SMO is as effective as oxazepam , one of the gold standard BDZs , in the treatment of uncomplicated AWS .


Due to its tolerability and absence of significant side effects , SMO may be considered a valid alternative choice in the treatment of AWS .


Cervical cancer is the second most common cancer among Malaysian women with an ASR of @ and a mortality rate of @ per @,@ population in @ ( GLOBOCAN , @ ) .


The @ year prevalence was estimated to be @ per @,@ population .


As the second most common cancer affecting productive females , cervical cancer imposes an impact to the socioeconomic aspect of the country .


However , the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus , delay in initiating treatment for cervical cancer .


Realizing the urgency to increase the uptake of PAP smear , besides enhancing the promotion of PAP smear screening for women above @ years old , the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening .


This is of public health importance as identifying the best feasible option to increase patient 's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting .


The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program .


This was a population based randomized control trial .


Women aged @-@ years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear .


There are four different intervention groups ; letter , registered letters , short messages services ( SMS ) and phone calls where @ subjects were recruited into each group .


Samples were generated randomly from the same population in Klang into four different groups .


The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation .


The intervention groups were either be given a registered letter , an SMS or a phone call to re-call them .


The socio-demographic data of the patients who came for uptake were collected for further analysis .


All the groups were followed up after @ weeks to assess their compliance to the recall .


The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes : i ) patients response ; ii ) uptake for repeat pap smear .


To determine the pharmacokinetics ( PK ) and placental transfer of intravenous ( i.v. ) N-acetylcysteine ( NAC ) in mothers with a clinical diagnosis of chorioamnionitis ( CA ) and determine the PK of i.v. NAC in their infants .


In this prospective , double-blind study i.v. NAC @ mg/kg/dose or saline was administered within @ hours of CA diagnosis to pregnant women @ weeks ' gestation and then every @ hours until delivery .


Maternal PK and placental transfer were determined with maternal blood and matched maternal and cord venous blood .


Neonatal PK estimates were determined from i.v. NAC ( @-@ mg/kg/dose ) administered every @ hours for @ doses .


Noncompartmental analyses were performed for maternal and neonatal PK estimates .


Eleven mothers ( @ preterm , @ near-term ) and @ infants ( @ set of twins ) received NAC .


Maternal clearance ( CL ) of NAC was faster than in nonpregnant adults , with a terminal elimination half-life of @ @ hours .


The NAC cord to maternal ratio was @ @ , suggesting rapid placental transfer and slower rate of fetal CL .


Neonatal PK estimates for near-term compared with preterm infants showed a significantly shorter terminal elimination half-life ( @ vs @ hours , respectively ) and greater CL ( @ vs @ mL/h/kg , respectively ) .


Maternal CL and placental transfer of NAC was rapid , with umbilical cord concentrations frequently exceeding maternal concentrations .


The administration of NAC to mothers with CA achieves predictable NAC plasma concentrations in the fetus , indicating that antenatal neuroprotection may be possible for these newborns at high risk for neuroinflammation .


The primary study hypothesis was that ranibizumab @ mg monotherapy or combined with laser is superior to laser monotherapy based on mean average change in best-corrected visual acuity ( BCVA ) over @ months in Asian patients with visual impairment resulting from diabetic macular edema ( DME ) .


A @-month , randomized , double-masked , multicenter , laser-controlled , phase III study .


Three hundred ninety-six patients aged @ years , with type @ or @ diabetes mellitus , BCVA of @-@ Early Treatment Diabetic Retinopathy Study ( ETDRS ) letters , and visual impairment resulting from DME .


Patients were randomized to ranibizumab + sham laser ( n = @ ) , ranibizumab + active laser ( n = @ ) , or sham injection + active laser ( n = @ ) .


Ranibizumab/sham injections were administered on day @ and continued monthly .


As of month @ , monthly injections were continued if stable vision was not reached .


Treatment was reinitiated if BCVA decreased because of DME progression .


Active/sham laser was administered on day @ and thereafter according to ETDRS guidelines .


Average change in BCVA from baseline to months @ through @ , central retinal subfield thickness ( CRST ) , and safety over @ months .


Ranibizumab monotherapy or combined with laser was superior to laser in improving mean average change in BCVA from baseline to months @ through @ ( +@ and +@ vs +@ letters ) .


At month @ , greater proportion of patients gained @ letters with ranibizumab and ranibizumab + laser compared with laser ( @ % and @ % vs @ % ) .


Mean CRST reduced significantly from baseline to month @ with ranibizumab ( -@ m ) and ranibizumab + laser ( -@ m ) versus laser ( -@ m ) .


Patients received a mean of @ and @ ranibizumab injections in the ranibizumab and ranibizumab + laser arms , respectively , and @-@ @ active laser across treatment arms over @ months .


Conjunctival hemorrhage was the most common ocular , whereas nasopharyngitis and hypertension were the most common nonocular adverse events .


Ranibizumab was not associated with any cases of cerebrovascular hemorrhage and cerebrovascular ischemia .


No death related to study treatment was reported .


Ranibizumab monotherapy or combined with laser showed superior BCVA improvements over laser treatment alone in Asian patients with visual impairment resulting from DME .


No new ocular or nonocular safety findings were observed and treatment was well tolerated over @ months .


Despite promising results of Er : YAG laser in periodontal debridement , to date there is no consensus about the ideal settings for clinical use .


This experimental clinical trial aimed to determine the effects of debridement using Er : YAG laser and to compare with ultrasonic treatment .


Sixty-four teeth were divided into two in vivo and in vitro subgroups .


Each tooth received ultrasonic treatment on one side and Er : YAG laser debridement at either @ , @ , @ or @ mJ pulse ( -@ ) and at @ Hz on the other side on a random basis .


All samples were morphologically analyzed afterwards under scanning electron microscope for surface changes and dentinal tubules exposure .


Treatment duration ( d ) was also recorded .


Laser debridement produced an irregular , rough and flaky surface free of carbonization or meltdown while ultrasound produced a relatively smoother surface .


The number of exposed dentinal tubules ( n ) followed an energy-dependent trend .


The number of exposed tubules among the in vivo laser groups was n @ mJ = n @ mJ < n @ mJ < n @ mJ ( P < @ ) .


Also @ and @ mJ lasers led to significantly more dentinal exposure than ultrasound under in vivo condition .


Within the in vitro laser groups , dentinal tubules exposure was n @ mJ < n @ mJ < n @ mJ < n @ mJ ( P @ ) .


Furthermore , in vitro laser treatments at @ , @ and @ mJ led to significantly more dentinal denudation than ultrasound .


Treatment duration ( d ) for the in vivo groups was d @ mJ > d @ mJ > d Ultrasound = d @ mJ > d @ mJ ( P @ ) , while for the in vitro groups it was d @ mJ > d @ mJ = d Ultrasound = d @ mJ > d @ mJ ( P @ ) .


Due to excessive treatment duration and surface damage , Er : YAG laser debridement at @ and @ mJ pulse ( -@ ) , respectively , is not appropriate for clinical use .


Although laser debridement at @ and @ mJ pulse ( -@ ) seems more suitable for clinical application , compared to ultrasound the former is more time-consuming and the latter is more aggressive .


Using a feedback device or lower pulse energies are recommended when using laser in closed field .


To determine whether dexmedetomidine sedation in the postanesthesia care unit ( PACU ) could decrease agitation and delirium after free flap surgery .


Eighty patients were randomly divided into @ groups .


In the experimental group , dexmedetomidine was given at an hourly infusion rate of @ g/kg for @hour before the operation was completed and continued in the PACU at @ to @ g/kg continuously until the next morning .


In the control group , normal saline was given during the same periods .


Patients in the @ groups received sufentanil and midazolam for sedation and pain relief when necessary .


Agitation was monitored with the Riker Sedation-Agitation Scale in the PACU and delirium was monitored with the Confusion Assessment Method for the Intensive Care Unit for @days postoperatively .


The overall incidence of agitation was similar between the @ groups .


However , when the influence of patient shifting was excluded , the incidence of agitation in the dexmedetomidine group was apparently lower than that in the control group ( @ vs @ % ; P = @ ) .


No difference was found in the occurrence of delirium between the experimental and control groups ( @ vs @ % ; P = @ ) .


Dexmedetomidine does not change the overall incidence of agitation after free flap surgery ; however , it does decrease agitation after PACU admission .


It does not prevent delirium within @days postoperatively .


Through many years , the standard care has been to use continuous sedation of critically ill patients during mechanical ventilation .


However , preliminary randomised clinical trials indicate that it is beneficial to reduce the sedation level .


No randomised trial has been conducted comparing sedation with no sedation , a priori powered to have all-cause mortality as primary outcome.The objective is to assess the benefits and harms of non-sedation versus sedation with a daily wake-up trial in critically ill patients .


The non-sedation ( NONSEDA ) trial is an investigator-initiated , randomised , clinical , parallel-group , multinational trial designed to include @ patients from at least six ICUs in Denmark , Norway and Sweden.Inclusion criteria are mechanically ventilated patients with expected duration of mechanical ventilation > @ hours.Exclusion criteria are non-intubated patients , patients with severe head trauma , coma at admission or status epilepticus , patients treated with therapeutic hypothermia , patients with PaO@/FiO@ < @ where sedation might be necessary to ensure sufficient oxygenation or place the patient in prone position.Experimental intervention is non-sedation supplemented with pain management during mechanical ventilation.Control intervention is sedation with a daily wake-up trial.The primary outcome will be all cause mortality at @ days after randomization .


Secondary outcomes will be : days until death throughout the total observation period ; coma - and delirium-free days ; highest RIFLE score ; days until discharge from the intensive care unit ( within @ days ) ; days until the participant is without mechanical ventilation ( within @ days ) ; and proportion of patients with a major cardiovascular outcome .


Explorative outcomes will be : all cause mortality at @ days after randomisation ; days until discharge from the intensive care unit ; days until the participant is without mechanical ventilation ; days until discharge from the hospital ; organ failure.Trial size : we will include @ participants ( @ ) in order to detect or reject @ % relative risk reduction in mortality with a type I error risk of @ % and a type II error risk of @ % ( power at @ % ) .


The trial investigates potential benefits of non-sedation .


This might have large impact on the future treatment of mechanically ventilated critically ill patients .


Few school programs are effective in preventing adolescents ' tobacco smoking initiation .


