The mean number of inappropriate drugs ( STOPP criteria ) was higher at the end of the study in the control than in the intervention group ( @ @ vs @ @ ) , as was the number of residents on @ or more drugs ( @ % vs. @ % ) , using antipsychotics ( @ % vs @ % ) or duplicate medications ( @ % vs @ % ) .


The number of fallers increased in the control group ( from @ % to @ % ) and did not significantly change in the intervention group ( from @ % to @ % ) ; the number of residents with delirium increased in the control group ( from @ % to @ % ) and decreased in the intervention group ( from @ % to @ % ) .


The number of visits to a physician did not change in the control group ( -@ , P = @ ) but were significantly reduced in the intervention group ( -@ , P = @ ) , the same happened with the number of visits to a nurse ( -@ , P = @ in controls , -@ in the intervention group , P < @ ) .


Visits to the emergency room and days in hospital significantly increased in the control group ( +@ and +@ ) but were unchanged in the intervention group ( +@ and +@ ) .


An educational intervention on drug use is feasible in nursing home physicians and improves the use of inappropriate drugs , use of antipsychotics , and drug duplications in their residents .


It may also improve the risk of delirium and falls , and reduce the use of health care resources .


This study investigated the isolated and combined effects of heat -LSB- temperate ( @C/@ % rH ) vs. hot ( @C/@ % rH ) -RSB- and hypoxia -LSB- sea level ( FiO@ @ ) vs. moderate altitude ( FiO@ @ ) -RSB- on exercise capacity and neuromuscular fatigue characteristics .


Eleven physically active subjects cycled to exhaustion at constant workload ( @ % of the power output associated with their maximal oxygen uptake in temperate conditions ) in four different environmental conditions -LSB- temperate/sea level ( control ) , hot/sea level ( hot ) , temperate/moderate altitude ( hypoxia ) and hot/moderate altitude ( hot + hypoxia ) -RSB- .


Torque and electromyography ( EMG ) responses following electrical stimulation of the tibial nerve ( plantar-flexion ; soleus ) were recorded before and @min after exercise .


Time to exhaustion was reduced ( P < @ ) in hot ( -@ % ) or hypoxia ( -@ % ) compared to control ( @min ) , while hot + hypoxia ( -@ % ) further compromised exercise capacity ( P < @ ) .


However , the effect of temperature or altitude on end-exercise core temperature ( P = @ and P = @ , respectively ) and rating of perceived exertion ( P > @ ) did not reach significance .


Maximal voluntary contraction torque , voluntary activation ( twitch interpolation ) and peak twitch torque decreased from pre - to post-exercise ( -@ , -@ and -@ % all trials compounded , respectively ; P < @ ) , with no effect of the temperature or altitude .


M-wave amplitude and root mean square activity were reduced ( P < @ ) in hot compared to temperate conditions , while normalized maximal EMG activity did not change .


Altitude had no effect on any measured parameters .


Moderate hypoxia in combination with heat stress reduces cycling time to exhaustion without modifying neuromuscular fatigue characteristics .


Impaired oxygen delivery or increased cardiovascular strain , increasing relative exercise intensity , may have also contributed to earlier exercise cessation .


To evaluate to what extent a twice daily dose of Transcranial Pulsating ElectroMagnetic Fields ( T-PEMF ) was superior to once daily in patients with treatment-resistant depression as to obtaining symptom remission after @ weeks of augmentation therapy .


A self-treatment set-up of the T-PEMF device was used allowing self-administration by patients in own homes .


All patients were treated for @ min per T-PEMF session .


The antidepressant medication the patients were receiving at baseline remained unchanged during the trial .


The patients were randomised to either one T-PEMF dose ( active dose in the morning and sham in the afternoon ) or two T-PEMF doses ( active dose both morning and afternoon ) in a double-blind procedure .


A score of @ or less on the Hamilton Depression Scale ( HAM-D@ ) was the criterion of remission .


In total @ patients received active T-PEMF once a day and @ patients twice daily .


After @ weeks of therapy remission was obtained in @ % and @ % on one dose and two doses of T-PEMF , respectively .


After @ weeks the rate of remission was @ % and @ % , respectively .


The side effects as measured by the Udvalget for Kliniske Undersgelser scale showed a better toleration of the antidepresssive medication in both treatment groups , which was reflected by the WHO-@ well-being scale with increased scores in both groups of patients .


The high remission rate obtained by the T-PEMF augmentation was not a dose effect ( one versus two daily T-PEMF sessions ) but was explained by the extension of the treatment period from @ to @ weeks .


Broadband ultraviolet A ( BB-UVA ) has been successfully used in the treatment of scleroderma , a UVA@-responsive dermatosis .


To compare the efficacy of BB-UVA versus psoralen + UVA ( PUVA ) in psoriasis treatment and assess apoptosis as an effector mechanism .


This randomized controlled trial included @ patients with chronic plaque psoriasis randomly divided into group I or II .


Group I were further randomized to either IA or IB who received UVA @ or @J/cm ( @ ) per session , respectively , while group II received PUVA .


Therapy was delivered thrice weekly until clearance or @ treatments at most .


The primary outcome measured was clearance of psoriasis .


Dermal lymphocytic counts and bcl-@ expression were measured in @ patients from each group .


Final Psoriasis Area Severity Index scores were reduced within each group .


The UVA group achieved results comparable to PUVA until session @ but failed to match it at final evaluation , with significantly better clinical , immunohistochemical , and histopathological results achieved by PUVA ( P@ @ ) .


Both modalities caused a reduction in dermal lymphocytic counts and epidermal bcl-@ expression .


BB-UVA appears to be safe and acceptable for the treatment of chronic plaque psoriasis possibly through bcl-@-mediated apoptosis of keratinocytes and epidermal lymphocytes .


The public reporting of health outcomes has become one of the most popular topics and is accepted as a quality improvement method in the healthcare field .


However , little research has been conducted on the transparency mechanism , and results are mixed with regard to the evaluation of the effect of public reporting on quality improvement .


The objectives of this trial are to investigate the transparency mechanism and to evaluate the effect of public reporting on prescription at the level of individual participants .


This study involves a cluster randomized controlled trial conducted in @ primary-care facilities ( clusters ) .


Eligible clusters are those facilities with excellent hospital information systems and that have agreed to participate in the trial .


The @ clusters are matched into @ pairs according to Technique for Order Preference by Similarity to Ideal Solution score .


As the unit of randomization , each pair of facilities is assigned at random to a control or an intervention group through coin flipping .


Prescribed ranking information is publicly reported in the intervention group .


The public materials include the posters of individuals and of facilities , the ranking lists of general practitioners , and brochures of patients , which are updated monthly .


The intervention began on @th November @ and lasted for one year .


Specifically , participants are surveyed at five points in time ( baseline , quarterly following the intervention ) through questionnaires , interviews , and observations .


These participants include an average of @ patients , @ general practitioners , @ directors , and @ health bureau administrators .


The primary outcomes are the transparency mechanism model and the changes in medicine-prescribe .


Subsequently , the modifications in the transparency mechanism constructs are evaluated .


The outcomes are measured at the individual participant level , and the professional who analyzes the data is blind to the randomization status .


This study protocol outlines a design that aims to examine the transparency mechanism and to evaluate the effect of public reporting on prescription .


The research design is significant in the field of public policy .


Furthermore , this study intends to fill the gap of the investigation of the transparency mechanism and the evaluation of public reporting on prescription .


New tools are required for the diagnosis of pre-symptomatic leprosy towards further reduction of disease burden and its associated reactions .


To address this need , two new skin test antigens were developed to assess safety and efficacy in human trials .


A Phase I safety trial was first conducted in a non-endemic region for leprosy ( U.S.A. ) .


Healthy non-exposed subjects ( n = @ ) received three titrated doses ( @ g , @ g and @ g ) of MLSA-LAM ( n = @ ) or MLCwA ( n = @ ) and control antigens -LSB- Rees MLSA ( @ g ) and saline -RSB- .


A randomized double blind Phase II safety and efficacy trial followed in an endemic region for leprosy ( Nepal ) , but involved only the @ g ( high dose ) and @ g ( low dose ) of each antigen ; Tuberculin PPD served as a control antigen .


This Phase II safety and efficacy trial consisted of three Stages : Stage A and B studies were an expansion of Phase I involving @ and @ subjects respectively , and Stage C was then conducted in two parts ( high dose and low dose ) , each enrolling @ participants : @ borderline lepromatous/lepromatous ( BL/LL ) leprosy patients , @ borderline tuberculoid/tuberculoid ( BT/TT ) leprosy patients , @ household contacts of leprosy patients ( HC ) , and @ tuberculosis ( TB ) patients .


The primary outcome measure for the skin test was delayed type hypersensitivity induration .


In the small Phase I safety trial , reactions were primarily against the @ g dose of both antigens and Rees control antigen , which were then excluded from subsequent studies .


In the Phase II , Stage A/B ramped-up safety study , @ % of subjects ( @ of @ ) showed induration against the high dose of each antigen , and @ % ( @ of @ ) reacted to the low dose of MLSA-LAM .


Phase II , Stage C safety and initial efficacy trial showed that both antigens at the low dose exhibited low sensitivity at @ % and @ % in BT/TT leprosy patients , but high specificity at @ % and @ % compared to TB patients .


The high dose of both antigens showed lower specificity ( @ % and @ % ) and sensitivity ( @ % and @ % ) .


BL/LL leprosy patients were anergic to the leprosy antigens .


MLSA-LAM and MLCwA at both high ( @ g ) and low ( @ g ) doses were found to be safe for use in humans without known exposure to leprosy and in target populations .


At a sensitivity rate of @-@ % these antigens are not suitable as a skin test for the detection of the early stages of leprosy infection ; however , the degree of specificity is impressive given the presence of cross-reactive antigens in these complex native M. leprae preparations .


Recurrence and toxicity occur commonly among patients with rectal cancer who are treated with @-fluorouracil ( @-FU ) .


The authors hypothesized that genetic variation in folate-metabolizing genes could play a role in interindividual variability .


The objective of the current study was to evaluate the associations between genetic variants in folate-metabolizing genes and clinical outcomes among patients with rectal cancer treated with @-FU .


The authors investigated @ functionally significant polymorphisms in @ genes ( methylenetetrahydrofolate reductase -LSB- MTHFR -RSB- -LSB- C@T , A@C -RSB- , SLC@A@ -LSB- G@A -RSB- , SHMT@ -LSB- C@T -RSB- , dihydrofolate reductase -LSB- DHFR -RSB- -LSB- Del@bp -RSB- , TS @del , and TSER ) involved in folate metabolism in @ patients with TNM stage II or III rectal cancer enrolled in a phase @ adjuvant clinical trial of @ regimens of @-FU and radiotherapy ( INT-@ and SWOG @ ) .


There were no statistically significant associations noted between polymorphisms in any of the genes and overall survival , disease-free survival ( DFS ) , and toxicity in the overall analyses .


