treatments on each third of the face ( upper , middle and lower ) .


They were randomized into @ groups , with pre-defined total dose range of ABO , varying from @ to @ U.


Most of the subjects were women ( @ % ) .


The statistically significant improvement from baseline lasted for more than @ weeks for glabellar lines , and more than @ weeks for forehead wrinkles and crow 's feet , all P < @ , with no differences between groups .


The most frequent adverse event ( excessive perioral weakness ) was related to high dose in the perioral area .


This is the first study to compare safety and efficacy of different doses of ABO administered to the entire face simultaneously .


As long as the recommended doses are used , concomitant injections of ABO are safe and efficient , with no increase in adverse events .


Because of frequent exposure to tick habitats , outdoor workers are at high risk for tick-borne diseases .


Adherence to National Institute for Occupational Safety and Health-recommended tick bite prevention methods is poor .


A factory-based method for permethrin impregnation of clothing that provides long-lasting insecticidal and repellent activity is commercially available , and studies are needed to assess the long-term effectiveness of this clothing under field conditions .


To evaluate the protective effectiveness of long-lasting permethrin impregnated uniforms among a cohort of North Carolina outdoor workers .


A double-blind RCT was conducted between March @ and September @ .


Subjects included outdoor workers from North Carolina State Divisions of Forestry , Parks and Recreation , and Wildlife who worked in eastern or central North Carolina .


A total of @ volunteer subjects were randomized , and @ and @ subjects completed the first and second years of follow-up , respectively .


Uniforms of participants in the treatment group were factory-impregnated with long-lasting permethrin whereas control group uniforms received a sham treatment .


Participants continued to engage in their usual tick bite prevention activities .


Incidence of work-related tick bites reported on weekly tick bite logs .


Study subjects reported @,@ work-related tick bites over @,@ person-weeks of follow-up .


The mean number of reported tick bites in the year prior to enrollment was similar for both the treatment and control groups , but markedly different during the study period .


In our analysis conducted in @ , the effectiveness of long-lasting permethrin impregnated uniforms for the prevention of work-related tick bites was @ ( @ % CI = @ , @ ) and @ ( @ % CI = -@ , @ ) for the first and second years of follow-up .


These results indicate that long-lasting permethrin impregnated uniforms are highly effective for at least @ year in deterring tick bites in the context of typical tick bite prevention measures employed by outdoor workers .


Natural orifice transluminal endoscopic surgery ( NOTES ) has the potential to reduce postoperative pain .


We compared postoperative pain in the hybrid NOTES procedure transvaginal video-assisted cholecystectomy ( TVC ) with standard conventional laparoscopic cholecystectomy ( CLC ) .


Single-center , double-blind , randomized controlled trial in a level II hospital between June @ and June @ .


Female patients , older than @ years of age with symptomatic cholecystolithiasis were randomized to receive either TVC or CLC .


The follow-up period was @ days and the primary outcome of the study was postoperative pain .


We hypothesized that there is no reduction of pain ( Visual Rating Scale @ ) while resting or coughing over a @-h period after the operation .


Secondary outcome included wound infections , complications , and patient reported outcomes .


Sealed envelopes with computer-generated randomization information were kept for allocation in theater .


All patients received opaque wound dressing , as in standard four-trocar cholecystectomy and a vaginal tamponade .


Theater protocol and surgical notes were kept separate after the procedure .


Overall , @ of @ patients assessed for participation were randomized for either TVC or CLC .


A total of @ patients had a TVC and @ had a CLC .


Five patients were excluded from the analysis .


There was no difference in age , body mass index , American Society of Anesthesiologists ( ASA ) grade , or hospital stay , but anesthetic and surgical times were significantly longer in TVC ( p < @ ) .


There was no statistical difference in postoperative pain between the two groups while resting or coughing .


Complications included conversion to laparotomy , bleeding , wound infections , and re-admission .


No difference in the rate of complications between the two groups was seen .


Overall , @ and @ % of CLC and TVC patients , respectively , would recommend the procedure to other patients .


In this study , no significant difference in pain on days @ and @ postoperatively between the two methods was found .


The safety profile of TVC is comparable to CLC , and TVC patients would generally recommend this procedure to other patients .


To compare the change in iris-trabecular contact ( ITC ) area using swept-source optical coherence tomography ( SS-OCT ) in eyes with primary angle closure glaucoma ( PACG ) and cataract that underwent phacoemulsification ( PE ) with intraocular lens implantation alone compared with PE with goniosynechialysis ( GSL ) .


One eye of @ patients with PACG with peripheral anterior synechiae ( PAS ) detected by indentation gonioscopy was randomised into two groups ( PE alone ( n = @ ) and PE+GSL ( n = @ ) ) .


The anterior chamber angles were evaluated by SS-OCT under dark conditions before and @months after surgery using the three-dimensional angle analysis scan protocol that simultaneously obtains @ cross-sectional radial scans across the anterior chamber at equal intervals ( every @ ) .