The `` Lega contro i Tumori - Luoghi di Prevenzione '' is a cluster randomized controlled trial designed to evaluate a school-based peer-led smoking prevention intervention with extracurricular activities for students aged @-@ years .


This paper presents the study design and the baseline characteristics of the study population .


Twenty secondary schools located in the Reggio Emilia province took part in the study .


Five schools were excluded because they already participated in smoking prevention interventions .


The schools were randomized to control or intervention arms .


The study population consisted of students attending the first grade .


Components of the intervention included @ ) the out-of-school `` Smoking Prevention Tour '' ( SPT ) at the `` Luoghi di Prevenzione '' Center , a @-hour ( @ sessions ) extracurricular activity ; @ ) the `` Smoke-free Schools '' intervention , combining a life-skills-based peer-led intervention at school , an in-depth lesson on one of the SPT sessions , and enforcement surveillance of the school antismoking policy .


Tobacco use was studied through a questionnaire administered before and @ months after the intervention .


Eleven high schools and @ vocational secondary schools took part in the study for a total of @,@ out of @,@ eligible students ( @ % ) .


The proportions of respondents in high schools and vocational secondary schools were @ % and @ % , respectively ( P < @ ) .


Intervention and control arms showed a different distribution of gender and school type , whereas no difference was observed in any tobacco-use characteristic .


This study is one of the few Italian trials to evaluate the effectiveness of a school-based program for preventing smoking initiation .


To study the change in spherical equivalent and other ocular parameters @ year after stopping the administration of atropine .


Prospective randomized double-masked clinical trial .


We assigned @ myopic children , @ to @ years of age , to receive atropine @ % , @ % or @ % for @ months , after which medication was stopped .


Parents and children gave informed consent to participate in the research .


Children were reviewed at @ , @ and @ months , and changes in cycloplegic spherical equivalent ( SE ) , axial length ( AL ) , visual acuity , pupil size , and accommodation were assessed .


Of the children , @ ( @ % ) entered into the washout phase .


At entry , there was no significant difference in age , gender , SE , or AL among the children in the various atropine groups .


Over the following @ months , myopic progression was greater in the @ % eyes ( -@ @ D ) , compared to the @ % ( -@ @ D ) and @ % eyes ( -@ @ D , P < @ ) .


AL growth was also greater in the @ % ( @ @ mm ) and @ % ( @ @ mm ) eyes , compared to the @ % eyes ( @ @ mm , P < @ ) .


Pupil size and near visual acuity returned to pre-atropine levels in all groups , but accommodation at @ months was less in the @ % eyes ( @ @ D ) compared to the @ % ( @ @ D ) and @ % eyes ( @ @ D , P < @ ) .


The overall increase in SE over the entire @ months in the @ % , @ % and @ % groups was -@ @ D , -@ @ D and -@ @ D , respectively ( P < @ ) .


There was a myopic rebound after atropine was stopped , and it was greater in eyes that had received @ % and @ % atropine .


The @ % atropine effect , however , was more modulated and sustained .


The purpose of this prospective , randomized , double-blind , placebo-controlled study was to determine the effect of the administration of the combination acetaminophen/hydrocodone on the anesthetic success of mandibular posterior teeth in patients experiencing symptomatic irreversible pulpitis .


One hundred emergency patients in moderate to severe pain diagnosed with symptomatic irreversible pulpitis of a mandibular posterior tooth randomly received , in a double-blind manner , identical capsules of either a combination dose of @ mg acetaminophen/@ mg hydrocodone or placebo @ minutes before the administration of a conventional inferior alveolar nerve ( IAN ) block .


Endodontic access was begun @ minutes after completion of the block , and all patients used for data analysis had profound lip numbness .


Success was defined as no or mild pain ( visual analog scale recordings ) on pulpal access or instrumentation .


The success rate for the IAN block was @ % for the combination dose of @ mg acetaminophen/@ hydrocodone and @ % for the placebo dose , with no statistically significant difference between the @ groups ( P = @ ) .


A combination dose of @ mg acetaminophen/@ mg hydrocodone given @ minutes before the administration of the IAN block did not result in a statistically significant increase in anesthetic success for mandibular posterior teeth in patients experiencing symptomatic irreversible pulpitis .


The aim of this study is to evaluate the benefits and disadvantages of closing the mesenteric defects during gastric bypass to avoid internal herniation ( IH ) .


The study is performed as a single-centre , randomised , controlled , blinded trial .


Patients are randomly assigned to either conventional laparoscopic Roux-en-Y gastric bypass ( LRYGB ) without closing the mesenteric defects ( n = @ ) or RYGB with closing of the defects with hernia clips ( n = @ ) .


Follow-up is conducted at six months , one year , two years and five years after RYGB .


The primary endpoint is the incidence of IH .


This study will be the first Danish , randomised , controlled study comparing conventional LRYGB with and without closure of the mesenteric defects .


The results will contribute to evidence-based recommendations for the prevention of IH .


We performed a multicenter , randomized , double-blind trial to assess the efficacy and safety of a single , fixed , intravenous dose of palonosetron ( @ mg ) in the treatment of established postoperative nausea and vomiting ( PONV ) .


Three hundred and eighty-four patients who had at least one risk factors of PONV and underwent surgery under general anesthesia were screened .


Those who developed PONV were randomized to receive either @ mg intravenous palonosetron or a placebo .


The incidence of nausea and vomiting , severity of nausea , requirements for rescue anti-emetics , and adverse effects at @ , @ , and @ h after drug administration were evaluated .


Complete response ( CR ) and complete control ( CC ) rate were compared for @ and @ h.


Among the @ patients , @ ( @ % ) developed PONV and were randomized to either the palonosetron ( n = @ ) or placebo ( n = @ ) group .


The number of patients with CR at @ and @ h was higher in the palonosetron group than the placebo group -LSB- @-@ h : n = @ ( @ % ) vs. n = @ ( @ % ) , p < @ ; @-@ h : n = @ ( @ % ) vs. n = @ ( @ % ) , p < @ -RSB- .


The incidence of PONV at @ , @ , and @ h periods was lower in the palonosetron group than the placebo group ( @ , @ , and @ % in the palonosetron group vs. @ , @ , and @ % in the placebo group , p = @ , @ , @ , respectively ) .


The incidence of adverse events was not different between the groups .


A single @ mg IV dose of palonosetron effectively increased the CR rates at @ and @ h in these moderate-risk patients with established PONV .


Assessing the immunogenicity of a single dose of hepatitis A virus ( HAV ) vaccines is important because some people receive only a single dose .


However , previous studies have shown variable results and have not examined the effects of demographic characteristics other than gender .


This study was performed to examine the immunogenicity of a single dose of HAV vaccine according to the vaccine type and demographic characteristics in young adults .


Seronegative medical school students were randomly allocated to receive either Havrix or Epaxal .


After approximately @ months , the seroconversion rate in @ participants was @ % .


In men , the Havrix group showed a significantly higher seroconversion rate ( @ % ) than the Epaxal group ( @ % ) , whereas both vaccine groups showed similarly high immunogenicity in women ( Havrix : @ % , Epaxal : @ % ; P for interaction = @ ) .


According to the results of a multivariate analysis , Epaxal showed significantly lower immunogenicity than Havrix only in men .


Age , obesity , drinking , smoking , and follow-up time did not significantly affect seroconversion in either gender .


The seroconversion rate of single-dose HAV vaccines was low in men , particularly in those who received Epaxal .


Our results suggest that gender effects should be considered when comparing the immunogenicity of different HAV vaccines .


To compare the corticosteroid injection ( CSI ) with or without thumb spica cast ( TSC ) for de Quervain tendinitis .


In this prospective trial , @ eligible patients with de Quervain tenosynovitis were randomly assigned into CSI + TSC ( @ cases ) and CSI ( @ cases ) groups .


All patients received @ mg of methylprednisolone acetate with @ cc lidocaine @ % in the first dorsal compartment at the area of maximal point tenderness .


The primary outcome was the treatment success rate , and the secondary outcome was the scale and quality of the treatment method using Quick Disabilities of Arm , Shoulder and Hand and visual analog scale scores .


The groups had no differences in mean age , sex , and occupation .


The visual analog scale and Quick Disabilities of the Arm , Shoulder and Hand scores were similar in both groups before the treatment .


The treatment success rate was @ % in the CSI + TSC group and @ % in the CSI group .


Although both methods improved the patients ' conditions significantly in terms of relieving pain and functional ability , CSI + TSC had a significantly higher treatment success rate .


The combined technique of corticosteroid injection and thumb spica casting was better than injection alone in the treatment of de Quervain tenosynovitis in terms of treatment success and functional outcomes .


Therapeutic II .


Preoperative oral rehydration solution ( ORS ) prevents hypovolemia .


The aim of this study was to compare the effect of intubating dose of rocuronium in patients taking and those not taking preoperative ORS .


Twenty patients , ASA I aged @-@ years scheduled for elective surgery , were investigated and randomly assigned to two groups : drinking @,@ ml ORS @ to @ hours before anesthesia ( ORS group ) and nothing by mouth from @ hours before anesthesia ( control group ) .


Anesthesia was maintained with propofol and remifentanil , and rocuronium @ mg x kg ( -@ ) was administrated .


To evaluate the effect of rocuronium , acceleromyography at the adductor pollicis was performed using @ Hz stimulation .


Cardiac index ( CI ) and stroke volume variation ( SVV ) from FloTra/Vigileo , times to @ % twitch depression as onset time ( OT ) , and times to first twitch re-detection ( TR ) were recorded .


SVV was significantly lower in ORS group ( P = @ ) , and CI showed no difference .


In ORS group , TR was significantly shorter than that of control group ( P = @ ) , and OT tended to be prolonged ( @ @ s vs. @ @ s ) , but not significantly .


Preoperative oral rehydration possibly increases circulating blood volume , and shortens the duration of rocuronium effect .


Measles vaccine ( MV ) has a greater effect on child survival when administered in early infancy , when maternal antibody may still be present .


To test whether MV has a greater effect on overall survival if given in the presence of maternal measles antibody , we reanalyzed data from @ previously published randomized trials of a @-dose schedule with MV given at @-@ months and at @ months of age .


In both trials antibody levels had been measured before early measles vaccination .