Nevertheless , there was a trend toward worse DFS among patients with the variant allele of MTHFR C@T compared with wild-type , particularly in treatment arm @ , in which patients with the MTHFR C@T TT genotype had worse overall survival ( hazards ratio , @ ; @ % confidence interval , @-@ @ -LSB- P = @ -RSB- ) and DFS ( hazards ratio , @ ; @ % confidence interval , @-@ @ -LSB- P = @ -RSB- ) compared with those with homozygous wild-type .


In addition , there was a trend toward reduced hematological toxicity among patients with variants of SLC@A@ G@A in treatment arm @ ( P for trend , @ ) and reduced esophagitis/stomatitis noted among patients with variants of TSER in treatment arm @ ( P for trend , @ ) .


Genetic variability in folate-metabolizing enzymes was found to be associated only to a limited degree with clinical outcomes among patients with rectal cancer treated with @-FU .


Pelvic organ prolapse is common and is strongly associated with childbirth and increasing age .


Women with prolapse are often advised to do pelvic floor muscle exercises , but evidence supporting the benefits of such exercises is scarce .


We aimed to establish the effectiveness of one-to-one individualised pelvic floor muscle training for reducing prolapse symptoms .


We did a parallel-group , multicentre , randomised controlled trial at @ centres in the UK , one in New Zealand , and one in Australia , between June @ , @ , and April @ , @ .


Female outpatients with newly-diagnosed , symptomatic stage I , II , or III prolapse were randomly assigned ( @:@ ) , by remote computer allocation with minimsation , to receive an individualised programme of pelvic floor muscle training or a prolapse lifestyle advice leaflet and no muscle training ( control group ) .


Outcome assessors , and investigators who were gynaecologists at trial sites , were masked to group allocation ; the statistician was masked until after data analysis .


Our primary endpoint was participants ' self-report of prolapse symptoms at @ months .


Analysis was by intention-to-treat analysis .


This trial is registered , number ISRCTN@ .


@ eligible patients were randomised to the intervention group ( n = @ ) or the control group ( n = @ ) .


@ ( @ % ) participants completed follow-up for questionnaires at @ months and @ ( @ % ) for questionnaires at @ months .


Women in the intervention group reported fewer prolapse symptoms ( ie , a significantly greater reduction in the pelvic organ prolapse symptom score -LSB- POP-SS -RSB- ) at @ months than those in the control group ( mean reduction in POP-SS from baseline @ -LSB- SD @ -RSB- vs @ -LSB- @ -RSB- ; adjusted difference @ , @ % CI @-@ @ ; p = @ ) .


Findings were robust to missing data .


Eight adverse events ( six vaginal symptoms , one case of back pain , and one case of abdominal pain ) and one unexpected serious adverse event , all in women from the intervention group , were regarded as unrelated to the intervention or to participation in the study .


One-to-one pelvic floor muscle training for prolapse is effective for improvement of prolapse symptoms .


Long-term benefits should be investigated , as should the effects in specific subgroups .


To compare the efficacy of the Newcastle infant dialysis and ultrafiltration system ( Nidus ) with peritoneal dialysis ( PD ) and conventional haemodialysis ( HD ) in infants weighing < @ kg .


We compared the urea , creatinine and phosphate clearances , the ultrafiltration precision , and the safety of the Nidus machine with PD in @ piglets weighing @-@ kg , in a planned randomised cross-over trial in babies , and in babies for whom no other therapy existed , some of whom later graduated to conventional HD .


Two babies entered the randomised trial ; @ recovered rapidly on PD , the other remained on the Nidus as PD failed .


Additionally , @ babies were treated on the Nidus on humanitarian grounds : @ because of failed PD , and @ with permanent kidney failure later converted to conventional HD .


We haemodialysed @ babies weighing between @ and @ kg for @,@ h during @ Nidus sessions without any clinically important incidents , and without detectable haemolysis .


Single-lumen vascular access was used with no blood priming of circuits .


The urea , creatinine and phosphate clearances using the Nidus were around @ to @ ml/min in piglets and babies , and were consistently higher than PD clearances , which ranged from about @ to @ ml/min ( p@ @ for each chemical ) .


Ultrafiltration was achieved to microlitre precision by the Nidus , but varied widely with PD .


Fluid removal using conventional HD was imprecise and resulted in some hypovolaemic episodes requiring correction .


The Nidus can provide HD in the Pediatric Intensive Care Unit ( PICU ) and outpatient intermittent HD without blood priming for babies weighing < @ kg , It generates higher dialysis clearances than PD , and delivers more precise ultrafiltration control than either PD or conventional HD .


To evaluate the effects of canagliflozin on plasma volume , urinary glucose excretion ( UGE ) , fasting plasma glucose ( FPG ) , glycated haemoglobin ( HbA@c ) and additional measures of fluid/electrolyte balance in patients with type @ diabetes on background therapy with metformin and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers .


Patients ( N = @ ) were randomized ( @:@ ) to receive canagliflozin @ mg or placebo for @ weeks .


Pharmacodynamic parameters were assessed at baseline and at weeks @ and @ .


Increased @-h UGE was seen in the canagliflozin group compared with a reduction in the placebo group at both week @ ( @ vs. -@ g ) and week @ ( @ vs. -@ g ) .


Canagliflozin also reduced both FPG and HbA@c .


Reductions in body weight and blood pressure were observed at weeks @ and @ .


Canagliflozin decreased plasma volume compared with an increase with placebo at week @ ( -@ vs. @ % ; p = @ ) , but this was largely attenuated at week @ ( @ vs. @ % ; p = @ ) .


A modest numerical increase in urine volume was observed with canagliflozin at week @ that was attenuated at week @ ; other measures of volume status ( i.e. blood urea nitrogen , serum creatinine and haematocrit ) remained modestly increased with canagliflozin at week @ .


Canagliflozin provided sustained effects on UGE and FPG over @ weeks and a transient reduction in plasma volume that was largely attenuated by week @ .


Androgen-deprivation therapy ( ADT ) has been the backbone of treatment for metastatic prostate cancer since the @s .


We assessed whether concomitant treatment with ADT plus docetaxel would result in longer overall survival than that with ADT alone .


We assigned men with metastatic , hormone-sensitive prostate cancer to receive either ADT plus docetaxel ( at a dose of @ mg per square meter of body-surface area every @ weeks for six cycles ) or ADT alone .


The primary objective was to test the hypothesis that the median overall survival would be @ % longer among patients receiving docetaxel added to ADT early during therapy than among patients receiving ADT alone .


A total of @ patients ( median age , @ years ) underwent randomization .


After a median follow-up of @ months , the median overall survival was @ months longer with ADT plus docetaxel ( combination therapy ) than with ADT alone ( @ months vs. @ months ; hazard ratio for death in the combination group , @ ; @ % confidence interval -LSB- CI -RSB- , @ to @ ; P < @ ) .


The median time to biochemical , symptomatic , or radiographic progression was @ months in the combination group , as compared with @ months in the ADT-alone group ( hazard ratio , @ ; @ % CI , @ to @ ; P < @ ) .


The rate of a prostate-specific antigen level of less than @ ng per milliliter at @ months was @ % in the combination group versus @ % in the ADT-alone group ( P < @ ) .


In the combination group , the rate of grade @ or @ febrile neutropenia was @ % , the rate of grade @ or @ infection with neutropenia was @ % , and the rate of grade @ sensory neuropathy and of grade @ motor neuropathy was @ % .


Six cycles of docetaxel at the beginning of ADT for metastatic prostate cancer resulted in significantly longer overall survival than that with ADT alone .


( Funded by the National Cancer Institute and others ; ClinicalTrials.gov number , NCT@ . )


The aim of this study was to evaluate the haemodynamic effects of serelaxin ( @ g/kg/day @-h infusion and @-h post-infusion period ) in patients with acute heart failure ( AHF ) .


This double-blind , multicentre study randomized @ AHF patients with pulmonary capillary wedge pressure ( PCWP ) @ mmHg , systolic blood pressure ( BP ) @ mmHg , and estimated glomerular filtration rate @ mL/min/@ @ m ( @ ) to serelaxin ( n = @ ) or placebo ( n = @ ) within @ h of hospitalization .


Co-primary endpoints were peak change from baseline in PCWP and cardiac index ( CI ) during the first @ h of infusion .


Among @ patients eligible for haemodynamic analysis ( serelaxin , n = @ ; placebo , n = @ ) , those treated with serelaxin had a significantly higher decrease in peak PCWP during the first @ h of infusion ( difference vs. placebo : -@ mmHg , P = @ ) .


Serelaxin showed no significant effect on the peak change in CI vs. placebo .


Among secondary haemodynamic endpoints , a highly significant reduction in pulmonary artery pressure ( PAP ) was observed throughout the serelaxin infusion ( largest difference in mean PAP vs. placebo : -@ mmHg at @ h , P < @ ) .


Right atrial pressure , systemic/pulmonary vascular resistance , and systolic/diastolic BP decreased from baseline with serelaxin vs. placebo and treatment differences reached statistical significance at some time points .


Serelaxin administration improved renal function and decreased N-terminal pro-brain natriuretic peptide levels vs. placebo .


Treatment with serelaxin was well tolerated with no apparent safety concerns .


The haemodynamic effects of serelaxin observed in the present study provide plausible mechanistic support for improvement in signs and symptoms of congestion observed with this agent in AHF patients .


ClinicalTrials.gov identifier NCT@ .


Quetiapine is an atypical antipsychotic with demonstrated efficacy in the treatment of adolescent schizophrenia and pediatric bipolar mania .


Large , placebo-controlled studies of interventions in pediatric bipolar depression are lacking .


The current study investigated the efficacy and safety of quetiapine extended-release ( XR ) in patients @-@ years of age , with acute bipolar depression .


This multicenter , double-blind , randomized , placebo-controlled study investigated quetiapine XR ( dose range , @-@mg / day ) in pediatric outpatients with an American Psychiatric Association , Diagnostic and Statistical Manual of Mental Disorders , @th ed. , Text Revision ( DSM-IV-TR ) diagnosis of bipolar I or bipolar II disorder ( current or most recent episode depressed ) treated for up to @ weeks ( ClinicalTrials.gov identifier : NCT@ ) .


The primary study outcome was mean change in Children 's Depression Rating Scale-Revised ( CDRS-R ) total score .


Secondary efficacy outcomes included CDRS-R-based response and remission rates .


Of @ patients randomized to treatment , @ patients completed the study ( @ % of quetiapine XR group -LSB- n = @ -RSB- ; @ % of placebo group -LSB- n = @ -RSB- ) .


Least squares mean changes in CDRS-R total score at week @ were : -@ ( SE , @ ) with quetiapine XR and -@ ( SE , @ ) with placebo , a between-treatment group difference of -@ ( SE , @ ; @ % CI , -@ , @ ; p = @ ; mixed-model for repeated measures analysis ) .