The ITC area , defined as the area of extent of the circumferential contact of peripheral iris to the angle wall , was computed automatically by SS-OCT after an observer marked the scleral spurs of all @ scans of each eye .


The majority of the @ subjects were women ( @ % ) and the meanSD age was @ years .


The ITC area was significantly reduced in the PE+GSL group compared with the PE alone group ( @ mm@ vs. @ mm@ , = @ , p = @ ) after adjusting for age , gender , intraocular pressure , extent of PAS and pupil diameter before surgery .


Smaller iris volume at baseline was associated with greater ITC area reduction by PE+GSL ( = -@ , p = @ ) .


Eyes that undergo PE+GSL surgery have a greater reduction in circumferential ITC area than eyes that undergo PE alone .


Prior research supports the hypothesis that cancer survivors who help others face treatment experience a range of psychosocial and health-related benefits as a result of peer helping .


This study investigates an expressive helping ( EH ) intervention designed to harness those benefits by targeting survivorship problems among cancer survivors treated with hematopoietic stem cell transplant .


EH includes two components : ( a ) emotionally expressive writing ( EW ; writing one 's deepest thoughts and feelings about the transplant experience in a series of brief , structured writing sessions ) followed by ( b ) peer helping ( PH ; helping other people prepare for transplant by sharing one 's own transplant experiences along with advice and encouragement through a written narrative ) .


EH was compared with neutral writing ( NW ) , EW ( without PH ) , and PH ( without EW ) in a @-arm randomized controlled trial in which survivors completed baseline measures , @ structured writing exercises ( with instructions depending on randomization ) , and postintervention measures including validated measures of general psychological distress , physical symptoms , and health-related quality of life ( HRQOL ) .


Among survivors with moderate-severe survivorship problems , EH reduced distress ( compared with NW and PH ; ps < @ ) and improved physical symptoms ( compared with NW , PH , and EW ; ps < @ ) and HRQOL ( compared with NW ; p = @ ) .


Peer helping through writing benefits transplant survivors with moderate-severe survivorship problems , but only if they have first completed expressive writing .


The TAXUS Libert Post Approval Study ( TL-PAS ) contributed patients treated with TAXUS Libert paclitaxel-eluting stent and prasugrel to the Dual Antiplatelet Therapy Study ( DAPT ) that compared @ and @ months thienopyridine plus aspirin therapy after drug-eluting stents .


Outcomes for @ TL-PAS patients enrolled into DAPT were assessed .


The DAPT coprimary composite end point ( death , myocardial infarction -LSB- MI -RSB- , or stroke ) was lower with @ compared with @ months prasugrel treatment ( @ % versus @ % ; hazard ratio -LSB- HR -RSB- , @ ; P < @ ) .


Rates of death and stroke were similar between groups , but MI was significantly reduced with prolonged prasugrel treatment ( @ % versus @ % ; HR , @ ; P < @ ) .


The DAPT coprimary end point , stent thrombosis , was also lower with longer therapy ( @ % versus @ % ; HR , @ ; P < @ ) .


MI related to stent thrombosis ( @ % versus @ % ; P < @ ) and occurring spontaneously ( @ % versus @ % ; HR , @ ; P = @ ) were both reduced with prolonged prasugrel .


MI rates increased within @ days of prasugrel cessation after both @ and @ months treatment .


Composite Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries ( GUSTO ) moderate or severe bleeds were modestly increased ( @ % versus @ % ; HR , @ ; P = @ ) but severe bleeds were not more frequent ( @ % versus @ % ; HR , @ ; P = @ ) in the prolonged treatment group .


Prasugrel and aspirin continued for @ months reduced ischemic events for the TAXUS Libert paclitaxel-eluting stent patient subset from DAPT through reductions in MI and stent thrombosis .


Withdrawal of prasugrel was followed by an increase in MI after both @ and @ months therapy .


The optimal duration of dual antiplatelet therapy with prasugrel after TAXUS Libert paclitaxel-eluting stent remains unknown , but appears to be > @ months .


In the cervical spine , the ligamentum flavum ( LF ) is often incompletely fused at the midline .


Therefore , accessing the epidural space ( ES ) using the loss of resistance ( LOR ) technique via the midline approach could be less reliable than the paramedian approach .


Since the tactile sensation of LOR is due to abrupt loss of pressure upon entering the ES , we have compared pressure changes between the @ different cervical epidural techniques .


The aim of this study was to compare pressure changes during the pathway to the cervical ES between the @ approaches .


A prospective , open-labeled , randomized , comparative study .


An interventional pain management practice in a hospital , Republic of Korea .


The @ patients were randomly assigned to either a midline or paramedian group .


The pressure changes were monitored and classified into @ grades according to the following criteria : Grade I.


The pressure waveform sequence consisted of @ components in chronological order : @ ) a high positive pressure just prior to entering the ES ; @ ) an abrupt pressure decrease at the moment of entering the ES ; and @ ) a negative peak pressure before cervical epidural pressure equilibration .


Grade II .


A high positive pressure followed by a precipitous pressure drop , without negative peak pressure upon entering the ES .