In trial I ( @-@ ) , the mortality rate was @ per @ person-years among children vaccinated with MV in the presence of maternal antibody and @ per @ person-years without maternal antibody ( mortality rate ratio -LSB- MRR -RSB- , @ ; @ % confidence interval -LSB- CI -RSB- , @ -@ ) .


In trial II ( @-@ ) , the mortality rate was @ per @ person-years among children vaccinated in presence of maternal measles antibody and @ per @ person-years without measles antibody ( MRR , @ ; @ % CI , @ -@ ) .


Possible confounding factors did not explain the difference .


In a combined analysis , children who had measles antibody detected when they received their first dose of MV at @-@ months of age had lower mortality than children with no maternal antibody , the MRR being @ ( @ % CI , @ -@ ) between @-@ months and @ years .


Child mortality in low-income countries may be reduced by vaccinating against measles in the presence of maternal antibody , using a @-dose schedule with the first dose at @-@ months ( earlier than currently recommended ) and a booster dose at @-@ months of age .


Acute hydrocephalus is a well-known sequela of aneurysmal subarachnoid hemorrhage ( SAH ) .


Controversy exists about whether open microsurgical methods serve to reduce shunt dependency compared with endovascular techniques .


To determine predictors of shunt-dependent hydrocephalus and functional outcomes after aneurysmal SAH .


A total of @ patients who were part of a prospective , randomized , controlled trial from @ to @ were retrospectively reviewed .


All variables including demographic data , medical history , treatment , imaging , and functional outcomes were included as part of the trial .


No additional variables were retrospectively collected .


Ultimately , @ patients ( @ % ) required a ventriculoperitoneal shunt ( VPS ) in our series .


Age , dissecting aneurysm type , ruptured vertebrobasilar aneurysm , Fisher grade , Hunt and Hess grade , admission intraventricular hemorrhage , admission intraparenchymal hemorrhage , blood in the fourth ventricle on admission , perioperative ventriculostomy , and hemicraniectomy were significant risk factors ( P < @ ) associated with shunt-dependent hydrocephalus on univariate analysis .


On multivariate analysis , intraventricular hemorrhage and intraparenchymal hemorrhage were independent risk factors for shunt dependency ( P < @ ) .


Clipping vs coiling treatment was not statistically associated with VPS after SAH on both univariate and multivariate analyses .


Patients who did not receive a VPS at discharge had higher Glasgow Outcome Scale and Barthel Index scores and were more likely to be functionally independent and to return to work @ months after surgery ( P < @ ) .


There is no difference in shunt dependency after SAH among patients treated by endovascular or microsurgical means .


Patients in whom shunt-dependent hydrocephalus does not develop after SAH tend to have improved long-term functional outcomes .


Acute neural effects of antidepressant medication on emotion processing biases may provide the foundation on which clinical outcomes are based .


Along with effects on positive and negative stimuli , acute effects on neutral stimuli may also relate to antidepressant efficacy , yet these effects are still to be investigated .


The present study therefore examined the impact of a single dose of the selective serotonin reuptake inhibitor escitalopram ( @ mg ) on positive , negative and neutral stimuli using pharmaco-fMRI .


Within a double-blind , randomized , placebo-controlled crossover design , healthy women completed @ sessions of treatment administration and fMRI scanning separated by a @-week washout period .


We enrolled @ women in our study .


When participants were administered escitalopram relative to placebo , left amygdala activity was increased and right inferior frontal gyrus ( IFG ) activity was decreased during presentation of positive pictures ( potentiation of positive emotion processing ) .


In contrast , escitalopram was associated with decreased left amygdala and increased right IFG activity during presentation of negative pictures ( attenuation of negative emotion processing ) .


In addition , escitalopram decreased right IFG activity during the processing of neutral stimuli , akin to the effects on positive stimuli ( decrease in negative appraisal ) .


Although we used a women-only sample to reduce heterogeneity , our results may not generalize to men .


Potential unblinding , which was related to the subjective occurrence of side effects , occurred in the study ; however , manipulation check analyses demonstrated that results were not impacted .


These novel findings demonstrate that a single dose of the commonly prescribed escitalopram facilitates a positive information processing bias .


These findings provide an important lead for better understanding effects of antidepressant medication .


We explored whether preoperative rosuvastatin could protect the cardiac health of patients with coronary artery disease undergoing emergency , noncardiac surgery .


We randomized @ noncardiac emergency surgery patients with stable coronary artery disease on long-term statin therapy to treatment with and without preoperative rosuvastatin .


All patients received rosuvastatin after surgery .


We evaluated the incidence of myocardial necrosis and major adverse cardiovascular and cerebrovascular events ( MACCE ) @ days and @ months after surgery .


Creatinine kinase-myocardial band ( CK-MB ) isoform elevations occurred less frequently @ and @ h after noncardiac emergency surgery in the experimental group than in the control group ( p = @ ) .


After surgery , the incidence of MACCE was also lower in the experimental group than in the control group ( p = @ ) .


The difference was mainly due to the incidence of perioperative myocardial infarction ( p = @ ) .


Multivariable analysis found that rosuvastatin reload reduced the incidence of MACCE @ % @ months after surgery ( p = @ ) .


Preoperative rosuvastatin reload therapy decreases the incidence of myocardial necrosis and MACCE after noncardiac emergency surgery in patients with stable coronary artery disease on long-term statin therapy .


To compare the effect , safety , and advantage of flexible fixation with paperboard and pad versus short leg plaster in treating the fifth metatarsal base fracture , and establish the standard of diagnosis and treatment of the fifth metatarsal base fractures in flexible fixation with paperboard and pad .


From June @ to March @,@ patients with the fifth metatarsal base fracture were treated with paperboard and pad fixation or short leg plaster .


Patients were enrolled and divided into paperboard and pad treatment group ( paperboard group ) and short leg plaster treatment group ( plaster group ) randomly according to the random number table .


In paperboard group , there were @ cases including @ males and @ females with an average age of ( @ ) years old ; the average course of injury was ( @ ) hours .


In plaster group , there were @ cases including @ males and @ females with an average age of ( @ +@ ) years old ; the average course of injury was ( @ ) hours .


According to whether the fracture line across the articular surface , in paperboard group there were @ cases of type A ,@ of type B ; in plaster group ,@ of type A , @ of type B.


According to the degree of dislocation , in paperboard group there were @ cases of degree I ,@ of degree II ; in plaster group ,@ were degree I ,@ were degree II .


Fracture was restored according to the type in manual .


Patients in paperboard group were treated with paperboard and pad , and patients in plaster group were treated with short leg plaster .


Fracture was fixed for @ to @ weeks according to fracture healing .


On the @nd , @th ,@ th , @th week and @rd , @th month after fixation , patients were followed up , and the foot function score was used to evaluate the function of injured foot .


X-ray of injured foot was taken on the @nd , @th , @th and @th week were used to assess fracture healing .


All patients got complete follow-up .


The X-ray result showed that all fracture reached at clinical healing on the @th week after fixation without skin ulcer , nonunion and displacement of fracture .


From the @th to @th week after fixation , paperboard group had a higher X-ray score than plaster group , but the difference between two groups had no statistically significance .


Repeated analysis result showed that there was interact at different time point and between groups , the difference had statistically significance ( P < @ ) .


The foot function score showed that at all time point , paperboard group had a higher score than plaster group , and on the @nd , @th , and @th week , it had statistically significant difference ( P < @ ) between two groups .


On the @th months after fixation , the excellent and good rate of paperboard group was @ % , higher than that of plaster group , which was @ % .


But it had no statistically difference ( P = @ ) between two groups .


Using paperboard and pad fixation to treat the fifth metatarsal base fracture has the advantage of simplicity operating , reliable fixation , satisfactory effects , easily obtainable material .


In the present study , we investigated how the electrical activity in the sensorimotor cortex contributes to improved cognitive processing capabilities and how SMR ( sensorimotor rhythm , @-@Hz ) neurofeedback training modulates it .


Previous evidence indicates that higher levels of SMR activity reduce sensorimotor interference and thereby promote cognitive processing .


Participants were randomly assigned to two groups , one experimental ( N = @ ) group receiving SMR neurofeedback training , in which they learned to voluntarily increase SMR , and one control group ( N = @ ) receiving sham feedback .


Multiple cognitive functions and electrophysiological correlates of cognitive processing were assessed before and after @ neurofeedback training sessions .


The experimental group but not the control group showed linear increases in SMR power over training runs , which was associated with behavioural improvements in memory and attentional performance .


Additionally , increasing SMR led to a more salient stimulus processing as indicated by increased N@ and P@ event-related potential amplitudes after the training as compared to the pre-test .


Finally , functional brain connectivity between motor areas and visual processing areas was reduced after SMR training indicating reduced sensorimotor interference .


These results indicate that SMR neurofeedback improves stimulus processing capabilities and consequently leads to improvements in cognitive performance .


The present findings contribute to a better understanding of the mechanisms underlying SMR neurofeedback training and cognitive processing and implicate that SMR neurofeedback might be an effective cognitive training tool .


We ( i ) described variability in colorectal cancer ( CRC ) test use across multiple levels , including physician , clinic , and neighborhood ; and ( ii ) compared the performance of novel cross-classified models versus traditional hierarchical models .


We examined multilevel variation in CRC test use among patients not up-to-date with screening in a large , urban safety net health system ( @-@ ) .


Outcomes included : ( i ) fecal occult blood test ( FOBT ) or ( ii ) colonoscopy and were ascertained using claims data during a @-year follow-up .


We compared Bayesian ( i ) cross-classified four-level logistic models nesting patients within separate , nonoverlapping `` levels '' ( physicians , clinics , and census tracts ) versus ( ii ) three hierarchical two-level models using deviance information criterion .


Models were adjusted for covariates ( patient sociodemographic factors , driving time to clinic , and census tract poverty rate ) .


Of @,@ patients , @ ( @ % ) completed FOBT and @ ( @ % ) completed colonoscopy during the study year .


Patients attended @ clinics , saw @ physicians , and resided in @ census tracts .


Significant variability was observed across all levels in both hierarchical and cross-classified models that was unexplained by measured covariates .


For colonoscopy , variance was similar across all levels .


For FOBT , physicians , followed by clinics , demonstrated the largest variability .


Model fit using cross-classified models was superior or similar to @-level hierarchical models .


Significant and substantial variability was observed across neighborhood , physician , and clinic levels in CRC test use , suggesting the importance of factors at each of these levels on CRC testing .