Rates of response and remission did not differ significantly between treatment groups .


The safety profile of quetiapine XR was broadly consistent with the profile reported previously in adult studies of quetiapine XR and pediatric studies of quetiapine immediate-release ( IR ) .


Potentially clinically significant elevations in clinical chemistry values included triglycerides ( @ % , quetiapine XR ; @ % , placebo group ) and thyroid stimulating hormone ( @ % , quetiapine XR ; @ % , placebo group ) .


An adverse event potentially related to diabetes mellitus occurred in @ % of the quetiapine XR versus no adverse events in the placebo group .


Quetiapine XR did not demonstrate efficacy relative to placebo in this @ week study of pediatric bipolar depression .


Quetiapine XR was generally safe and well tolerated .


Patients who adhere to medications experience better outcomes than their nonadherent counterparts .


However , these observations may be confounded by patient behaviors .


The level of adherence necessary for patients to derive benefit and whether adherence to all agents is important for diseases that require multiple drugs remain unclear .


This study quantifies the relationship between medication adherence and post-myocardial infarction ( MI ) adverse coronary events .


This is a secondary analysis of the randomized MI FREEE trial .


Patients who received full prescription coverage were classified as adherent ( proportion of days covered @ % ) or not based upon achieved adherence in the @ months after randomization .


First major vascular event or revascularization rates were compared using multivariable Cox models adjusting for comorbidity and health-seeking behavior .


Compared with patients randomized to usual care , full coverage patients adherent to statin , - blocker , or angiotensin-converting enzyme inhibitor/angiotensin receptor blocker were significantly less likely to experience the study 's primary outcome ( hazard ratio -LSB- HR -RSB- range @-@ @ ) .


In contrast , nonadherent patients derived no benefit ( HR range @-@ @ , P @ for the difference in HRs between adherent and nonadherent patients ) .


Partially adherent patients had no reduction in clinical outcomes for any of the drugs evaluated , although their achieved adherence was higher than that among controls .


Achieving high levels of adherence to each and all guideline-recommended post-MI secondary prevention medication is associated with improved event-free survival .


Lower levels of adherence appear less protective .


To evaluate whether ramosetron increases the corrected QT ( QTc ) interval .


Prospective , randomized , controlled study .


Operating room .


@ patients undergoing elective laparoscopic cholecystectomy .


Patients were allocated to three groups to receive ondansetron @ mg ( Group O@ ) , ramosetron @ mg ( Group R ) , or ondansetron @ mg ( Group O@ ) .


The study drugs were administered intravenously approximately @ minutes before the end of surgery .


The QT interval for @ minutes after administration was recorded .


The QTc interval was calculated according to the Fridericia ( QTcF ) formula .


The primary outcome was the QTcF interval among the three groups during the @ minutes after administration of the study drugs .


The QTcF interval was not significantly prolonged after administration of ondansetron @ mg and ramosetron .


It was significantly increased from one minute after administration until @ minutes after ondansetron @ mg ( Group O@ ) .


The QTcF interval was significantly longer in Group O@ at @ , @ , @ , @ , and @ minutes .


The prophylactic administration @ mg of ramosetron does not increase the QTc interval .


Ondansetron @ mg increases the QTc interval more so than @ mg of ondansetron .


To determine whether mechanical cleaning with interdental brushes combined with the use of cetylpyridinium chloride ( @ % CPC ) gel was more effective at plaque control than mechanical cleaning with interdental brushes alone .


Forty individuals ( @-@ years old ) with at least @ teeth and moderate chronic periodontitis who had no experience with interdental cleaning aids were randomly assigned to a treatment group ( brush + gel , n = @ ) or a control group ( brush , n = @ ) .


Both groups were examined by a dentist at baseline and at @ and @ months for changes in interdental plaque ( interproximal plaque index -LSB- API -RSB- ) levels , gingival inflammation ( sulcus bleeding index -LSB- SBI -RSB- ) , probing depth ( PD ) and bleeding on probing ( BOP ) .


No baseline differences in age , gender or number of teeth were observed between the two groups .


During the study period , improvements in API and BOP were comparable between groups .


However , improvements in SBI and PD were significantly greater in the test group than in the control group ( p = @ and p = @ , respectively ) .


Mechanical interdental plaque control using interdental brushes combined with the use of CPC gel significantly improved @-month gingival and periodontal outcomes ( SBI and PD ) compared with mechanical cleaning with interdental brushes alone .


Nicotine patches have been reliably demonstrated to improve smoking cessation outcomes but most users still lapse , and then relapse , during treatment .


While patch has been shown to alleviate background cravings , its effects on cue-induced cravings - which have been linked to the occurrence of lapse events - are poorly understood .


Here we investigate the effect of nicotine patch on the intensity of craving and negative affect experienced during the hours immediately preceding lapse episodes .


Participants were @ smokers who had quit in the context of a randomized , double-blind trial of high-dose ( @mg ) nicotine patch and who lapsed at least once during the first @ weeks of treatment .


Participants used electronic diaries to monitor their smoking , affect , and craving during their cessation attempt .


The data suggest that developments on the lapse day - either external events or changes in internal states - caused craving and negative affect to rise , cumulating in the lapse .


Nicotine is known to lower background craving and negative affect , but the difference between patch and placebo appeared to dissipate in the hours immediately preceding lapse episodes .


Understanding the process by which these symptoms `` spike '' prior to a lapse - and developing treatments to counter it - are worthy research endeavors .


This randomized double-blind study was designed to determine if respiratory muscle weakness - measured by maximum inspiratory pressure ( MIP ) , maximum expiratory pressure ( MEP ) , forced vital capacity ( FVC ) , and forced expiratory volume in one second ( FEV@ ) - persists even if an acceleromyographic train-of-four ratio ( TOFR ) of @ is reached after major abdominal surgery .


Twenty patients underwent respiratory function tests before induction of anesthesia .


Rocuronium was given , and the tests were repeated after extubation when the TOFR reached @ .


The patients were then randomized to receive sugammadex @ mgkg ( -@ ) or placebo , and the same tests were repeated five and @ min later .


Between-group comparisons were carried out with a mixed-model analysis of variance analysis .


After anesthesia and adequate epidural analgesia , MIP and MEP decreased by @ % in both groups .


In the placebo group , MIP decreased from a pre-induction value ( median -LSB- range -RSB- ) of @ -LSB- @-@ @ -RSB- to @ -LSB- @-@ @ -RSB- cm H@O after extubation without significant variation five and @ min after placebo .


In the sugammadex group , MIP decreased from a pre-induction value of @ -LSB- @-@ @ -RSB- to @ -LSB- @-@ @ -RSB- cm H@O after extubation .


No differences were recorded after sugammadex administration ( P = @ between groups ) .


In the placebo group , MEP decreased from @ -LSB- @-@ @ -RSB- before induction to @ -LSB- @-@ @ -RSB- cm H@O after extubation .


In the sugammadex group , MEP decreased from @ -LSB- @-@ @ -RSB- to @ -LSB- @-@ @ -RSB- cm H@O , with no improvement five and @ min after either placebo or sugammadex administration ( P = @ ) .


Similarly , the FCV and FEV@ decreased @-@ % after extubation in both study groups .


Acceleromyographic TOFR of @ excludes residual neuromuscular paralysis .


However , major respiratory dysfunction is observed after abdominal surgery .


This trial was registered at ClinicalTrials.gov : NCT@ .


To compare the rates of neonatal morbidity and cerebral palsy among preterm neonates ( less than @ weeks of gestation ) delivered by cesarean for a nonreassuring fetal heart rate ( FHR ) tracing compared with those who did not .


This was a secondary analysis of a multicenter randomized trial of MgSO@ for the prevention of cerebral palsy .


Newborns of women delivered by cesarean delivery for nonreassuring FHR were compared with a control group composed of the offspring of women who labored for @ hours or longer but did not undergo cesarean delivery for nonreassuring FHR regardless of the mode of delivery .


Using multivariable analysis to adjust for potential confounders , our objective was to compare two outcomes : @ ) composite neonatal morbidity ( Apgar score @ or less at @ minutes , seizure , sepsis , necrotizing enterocolitis grade II or III , intraventricular hemorrhage grade III or IV , or death before discharge ) and @ ) neurologic injury ( cerebral palsy ) at @ years or more of corrected age between the groups .


Of the @,@ preterm neonates who met the inclusion criteria , @ ( @ % ) were delivered by cesarean for nonreassuring FHR compared with @,@ ( @ % ) in the control group .


Composite neonatal morbidity was similar between the groups ( @ compared with @ % , adjusted odds ratio -LSB- OR -RSB- @ , @ % confidence interval -LSB- CI -RSB- @-@ @ ) .


The rate of cerebral palsy of any severity ( @ compared with @ % , adjusted OR @ , @ % CI @-@ @ ) and moderate-to-severe cerebral palsy at @ years of corrected age ( @ compared with @ % , adjusted OR @ , @ % CI @-@ @ ) was significantly higher in children born through cesarean delivery for nonreassuring FHR .


Nonreassuring fetal tracing deemed so serious as to require cesarean delivery is associated with an increased risk of cerebral palsy in preterm neonates .


Concerns that general health checks , including screening for risk factors to ischemic heart disease ( IHD ) , have negative psychological consequences seem widely unfounded ; however , previous studies are only based on self-reports from participants .


To investigate if risk factor screening in healthy adults leads to mental distress in the study population , independent of participation .


The Inter@ study ( @ - @ ) was a randomised intervention in the general population , aiming to prevent IHD by a healthier lifestyle .


We included the whole study population , independent of participation ( n = @,@ ) .


We merged data with information on the use of psychotropic medication and/or hospitalisation due to psychiatric diagnoses , as retrieved from national registers in Denmark , @ years before and @ years after the study began .


We conducted analyses using generalised estimating equations .


There was no significant difference between the intervention and control groups in their use of antipsychotics , hypnotics/sedatives , antidepressants or anxiolytics .


As regards admission to the hospital with mental disorders , no significant difference was seen .


These findings were true based on a yearly basis , and when investigating both short-term and a long-term effects of the intervention .


There was no interaction with socioeconomic status .


Of the @ persons with a psychiatric diagnosis before the study start , @ ( @ % ) were re-admitted in the intervention period .


Pre-screening of psychological status did not influence the psychological impact of screening .


This large , randomised intervention study supports that screening for risk factors to IHD does not increase mental distress , not even in the mentally or socioeconomically most vulnerable persons .


This study included the whole Inter@ study population not only study participants .


Postoperative pain is an important adverse event following inguinal hernia repair .


The aim of this trial was to compare postoperative pain within the first @ months and @ year after surgery in patients undergoing open mesh inguinal hernia repair using either a self-gripping lightweight polyester mesh or a polypropylene lightweight mesh fixed with sutures .


Adult men undergoing Lichtenstein repair for primary inguinal hernia were randomized to ProGrip self-gripping mesh or standard sutured lightweight polypropylene mesh .