Grade III .


High positive pressure before entering the ES , followed by continuous pressure decrease without negative pressure .


Grade IV .


No pressure changes before or after entering the cervical ES .


An abrupt pressure decrease at the moment of exiting the LF or entering the ES was more frequently observed when using the paramedian approach ( P < @ ) with the odds ratio of @ ( @ % CI , @ - @ ) as compared with the midline approach .


A correlation between the abrupt pressure decrease and LOR tactile sensation has been assumed .


Under the assumption that the LOR sensation is due to an abrupt decrease in pressure the moment the needle enters the ES or exits the LF , this study claims that the accuracy of accessing the cervical ES can be improved significantly using the paramedian approach .


To compare the difference in depression relief in the treatment of depressive disorder at the acute stage between the combined therapy of acupuncture and @-HT ( @-hydroxytryptamine ) selective serotonini reuptake inhibitors ( SSRIs ) and the single application of SSRIs and explore the impact on the imbalance of @-HT and TH@/TH@ .


Ninety cases of depressive disorder at the acute stage were randomized into a combined therapy group and a medication group , @ cases in each one .


In the medication group , SSRIs were prescribed forl oral administration , once or twice a day , continuously for @ weeks .


In the combined therapy group , on the basis of treatment as the medication group , acupuncture was combined .


The main acupoints were Baihui ( GV @ ) , Yintang ( GV @ ) , Shenting ( GV @ ) , Fengchi ( GB @ ) , Dazhui ( GV @ ) and Sishencong ( EX-HN @ ) , once every two .


days , continuously for @ weeks .


Before treatment , and after the @st , @nd and @th weeks of treatment , the Hamilton depression scale ( HAMD ) was used to evaluate the depression severity .


Separately , before and after the @ weeks of treatment , the levels of serum @-HT , interleukin-@ beta ( IL-@ ) , interleukin-@ ( IL-@ ) , interleukin-@ ( IL-@ ) and interleukin-@ ( IL-@ ) were determined and compared with those in @ cases of the healthy group .


HAMD score was reduced in the @st , @nd and @th weeks of treatment as compared with that before treatment in the combined therapy group ( all P < @ @ ) .


HAMD score was reduced in the @nd and @th weeks of treatment as compared with that before treatment in the medication group ( all P < @ ) .


HAMD scores in the combined therapy group were lower than those in the medication group in the @st , @nd and @th weeks of treatment ( all P < @ ) .


Before treatment , in the combined therapy group and the medication group , the levels of serum @-HT , IL-@ and IL-@ were all lower than those in the healthy group ( all P < @ ) ; the levels of IL-@ and IL-@ were higher than those in the healthy group ( all P < @ ) .


In the combined therapy group and the medication group , the levels of @-HT , IL-@ and IL-@ in @ weeks of treatment were all increased as compared with those before treatment ( all P < @ ) , and the levels of IL-@ and IL-@ were lower than those before treatment ( all P < @ ) .


In the combined therapy group , the levels of IL-@ and IL-@ in @ weeks of treatment were lower than those in the medication group , and the levels of @-HT , IL-@ and IL-@ were higher than those in the medication group ( P < @ , P < @ ) .


The combined therapy of acupuncture and SSRIs achieves much quicker and more effective re - ' sult for relieving depression in the patients of depressive disorder as compared with simple oral administration of ' SSRIs , and much more contributes to adjust the imbalance of serum @-HT and TH@/TH@ .


To determine whether the use of @-dimensional ( @D ) imaging translates into a better surgical performance of nave urologic laparoscopic surgeons during pyeloplasty ( PY ) and partial nephrectomy ( PN ) procedures .


Eighteen surgeons without any previous laparoscopic experience were randomly assigned to perform PY and PN in a porcine model using initially @-dimensional ( @D ) and @D laparoscopy .


A surgical performance score was rated by an `` expert '' tutor through a modified @-item global rating scale contemplating operative field view , bimanual dexterity , efficiency , tissue handling , and autonomy .


Overall surgical time , complications , subjective perception of participating surgeons , and inconveniences related to the @D vision were recorded .


No difference in terms if operative time was found between @D or @D laparoscopy for both the PY ( P = @ ) and the PN ( P = @ ) procedures .


A better rate in terms of surgical performance score was noted by the tutors when the study participants were using @D vs @D , for both PY ( @ -LSB- @ -RSB- vs @ -LSB- @ -RSB- ; P = @ ) and PN ( @ -LSB- @ -RSB- vs @ -LSB- @ -RSB- ; P = @ ) .


No complications occurred in any of the procedures .


Most ( @ % ) of the participating nave laparoscopic surgeons had the perception that @D laparoscopy was overall easier than @D .


Headache ( @ % ) , nausea ( @ % ) , and visual disturbance ( @ % ) were the most common issues reported by the surgeons during @D procedures .


Despite the absence of translation in a shorter operative time , the use of @D technology seems to facilitate the surgical performance of nave surgeons during laparoscopic kidney procedures on a porcine model .