Future multilevel research and intervention should consider the simultaneous influences of multiple levels , including clinic , physician , and neighborhood .


Prevalence of tobacco use is higher in the rural than urban areas of India .


Unlike tobacco cessation clinics located in urban areas , community-based smoking cessation intervention has the potential to reach a wider section of the community to assist in smoking cessation in the rural setting .


The present study aimed to assess the effectiveness of a cessation intervention in rural Kerala state , India .


Current daily smoking resident males in the age group @-@ years from four community development blocks in rural Kerala were randomly allocated to intervention and control groups .


The intervention group received multiple approaches in which priority was given to face-to-face interviews and telephone counselling .


Initially educational materials on tobacco hazards were distributed .


Further , four rounds of counselling sessions were conducted which included a group counselling with a medical camp as well as individual counselling by trained medical social workers .


The control group received general awareness training on tobacco hazards along with an anti-tobacco leaflet .


Self-reported smoking status was assessed after @ and @ months .


Factors associated with tobacco cessation were estimated using binomial regression method .


Overall prevalence of smoking abstinence was @ % in the intervention and @ % in the control group ( Relative risk : @ , @ % CI : @ , @ ) .


A total of @ % subjects in the intervention area and @ % in the control area had reduced smoking by @ % or more at the end of @ months .


Lower number of cigarettes / bidi used , low nicotine dependence and consultation with a doctor for a medical ailment were the statistically significant predictors for smoking cessation .


Rigorous approaches for smoking cessation programmes can enhance quit rates in smoking in rural areas of India .


The benefits of pharmacotherapy with tiotropium HandiHaler @g for patients with chronic obstructive pulmonary disease ( COPD ) have been previously demonstrated .


However , few data exist regarding the treatment of moderate disease ( Global Initiative for Chronic Obstructive Lung Disease ( GOLD ) stage II ) .


To determine whether tiotropium improves lung function/patient-reported outcomes in patients with GOLD stage II COPD naive to maintenance therapy .


A randomised @-week double-blind placebo-controlled trial of tiotropium @g once daily ( via HandiHaler ) was performed in maintenance therapy-naive patients with forced expiratory volume in @ s ( FEV@ ) / forced vital capacity ( FVC ) ratio < @ and post-bronchodilator FEV@ @ and < @ % .


A total of @ patients were randomised ( @ tiotropium , @ placebo ; mean age @ years ; FEV@ @ l ( @ % predicted ) ) .


Tiotropium was superior to placebo in mean change from baseline in post-dose FEV@ area under the curve from @ to @h ( AUC@-@h ) at week @ ( primary endpoint ) : @ vs. -@ l ( least-squares mean difference @ l , P < @ ) .


FVC AUC@-@h , trough and peak FEV@ and FVC were significantly improved with tiotropium versus placebo ( P < @ ) .


Compared with placebo , tiotropium provided numerical improvements in physical activity ( P = NS ) .


Physician 's Global Assessment ( health status ) improved ( P = @ ) with less impairment on the Work Productivity and Activity Impairment questionnaire ( P = @ ) at week @ .


The incidence of exacerbations , cough , bronchitis and dyspnoea was lower with tiotropium than placebo .


Tiotropium improved lung function and patient-reported outcomes in maintenance therapy-naive patients with GOLD stage II COPD , suggesting benefits in initiating maintenance therapy early .


To determine the effect of removing presumptive apoptotic sperm cells from samples from unselected males by means of magnetic activated cell sorting ( MACS ) on live-birth delivery rates after intracytoplasmic sperm injection ( ICSI ) in couples undergoing ovum donation ( OD ) .


Prospective , randomized , triple-blinded , and controlled study .


Private university-affiliated IVF center .


A total of @ infertile couples undergoing ICSI as part of an OD program .


Semen specimens from the control group were prepared by swim-up .


Samples from the study group were prepared by swim-up followed by MACS and incubation with annexin V-conjugated microbeads to remove annexin V-positive ( AV + ) sperm cells .


Fertilization rates , morphological features of early embryo development , implantation rates , ongoing pregnancy rates , and live-birth rates .


Similar results were obtained between groups for all the parameters compared : fertilization rates of @ % ( @ % confidence interval -LSB- CI -RSB- , @-@ @ ) versus @ % ( @ % CI , @-@ @ ) ; percentage of good-quality embryos on day @ of @ % ( @ % CI , @-@ @ ) versus @ % ( @ % CI , @-@ @ ) and on day @ of @ % ( @ % CI , @-@ @ ) versus @ % ( @ % CI , @-@ @ ) ; implantation rates of @ % ( @ % CI , @-@ @ ) versus @ % ( @ % CI , @-@ @ ) ; positive beta-hCG tests of @ % ( @ % CI , @-@ @ ) versus @ % ( @ % CI , @-@ @ ) , and live-birth rates of @ % ( @ % CI , @-@ @ ) versus @ % ( @ % CI , @-@ @ ) in the MACS versus control group .


None of the differences reached statistical significance .


Applying MACS technology to remove AV + sperm cells from unselected males does not improve the reproductive outcome of ICSI in OD .


In-situ audiometry is a hearing aid feature that enables the measurement of hearing threshold levels through the hearing instrument using the built-in sound generator and the hearing aid receiver .


This feature can be used in hearing aid fittings instead of conventional pure-tone audiometry ( PTA ) , particularly in places where no standard audiometric equipment is available .


Differences between conventional and in-situ thresholds are described and discussed for some particular hearing aids .


No previous investigation has measured and compared these differences for a number of current hearing aid models by various manufacturers across a wide range of hearing losses .


The purpose of this study was to perform a model-based comparison of conventionally and in-situ measured hearing thresholds .


Data were collected for a range of hearing aid devices to study and generalize the effects that may occur under clinical conditions .


Research design was an experimental and regression study .


A total of @ adults with sensorineural hearing loss served as test persons .


They were assigned to three subgroups of @ subjects with mild ( M ) , moderate to severe ( MS ) , and severe ( S ) sensorineural hearing loss .


All @ test persons underwent both conventional PTA and in-situ audiometry with four hearing aid models by various manufacturers .


The differences between conventionally and in-situ measured hearing threshold levels were calculated and evaluated by an exploratory data analysis followed by a sophisticated statistical modeling process .


At @ and @ Hz , almost all threshold differences ( conventional PTA minus in-situ data ) were negative , i.e. , in the low to mid frequencies , hearing loss was overestimated by most devices relative to PTA .


At @ Hz , the majority of differences ( @ of @ ) were positive , i.e. , in the frequency range above @ Hz , hearing loss was frequently underestimated .


As hearing loss increased ( MMSS ) , the effect of the underestimation decreased .


At @ and @ Hz , Resound devices showed the smallest threshold deviations , followed by Phonak , Starkey , and Oticon instruments .


At @ Hz , this observed pattern partly disappeared and Starkey and Oticon devices showed a reversed effect with increasing hearing loss ( MMSS ) .


Because of high standard errors for the estimates , only a few explicit rankings of the devices could be established based on significant threshold differences ( @ % level ) .


Differences between conventional PTA and in-situ threshold levels may be attributed to ( @ ) frequency , ( @ ) device/hearing loss , and ( @ ) calibration/manufacturer effects .


Frequency effects primarily resulting in an overestimation of hearing loss by in-situ audiometry in the low and mid frequencies are mainly due to sound drain-off through vents and leaks .


Device/hearing loss effects may be due to leakage as well as boundary effects because in-situ audiometry is confined to a limited measurement range .


Finally , different calibration approaches may result in different offset levels between PTA and in-situ audiometry calibration .


In some cases , the observed threshold differences of up to @-@ dB may translate to varied hearing aid fittings for the same user depending on how hearing threshold levels were measured .


Vitamin D is related to resistance to chronic diseases , physiological parameters and functional measures .


All of these relationships underscore the potential benefits of cholecalciferol or D@ ( nutritional vitamin D ) in cancer .


This is the first study designed to obtain conclusive evidence on the effect of cholecalciferol in advanced patients with cancer .


The main goal is to assess its effects on the patient 's perceived quality of life .


Cholecalciferol 's impact on fatigue and physical performance , as well as its cost utility , will also be assessed .


A randomised triple-blind phase II/III placebo-controlled multicentre trial has been designed .


Patients satisfying the inclusion and exclusion criteria will be randomly assigned to receive cholecalciferol or placebo .


Eligible patients will be adults with a locally advanced or metastatic or inoperable solid cancer in palliative care , who have given signed informed consent and have matched inclusion and exclusion criteria .


The randomisation will be based on a computer-generated procedure and centralised by the pharmacy service of the coordinating centre .


The assigned treatment will be administered by the hospital 's pharmacy to conceal group allocation for patients and healthcare providers .


Cholecalciferol ( @ IU/day ) or placebo , starting at day @ and continuing up to day @ , will be added to palliative care treatment .


Outpatient visits will be scheduled every @ days .


Adherence to medication is an issue of great importance for patients with ulcerative colitis .


Once daily mesalazine seems to be no worse than divided doses in preventing relapse in remitting patients .


Although this has been attributed to improved adherence , detailed measures of adherence have been lacking from previous studies .


A @-year substudy was conducted alongside a trial that compared @ different dosing regimens ( once daily versus three times daily ) of mesalazine for patients in remission with ulcerative colitis .


Participants in the substudy had their adherence monitored electronically using the medication event monitoring system , self-report , and tablet counts .


We compared measures , determined factors associated with adherence and associations between adherence and relapse , modeled adherence over time , and explored behavioral aspects .


We included @ participants .


Adherence was high across all measures ( @ % self-report , @ % tablet counts , and @ % medication event monitoring system ) .


Agreement between the measures was poor at times .


Adherence according to the medication event monitoring system best distinguished between the participants who relapsed ( @ % ) and those who remained in remission ( @ % ) , although this difference was not statistically discernible at the @ % level .


Adherence deteriorated over the study period , with three times daily participants generally less adherent than once-daily participants ( odds ratio , @ ; @ % confidence interval , @-@ @ ) .


Adherence was higher on weekdays ( odds ratio , @ ; @ % confidence interval , @-@ @ ) and around clinic visit dates ( odds ratio , @ ; @ % confidence interval , @-@ @ ) .


Simple dosing regimens are preferable to multiple daily dosing regimens .


Electronic monitoring of adherence should be used more often in clinical studies .