In total @ men were included in the final analysis ( self-gripping mesh @ , sutured mesh @ ) .


Early postoperative pain scores were lower with self-gripping mesh than with sutured lightweight mesh : mean visual analogue pain score relative to baseline +@ and +@ respectively at discharge ( P = @ ) , and mean surgical pain scale score relative to baseline +@ and +@ respectively on day @ ( P = @ ) .


There was no significant difference in mid-term ( @month ) and long-term ( @months and @ year ) pain scores between the groups .


Surgery was significantly quicker with self-gripping mesh ( mean difference @min ; P < @ ) .


There were no significant differences in reported mesh handling , analgesic consumption , other wound complications , patient satisfaction or hernia recurrence between the groups .


Self-gripping mesh for open inguinal hernia repair was well tolerated and reduced early postoperative pain ( within the first week ) , without increasing the risk of early recurrence .


It did not reduce chronic pain .


Older adults are frequently hospitalized from the emergency department ( ED ) after an episode of unexplained syncope .


Current admission patterns are costly , with little evidence of benefit .


We hypothesize that an ED observation syncope protocol will reduce resource use without adversely affecting patient-oriented outcomes .


This randomized trial at @ EDs compared an ED observation syncope protocol to inpatient admission for intermediate-risk adults ( @ years ) presenting with syncope or near syncope .


Primary outcomes included inpatient admission rate and length of stay .


Secondary outcomes included @-day and @-month serious outcomes after hospital discharge , index and @-day hospital costs , @-day quality-of-life scores , and @-day patient satisfaction .


Study staff randomized @ patients .


Observation resulted in a lower inpatient admission rate ( @ % versus @ % ; @ % confidence interval -LSB- CI -RSB- difference -@ % to -@ % ) and shorter hospital length of stay ( @ versus @ hours ; @ % CI difference -@ to -@ ) .


Serious outcome rates after hospital discharge were similar for observation versus admission at @ days ( @ % versus @ % ; @ % CI difference -@ % to @ % ) and @ months ( @ % versus @ % ; @ % CI difference -@ % to @ % ) .


Index hospital costs in the observation group were $ @ ( @ % CI difference - $ @,@ to - $ @ ) lower than in the admission group .


There were no differences in @-day quality-of-life scores or in patient satisfaction .


An ED observation syncope protocol reduced the primary outcomes of admission rate and hospital length of stay .


Analyses of secondary outcomes suggest reduction in index hospital costs , with no difference in safety events , quality of life , or patient satisfaction .


Our findings suggest that an ED observation syncope protocol can be replicated and safely reduce resource use .


Elevated lipoprotein-associated phospholipase A@ activity promotes the development of vulnerable atherosclerotic plaques , and elevated plasma levels of this enzyme are associated with an increased risk of coronary events .


Darapladib is a selective oral inhibitor of lipoprotein-associated phospholipase A@ .


In a double-blind trial , we randomly assigned @,@ patients with stable coronary heart disease to receive either once-daily darapladib ( at a dose of @ mg ) or placebo .


The primary end point was a composite of cardiovascular death , myocardial infarction , or stroke .


Secondary end points included the components of the primary end point as well as major coronary events ( death from coronary heart disease , myocardial infarction , or urgent coronary revascularization for myocardial ischemia ) and total coronary events ( death from coronary heart disease , myocardial infarction , hospitalization for unstable angina , or any coronary revascularization ) .


During a median follow-up period of @ years , the primary end point occurred in @ of @ patients ( @ % ) in the darapladib group and @ of @ patients ( @ % ) in the placebo group ( hazard ratio in the darapladib group , @ ; @ % confidence interval -LSB- CI -RSB- , @ to @ ; P = @ ) .


There were also no significant between-group differences in the rates of the individual components of the primary end point or in all-cause mortality .


Darapladib , as compared with placebo , reduced the rate of major coronary events ( @ % vs. @ % ; hazard ratio , @ ; @ % CI , @ to @ ; P = @ ) and total coronary events ( @ % vs. @ % ; hazard ratio , @ ; @ % CI , @ to @ ; P = @ ) .


In patients with stable coronary heart disease , darapladib did not significantly reduce the risk of the primary composite end point of cardiovascular death , myocardial infarction , or stroke .


( Funded by GlaxoSmithKline ; STABILITY ClinicalTrials.gov number , NCT@ . )


The association between testosterone deficiency and insulin resistance in men with type @ diabetes is well established .


Current Endocrine Society and European Association of Urology guidelines recommend the measurement of testosterone levels in all men with type @ diabetes and in men suffering from erectile dysfunction .


It is recognised that a range of physical symptoms appear as the testosterone level falls but few studies have addressed the threshold at which symptoms improve with physiological replacement .


We report the first double-blind placebo-controlled study conducted exclusively in a male type @ diabetes population to assess the metabolic changes with testosterone replacement .


The type @ diabetes registers of seven general practices were screened to establish the prevalence of low testosterone and the associations with diabetes control .


Of @ eligible patients approached , @ men ( mean age @ ) consented to take part in screening with a morning testosterone level , assessed between @ and @ am .


This identified @ patients for a double-blind placebo-controlled study of long acting testosterone undecanoate ( TU ) @ mg lasting @ weeks followed by @ weeks of open label use .


The population was divided into a SEVERE group with either total testosterone ( TT ) of @ nmol/l or less or free testosterone ( FT ) @ pmol/l or less or a MILD group with TT @-@ nmol/l or FT @-@ pmol/l .


Men in the SEVERE group increased mean through TT from @ nmol/l at baseline to @ at @ weeks and the MILD group from @ to @ .


The SEVERE group showed marked improvement in sexual function , but no significant improvement in metabolic parameters .


The MILD group showed no improvement in sexual function , but significant improvement in weight , body mass index , waist circumference and Hospital Anxiety and Depression Scale .


Improvement was seen in all parameters during @ weeks open label treatment where trough TT levels approached @ nmol/l .


Baseline prostate-specific antigen ( PSA ) was lower in the SEVERE group and increased with TU for @ weeks and then stabilised .


There was no increase in PSA with treatment in the MILD group .


Testosterone undecanoate significantly improves sexual parameters and Ageing Male Symptom Score , but not metabolic factors at @ weeks in men with SEVERE testosterone deficiency syndrome ( TDS ) .


In men with MILD TDS , significant improvements in metabolic but not sexual parameters were seen , suggesting that there are threshold levels for response to testosterone replacement therapy and that trials of therapy need to achieve sustained therapeutic levels to be effective .


PSA showed minor rises , but only for @ weeks in the SEVERE group .


Randomized controlled trial .


Objectives To examine the efficacy of exercise intervention in patients with knee osteoarthritis ( OA ) , as directed by Mechanical Diagnosis and Therapy ( MDT ) assessment , and , secondarily , to explore outcomes between MDT assessment-defined subgroups within the exercise group .


Due to the high physical and economic burden of knee OA , the effectiveness of conservative interventions and determining those patients who will respond to them should be investigated .


Patients with knee OA ( n = @ ) were randomized to an exercise intervention group or a control group .


The intervention group , in which patients classified as having knee derangements ( MDT derangement ) received MDT directional exercises and patients classified as nonresponders ( MDT nonresponders ) received evidence-based exercises , was compared to a control group that received no exercise intervention .


Pain and function were assessed at baseline , @ weeks , and @ months , using the P@ pain scale and Knee injury and Osteoarthritis Outcome Score ( KOOS ) pain and function subscales .


Two-way analysis of covariance was used to examine treatment and time effects .


Multiple comparisons were examined , and mean differences with @ % confidence intervals ( CIs ) were reported .


The exercise intervention group had significantly improved P@ scores ( mean difference , -@ ; @ % CI : -@ , -@ ) , KOOS pain scores ( mean difference , @ ; @ % CI : @ , @ ) , and KOOS function scores ( mean difference , @ ; @ % CI : @ , @ ) compared to those of the control group at @ weeks .


At @ months , the exercise intervention group had significantly improved KOOS pain scores ( mean difference , @ ; @ % CI : @ , @ ) and KOOS function scores ( mean difference , @ ; @ % CI : @ , @ ) compared to controls .


Patients with knee OA who were prescribed exercises based on an MDT assessment had superior outcomes compared to those of wait-list controls .


The MDT subgroup of knee derangement may warrant further investigation in patients with knee OA .


Protocol registered at ClinicalTrials.gov ( NCT@ ) .


Therapy , level @b - .


Inappropriate use and overuse of antibiotics is a serious concern in the treatment of upper respiratory tract infections ( URTIs ) , especially in developing countries .


In recent decades , information disclosure and public reporting ( PR ) has become an instrument for encouraging good practice in healthcare .


This study evaluated the impact of PR on antibiotic prescribing for URTIs in a sample of primary care institutions in China .


A matched-pair cluster-randomized trial was undertaken in QJ city , with @ primary care institutions participating in the trial .


Participating institutions were matched into pairs before being randomly assigned into a control and an intervention group .


Prescription statistics were disclosed to patients , health authorities , and health workers monthly within the intervention group , starting from October @ .


Outpatient prescriptions for URTIs were collected from both groups before ( @st March to @st May , @ ) and after the intervention ( @st March to @st May , @ ) .


A total of @,@ URTI prescriptions were included in a difference-in-difference analysis using multivariate linear or logistic regression models , controlling for patient attributes as well as institutional characteristics .


Overall , @ % URTI prescriptions required antibiotics and @ % required combined use of antibiotics .


More than @ % of URTI prescriptions required intravenous ( IV ) injection or infusion of drugs .


PR resulted in a @ percentage point ( @ % CI -@ to -@ ) reduction in the use of oral antibiotics ( adjusted RR = @ % , P = @ ) , while the use of injectable antibiotics remained unchanged .


PR led to a @ percentage point reduction ( @ % CI -@ to @ ; adjusted RR = @ % ) in combined use of antibiotics ( P = @ ) , which was largely driven by a significant reduction in male patients ( -@ % , @ % CI -@ to -@ , P = @ ) .


The intervention had little impact on the use of IV injections or infusions , or the total prescription expenditure .


The results suggest that PR could improve prescribing practices in terms of reducing oral antibiotics and combined use of antibiotics ; however , the impacts were limited .


We suggest that PR would probably be enhanced by provider payment reform , management and training for providers , and health education for patients .


The aim of this study was to evaluate the effects of guided imagery as a nursing intervention for pain management and depression in patients diagnosed with fibromyalgia .


Many studies support the use of guided imagery to improve patient outcomes .


Guided imagery has been used for different purposes and it is thought to be an effective intervention for people suffering from nonmalignant pain .


A @-group quasi-experimental study was conducted during @ weeks by the University of Nursing in Almeria ( Spain ) .


Patients diagnosed with fibromyalgia aged @ to @ years ( n = @ ) were randomly assigned to a guided imagery group ( n = @ ) or a control group ( n = @ ) .