To evaluate the long-term effects of radiofrequency ablation ( RFA ) of renal masses ( RM ) and compare them with surgery .


A total of @ RM ( @ malignant ; mean size @ mm ) in @ patients ( @ male subjects ; average age @ years ) underwent RFA .


Complications and technique effectiveness were evaluated .


Overall survival , cancer-specific survival , and disease-free survival were calculated ( mean follow-up time @ months ) .


Predictors for complications , technique effectiveness , and survival were investigated .


Seventeen ( @ % ) adverse events were recorded ( @ % major complications ) .


Exophytic development and smaller size were protective against adverse events .


Complete ablation was obtained in @ % RM ( @ % @ cm , @ % @ cm ) .


T@a threshold was a positive predictor for complete ablation and central location a negative one .


Three - and @-year overall survival were @ and @ % ; cancer-specific survival @ and @ % ; and disease-free survival @ and @ % .


Considering only the @ patients with newly diagnosed renal cell carcinoma , T@a disease stage resulted a positive predictor for both overall survival ( @ and @ % at @ and @ years ) and cancer-specific survival ( @ % at @ years ) .


RFA of noncentral small RM is safe and effective , and it provides favorable long-term oncological outcomes .


Selection criteria for RFA can also include T@a renal cell carcinoma in patients without surgical contraindications , even though randomized controlled trials are needed to establish the best treatment .


To compare the free-hand ( FH ) technique of placing interlocking screws to a commercially available electromagnetic ( EM ) targeting system in terms of operating time , radiation dose , and accuracy of screw placement .


Between September @ and July @ , we prospectively randomized @ consecutive femur shaft fractures in @ patients requiring intramedullary nails to either FH using fluoroscopy ( n = @ ) or EM targeting ( n = @ ; Sureshot ) .


Single Level @ University Hospital Trauma Center .


The @ groups were assessed for distal locking with respect to time , radiation , and accuracy .


Eight-one fractures had data accurately recorded ( @ EM/@ FH ) .


The average total operative time was @ minutes ( range , @-@ minutes ; SD , @ minutes ) for the FH group and @ minutes ( range , @-@ minutes ; SD , @ minutes ) for the EM group .


The average time for distal locking was @ minutes ( range , @-@ minutes ; SD , @ minutes ) with FH and @ minutes ( range , @-@ minutes ; SD , @ minutes ) with EM .


Average radiation dose for distal locking was significantly less ( P < @ ) for EM at @ Gy ( range , @-@ Gy ; SD , @ Gy ) compared with @ Gy ( range , @-@ Gy ; SD , @ Gy ) for FH .


There were @ misplaced drill bits in FH and @ in EM .


This was not statistically significant ( P = @ ) .


The electromagnetic targeting device ( Sureshot ) significantly reduced radiation exposure during placement of distal interlocking screws , without sacrificing operative time , and was equivalent in accuracy when compared with the FH technique .


Therapeutic level II .


The resin-based pit and fissure sealant is considered a successful tool in caries prevention , however there is a growing evidence of its use in controlling already established caries in posterior teeth .


The aim of this clinical trial is to verify the efficacy of pit and fissure sealants in arresting dentinal caries lesions compared to partial excavation and restorative treatment in primary molar teeth .


Thirty six patients with occlusal cavitated primary molar reaching outer half of dentin were selected .


The patients were randomly allocated into two groups : sealant application ( experimental group - n = @ ) and restoration with composite resin ( control group - n = @ ) .


Clinical and radiograph evaluation were performed after @ , @ and @ months .


The chi-square test was used to verify the distribution of characteristics variables of the sample among the groups .


The survival rate of treatments was evaluated using Kaplan-Meier survival and log-rank test .


Fisher 's Exact and logistic regression tests were calculated in each evaluation period ( = @ % ) .


The control group showed significantly better clinical survival after @ months ( p = @ ) .


In both groups , no caries progression was registered on the radiographic evaluations .


Sealing had similar efficacy in the arrestment of caries progression of cavitated occlusal lesions compared to partial excavation of the lesions , even though the frequency of re-treatments was significantly higher in sealed lesions .


A previous randomised controlled trial that investigated Assertive Community Treatment ( ACT ) in the UK ( the REACT Study ) found no clinical advantage over usual care delivered by Community Mental Health Teams ( CMHTs ) at @ and @ month follow-ups .


No studies have investigated long term clinical and social outcomes for patients receiving ACT .


We investigated inpatient service use , social outcomes , service contact and adverse events for the @ REACT study participants @ years after randomisation through case note review .


Data were analysed using regression models adjusted for original treatment group allocation and changes in treatment group .


We found no statistically significant differences in outcomes by original treatment group over the @ years .


Those whose care remained with ACT , or transferred to ACT or forensic services , had more inpatient days over the @ years ( coefficient @ , @ % CI @ to @ , p = @ ) than those whose care remained with the CMHTs or were discharged to primary care .


Being subject to a Community Treatment Order was associated with a greater chance of being under ACT at @ year follow-up ( OR @ , @ % CI @ to @ , p < @ ) .