Self-reported adherence and tablet counts may underestimate adherence .


Adherence declined over time , and adherence was generally lower and more varied for those allocated to the three times daily regimen .


The role of adjuvant chemotherapy for patients with rectal cancer is controversial , especially when used after preoperative chemoradiotherapy .


Fluoropyrimidine-based adjuvant chemotherapy , including fluorouracil and leucovorin , has been widely used ; however , the addition of oxaliplatin to fluorouracil and leucovorin ( FOLFOX ) , a standard adjuvant regimen for colon cancer , has not been tested in rectal cancer .


We aimed to compare the efficacy and safety of adjuvant fluorouracil and leucovorin with that of FOLFOX in patients with locally advanced rectal cancer after preoperative chemoradiotherapy .


In this open-label , multicentre , phase @ , randomised trial , patients with postoperative pathological stage II ( ypT@-@N@ ) or III ( ypTanyN@-@ ) rectal cancer after preoperative fluoropyrimidine-based chemoradiotherapy and total mesorectal excision were recruited and randomly assigned ( @:@ ) via a web-based software platform to receive adjuvant chemotherapy with either four cycles of fluorouracil and leucovorin ( fluorouracil @ mg/m ( @ ) and leucovorin @ mg/m ( @ ) on days @-@ , every @ weeks ) or eight cycles of FOLFOX ( oxaliplatin @ mg/m ( @ ) , leucovorin @ mg/m ( @ ) , and fluorouracil bolus @ mg/m ( @ ) on day @ , and fluorouracil infusion @ mg/m ( @ ) for @ h , every @ weeks ) .


Stratification factors were pathological stage ( II vs III ) and centre .


Neither patients nor investigators were masked to group assignment .


The primary endpoint was @-year disease-free survival , analysed by intention to treat .


This study is fully enrolled , is in long-term follow-up , and is registered with ClinicalTrials.gov , number NCT@ .


Between Nov @ , @ , and June @ , @ , @ patients were randomly assigned to fluorouracil and leucovorin ( n = @ ) and FOLFOX ( n = @ ) .


@ ( @ % ) of @ patients in the fluorouracil plus leucovorin group and @ ( @ % ) of @ in the FOLFOX group completed all planned cycles of adjuvant treatment .


Median follow-up was @ months ( IQR @-@ ) .


@-year disease-free survival was @ % ( @ % CI @-@ ) in the FOLFOX group and @ % ( @-@ ) in the fluorouracil plus leucovorin group ( hazard ratio @ , @ % CI @-@ ; p = @ ) .


Any grade neutropenia , thrombocytopenia , fatigue , nausea , and sensory neuropathy were significantly more common in the FOLFOX group than in the fluorouracil plus leucovorin group ; however , we noted no significant difference in the frequency of these events at grade @ or @ .


The most common grade @ or worse adverse events were neutropenia ( @ -LSB- @ % -RSB- of @ patients in the fluorouracil plus leucovorin group vs @ -LSB- @ % -RSB- of @ patients in the FOLFOX group ) , leucopenia ( eight -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , febrile neutropenia ( four -LSB- @ % -RSB- vs one -LSB- < @ % -RSB- ) , diarrhoea ( four -LSB- @ % -RSB- vs two -LSB- @ % -RSB- ) , and nausea ( one -LSB- < @ % -RSB- vs two -LSB- @ % -RSB- ) .


Adjuvant FOLFOX improves disease-free survival compared with fluorouracil plus leucovorin in patients with locally advanced rectal cancer after preoperative chemoradiotherapy and total mesorectal excision , and warrants further investigation .


To investigate the efficacy and safety of corneal collagen cross-linking ( CXL ) with photoactivated riboflavin ( photoactivated chromophore for infectious keratitis -LSB- PACK -RSB- - CXL ) in the management of infectious keratitis with corneal melting .


Prospective clinical trial .


Forty eyes from @ patients with advanced infectious keratitis and coexisting corneal melting .


Twenty-one patients ( @ eyes ) underwent PACK-CXL treatment in addition to antimicrobial therapy .


The control group consisted of @ patients ( @ eyes ) who received only antimicrobial therapy .


The slit-lamp characteristics of the corneal ulceration , corrected distance visual acuity , duration until healing , and complications were documented in each group .


The Mann-Whitney U test was used for statistical analysis .


P values less than @ were considered statistically significant .


The average time until healing was @ @ days in the PACK-CXL group and @ @ days in the control group ( P = @ ) .


After treatment and healing , corrected distance visual acuity was @ @ in the PACK-CXL group and @ @ in the control group ( P = @ ) .


The corneal ulceration 's width and length was significantly bigger in the PACK-CXL group ( P = @ and P = @ ) .


Three patients in the control group demonstrated corneal perforation ; infection recurred in @ of them .


No serious complications occurred in the PACK-CXL group .


Corneal CXL with photoactivated riboflavin did not shorten the time to corneal healing ; however , the complication rate was @ % in the control group , whereas there was no incidence of corneal perforation or recurrence of the infection in the PACK-CXL group .


These results indicate that PACK-CXL may be an effective adjuvant therapy in the management of severe infectious keratitis associated with corneal melting .


Sweet esophagectomy is performed widely in China , while the Ivor-Lewis procedure , with potential benefit of an extended lymphadenectomy , is limitedly conducted owing to concern for a higher risk for morbidity .


Thus , the role of the Ivor-Lewis procedure for thoracic esophageal cancer needs further investigation .


To determine whether Ivor-Lewis esophagectomy is associated with increased postoperative complications compared with the Sweet procedure .


A randomized clinical trial was conducted from May @ to July @ at Fudan University Shanghai Cancer Center , Shanghai , China , of @ patients with resectable squamous cell carcinoma in the middle and lower third of the thoracic esophagus .


Intent-to-treat analysis was performed .


Patients were randomly assigned to receive either the Ivor-Lewis ( n = @ ) or Sweet ( n = @ ) esophagectomy .


The primary outcome of this clinical trial was operative morbidity ( any surgical or nonsurgical complications ) .


Secondary outcomes included oncologic efficacy ( number of lymph nodes resected and positive lymph nodes ) , postoperative mortality ( @-day and in-hospital mortality ) , and patient discharge .


Resection without macroscopical residual ( R@/R@ ) was achieved in @ of @ patients in each group .


Although there was no significant difference between the @ groups regarding the incidence of each single complication , a significantly higher morbidity rate was found in the Sweet group ( @ of @ -LSB- @ % -RSB- ) than in the Ivor-Lewis group ( @ of @ -LSB- @ % -RSB- ) ( P = @ ) .


More patients in the Sweet group ( @ of @ -LSB- @ % -RSB- ) received reoperations than in the Ivor-Lewis group ( @ of @ -LSB- @ % -RSB- ) ( P = @ ) .


The median hospital stay was @ days in the Sweet group vs @ days in the Ivor-Lewis group ( P = @ ) .


Postoperative mortality rates in the Ivor-Lewis ( @ of @ ) and Sweet ( @ of @ ) groups were @ % and @ % , respectively ( P = @ ) .


More lymph nodes were removed during Ivor-Lewis esophagectomy than during the Sweet procedure ( @ vs @ , P < @ ) .


Early results of this study demonstrate that the Ivor-Lewis procedure can be performed with lower rates of postoperative complications and more lymph node retrieval .


Ivor-Lewis and Sweet esophagectomies are both safe procedures with low operative mortalities .


Hypotensive anesthesia is routinely used during craniosynostosis corrections to reduce blood loss .


Noting that cerebral oxygenation levels often fell below recommended levels , the authors sought to measure the effects of hypotensive versus standard anesthesia on blood transfusion rates .


One hundred children undergoing craniosynostosis corrections were randomized prospectively into two groups : a target mean arterial pressure of either @ mm Hg or @ mm Hg .


Aside from anesthesiologists , caregivers were blinded and strict transfusion criteria were followed .


Multiple variables were analyzed , and appropriate statistical testing was performed .


The hypotensive and standard groups appeared similar , with no statistically significant differences in mean age ( @ months versus @ months ) , weight ( @ kg versus @ kg ) , procedure -LSB- anterior remodeling ( @ versus @ ) versus posterior ( @ versus @ ) -RSB- , or preoperative hemoglobin level ( @ g/dl versus @ g/dl ) .


Intraoperative mean arterial pressures differed significantly ( @ mm Hg versus @ mm Hg ; p < @ ) .


The captured cell saver amount was lower in the hypotensive group ( @ cc versus @ cc ; p = @ ) , yet no significant differences were noted in postoperative hemoglobin levels ( @ g/dl versus @ g/dl ) .


Fifteen of @ patients ( @ percent ) received allogenic transfusions , but no statistically significant differences were noted in transfusion rates between the hypotensive -LSB- nine of @ ( @ percent ) -RSB- and standard anesthesia -LSB- six of @ ( @ percent ) -RSB- group ( p = @ ) .


No significant difference in transfusion requirements was found between hypotensive and standard anesthesia during craniosynostosis corrections .


Considering potential benefits of improved cerebral blood flow and total body perfusion , surgeons might consider performing craniosynostosis corrections without hypotension .


Therapeutic , II .


Sensorimotor rhythm patterns in patients with lower limb amputations might be altered because of reorganization of the sensorimotor cortices .


The authors evaluated the sensorimotor rhythm of motor imagery ( MI ) in healthy subjects and patients with lower limb amputations .


In addition , the authors investigated whether transcranial direct current stimulation ( tDCS ) could modulate sensorimotor rhythm control .


Six healthy subjects and six patients with lower limb amputations were assigned to receive anodal , cathodal , or sham tDCS over the foot motor area in a randomized order .


The authors evaluated event-related desynchronization and event-related synchronization ( ERS ) of unilateral hand and bilateral foot MI before and after tDCS .


Beta ERS of foot MI in patients with lower limb amputations was significantly lesser than that in healthy subjects .


Compared with sham stimulation , cathodal tDCS enhanced beta ERS of foot MI in patients with lower limb amputations .


In contrast , anodal tDCS decreased beta ERS of foot MI in healthy subjects .


This is the first study to demonstrate that cathodal tDCS can enhance a weak beta ERS of foot MI in patients with lower limb amputations .


These findings might contribute in improving the effectiveness of sensorimotor rhythm-based brain computer interface for gait restoration after lower limb amputation .