The outcomes measures were scores for pain with the McGill Pain Questionnaire long form ( MPQ-LF ) and the Visual Analogue Scale ( VAS ) and depression with the Beck Depression Inventory and the VAS for depression .


The effects were examined at baseline , postintervention ( @th week ) , and at the end of the study ( @th week ) .


Treatment efficacy was analyzed by using a t test for paired samples .


Temporal changes in the scores were examined by using a @-way repeated-measures analysis of variance .


The treatment group reported statistically significantly lower levels of pain ( P < @ ) and depression ( P < @ ) than the control group at the week @ evaluation .


A statistically significant effect on pain as measured by the daily VAS diary was also found in the experimental group .


At week @ , no significant differences were found for pain .


Patients diagnosed with fibromyalgia may benefit from this nursing intervention in terms of relieving pain and depression .


Guided imagery relaxation therapy could be incorporated as part of fibromyalgia treatment to promote health among people with fibromyalgia .


Guided imagery as a nursing intervention can alleviate pain and depression in patients diagnosed with fibromyalgia .


To characterize brain functional connectivity in subjects with prechiasmatic visual system damage and relate functional connectivity features to extent of vision loss .


In this case-control study , resting-state , eyes-closed EEG activity was recorded in patients with partial optic nerve damage ( n = @ ) and uninjured controls ( n = @ ) .


We analyzed power density and functional connectivity ( coherence , Granger causality ) , the latter as ( @ ) between-areal coupling strength and ( @ ) individually thresholded binary graphs .


Functional connectivity was then modulated by noninvasive repetitive transorbital alternating current stimulation ( rtACS ; @ days , @ minutes daily ; n = @ ; sham , n = @ ) to study how this would affect connectivity networks and perception .


Patients exhibited lower spectral power ( p = @ ) , decreased short - ( p = @ ) and long-range ( p = @ ) coherence , and less densely clustered coherence networks ( p = @ ) in the high-alpha frequency band ( @-@ Hz ) .


rtACS strengthened short - ( p = @ ) and long-range ( p = @ ) alpha coherence and this was correlated with improved detection abilities ( r = @ , p = @ ) and processing speed ( r = @ , p = @ ) , respectively .


Vision loss in the blind is caused not only by primary tissue damage but also by a breakdown of synchronization in brain networks .


Because visual field improvements are associated with resynchronization of alpha band coherence , brain connectivity is a key component in partial blindness and in restoration of vision .


To compare the effects on left ventricular ( LV ) function of right ventricular ( RV ) septal pacing vs. cardiac resynchronization therapy ( CRT ) in patients with an indication for the latter .


Cardiac resynchronization therapy is an effective therapy in patients with drug-refractory heart failure .


Despite advances in implantation techniques , LV lead placement can be impossible in up to @ % of cases .


We , therefore , assessed the effects of RV septal pacing from mid septum ( RVmIVS ) and outflow tract ( RVOT ) on cardiac performance , in comparison with CRT .


Twenty-two patients scheduled for CRT underwent dual-chamber temporary pacing .


The ventricular lead was placed at the RV apex ( RVA ) , RVmIVS , and RVOT in random order .


Comprehensive echocardiography was performed in a baseline AAI mode and then at each RV position in dual chamber pacemaker function ( D pacing , D sensing , D dual responses ) mode and repeated on the next day following CRT implantation .


Right ventricular apex pacing did not change any of the assessed echocardiography parameters .


Both RVmIVS and RVOT pacing increased LV ejection fraction ( EF ) : @ @ % at baseline vs. @ @ % ( P = @ ) and @ @ % ( P = @ ) with RVmIVS and RVOT pacing , respectively .


Similarly , the dyssynchrony index ( Ts-SD ) decreased : @ @ ms at baseline vs. @ @ ms ( P = @ ) and @ @ ms ( P = @ ) with RVmIVS and RVOT pacing , respectively .


Cardiac resynchronization therapy further improved LVEF and Ts-SD to @ @ % and @ @ ms , respectively , however , only LVEF was significantly higher compared with RVmIVS and RVOT pacing ( P = @ and P = @ respectively ) .


There were no significant differences in either LVEF or Ts-SD between RVmIVS and RVOT .


Right ventricular septal pacing from mid septum or RVOT pacing improves LVEF and LV synchrony in CRT candidates .


Further improvement in LVEF was achieved by CRT , which remains the ` gold standard ' therapy in these patients .


However , RV septal pacing is worthy of further study as an alternative strategy when LV lead implantation fails .


To investigate variables associated with myopic progression despite treatment in the Atropine in the Treatment of Myopia Study .


Retrospective cohort study .


Two hundred of @ children were randomized to receive atropine @ % in @ eye only in this institutional study .


Children were followed up with cycloplegic autorefraction every @ months over @ years .


Children whose myopia progressed by more than @ diopter ( D ) in the atropine-treated eye at @ year were classified as being progressors .


Among the @ children still in the study at @ year , @ ( @ % ) were classified as progressors .


Univariate analysis suggested these children tended to be younger ( @ @ years vs @ @ years ; P = @ ) , to have higher myopic spherical equivalent ( SE ) at baseline ( -@ @ D vs -@ @ D ; P = @ ) , and to have @ myopic parents ( @ % vs @ % ; P = @ ) .


In nonprogressors , the myopia progression at @ year was less in the atropine-treated eyes compared with the untreated fellow eye ( +@ @ D vs -@ @ D ; P < @ ) , but in progressors , progression was more similar between eyes ( -@ @ D vs -@ @ D ; P = @ ) .


Regression analysis showed that the risk of being a progressor was @ % lower with each year of increased age , @ % lower for every @ D less in myopia at baseline , and @ % lower for every @ D less in myopic change in the untreated eyes over the first year .


Doctors and parents need to be aware that there is a small group of children ( younger , with higher myopia , and greater tendency of myopic progression ) who may still progress while receiving atropine treatment .


Combined treatment of a calcium antagonist and / - adrenoreceptor blocker is expected to offer some advantages in the management of hypertension ; however , their antihypertensive efficacy and safety remain relatively under-explored .


The current study addresses the @-h antihypertensive efficacy and safety of arotinolol combined with a different calcium channel blocker .


One-hundred fifty-two patients were randomly divided into three groups : nifedipine , amlodipine and felodipine group .


In each group , the antihypertensive treatment dose was @mg/d , @mg/d , @mg/d long acting nifedipine , amlodipine , felodipine plus @mg/d arotinolol , respectively .


Blood pressure was measured in ABPM devices and mercury manometer .


The result showed that the effective rate of one year antihypertensive treatment of arotinolol combined with nifedipine was @ of @ , significantly effective ( p < @ ) among three combinations .


It also showed that there was no statistical significant difference ( p > @ ) in controlled rate of morning peak blood pressure between treatment of arotinolol combined with amlodipine and arotinolol combined with nifedipine , but there was a significant difference ( p < @ ) in controlled rate of morning peak blood pressure between arotinolol combined with nifedipine vs. felodipine and arotinolol combined with amlodipine vs. felodipine .


The therapy approached of arotinolol combined with nifedipine or amlodipine could be effective and well-tolerated , and they can be used as the better chosen antihypertensive drug .


Most research on the Illness Management and Recovery ( IMR ) program for people with severe mental illnesses has focused on individuals with stable symptoms living in the community , with less attention to persons being treated in an inpatient setting .


We evaluated the feasibility and effects of an IMR program adapted for individuals with schizophrenia who were awaiting discharge into the community .


A randomized controlled trial was conducted at @ hospitals in Taiwan to compare the adapted IMR program with treatment as usual ( TAU ) .


Ninety-seven individuals with schizophrenia were randomized to the adapted IMR program or TAU .


Four outcome indicators including illness-management knowledge , attitudes toward medication , insight , and symptoms were assessed at baseline , posttreatment , and at a @-month follow-up following discharge from the hospital .


Participants in the adapted IMR group showed significantly greater improvements at posttreatment and @-month follow-up in illness-management knowledge , attitudes toward medication , insight , and negative symptoms on the Brief Psychiatric Rating Scale ( BPRS ) than individuals in the TAU group .


There were no significant differences between the @ groups on other subscales of the BPRS .


This is the first controlled evaluation of a version of the IMR program in an East Asian culture , and the first to evaluate it in an acute care inpatient setting .


Our findings support the feasibility and potential benefits of implementing an adapted IMR program , focused on the prevention of relapses and rehospitalizations , during the discharge period of an inpatient treatment stay to prepare individuals to reenter the community .


Following discharge home from the ICU , patients often suffer from reduced physical function , exercise capacity , health-related quality of life and social functioning .


There is usually no support to address these longer term problems , and there has been limited research carried out into interventions which could improve patient outcomes .


The aim of this study is to investigate the effectiveness and cost-effectiveness of a @-week programme of exercise on physical function in patients discharged from hospital following critical illness compared to standard care .


The study design is a multicentre prospective phase II , allocation-concealed , assessor-blinded , randomised controlled clinical trial .


Participants randomised to the intervention group will complete three exercise sessions per week ( two sessions of supervised exercise and one unsupervised session ) for @weeks .


Supervised sessions will take place in a hospital gymnasium or , if this is not possible , in the participants home and the unsupervised session will take place at home .


Blinded outcome assessment will be conducted at baseline after hospital discharge , following the exercise intervention , and at @months following baseline assessment ( or equivalent time points for the standard care group ) .


The primary outcome measure is physical function as measured by the physical functioning subscale of the Short-Form-@ health survey following the exercise programme .


Secondary outcomes are health-related quality of life , exercise capacity , anxiety and depression , self efficacy to exercise and healthcare resource use .


In addition , semi-structured interviews will be conducted to explore participants ' perceptions of the exercise programme , and the feasibility ( safety , practicality and acceptability ) of providing the exercise programme will be assessed .


A within-trial cost-utility analysis to assess the cost-effectiveness of the intervention compared to standard care will also be conducted .


If the exercise programme is found to be effective , this study will improve outcomes that are meaningful to patients and their families .


It will inform the design of a future multicentre phase III clinical trial of exercise following recovery from critical illness .


It will provide useful information which will help the development of services for patients after critical illness .


The primary aims of this hybrid Type @ effectiveness-implementation trial were to quantitatively assess whether an evidence-based exercise intervention for breast cancer survivors , Strength After Breast Cancer , was safe and effective in a new setting and to qualitatively assess barriers to implementation .


A cohort of @ survivors completed measurements related to limb volume , muscle strength , and body image at baseline , @ survivors completed measurements @ months later .


Qualitative methods were used to understand barriers to implementation experienced by referring oncology clinicians and physical therapists who delivered the program .


Similar to the efficacy trial , the revised intervention demonstrated safety with regard to lymphedema , and led to improvements in lymphedema symptoms , muscular strength , and body image .


Comparison of effects in the effectiveness trial to effects in the efficacy trial revealed larger strength increases in the efficacy trial than in the effectiveness trial ( P < @ ) , but few other differences were found .