The ACT teams in this study showed no clinical advantage over usual care provided by CMHTs at @ year follow-up .


We also found that the ACT teams accrued patients from the original study sample who had more complex needs than those who remained with or transferred to the CMHTs or primary care during this period .


Further well conducted trials are needed to identify the most cost-effective approaches to supporting successful community living and optimum long term outcomes for this group .


The percentage of older and chronically ill workers is increasing rapidly in the US and in many other countries , but few interventions are available to help employees overcome the workplace challenges of chronic pain and other physical health conditions .


While most workers are eligible for job accommodation and disability compensation benefits , other workplace strategies might improve individual-level coping and problem solving to prevent work disability .


In this study , we hypothesize that an employer-sponsored group intervention program employing self-management principles may improve worker engagement and reduce functional limitation associated with chronic disorders .


In a randomized controlled trial ( RCT ) , workers participating in an employer-sponsored self-management group intervention will be compared with a no-treatment ( wait list ) control condition .


Volunteer employees ( n = @ ) will be recruited from five participating employers and randomly assigned to intervention or control .


Participants in the intervention arm will attend facilitated group workshop sessions at work ( @ hours total ) to explore methods for improving comfort , adjusting work habits , communicating needs effectively , applying systematic problem solving , and dealing with negative thoughts and emotions about work .


Work engagement and work limitation are the principal outcomes .


Secondary outcomes include fatigue , job satisfaction , self-efficacy , turnover intention , sickness absence , and health care utilization .


Measurements will be taken at baseline , @ - , and @-month follow-up .


A process evaluation will be performed alongside the randomized trial .


This study will be most relevant for organizations and occupational settings where some degree of job flexibility , leeway , and decision-making autonomy can be afforded to affected workers .


The study design will provide initial assessment of a novel workplace approach and to understand factors affecting its feasibility and effectiveness .


Asthma exacerbations are commonly precipitated by viral upper respiratory infections ( URIs ) .


Vitamin D insufficiency associates with susceptibility to URI in patients with asthma .


Trials of vitamin D in adults with asthma with incidence of exacerbation and URI as primary outcome are lacking .


To conduct a randomised controlled trial of vitamin D@ supplementation for the prevention of asthma exacerbation and URI ( coprimary outcomes ) .


@ adults with asthma in London , UK were allocated to receive six @-monthly oral doses of @mg vitamin D@ ( n = @ ) or placebo ( n = @ ) over @year .


Secondary outcomes included asthma control test and St George 's Respiratory Questionnaire scores , fractional exhaled nitric oxide and concentrations of inflammatory markers in induced sputum .


Subgroup analyses were performed to determine whether effects of supplementation were modified by baseline vitamin D status or genotype for @ single nucleotide polymorphisms in @ vitamin D pathway genes .


@/@ participants ( @ % ) were vitamin D insufficient at baseline .


Vitamin D@ did not influence time to first severe exacerbation ( adjusted HR @ , @ % CI @ to @ , p = @ ) or first URI ( adjusted HR @ , @ % CI @ to @ , p = @ ) .


No clinically important effect of vitamin D@ was seen on any of the secondary outcomes listed above .


The influence of vitamin D@ on coprimary outcomes was not modified by baseline vitamin D status or genotype .


Bolus-dose vitamin D@ supplementation did not influence time to exacerbation or URI in a population of adults with asthma with a high prevalence of baseline vitamin D insufficiency .


Topiroxostat , a selective xanthine oxidase inhibitor , shows effective reduction in the serum urate level in hyperuricemic patients with or without gout .


The objective of this study was to evaluate the efficacy and safety of topiroxostat in hyperuricemic stage @ chronic kidney disease patients with or without gout .


The study design was a @-week , randomized , multicenter , double-blind study .


The enrolled patients were randomly assigned to treatment with topiroxostat @ mg/day ( n = @ ) or to the placebo ( n = @ ) .


The endpoints were the percent change in the serum urate level , change in the estimated glomerular filtration rate , the urinary albumin-to-creatinine ratio , the proportion of patients with serum urate levels of @ mol/L or less , blood pressure , and serum adiponectin .


After @ weeks , although the changes in the estimated glomerular filtration rate and blood pressure were not significant , the percent change in the serum urate level ( -@ vs. -@ % , P < @ ) and the percent change in urinary albumin-to-creatinine ratio ( -@ vs. -@ % , P = @ ) were found to have decreased in the topiroxostat as compared with the placebo .


Although the incidence of ` alanine aminotransferase increased ' was higher in the topiroxostat , serious adverse event rates were similar in the two groups .


Topiroxostat @ mg effectively reduced the serum urate level in the hyperuricemic stage @ chronic kidney disease patients with or without gout .


The aim of this study was to compare the ligation of the intersphincteric fistula track with the mucosal advancement flap in the treatment of high transsphincteric anal fistulas .


This was a prospective randomized study performed at academic medical centers .


Patients with transsphincteric anal fistulas involving the upper part of anal sphincter were included .