To determine whether topical aqueous suppressants affect the duration of pure expansile intraocular gas in nonvitrectomized eyes .


A prospective randomized controlled trial was performed on nonvitrectomized patients undergoing retinal detachment repair with scleral buckle or pneumatic retinopexy using @ mL of @ % perfluoropropane ( C@F@ ) gas tamponade .


Eyes were randomly assigned to receive topical dorzolamide @ % and timolol @ % twice daily postoperatively until gas dissolution or to observation .


Twenty-one patients met all inclusion and exclusion criteria .


Twelve were randomized to the control group and nine to the dorzolamide-timolol group .


In the dorzolamide-timolol group , mean intraocular pressure was @ on postoperative Day @ and @ on postoperative Week @ ( P = @ ) .


In the control group , mean intraocular pressure was @ on postoperative Day @ and @ on postoperative Week @ ( P = @ ) .


The mean duration of C@F@ was @ days in the dorzolamide-timolol group and @ days in the control group ( P = @ ) .


Topical aqueous suppression does not seem to have a significant effect on the duration of pure expansile intraocular C@F@ in nonvitrectomized eyes after pneumatic retinopexy or scleral buckling .


Inhibitors of the phosphatidylinositol-@-kinase / protein kinase B/mammalian target of rapamycin ( PI@K/AKT/mTOR ) pathway can overcome endocrine resistance in estrogen receptor ( ER ) - positive breast cancer , but companion diagnostics indicating PI@K/AKT/mTOR activation and consequently endocrine resistance are lacking .


PIK@CA mutations frequently occur in ER-positive breast cancer and result in PI@K/AKT/mTOR activation in vitro .


Nevertheless , the prognostic and treatment-predictive value of these mutations in ER-positive breast cancer is contradictive .


We tested the clinical validity of PIK@CA mutations and other canonic pathway drivers to predict intrinsic resistance to adjuvant tamoxifen .


In addition , we tested the association between these drivers and downstream activated proteins .


Primary tumors from @ ER-positive postmenopausal patients , randomized between adjuvant tamoxifen ( @ to @ years ) versus observation were recollected .


PIK@CA hotspot mutations in exon @ and exon @ were assessed with Sequenom Mass Spectometry .


Immunohistochemistry was performed for human epidermal growth factor receptor @ ( HER@ ) , phosphatase and tensin homolog ( PTEN ) , and insulin-like growth factor @ receptor ( IGF-@R ) .


We tested the association between these molecular alterations and downstream activated proteins ( like phospho-protein kinase B ( p-AKT ) , phospho-mammalian target of rapamycin ( p-mTOR ) , p-ERK@ / @ , and p-p@S@K ) .


Recurrence-free interval improvement with tamoxifen versus control was assessed according to the presence or absence of canonic pathway drivers , by using Cox proportional hazard models , including a test for interaction .


PIK@CA mutations ( both exon @ and exon @ ) were associated with low tumor grade .


An enrichment of PIK@CA exon @ mutations was observed in progesterone receptor - positive tumors .


PIK@CA exon @ mutations were not associated with downstream-activated proteins .


No significant interaction between PIK@CA mutations or any of the other canonic pathway drivers and tamoxifen-treatment benefit was found .


PIK@CA mutations do not have clinical validity to predict intrinsic resistance to adjuvant tamoxifen and may therefore be unsuitable as companion diagnostic for PI@K/AKT/mTOR inhibitors in ER - positive , postmenopausal , early breast cancer patients .


Osteoarthritis of the first metatarsophalangeal joint ( hallux rigidus ) leads to pain and poor function and mobility .


Arthrodesis is the gold standard treatment for end-stage disease .


Total joint arthroplasties have been attempted , but early loosening has been attributed to dorsally directed shear forces on the metatarsal component .


Metallic proximal phalangeal hemiarthroplasty theoretically avoids this .


Whilst early results are promising , no comparative trials exist comparing this to arthrodesis .


The primary objectives are to determine the range of outcome scores between the two treatment arms ( to inform a power calculation ) .


Outcome measures will include the MOXFQ , AOFAS-Hallux and EuroQol EQ-@D-@ L. Secondary objectives are to determine the accrual rate , dropout rate and trial acceptability to both patients and surgeons .


These data will allow the development of a larger trial with longer follow-up .


This is a prospective randomised controlled single-centre study comparing proximal phalanx hemiarthroplasty ( AnaToemic , Arthrex Ltd. , Sheffield , UK ) with arthrodesis ( @ patients in each arm ) .


Randomisation will be performed using a @:@ allocation ratio in blocks of six.Patients meeting the eligibility criteria will be recruited from three foot and ankle consultant surgeon 's clinics ( East Lancashire Hospitals NHS Trust ) .


If agreeable , informed consent will be obtained before patients are randomised.The outcome measure scores will be completed pre-operatively and repeated at @ weeks , @ months and @ months .


A radiological review will be performed at @ weeks and @ months to determine rates of loosening ( hemiarthroplasty ) and union ( arthrodesis ) .


Data on length of stay , return to work , complications and re-operation rates will also be collected.The analysis will compare the change in outcome scores between treatment groups at all follow-up time points .


Scores will be compared using a Student t-test , adjusting for scores at baseline.This study will be conducted in accordance with the current revision of the Declaration of Helsinki ( @ ) and the ICH-GCP Guideline ( International Conference on Harmonisation , Good Clinical Practice , E@ ( R@ ) , @ ) .


This study has been approved by the sponsor , the Trust Research & Development office .


Ethical approval has been received from the National Research Ethics Service ( North East : @/NE/@ for protocol version @ dated @ June @ ) .


Selumetinib ( AZD@ , ARRY-@ ) + docetaxel increases median overall survival ( OS ) and significantly improves progression-free survival ( PFS ) and objective response rate ( ORR ) compared with docetaxel alone in patients with KRAS mutant , stage IIIB/IV non-small-cell lung cancer ( NSCLC ; NCT@ ) .


Retrospective analysis of OS , PFS , ORR and change in tumour size at week @ for different sub-populations of KRAS codon mutations .


In patients receiving selumetinib + docetaxel and harbouring KRAS G@C or G@V mutations there were trends towards greater improvement in OS , PFS and ORR compared with other KRAS mutations .


Different KRAS mutations in NSCLC may influence selumetinib/docetaxel sensitivity .


Minimal sedation obviates patient recovery burdens , but intolerable pain limits success of cecal intubation .


Painless or minimally uncomfortable insertion ensures success of cecal intubation , current patient satisfaction , and willingness to repeat future colonoscopy with minimal sedation .


Water immersion ( WI ) and water exchange ( WE ) , when separately compared with air insufflation ( AI ) , significantly reduced insertion pain .


To assess comparative effectiveness , we conducted a randomized controlled trial with head-to-head comparison of these three methods .


We hypothesized that WE could produce the highest proportion of patients reporting painless insertion .


This prospective patient-blinded trial ( NCT@ ) enrolled minimally sedated ( @mg intramuscular meperidine ) patients randomized to AI , WI , or WE ( @ patients/group ) to aid insertion .


The previously validated primary outcome was the proportion of patients reporting painless insertion .


Painless insertion was reported by @ % ( AI ) , @ % ( WI ) , and @ % ( WE ) of patients ( P < @ ) .


Multivariate logistic regression analysis revealed that , after adjusting for gender , body mass index , abdominal compression , position change , insertion time to cecum , and length of scope at cecum , only WE was significantly associated with painless insertion compared with AI ( odds ratio ( OR ) = @ , @ % confidence interval ( CI ) = @-@ @ , P < @ ) or WI ( OR = @ , @ % CI = @-@ @ , P < @ ) .


Adenoma detection rate ( ADR ) in the right ( cecum and ascending ) colon was @ % ( AI ) , @ % ( WI ) , and @ % ( WE ) ( P = @ ) .


The limitations included single site study with unblinded colonoscopist and assistant .


This head-to-head comparison of AI vs. WI vs. WE confirmed that WE was superior to WI and AI , with a significantly greater proportion of patients reporting painless insertion .


The significantly higher ADR in the right colon in the WE group warrants further investigations .


One of the most common and severe complications affecting peritoneal dialysis ( PD ) patients is exit-site infection of the peritoneal catheter ; it is therefore of vital importance to prevent it .


This complication has a negative impact on the success of the technique .


In spite of this , there are no clear guidelines concerning how to take care of the exit site .


The objective of this study was to assess the efficacy of polyhexanide in preventing exit-site infection over a @-month period .


We designed a single-center , prospective , open-labeled , randomized controlled clinical trial with parallel groups .


Requirements for participation in the study included implantation of the peritoneal catheter at least six weeks before entering the study and no infectious complications requiring either hospital admission or antibiotic treatment for at least three months before entering into the study .


Patients were randomized to be daily cured as follows : Group A : traditional care with saline serum and povidone-iodine ; and Group B : polyhexanide solution .


Exit sites were evaluated at baseline and every four to six weeks or if any event occurred , according to the Twardowski criteria .


Of the @ included patients , @ completed the @-month follow-up period .


Six underwent transplantation , five died and three were transferred to hemodialysis ( HD ) .


The treatment was well tolerated , with no side effects nor abandonments due to such effects .


Throughout the study period , six patients ( @ % ) undergoing traditional care and only two ( @,@ % ) receiving polyhexanide developed an exit-site infection ( p = @ ) .


There were a total number of @ infections ; nine occurred in patients following the traditional approach and only three in patients treated with polyhexanide ( p = @ ) .


The germs responsible for the infections were : S. aureus ( six cases ) , Corynebacterium jeikeium ( two cases ) and P. aeruginosa ( one case ) in the saline serum and povidone-iodine group and P. aeruginosa ( three cases ) in the polyhexanide group .


The mean rate of exit-site infection was @ episode/@ @ patient-months for the traditional care group and @ episode/@ @ patient-months for the polyhexanide group ( p = @ ) .


Patients following the traditional treatment required fewer days to get infected than those using polyhexanide ( p = @ ; log rank : @ ) .


These results show that using polyhexanide is efficient for the prevention of exit-site infections .


Patients treated with this product suffer from fewer infections and need more time to become infected .


Polyhexanide application is painless , no allergies have been described and it is well tolerated by patients .


We therefore propose that it may be used routinely from now on for the care of healthy exit site .