Qualitative implementation data suggested significant barriers around intervention characteristics , payment , eligibility criteria , the referral process , the need for champions ( ie , advocates ) , and the need to adapt during implementation of the intervention , which should be considered in future dissemination and implementation efforts .


This trial successfully demonstrated that a physical therapy led strength training program for breast cancer survivors can be implemented in a community setting while retaining the effectiveness and safety of the clinical trial .


However , during the translation process , strategies to reduce barriers to implementation are required .


This new program can inform larger scale dissemination and implementation efforts .


Physical activity has been related to improved breast cancer outcomes .


Especially in the older breast cancer population , physical activity may be important because old age is associated with comorbidities and decreased physical function .


The purpose of this study was to investigate the relation between physical activity and overall survival , breast cancer-specific survival , and recurrence in several age groups of postmenopausal breast cancer patients .


The Tamoxifen Exemestane Adjuvant Multinational Lifestyle study was a side study of the Tamoxifen Exemestane Adjuvant Multinational trial and prospectively investigated lifestyle habits of postmenopausal , hormone receptor-positive breast cancer patients .


The relations between prediagnosis and postdiagnosis physical activity and overall survival , breast cancer-specific survival , and recurrence-free survival were assessed with Cox regression and competing risk regression models .


Among @ patients , high levels of physical activity before and after the diagnosis were associated with better overall survival ( the multivariate hazard ratios were @ -LSB- @ % confidence interval = @-@ @ -RSB- and @ ( @ % confidence interval = @-@ @ -RSB- for patients who were very active before and after the diagnosis , respectively , in comparison with inactive patients ) .


This was most evident in patients who were @ years old or older .


Physical activity was not significantly associated with breast cancer-specific survival or the relapse-free period .


Overall survival was better for patients who were active before and after the diagnosis .


In contrast with previous studies , breast cancer survival and the risk of recurrence were not significantly associated with physical activity .


These findings confirmed the need for more studies investigating the use of physical activity to supplement breast cancer treatment in older patients .


This article investigated how a multicomponent memory intervention affected memory for prose .


We compared verbatim and paraphrased recall for short stories immediately and @ , @ , @ , and @ years post-intervention in the Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) sample .


We studied @,@ ACTIVE participants aged @ to @ .


Participants were randomized into one of three training arms ( Memory , Reasoning , Speed of Processing ) or a no-contact Control group ; about half of the trained participants received additional booster training @ and @ years post-intervention .


Memory-trained participants showed higher verbatim recall than non-memory-trained participants .


Booster-memory training led to higher verbatim recall .


Memory training effects were evident immediately following training and not after @ year following training .


Results suggest that multifactorial memory training can improve verbatim recall for prose , but the effect does not last without continued intervention .


This study was developed as a pilot study to determine if targeted interventions regarding increasing physical activity level through the use of pedometers and fitness DVDs would result in a decrease in BMI in overweight or obese children .


@ children aged @-@ taking part in `` Moving and Losing '' were randomized to ( @ ) Control Group ; ( @ ) Pedometer Group ; ( @ ) DVD Group ; ( @ ) Pedometer + DVD Group and asked to complete self-report physical activity logs at visit one and two .


Baseline , midpoint , and endpoint weight , height , Body Mass Index ( BMI ) were measured for outcome variables .


Almost half ( @ % ) of participants turned in their activity logs and pedometers at midpoint , but at endpoint less than a quarter of participants turned in their pedometers and/or activity logs .


BMI increased by @ % in the Control Group , @ % in the Pedometer Group , and @ % in the DVD Group .


BMI decreased by @ % in the Pedometer + DVD Group .


The use of pedometers and fitness DVDs may not be culturally acceptable in African-American female children and adolescents from South Carolina who are overweight or obese .


Further studies should look into in-depth needs assessments and planning processes that include participants as stakeholders .


Bronchodilator medications are central to the symptomatic management of chronic obstructive pulmonary disease ( COPD ) .


Metered-dose inhalers ( MDIs ) are the most commonly used devices to deliver treatment to patients with COPD and asthma , comprising approximately @ % of bronchodilator prescriptions .


Proprietary porous-particle technology permits the formulation of long-acting muscarinic antagonists , long-acting @-agonists , and a combination of both in hydrofluoroalkane ( HFA ) MDIs , providing a solution to formulation challenges inherent to the development of HFA MDIs , which have contributed to the development of dry-powder inhalers .


In this randomized , double-blind , @-period , @-treatment , placebo - and active-controlled , multicenter , crossover study , @ ascending single doses of a proprietary glycopyrronium ( GP ) MDI were evaluated compared with Placebo MDI and open-label tiotropium ( TIO ) in study patients with COPD .


Thirty-three study patients were enrolled and received single-dose administration of @ of the @ treatments ( Placebo MDI , TIO @ g , or GP MDI at @ , @ , @ , and @ g ex-actuator ) with an interval of @ to @ weeks between doses .


The primary efficacy endpoint was peak change in forced expiratory volume in @ second ( FEV@ ) .


All @ doses of GP MDI showed statistically superior efficacy compared with Placebo MDI for peak FEV@ ( differences of @ to @ mL ; P < @ ) , with a clear dose ordering of the response .


Statistically significant differences compared with Placebo MDI were noted at almost all doses for the secondary FEV@ parameters ( P @ ) except @-hour trough FEV@ at @ g. All doses were safe and well tolerated in this study ; the most frequently reported adverse event was dry mouth ( @-@ @ % across doses ; @ % for Placebo MDI , and @ % for TIO ) .


This study demonstrated superior bronchodilatory efficacy of GP MDI compared with Placebo MDI at all doses tested , and no serious adverse events were reported .


This study supports the further evaluation of GP MDI in study patients with COPD .


In addition , these findings indicate that the correct dosage of glycopyrronium is no more than @ g total daily dose , or @ g twice daily based on comparisons with the active comparator .


We aimed to determine the timing and size of the cognitive deficit associated with poverty in the first @ years of life and to examine the role of parental characteristics , pre - and postnatal growth , and stimulation in the home in Bangladeshi children .


We hypothesized that the effect of poverty on cognition begins in infancy and is mainly mediated by these factors .


We enrolled @ singletons , a subsample from a pregnancy supplementation trial in a poor rural area .


We assessed mental development at @ , @ , and @ months ; anthropometry at birth , @ , @ , and @ months ; home stimulation at @ and @ months ; and family 's socioeconomic background .


In multiple regression analyses , we examined the effect of poverty at birth on IQ at @ months and the extent that other factors mediated the effect .


A mean cognitive deficit of @ ( @ % confidence interval -@ to -@ ) z scores between the first and fifth wealth quintiles was apparent at @ months and increased to @ ( @ % confidence interval -@ to -@ ) z scores of IQ by @ months .


Parental education , pre - and postnatal growth in length , and home stimulation mediated @ % of the effects of poverty on IQ and had independent effects .


Growth in the first @ years had larger effects than later growth .


Home stimulation had effects throughout the period .


Effects of poverty on children 's cognition are mostly mediated through parental education , birth size , growth in the first @ months , and home stimulation in the first @ years .


To compare the short-term outcomes of patients who underwent proximal gastrectomy with jejunal interposition ( PGJI ) with those undergoing total gastrectomy with Roux-en-Y anastomosis ( TGRY ) .


From January @ to January @ , thirty-five patients underwent PGJI , and forty-one patients underwent TGRY .


The surgical efficacy and short-term follow-up outcomes were compared between the two groups .


There were no differences in the demographic and clinicopathological characteristics .


The mean operation duration and postoperative hospital stay in the PGJI group were statistically longer than those in the TGRY group ( P = @ ) .


No anastomosis leakage was observed in two groups .


No statistically significant difference was found in endoscopic findings , Visick grade or serum albumin level .


The single-meal food intake in the PGJI group was more than that in the TGRY group ( P = @ ) .


The PG group showed significantly better hemoglobin levels in the second year ( P = @ ) .


The two-year survival rate was not significantly different ( PGJI vs TGRY , @ % vs @ % , P = @ ) .


PGJI is a safe , radical surgical method for proximal gastric cancer and leads to better outcomes in terms of the single-meal food intake and hemoglobin level , compared with TGRY in the short term .


An endoscopic ultrasound ( EUS ) - guided fine needle biopsy ( EUS-FNB ) device using a core biopsy needle was developed to improve diagnostic accuracy by simultaneously obtaining cytological aspirates and histological core samples .


We prospectively compared the diagnostic accuracy of EUS-FNB with standard EUS-guided fine needle aspiration ( EUS-FNA ) in patients with solid pancreatic masses .


Between January @ and May @ , consecutive patients with solid pancreatic masses were prospectively enrolled and randomized to undergo EUS-FNB using a core biopsy needle or EUS-FNA using a standard aspiration needle at a single tertiary center .


The specimen was analyzed by onsite cytology , Papanicolaou-stain cytology , and histology .


The main outcome measure was diagnostic accuracy for malignancy .


The secondary outcome measures were : the median number of passes required to establish a diagnosis , the proportion of patients in whom the diagnosis was established with each pass , and complication rates .


The overall accuracy of combining onsite cytology with Papanicolaou-stain cytology and histology was not significantly different for the FNB ( n = @ ) and FNA ( n = @ ) groups ( @ % -LSB- @ % CI @ % -@ % -RSB- vs. @ % -LSB- @ % CI @ % -@ % -RSB- ; P = @ ) .


Compared with FNA , FNB required a significantly lower median number of needle passes to establish a diagnosis ( @ vs. @ ; P < @ ) .


On subgroup analysis of @ patients with malignant lesions , the proportion of patients in whom malignancy was diagnosed on the first pass was significantly greater in the FNB group ( @ % vs. @ % ; P < @ ) .


The overall accuracy of FNB and FNA in patients with solid pancreatic masses was comparable ; however , fewer passes were required to establish the diagnosis of malignancy using FNB.This study was registered on the UMIN Clinical Trial Registry ( UMIN@ ) .


Patients with recurrent sinonasal polyposis after endoscopic sinus surgery ( ESS ) have limited treatment options .


This study evaluated the safety and efficacy of a bioabsorbable steroid-eluting implant with @ g of mometasone furoate for its ability to dilate obstructed ethmoid sinuses , reduce polyposis , and reestablish sinus patency .


This was a randomized , controlled , blinded study including @ patients chronic rhinosinusitis with nasal polyposis ( CRSwNP ) refractory to medical therapy and considered candidates for revision ESS .


Follow-up included endoscopic grading by investigators and patient-reported outcomes .


Treated patients ( n = @ ; age as mean standard deviation -LSB- SD -RSB- @ @ years ; @ % male ) underwent in-office bilateral placement .


Control patients ( n = @ ; age @ @ years ; @ % male ) underwent a sham procedure .