Patients were randomly assigned to either ligation of intersphincteric fistula track or mucosal advancement flap .


The primary end points of the study were fistula closure , recurrence within @ year , and continence by using the Wexner score .


Secondary end points were morbidity , postoperative pain with the use of the visual analog scale , and quality of life with the use of the Cleveland Global Quality of Life score .


There were @ patients ( @ in each group ) .


Mean age was @ years in patients undergoing ligation of the intersphincteric fistula track vs @ years in patients undergoing mucosal advancement flap ( p = @ ) .


Mean visual analog scale after @ week was significantly higher in the mucosal advancement flap group than in the ligation of intersphincteric fistula track group ( @ vs @ , p = @ ) , but no significant difference was found after @ weeks .


Primary healing was achieved in @ patients undergoing ligation of the intersphincteric fistula track vs @ patients undergoing mucosal advancement flap ( p = @ ) .


Mean healing time was @ days in the ligation of intersphincteric fistula track group vs @ days in mucosal advancement flap group ( p = @ ) .


After @ year of follow-up , successful outcome was achieved in @ patients ( @ % ) undergoing ligation of intersphincteric fistula track and in @ patients ( @ % ) undergoing mucosal advancement flap ( p = @ ) .


No significant change in Wexner score occurred @ weeks postoperatively .


There was no significant difference between groups regarding Cleveland Global Quality of Life score ( p = @ and @ after @ and @ weeks ) .


The short-term follow-up is a probable limitation .


Although the sample size was calculated to detect difference with @ % power at a significance level of @ % , the negative result within this relatively small number of patients might have resulted from type II statistical error .


In patients with high transsphincteric anal fistulas , both ligation of intersphincteric fistula track procedure and mucosal advancement flap have a similar long-term healing rate , recurrences , continence , and quality of life .


However , ligation of the intersphincteric fistula track has the advantage of less postoperative pain .


Executive dysfunction and psychomotor slowing in depressed patients have been associated with poor antidepressant clinical response , but little is known about the value of neurocognitive tests for differential prediction of response .


This report presents new findings for @ depressed patients tested on neurocogntive tests before receiving treatment with a SSRI ( escitalopram or citalopram ) , NDRI ( bupropion ) or dual mechanism therapy including a serotonergic agent , and for @ healthy controls .


As predicted from previous research , patients who did not respond to a SSRI or dual therapy showed poorer word fluency than responders , whereas this was not seen for patients treated with bupropion alone .


Longer choice reaction time ( RT ) was also found in nonresponders to a SSRI or dual therapy , but the opposite trend was seen for bupropion .


Using a combined index of word fluency and RT ( with normative performance as a cutoff ) yielded differential predictions of response .


Equal to or above normal performance predicted good response to a SSRI or dual therapy , with high positive predictive value ( @ % ) and specificity ( @ % ) but lower sensitivity ( @ % ) .


In contrast , less than normal performance predicted good response to bupropion alone ( positive predictive value = @ % ; specificity = @ % ; sensitivity = @ % ) .


Relatively small sample size , no placebo control , and combining across SSRI alone and dual treatments .


Although findings are preliminary due to small sample size , brief tests of word fluency and psychomotor speed may help identify depressed patients who are unresponsive to a serotonergic agent , but who may respond to bupropion alone .


Electroencephalogram ( EEG ) based depth of anesthesia algorithms developed in the adult population have not demonstrated the same reliability when applied to infants .


This may be due to frequency changes occurring in the EEG during development .


Amplitude-integrated EEG ( aEEG ) is based primarily in the time domain and hence may have greater utility in infants .


To investigate the relationship between age adjusted Minimal Alveolar Concentration ( MAC ) multiples and aEEG in children under @ years of age .


The aEEG , Spectral Edge Frequency @ % ( SEF@ ) and Bispectral Index ( BIS ) were investigated in a prospective study of children < @ years of age .


After anesthetic induction , and caudal block administration , EEG data were collected simultaneously with BrainZ BRM@ and BIS monitors .


Using a randomized crossover design , children received up to three age adjusted concentrations of sevoflurane : @ , @ and @ MAC .


After @ min of stable anesthetic delivery EEG readings were obtained .


Prediction Probability ( Pk ) and correlation coefficients were calculated for each EEG parameter .


From @ children @ stable anesthetics concentrations were obtained .


For all age groups Pk of aEEG to multiple of age adjusted MAC was < @ indicating a poor predictive power for aEEG .


In contrast for the SEF@ and BIS there was evidence for better predictive properties in children aged between @ months and @ years , with a Pk > @ .


The aEEG is unlikely to be a useful measure of anesthesia depth in young children .


To investigate the impact of early skin-to-skin contact ( SSC ) provided for first @h on incidence of hypothermia in stable newborns weighing @g or more during first @h of life .


Stable newborns ( term and late preterm : Mean gestational age @ ( @ ) weeks , range @-@ weeks ) having birth weight @g or more ( Mean weight @ ( @ ) grams ) were enrolled after approval from Institutional Human Research Ethics Committee ( CTRI/@/@ / @ ) and randomized into early SSC ( intervention group ) and conventional care ( control group ) .