Periprocedural ( @ h pre - and @ h post-angiography ) hemofiltration appears to effectively prevent contrast-induced nephropathy ( CIN ) in chronic kidney disease ( CKD ) patients undergoing coronary angiography .


However , this procedure over-uses medical resources , and the cessation of hemofiltration during coronary angiography results in persistent renal injury .


In comparison , simultaneous hemofiltration performed only during coronary angiography requires fewer medical resources and can provide instantaneous protection against CIN .


Sixty-eight CKD patients ( serum creatinine , @ mg/dL ) undergoing coronary angiography were randomized in a @:@ ratio to receive either periprocedural ( n = @ ) or simultaneous ( n = @ ) hemofiltration .


The expected CIN rate was similar for the two groups ( @ % versus @ % , p = @ ) .


On day @ after contrast exposure , four and seven patients in the periprocedural and simultaneous groups , respectively experienced CIN ( @ % versus @ % , p = @ ) .


On days @-@ , seven and three patients in the periprocedural and simultaneous groups , respectively experienced CIN ( @ % versus @ % , p = @ ) .


The serum creatinine levels of patients in the periprocedural group transiently decreased on day @ and persistently increased during days @-@ compared with the simultaneous group .


This difference between the two groups in terms of creatinine levels over time was statistically significant ( F statistic = @ ; p = @ , by ANCOVA ) .


The cost of hemofiltration was doubled in the periprocedural group ( $ @ versus $ @ , p < @ ) .


Simultaneous hemofiltration provide equal early ( day @ ) and better late-stage ( days @-@ ) renal protection against CIN at a significantly lower cost compared with periprocedural hemofiltration .


The purpose of this study is to evaluate the effectiveness of electromagnetic tracking in assisting CT-guided liver biopsies .


This was a single-center prospective randomized controlled trial comparing nonfluoroscopic CT-guided liver biopsy using an advance-and-scan technique with and without electromagnetic tracking .


Fifty patients with a liver lesion referred for biopsy ( women , @ % ; mean age , @ years ; mean lesion size , @ cm ) were enrolled in the study and were randomly assigned to either arm .


The primary and secondary objectives were to assess and quantify differences in the number of intraprocedural scans , cumulative effective radiation dose , number of needle manipulations , and procedure time from skin-stick to the target lesion with and without assistance .


Electromagnetic tracking significantly decreased the number of scans , effective radiation dose , number of manipulations per procedure , and time from skin-stick to the target lesion .


The ratio of the number of scans ( electromagnetic tracking to control ) was @ ( @ % CI , @-@ @ ; p < @ ) .


The mean difference in effective radiation dose ( electromagnetic tracking-control ) was -@ mSv ( @ % CI , -@ to -@ mSv ; p = @ ) , and the median difference was -@ mSv ( @ % CI , -@ to -@ mSv ; p < @ ) .


The ratio of the number of manipulations ( electromagnetic tracking to control ) was @ ( @ % CI , @-@ @ ; p < @ ) .


The mean difference for the time from skin-stick to the target lesion was -@ seconds ( @ % CI , -@ to -@ seconds ; p = @ ) and the median difference was -@ seconds ( @ % CI , -@ to -@ seconds ; p = @ ) .


Electromagnetic tracking assistance has the potential to decrease the number of intraprocedural CT scans and needle manipulations and to reduce patient radiation dose during CT-guided liver biopsy .


This report from the LEADER ( Liraglutide Effect and Action in Diabetes : Evaluation of Cardiovascular Outcome Results ) trial describes baseline lipase and amylase activity in type @ diabetic subjects without acute pancreatitis symptoms before randomization to the glucagonlike peptide analog liraglutide or placebo .


The LEADER is an international randomized placebo-controlled trial evaluating the cardiovascular safety of liraglutide in @ type @ diabetic patients at high cardiovascular risk .


Fasting lipase and amylase activity was assessed at baseline , before receiving liraglutide or placebo , using a commercial assay ( Roche ) with upper limit of normal values of @ U/L for lipase and @ U/L for amylase .


Either or both enzymes were above the upper limit of normal in @ % of subjects ; @ % ( n = @ ) had an elevated lipase level ( including @ % > @-fold elevated ) , and @ % ( n = @ ) had an elevated amylase level ( including @ % > @-fold elevated ) .


In multivariable regression models , severely reduced kidney function was associated with the largest effect on increasing activity of both .


However , even among subjects with normal kidney function , @ % and @ % had elevated lipase and amylase levels .


In this large study of type @ diabetic patients , nearly @ % had elevated lipase or amylase levels without symptoms of acute pancreatitis .


The clinician must take these data into account when evaluating abdominal symptoms in type @ diabetic patients .


Exacerbations of bronchial asthma usually occur in the autumn .


To our knowledge , however , the effectiveness of drugs for preventing exacerbations of asthma in the autumn has not been studied previously , except for leukotriene receptor antagonists and Omalizmab .


This study compared the prophylactic effectiveness of suplatast tosilate with that of mequitazine in children with asthma symptoms , which is usually exacerbated in the autumn .


The study group comprised @ children aged @ to @ years who required treatment for asthmatic attacks during the past year and tested positive at least for mite allergen in the preceding autumn .


The subjects were randomly assigned to receive either suplatast or mequitazine .


The primary endpoint of this study was the number of days without symptoms during the @ weeks of treatment .


In addition , the Japanese Pediatric Asthma Control Program ( JPAC ) scores were also recorded every @ weeks in each group .


Overall , @ patients received suplatast , and @ received mequitazine for @ weeks from September through early October .


During follow-up , the number of days without symptoms and the total JPAC scores did not differ significantly between the groups .


However , as compared with weeks @ to @ of treatment , the mean number of days without symptoms during weeks @ to @ increased significantly in only the suplatast group ( @ vs. @ days ; p = @ ) .


Our results suggest that short-term additional treatment with suplatast is useful for preventing asthma symptoms in children with asthma , which is usually exacerbated in the autumn .


The aim of this prospective randomized controlled cross sectional study was to evaluate the effect of a six month tibolone treatment in healthy postmenopausal women on biochemical CVD markers by calculating the changes of the blood serum levels of total cholesterol ( TC ) , low-density lipoprotein ( LDL ) , high-density lipoprotein ( HDL ) , triglycerides ( Tg ) , high-sensitivity C-reactive protein ( hsCRP ) , homocysteine ( Hcy ) , and endothelin-@ ( ET-@ ) at the beginning of the treatment and after six months .


Fifty-two healthy postmenopausal women were enrolled in a prospective , randomized , case-controlled outpatient trial .


Group @ ( n = @ ) received @,@ mg/d tibolone for six months , while Group @ ( n = @ ) received no treatment .


Serum levels ofTC , LDL , HDL , Tg , hsCRP , Hcy , and ET-@ were evaluated at baseline and after six months .


The two groups did not statistically differ at baseline characteristics .


In Group @ tibolone treatment decreased significantly TC ( p = @ ) , HDL ( p < @ ) , and Tg ( p < @ ) serum levels while a significant increase ofhsCRP ( p < @ ) was observed .


Finally no changes were noticed on LDL , Hcy , and ET-@ serum levels .


Regarding Group @ , no changes were observed .


Short-term tibolone treatment in healthy postmenopausal women exerts a mixed action , acting beneficially in some markers ( TC , LDL , Tg , Hcy , and ET-@ ) where as detrimentally in others ( HDL , hsCRP ) .


Few previous studies have examined the influence of instrumental and emotional social support on physical activity ( PA ) longitudinally in underserved adolescents .


This longitudinal study was a secondary analysis of the Active by Choice Today ( ACT ) trial examining whether instrumental social support predicts increases in PA in underserved adolescents , above and beyond emotional social support provided by family or peers .


Students in the sixth grade ( N = @,@ , @ % African American , @ % female , M age = @years ) in the ACT trial participated .


At baseline and @weeks , previously validated measures of social support ( family instrumental , family emotional , and peer emotional ) were completed and moderate-to-vigorous PA ( MVPA ) was assessed using @-day accelerometry estimates .


A mixed ANCOVA demonstrated that baseline ( p = @ ) and change in family instrumental support ( p = @ ) , but not emotional support from family or peers , predicted increases in MVPA across a @-week period .


Future interventions in underserved adolescents should enhance opportunities for instrumental support for PA. .


We aimed to determine whether head elevation during combined spinal-epidural anesthesia ( CSE ) and Caesarean section provided improved hemodynamics and appropriate sensory block height .


Forty-four parous women undergoing CSE for elective Caesarean section were randomly assigned to one of two groups : right lateral ( group L ) or right lateral and head elevated ( group HE ) position , for insertion of the block .


Patients were positioned in the supine wedged position ( group L ) or the left lateral and head elevated position ( group HE ) until a block height of T@ to light touch was reached .


Group HE was then turned to the supine wedged position with maintenance of head elevation until the end of surgery .


Hemodynamics , including the incidence of hypotension , ephedrine dose required , and characteristics of the sensory blocks were analyzed .


The incidence of hypotension ( @ versus @ , p = @ ) and the required dose of ephedrine -LSB- @ ( @-@ ) versus @ ( @-@ ) , p < @ -RSB- were greater in group L compared to group HE .


In group L , the time to achieve maximal sensory block level ( MSBL ) was shorter ( @ min versus @ min , p < @ ) and MSBL was also higher than in group HE -LSB- @ ( T@ ) versus @ ( T@ ) , p = @ -RSB- .


Head elevation during CSE and Caesarean section is superior to positioning without head elevation in the lateral to supine position , as it is associated with a more gradual onset , appropriate block height , and improved hemodynamics .


Self-monitoring is reported to have limited efficacy for hypertension management in high-income countries .


In this study , we aimed to evaluate the effect of self-monitoring on blood pressure ( BP ) control in an Iranian population .


A randomized controlled trial was conducted on @ mild to moderate hypertensive patients in an outpatient cardiovascular clinic .


Patients in the intervention group received a wrist self-monitoring device and were educated to measure and document their BP daily during the study period ( @ weeks ) .


Patients in the control group received usual care .


Three follow-up visits with the physician were scheduled for all patients ( weeks @ , @ , and @ ) , and the investigator assessed adherence to medications after each visit ( pill counting ) .


The primary outcome ( BP ) was compared between groups using repeated-measure analysis of variance .


One hundred ninety patients completed the study .


Systolic BP ( @ vs @ mm Hg ) and diastolic BP ( @ vs. @ mm Hg ) were similar between groups at baseline .