At @months , treated patients experienced a significant reduction in bilateral polyp grade ( p = @ ) and ethmoid sinus obstruction ( p = @ ) compared to controls .


Treated patients also experienced a @-fold improvement in the mean nasal obstruction/congestion score ( -@ @ vs -@ @ ; p = @ ) .


This improvement reached statistical significance ( p = @ ) in patients with greater polyp burden ( grade @ bilaterally ; n = @ ) .


At @months , @ % of treated patients compared to only @ % of controls were no longer indicated for repeat ESS .


There was no serious adverse event or clinically significant increases in intraocular pressure or cataract formation .


The symptomatic improvement and statistically significant reduction in polyp grade and ethmoid sinus obstruction supported the efficacy of the steroid-eluting implant for in-office treatment of CRS patient with recurrent polyposis after ESS .


The study results demonstrated that the steroid-eluting implant represents a safe and effective alternative to current management for this patient population .


Chronic Low Back Pain is a complex syndrome with multifactorial bio-psycho-social etiology and interdependences .


Thereby , physical activity seems to play an essential role regarding the prevention and rehabilitation of LBP .


In consequence , physical activity and exercise therapy is an integral part of musculoskeletal rehabilitation in LBP .


However , adherence to self-directed exercise and implementing a health-enhancing physical activity in daily routine after rehabilitation is a common problem for patients and only a few patients integrate health-enhancing physical activity and/or sport activities in their lifestyle .


The present paper describes a comprehensive multilevel approach combining face-to-face intervention , telephone and internet aftercare ( Movement Coaching ) .


Aim of the trial presented in this study protocol is to evaluate effectiveness of Movement Coaching compared to a control intervention .


The study is a prospective , single-blinded , monocenter randomized controlled trial ( RCT ) with three measuring points : T@ = start of inpatient rehabilitation ; T@ = six months follow-up ; T@ = twelve months follow-up .


In total , @ patients were recruited .


The intervention involves small-group face-to-face contact during inpatient rehabilitation ( two times , week @ & @ ) and telephone aftercare ( week @ & week @ after rehabilitation ) as well as internet-based aftercare ( web @ platform ; available until six months after rehabilitation ) .


Primary outcome is physical activity , assessed by GPAQ questionnaire .


The final data collection is expected by April @ .


Due to the burden of physical inactivity , there is a need to develop , evaluate and disseminate approaches that are effective in promoting physical activity and especially promoting the maintenance of physical activity in relevant target groups .


Considering the high prevalence and socioeconomic impact of low back pain and its multifactorial etiology , low back pain patients seem to be a relevant target group for physical activity promotion .


A multilevel approach to bridge the interface of ( inpatient ) rehabilitation and self-directed physical activity will help to target group-specific PA promotion .


There is controversy about the efficacy of currently used treatment modalities to alleviate migraine headaches .


We aimed to evaluate and compare the effects of magnesium sulfate and combined use of dexamethasone/metoclopramide on relieving acute migraine headache .


We randomly divided @ patients who had been referred to an emergency department , into two equal treatment groups with the two treatment plans , and analyzed pain severity at baseline using a numeric rating scale ( NRS ) .


We gave dexamethasone/metoclopramide to one group and magnesium sulfate to the other group , and evaluated pain severity at @ min and at @ - and @-h intervals after infusion .


Finally , we used repeated-measure and two-way analysis of variance for intra - and inter-group evaluations of pain severity and complications , respectively .


We found no significant differences in demographic data and pain severity at baseline ( @ vs. @ ) between the two groups ( p < @ ) .


In the dexamethasone/metoclopramide group , pain severity ( mean standard deviation ) was @ @ ( p = @ ) , @ @ , and @ @ ( p < @ ) at @-min , @-h , and @-h intervals after treatment , respectively , with statistically significant differences between the baseline values and @-h and @-h interval values .


Administration of magnesium sulfate was associated with decreased pain severity at the three intervals ( @ @ , @ @ , and @ @ , respectively ) , exhibiting significant differences compared to baseline values and the corresponding time intervals in the dexamethasone/metoclopramide group ( p < @ ) .


According to the results , magnesium sulfate was a more effective and fast-acting medication compared to a combination of dexamethasone/metoclopramide for the treatment of acute migraine headaches .


The association between the interleukin IL@ beta gene polymorphisms SNP-@ and SNP +@ and susceptibility to the development of Hashimoto 's thyroiditis among adult Caucasian-Polish population were analyzed .


The group studied comprised of @ unrelated patients with Hashimoto 's thyroiditis ( @ women and @ men , mean age @ years ) .


All patients were euthyroid on thyroid replacement therapy , had extremely high serum anti-TPO levels and in @ patients anti-TG levels were also increased .


The control group consisted of @ healthy blood donors without raised anti-TPO antibodies , in whom a personal and familial history of thyroid , autoimmune and inflammatory diseases was excluded .


No goiter or thyroid dysfunction was found @ polymorphisms of the IL@ beta were studied by PCR-RFLP analysis .


To confirm the accuracy of the method used , randomly selected patients were analyzed by direct sequencing .


In both groups allele frequencies were in Hardy-Weinberg equilibrium .


The significant statistical differences between the frequency of C and T allele for both SNPs ( C-@T and C +@ T ) in the group studied and in the controls were found ( p = @ ; OR = @ ; @ % CI : @-@ @ and p = @ ; OR = @ ; @ % CI : @-@ @ ) .


The frequencies of the genotype C-@C compared to C-@T and T-@T as well as C +@ C compared to C +@ T and T +@ T also differed significantly ( p = @ ; OR = @ ; @ % CI : @-@ @ and p = @ ; OR = @ ; @ % CI : @-@ @ ) between patients and controls .


An association between the SNPs of the IL@ beta and susceptibility to Hashimoto 's thyroiditis among the group of Caucasian-Polish population studied was found .


Antalgic radiotherapy for bone metastases might be improved by implementing biological information in the radiotherapy planning using ( @ ) F-FDG-PET-CT based dose painting by numbers ( DPBN ) .


Patients with uncomplicated painful bone metastases were randomized ( @:@:@ ) and blinded to receive either @Gy in a single fraction with conventionally planned radiotherapy ( arm A ) or @Gy in a single fraction with DPBN ( dose range between @Gy and @Gy ) ( arm B ) or @Gy in a single fraction with DPBN ( dose range between @Gy and @Gy ) ( arm C ) .


The primary endpoint was overall pain response at @month .


The phase II trial was designed to select the experimental arm with sufficient promise of efficacy to continue to a phase III trial .


Forty-five patients were randomized .


Eight ( @ % ) , @ ( @ % ) and @ patients ( @ % ) had an overall response to treatment in arm A , B and C , respectively .


The estimated odds ratio of overall response for arm B vs. A is @ ( @ % CI : @-@ @ , p = @ ) .


The estimated odds ratio of arm C vs. A is @ ( @ % CI : @-@ @ , p = @ ) .


A single fraction of @Gy with DPBN will be further evaluated in a phase III-trial .


This study evaluated the impact of nonculprit vessel myocardial perfusion on outcomes of non-ST-segment elevation acute coronary syndromes ( NSTE-ACS ) patients .


ST-segment elevation myocardial infarction patients have decreased perfusion in areas remote from the infarct-related vessel .


The impact of myocardial hypoperfusion of regions supplied by nonculprit vessels in NSTE-ACS patients treated with percutaneous coronary intervention ( PCI ) is unknown .


The angiographic substudy of the ACUITY ( Acute Catheterization and Urgent Intervention Triage Strategy ) trial included @,@ NSTE-ACS patients .


Complete @-vessel assessments of baseline coronary TIMI ( Thrombolysis In Myocardial Infarction ) flow grade and myocardial blush grade ( MBG ) were performed .


We examined the outcomes of PCI-treated patients according to the worst nonculprit vessel MBG identified per patient .


Among the @,@ patients treated with PCI , the worst nonculprit MBG was determined in@ ,@ ( @ % ) patients , including @ ( @ % ) MBG @/@ patients , @ ( @ % ) MBG @ patients , and @,@ ( @ % ) MBG @ patients .


Nonculprit MBG @/@ was associated with worse baseline clinical characteristics .


Patients with nonculprit MBG @/@ versus MBG @ had increased rates of @-day ( @ % vs. @ % , p < @ ) and @-year ( @ % vs. @ % , p < @ ) death .


Similar results were found among patients with pre-procedural TIMI flow grade @ in the culprit vessel , where nonculprit vessel MBG @/@ ( hazard ratio : @ -LSB- @ % confidence interval : @ to @ -RSB- , p = @ ) was the strongest predictor of @-year mortality .


Reduced myocardial perfusion in an area supplied by a nonculprit vessel is associated with increased short - and long-term mortality rates in NSTE-ACS patients undergoing PCI .


Furthermore , worst nonculprit MBG is able to risk-stratify patients with normal baseline flow of the culprit vessel .


Mechanical insufflation-exsufflation ( MI-E ) , more commonly known as ` cough assist therapy ' , is a method which produces inspiratory and expiratory assistance to improve cough performances .


However , other alternatives or combinations are possible .


The objective was to compare the effects of mechanical insufflation combined with manually assisted coughing ( MAC ) , insufflation-exsufflation alone and insufflation-exsufflation combined with MAC in neuromuscular patients requiring cough assistance .


Eighteen neuromuscular patients with severe respiratory muscle dysfunction and peak cough flow ( PCF ) lower than @ liters/s or maximal expiratory pressure ( MEP ) lower than +@ cm H@O were studied .


Patients were studied under three cough-assisted conditions , which were used in random order : insufflation by intermittent positive-pressure breathing ( IPPB ) combined with MAC , MI-E and MI-E + MAC .


Overall , PCF was higher with IPPB + MAC than with MI-E + MAC or MI-E alone .


Among the @ patients who had higher PCF values with IPPB + MAC than with the two other techniques , @ exhibited mask pressure swings during MI-E exsufflation , with a transient positive-pressure value due to the expiratory flow produced by the combined patient cough effort and MAC .


Each of these @ patients had higher PCF values ( > @ liters/s ) than did the other @ patients when using IPPB + MAC .


Our results indicate that adding the MI-E device to MAC is unhelpful in patients whose PCF with an insufflation technique and MAC exceeds @ liters/s .


This is because the expiratory flow produced by the patient 's effort and MAC transitorily exceeds the vacuum capacity of the MI-E device , which therefore becomes a transient load against the PCF .


The objective of this study was to evaluate the safety and efficacy of SprayShield Adhesion Barrier in preventing and/or reducing postoperative adhesion during gynecological surgery .


This was a prospective , controlled , blinded , and randomized study .


Patient blinding was performed intraoperatively .


Subjects were randomly assigned to the SprayShield or the control group in a @:@ ratio .


The study was conducted at the Clinic of Gynaecology and Obstetrics , at the University Hospital for Gynecology in Germany .


Fifteen patients participated in this study ; nine patients were assigned to the SprayShield and six patients to the control group .