Initial care in the delivery room for few minutes immediately after birth in both the groups was given under radiant warmer .


In the intervention group , newborns were provided SSC by their mother started between @min and @h after birth for first @h with minimal interruption and were provided conventional care other than SSC for next @h of life .


In the control group , newborns were kept with their mother and received conventional care other than SSC for first @h .


Temperature and heart rate of newborns were recorded at @min , @ , @ , @ , @ , @ , @ , @ , @ and at @h of life in both the groups .


Independent Samples t-Test and relative risk were used to analyze the data .


Both groups had @ neonates each with similar baseline characteristics .


Heart rates were in normal range in both the groups .


The intervention group provided an average ( s.d. ) of @ ( @ ) h of SSC over the first @h period .


The mean temperature was significantly high in the SSC group at all time intervals starting from @ to @h ( P < @ for all ) .


In the SSC group only two newborns ( @ % ) had mild hypothermia ( cold stress ) , and , of these two newborns , one had two episodes of hypothermia .


All these three episodes of hypothermia occurred within first @h of life .


In the control group @ newborns ( @ % ) developed hypothermia ( temperature < @ C ) during first @h of life .


Of them , @ newborns had single episode , @ newborns had two episodes and one newborn had three episodes of hypothermia .


Of these @ hypothermic episodes , @ occurred in the first @h of life and @ episodes occurred at @h of life .


Moderate hypothermia was seen in two newborns , whereas rest had mild hypothermia .


The relative risk of developing hypothermia in the control group as compared with the SSC group was @ ( @ % CI @-@ @ ) .


There was no seasonal variation in incidence of hypothermia in both the groups .


Newborns in the SSC group achieved rapid thermal control as compared with the control group .


Early SSC for @h after birth decreases incidence of hypothermia for initial @h of life .


Early SSC needs to be aggressively promoted in term and late-preterm newborns to reduce incidence of hypothermia .


Subacromial impingement is a common cause of shoulder complaints in general practice .


When the initial treatment with acetaminophen and low dose Non Steroidal Anti Inflammatory Drugs fails , triamcinolone acetonide injections are commonly used .


Triamcinolone acetonide injections are effective at four to six weeks .


Little is known about the pain relief effect of triamcinolone acetonide injections in the first days after injection and the effect of repeated injection .


In this study we investigate the effect of triamcinolone acetonide injections compared to hyaluronic acid and NaCl injections using a pain diary .


@ Patients recruited for an RCT comparing the effect of subacromial injections of triamcinolone acetonide , hyaluronic acid and sodium chloride ( NaCl ) were used in this study .


They were blinded for their treatment and could receive up to three injections .


Primary outcome consisted of the patient perceived pain on a VAS score recorded on a daily basis during @ days following injection .


Secondary outcome consisted of the amount of taken escape medication following injection and adverse effects .


All patients received the first injection .


@ patients also received the second and third injections .


@ % Of the paper and pencil pain diaries were returned for data analysis.The triamcinolone acetonide group showed the largest decrease in pain on the VAS scores after injection compared to the hyaluronic acid and NaCl group in the first week after injection .


The reduction in pain was best achieved after the first injection , the second triamcinolone acetonide injection showed a further reduction in pain .


The third triamcinolone acetonide injection only showed a slight improvement in pain reduction .


In this study we could show a booster effect in pain reduction after repeated triamcinolone acetonide injection .


The triamcinolone acetonide group showed a faster reduction in pain after injection compared to the hyaluronic acid and NaCl group .


The effect was best seen after the first and second triamcinolone acetonide injection , it is therefore questionable whether it is necessary to repeat triamcinolone acetonide injections more than two times .


Managing the oxygen saturation of preterm infants to a target range has been the standard of care for a decade .


Changes in target ranges have been shown to significantly impact mortality and morbidity .


Selecting and implementing the optimal target range are complicated not only by issues of training , but also the realities of staffing levels and demands .


The potential for automatic control is becoming a reality .


Results from the evaluation of different systems have been promising and our own experience encouraging .


This study was conducted in two tertiary level newborn nurseries , routinely using an automated FiO@-SpO@ control system ( Avea-CLiO@ , Yorba Linda CA , USA ) .


The aim of this study was to compare the performance of the system as used routinely ( set control range of @-@ % SpO@ ) , to a narrower higher range ( @-@ % ) .


We employed a @-hour cross-over design with the order of control ranges randomly assigned for each of up to three days .


The primary prospectively identified end points were time in the @-@ % SpO@ target range , time at SpO@ extremes and the distribution of the SpO@ exposure .


Twenty-one infants completed the study .


The infants were born with a median EGA of @ weeks and studied at a median age of @ days and weight of @ kg .


Their median FiO@ was @ ; @ were intubated , and the rest noninvasively supported ( @ positive pressure ventilation and @ CPAP ) .


The control in both arms was excellent , and required less than @ manual FiO@ adjustments per day .


There were no differences in the three primary endpoints .


The narrower/higher set control range resulted in tighter control ( IQR @ vs. @ p < @ ) , and less time with the SpO@ between @-@ ( @ % vs. @ % , p = @ ) .


We found that a shift in the median of the set control range of an automated FiO@-SpO@ control system had a proportional effect on the median and distribution of SpO@ exposure .


We found that a dramatic narrowing of the set control range had a disproportionally smaller impact .


Our study points to the potential to optimize SpO@ targeting with an automated control system .


Phambili , the Merck ( MRK ) - Adenovirus Type @ ( Ad@ ) HIV-@ gag/pol/nef subtype B vaccine study , conducted in South Africa , suspended enrollment and vaccination when companion study , Step , was found non-efficacious .


Although the vaccine did not prevent HIV-@ infection or lower viral-load setpoint , immune responses recognized clades B and C HIV-@ subtypes .


We investigated predictors of the vaccine-induced antigen-specific immune responses .


Vaccine-induced immunogenicity was ascertained by interferon - ELISpot assays on the first @ enrolled participants receiving two vaccinations .


Analyses , stratified by study arm/sex , were performed on baseline demographics -LSB- sex , age , Body Mass Index ( BMI ) , site , Adenovirus Type-@ ( Ad@ ) titer , Herpes Simplex Virus Type-@ ( HSV@ ) status , heavy drinking -RSB- .


Multivariate logistic regression determined predictors .


Of the @ participants , @ % ( n = @ ) were female , median BMI was @ -LSB- IQR : @-@ @ -RSB- , @ % ( n = @ ) were Ad@ seropositive , and @ % ( n = @ ) drank heavily .


All vaccine recipients responded to both clade B ( n = @ ; @ % ) and/or C ( n = @ ; @ % ) , p = @ .


In multivariate analysis , female sex -LSB- Adjusted Odds Ratio ( AOR ) : @ ; p = @ -RSB- , overweight/obese BMI ( AOR : @ ; p = @ ) , and heavy drinking ( AOR : @ ; p = @ ) significantly predicted immune response to clade C for any antigens .


A marginally significant predictor of clade C-pol antigen was female sex ( AOR : @ ; p = @ ) .


Sex , BMI , and heavy drinking affected vaccine-induced HIV-@ specific immune responses to clade C antigens .


The role of female sex and overweight/obese BMI boosting and suppressing vaccine-induced HIV-@ specific immune responses , respectively , requires elucidation , including any effect on HIV vaccine efficacy , especially in the era of colliding epidemics ( HIV and obesity ) .


This study was designed to test the effects of different types of influence on the expression of stereotypes towards people who are obese .


It was hypothesized that public social pressure would more significantly impact the expression of stereotypes towards obese people than other types of influence .


One-hundred fifty-eight undergraduate students were randomly assigned to one of three conditions or a control condition .


Participants completed measures of stereotypes towards obese people prior to and after receiving manipulated feedback depicting purported stereotypes possessed by others ( anonymously or publically ) or scientific information about the base rates of these stereotypical traits in the obese population ( i.e. , trait prevalence ) .


Participants also completed a measure of weight bias unrelated to the manipulated feedback .


Explicit beliefs were influenced more when people perceived that others ' views were inconsistent with their own in a public setting than an anonymous setting or when they received trait prevalence feedback .


However , levels of weight bias on a separate measure were unchanged .


Strong , public manipulations of social feedback have great potential to impact , at least , the short-term expression of stereotypes towards obese people .


Ulcerative colitis ( UC ) is a chronic idiopathic inflammatory disease in which reducing pro-inflammatory and/or increasing anti-inflammatory molecules is the mainstay of treatment .


The aim of this study was to evaluate the effects of supplementation with resveratrol as an antiinflammatory and antioxidant agent on inflammation and quality of life in patients with active UC .


In this randomized , double-blind , placebo-controlled study , @ eligible patients with active mild to moderate UC were supplemented with either a @-mg resveratrol or placebo capsule for @ weeks .


Serum inflammatory markers , activity of NF-B in peripheral blood mononuclear cells ( PBMC ) and quality of life were assessed at baseline and at the end of the study .


Resveratrol supplementation led to a significant reduction in plasma levels of TNF - ( @ @ to @ @ pg/mL ) and hs-CRP ( @ @ to @ @ ng/mL ) and activity of NF-B in PBMCs ( @ @ to @ @ OD ) ( p < @ ) , whereas there were no significant changes of these factors in placebo group .


Also , the score of inflammatory bowel disease questionnaire -@ ( IBDQ-@ ) increased , whereas the clinical colitis activity index score decreased significantly in the resveratrol group ( @ @ to @ @ ) ( p < @ ) and when compared with the placebo group ( @ @ to @ @ ) ( p < @ ) .


Our results indicate that @ weeks supplementation with @ mg resveratrol can improve quality of life and disease clinical colitis activity at least partially through inflammation reduction in patients with UC .