During first operation ( FLL ) in the SprayShield group , the agent was applied to all myomectomy suture lines .


Patients in the control group did not receive any anti-adhesion treatment , only good surgical practice .


A second-look laparoscopy ( SLL ) was performed @-@weeks after myomectomy to evaluate adhesion formation .


Main outcome measures were incidence , severity , and extent of uterine adhesions .


No significant differences were found between the two study groups .


SprayShield is easy to use .


No serious adverse event related to SprayShield was observed .


Efficacy data are inconclusive regarding the performance of SprayShield .


Further studies are needed to better understand this performance .


To compare an efficacy of a moisturizer containing spent grain wax , Butyrospermum parkii extract , Argania spinosa kernel oil ( S ) with @ % hydrocortisone cream ( HC ) for the treatment of mild to moderate atopic dermatitis .


Twenty-nine patients , age between @ and @ years old with mild to moderate atopic dermatitis were enrolled The body was randomly divided to left and right side .


One side was applied with S cream and the other side was applied with HC cream twice daily for four weeks .


Observation of recurrence rate after remission was recorded .


Clinical outcomes were analyzed by using the scoring ofAtopic Dermatitis ( SCORAD ) score .


Statistical analysis was done by using descriptive statistics , pair t-test , one-way repeated ANOVA , and McNemar 's test .


It was demonstrated that both agents had improvement of SCORAD score after two weeks , with statistically significant difference ( p < @ ) .


At fourth week , both agents had improvement of SCORAD score without being statistically significant different ( p > @ ) .


Although the S cream side had higher remission rate than the HC cream side , there was no statistically significant difference ( p > @ ) .


S cream was as effective as HC cream in the treatment and maintenance period of mild to moderate childhood atopic dermatitis .


Intracranial arteriovenous malformations ( AVMs ) are associated with high morbidity and mortality .


Modern microsurgery has improved the results of surgical treatment of AVMs ; however , the treatment of AVMs , particularly eloquently located AVMs , still carries a high risk .


Functional MRI ( fMRI ) has been reported to be used for the preoperative evaluation of AVMs in small case series .


The purpose is to identify the utility and efficacy of fMRI-guided microsurgery of AVMs in a large randomised controlled trial .


The study is a prospective , randomised controlled clinical trial .


This study will enrol a total of @ eligible patients .


These eligible patients will be randomised to the standard microsurgery group and the fMRI-guided microsurgery group in a @:@ ratio .


Patient baseline characteristics and AVM architecture and characteristics will be described .


In the fMRI-guided group , fMRI mapping of an eloquent cortex in all AVMs will be identified .


Surgical complications and outcomes at pretreatment , post-treatment , at discharge and at @-month , @-month and @-month follow-up intervals will be analysed using the modified Rankin Scale ( mRS ) .


This trial will determine whether fMRI-guided microsurgery could improve outcomes in patients with AVMs and also identify the safety and efficacy of fMRI-guided microsurgery .


Definitive therapy is not defined for the management of oral submucous fibrosis ( OSMF ) .


This study evaluated the efficacy of aloe vera gel as an adjuvant treatment of OSMF .


A double-blind , placebo-controlled , parallel-group randomized controlled trial was conducted on @ subjects with OSMF divided into medicinal treatment ( submucosal injection of hyaluronidase and dexamethasone , n = @ ) and surgical treatment ( n = @ ) categories .


Each category was randomly divided into groups A ( with aloe vera , n = @ per category ) and B ( without aloe vera , n = @ per category ) .


Follow-up assessment for various symptoms was performed , and results were analyzed using paired and unpaired Student t tests .


The group receiving aloe vera had a significant improvement in most symptoms of OSMF ( P < @ ) compared with the non-aloe vera group , in both the medicinal and surgical categories .


Aloe vera gel was effective as an adjuvant in treatment of OSMF .


As clinical studies conducted to explore the safety and efficacy of new procedures are considered an important focus in endodontic research , the aim of this controlled clinical study was to compare a laser-assisted endodontic treatment using an erbium , chromium : yttrium-scandium-gallium-garnet ( Er , Cr : YSGG ) laser and radial firing tips ( RFT ) versus the conventional use of @ % sodium hypochlorite and interim calcium hydroxide paste , in teeth with chronic apical periodontitis .


Forty-three single-rooted and premolar teeth were randomly assigned .


In group @ , teeth were prepared and irrigated with @ % sodium hypochlorite and calcium hydroxide inter-appointment dressing was applied ; in group @ teeth were prepared with saline solution and irradiated with Er , Cr : YSGG laser using RFT@ ( @ s , @ mJ , @ Hz ) and RFT@ ( @ s , @ mJ , @ Hz ) at the first and second appointments , respectively , four times each , moving at @ mm/sec ( -@ ) from apical to coronal .


The primary outcome measure was change in apical bone density at @ months , using the periapical index ( PAI ) for blind radiographic assessment .


Thirty teeth were examined and subjected to statistical analysis , @ in the control group and @ in the test group .


There were two treatment failures in the control group that were not included for analysis ; both groups exhibited statistically significant decreases in PAI scores .


The present findings suggest that for single-rooted and premolar teeth , this laser-assisted protocol can achieve predictable endodontic outcomes , comparable to conventional strategies in @ year of follow-up .


To assess the relative importance of independent risk factors for peripheral intravenous catheter ( PIVC ) failure .


Secondary data analysis from a randomized controlled trial of PIVC dwell time .


The Prentice , Williams , and Peterson statistical model was used to identify and compare risk factors for phlebitis , occlusion , and accidental removal .


Three acute care hospitals in Queensland , Australia .


The trial included @,@ adult medical and surgical patients ( @,@ catheters ) with a PIVC with greater than @ days of expected use .


Modifiable risk factors for occlusion included hand , antecubital fossa , or upper arm insertion compared with forearm ( hazard ratio -LSB- HR -RSB- , @ -LSB- @ % confidence interval ( CI ) , @-@ @ -RSB- , @ -LSB- @ % CI , @-@ @ -RSB- , and @ -LSB- @ % CI , @-@ @ -RSB- , respectively ) ; and for phlebitis , larger diameter PIVC ( HR , @ -LSB- @ % CI , @-@ @ -RSB- ) .


PIVCs inserted by the operating and radiology suite staff had lower occlusion risk than ward insertions ( HR , @ -LSB- @ % CI , @-@ @ -RSB- ) .


Modifiable risks for accidental removal included hand or antecubital fossa insertion compared with forearm ( HR , @ -LSB- @ % CI , @-@ @ -RSB- and @ -LSB- @ % CI , @-@ @ -RSB- , respectively ) , clinical staff insertion compared with intravenous service ( HR , @ -LSB- @ % CI , @-@ @ -RSB- ) ; and smaller PIVC diameter ( HR , @ -LSB- @ % CI , @-@ @ -RSB- ) .


Female sex was a nonmodifiable factor associated with an increased risk of both phlebitis ( HR , @ -LSB- @ % CI , @-@ @ -RSB- ) and occlusion ( HR , @ -LSB- @ % CI , @-@ @ -RSB- ) .


PIVC survival is improved by preferential forearm insertion , selection of appropriate PIVC diameter , and insertion by intravenous teams and other specialists .


To compare the differences in the clinical efficacy between Guan 's quadruple therapy for kidney disease and the conventional western medication in the treatment of chronic renal failure ( CRF ) .


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


In the observation group , besides the physician instruction of low protein and low phosphorus diet in the two groups , Guan 's quadruple therapy for kidney disease was applied , including ( @ ) the isolated herbal moxibustion at Shenshu ( BL @ ) and Pishu ( BL @ ) , or Ganshu ( BL @ ) , Zusanli ( ST @ ) and Guanyuan ( CV @ ) alternatively ; ( @ ) acupuncture at the auricular points such as shen ( CO@ ) , jiaogan ( AHR@ ) , Shenshangxian ( TG@ ) , fei ( CO@ ) and pizhixia ( AT@ ) ; ( @ ) injection of mixture of astragalus injection and lidocaine injection at Feishu ( BL @ ) , Pishu ( BL @ ) , Shenshu ( BL @ ) and the others ; ( @ ) modified Shenshuai Yihao decoction according to syndrome differentiation .


In the control group , the conventional western medication was used .


After @ months of treatment , the differences were observed between the two groups in the clinical efficacy , serum creatinine ( Scr ) , blood urea nitrogen ( BUN ) , endogenous creatinine ( Ccr ) and @ h urine protein quantitation ( UPQ ) .


In the observation group , after treatment , the remarkably effective rate was @ % ( @/@ ) and the total effective rate was @ % ( @/@ ) , which were superior to @ % ( @/@ ) and @ % ( @/@ ) in the control group ( both P < @ ) .


After treatment , the levels of Scr , BUN and @ h UPQ were reduced apparently ( all P < @ ) , and the level of Ccr was increased apparently in the two groups ( both P < @ ) .


After treatment , the levels of Scr , BUN and @ h UPQ were reduced much more apparently in the observation group as compared with those in the control group ( all P < @ ) .


Guan 's quadruple therapy for kidney disease achieves a better efficacy on CRF compared with the conventional western medication .


This therapy improves renal functions , relieves clinical symptoms and physical signs and benefits the life quality of patients .


The topical gel known as `` ABH gel , '' comprising lorazepam ( Ativan ( ) ) , diphenhydramine ( Benadryl ( ) ) , and haloperidol ( Haldol ( ) ) , is frequently used to treat nausea because of its perceived efficacy , relatively low cost , and ease of use in the home setting .


There are limited scientific data on this medication , however .


Recent pilot studies showed no absorption of the active ingredients of the gel , prompting further prospective studies into the cause of the perceived efficacy in the clinical setting .


To determine any difference in the effectiveness of ABH gel compared with placebo in cancer patients with nausea .


A randomized , double-blind , placebo-controlled , crossover , noninferiority clinical trial was developed to test the hypothesis that there is no difference in the effectiveness of ABH gel compared with placebo in cancer patients with nausea .


The primary outcome was the difference in nausea score ( on a @-@ scale ) at baseline and at @ minutes in each treatment group .


The difference in the ABH gel-treated group compared with placebo was evaluated for noninferiority .


Secondary outcomes included the number of vomiting episodes and side effects over time .


The mean change in nausea score from baseline to @ minutes after treatment in the ABH gel group was @ @ and @ @ for the placebo group ( P = @ ) .


The placebo group was found to be noninferior to the ABH gel group in reducing the nausea score .


ABH gel also did not decrease vomiting events better than placebo ( P = @ ) .


Only one patient reported any side effects from the treatments in either arm of the study .


ABH gel in its current formulation should not be used in cancer patients experiencing nausea .


Irritable bowel syndrome ( IBS ) is highly prevalent in young women under stressful conditions .


Cognitive behavioral therapy ( CBT ) has been known to be effective in treating IBS .


This study aimed to evaluate the clinical outcomes of CBT in female nursing students with IBS .