The trend of BP was not significantly different between groups during the study period .


Systolic and diastolic BP decreased significantly in both groups at the first follow-up visit ( systolic BP : @ vs. @ mm Hg ; diastolic BP : @ vs. @ mm Hg ) .


In the intervention group , we observed a small continued decrease in diastolic BP up to week @ BP ( P = @ ) .


Both groups showed adherence rates > @ % during the study period .


Our study could not confirm that self-monitoring can improve BP control in patients with frequent medical visits .


To explore in a panel of patient-derived xenograft models of human non-small cell lung cancer ( NSCLC ) whether high EGFR expression , was associated with cetuximab activity .


NSCLC patient-derived xenograft models ( n = @ ) were implanted subcutaneously into panels of nude mice and randomization cohorts were treated with either cetuximab , cisplatin , cisplatin plus cetuximab , vehicle control , or else were left untreated .


Responses according to treatment were assessed at week @ by analyzing the relative change in tumor volume and an experimental analogue of the Response Evaluation Criteria in Solid Tumors ( RECIST ) guidelines .


An EGFR IHC score was calculated for each patient-derived xenograft model and response was assessed according to EGFR expression level .


When tumors were stratified into high and low EGFR expression groups ( IHC score threshold @ ; scale @-@ ) , a stronger antitumor activity was seen in the high EGFR expression group compared with the low EGFR expression group in both the cetuximab monotherapy and cisplatin plus cetuximab combination therapy settings .


For tumors treated with cisplatin plus cetuximab , the objective response rate was significantly higher in the high EGFR expression group compared with the low EGFR expression group ( @ % vs. @ % ) .


Objective response rates were similar in high and low expression groups for tumors treated with cisplatin alone ( @ % vs. @ % , respectively ) .


Cetuximab activity in NSCLC patient-derived xenograft models was demonstrated clearly only in tumors that expressed high levels of EGFR , as defined by an IHC score of @ .


Outcome measures of breast reconstruction have used panel assessment of photographs .


This provides limited information to the assessor as these images are static .


The aim of this study was to assess whether the use of digital video was a valid assessment tool and to compare its use against photography .


@ patients post-reconstruction underwent photography , digital video capture and completed Breast Cancer Treatment Outcomes Scale ( BCTOS ) questionnaires .


The photographs/video clips were randomised and shown to a @ member panel .


Opinions on aesthetic aspects of the reconstruction were assessed using the BCTOS and Harris scale .


Panel inter-rater agreement and patient-panel correlation was assessed using Kendall 's Coefficient of Concordance and Spearman 's rank correlation tests respectively .


There was a `` moderate '' degree of inter-rater agreement amongst panel members in all categories .


Greater agreement occurred using video footage to assess overall cosmesis ( @ vs @ ) and shape ( @ vs @ ) .


Video showed a greater degree of correlation with patient self-assessment scores in comparison to photography ( @ vs @ ) .


Video footage coupled with panel assessment is a valid method of assessing post-operative outcomes of breast reconstruction and appears superior to still photographs in terms of inter-rater agreement and correlation with patient self-assessment .


This study was carried out to investigate the effect of vitamins E and C on cognitive performance among the elderly in Iran .


About @ elderly with mild cognitive impairment , aged @-@ years , received @ mg of vitamin E plus @ mg of vitamin C or placebo daily just for @ year .


Demographic characteristics , anthropometric variables food consumption , cognitive function by Mini-Mental State Examination ( MMSE ) , and some of the oxidative stress biomarkers were examined .


Antioxidant supplementation reduced malondialdehyde level ( P < @ ) and raised total antioxidant capacity ( P < @ ) and glutathione ( P < @ ) .


The serum @-hydroxydeoxyguanosine remained unchanged ( P < @ ) .


After adjusting for the covariates effects , MMSE scores following @ - ( @ @ ) and @-month antioxidant supplementation ( @ @ ) did not differ from control group ( @ @ and @ @ , respectively ) .


Despite significant improvement in most of the oxidative stress biomarkers , antioxidants ' supplementation was not observed to enhance cognitive performance .


A large number of kinetic and/or dynamic factors could be suspected .


Resorbable fixation material is an attractive option for those patients undergoing orthognathic surgery .


The efficacy of resorbable screws was tested in bilateral mandibular sagittal split osteotomies ( BSSOs ) performed for correction of retrognathic mandibles .


One hundred one patients were enrolled in this prospective randomized clinical trial .


Patients in group @ ( n = @ ) received titanium screws ( Stryker ) and patients in group @ ( n = @ ) received resorbable screws ( Inion CPS ) .


Outcome measurements were compared for statistical significance .


There was a statistically significant difference in the use of postoperative elastics ( P < @ ) .


There was no statistically significant difference in other outcome measurements , including clinical evidence of relapse .


Resorbable screws can be used effectively for fixation of BSSO for mandibular advancement .


A higher incidence of rotation around positional screws can result secondary to the mechanical `` looseness '' when using resorbable screws .


This can be treated effectively using Class III mechanic elastics during the initial stages of bone healing .


We sought to determine whether exclusion of infection and antibiotic stewardship with the infection biomarker procalcitonin improves outcomes in congestive heart failure ( CHF ) patients presenting to emergency departments with respiratory symptoms and suspicion of respiratory infection .


We performed a secondary analysis of patients with a past medical history of CHF formerly included in a Swiss multicenter randomized-controlled trial .


The trial compared antibiotic stewardship according to a procalcitonin algorithm or state-of-the-art guidelines ( controls ) .


The primary endpoint was a @-day adverse outcome ( death , intensive care unit admission ) ; the secondary endpoints included a @-day antibiotic exposure .


In the @/@ analyzed patients ( @ % ) with low initial procalcitonin ( < @ g/L ) , suggesting the absence of systemic bacterial infection , those randomized to procalcitonin guidance ( n = @ ) had a significantly lower adverse outcome rate compared to controls ( n = @ ) : @ % vs. @ % ( absolute difference -@ % , @ % confidence interval ( CI ) -@ % to -@ % , P = @ ) , and significantly reduced antibiotic exposure -LSB- days -RSB- ( mean @ @ vs. @ @ , difference -@ -LSB- @ % CI , -@ to -@ -RSB- , P < @ ) .


When initial procalcitonin was @ g/L , procalcitonin-guided patients had significantly reduced antibiotic exposure due to early stop of therapy without any difference in adverse outcomes ( @ % vs. @ % , difference -LSB- @ % CI -RSB- @ % -LSB- -@ % to @ % , P = @ -RSB- ) .


CHF patients presenting to the emergency department with respiratory symptoms and suspicion for respiratory infection had decreased antibiotic exposure and improved outcomes when procalcitonin measurement was used to exclude bacterial infection and guide antibiotic treatment .


These data provide further evidence for the potential harmful effects of antibiotic / fluid treatment when used instead of diuretics and heart failure medication in clinically symptomatic CHF patients without underlying infection .


Children surviving acute lymphoblastic leukemia ( ALL ) are at increased risk for overweight and obesity over that of the general population .


Whether a generic or tailored approach to weight management is needed for cancer survivors has yet to be tested .


Thirty-eight youth @-@ years with BMI @ % who had survived ALL were recruited for a randomized clinical trial evaluating a weight management intervention ( WMI ) tailored for childhood ALL survivors ( Fit@Life ) .


Fit@Life recipients received a @-month web , phone , and text message-delivered WMI tailored for cancer survivorship .


Controls received a general WMI delivered via phone and mail .


Assessments were performed at baseline and @ months .


Outcome data were analyzed according to assigned treatment condition over time .


Most ( @ % , ( @ % , @ % ) -LSB- median ( IQR ) -RSB- ) of the assigned curriculum was received by Fit@Life participants as compared to @ % ( @ % , @ % ) among controls .


Fit@Life recipients @ years demonstrated less weight gain ( P = @ ) and increased moderate-to-vigorous physical activity ( P < @ ) while all Fit@Life recipients reported reduced negative mood ( P < @ ) over time as compared to control counterparts .


We demonstrated acceptable feasibility of a WMI tailored for overweight and obese children surviving ALL utilizing a multimodal technology approach .


Improved weight , weight-related behavior , and psychological outcomes were demonstrated among Fit@Life intervention as compared to youth receiving a generic WMI .


Data from this pilot trial may be used to design a larger trial to determine whether youth of all ages also can derive a benefit from a cancer survivor-tailored WMI and whether short-term outcomes translate into improved long-term outcomes for childhood ALL survivors .


Patient self-management support may be augmented by using home-based technologies that generate data points that providers can potentially use to make more timely changes in the patients ' care .


The purpose of this study was to evaluate the effectiveness of short-term targeted use of remote data transmission on treatment outcomes in patients with diabetes who had either out-of-range hemoglobin A@c ( A@c ) and/or blood pressure ( BP ) measurements .


A single-center randomized controlled clinical trial design compared in-home monitoring ( n = @ ) and usual care ( n = @ ) in patients with type @ diabetes and hypertension being treated in primary care clinics .


Primary outcomes were A@c and systolic BP after a @-week intervention .


There were no significant differences between the intervention and control groups on either A@c or systolic BP following the intervention .


The addition of technology alone is unlikely to lead to improvements in outcomes .


Practices need to be selective in their use of telemonitoring with patients , limiting it to patients who have motivation or a significant change in care , such as starting insulin .


Attention to the need for effective and responsive clinic processes to optimize the use of the additional data is also important when implementing these types of technology .


It is empirically well documented that psychotherapy is vital in the treatment of chronic back pain .


To test in this randomized controlled clinical trial whether cognitive behavior group therapy is effective in respect to pain tolerance and disability apart from the effects on somatization in general and additional to the effects of a multimodal inpatient orthopedic rehabilitation programme .


Fifty-three patients were randomly assigned to an intervention group , receiving six sessions of `` cognitive behavior group therapy for back pain '' ( CBT-BP ) , and @ to a control group who got unspecific occupational therapy sessions instead .


Patients were suffering from chronic back pain for at least six months .


All patients were treated for @ days in an orthopedic inpatient rehabilitation unit with a multimodal orthopedic treatment , including active physical therapy , patient education or motivation to exercise .


In both groups there is a significant improvement over time in the Symptom Checklist ( SCL-@ ) , the Rating of Health Locus of Control Attributions , the Fear Avoidance Beliefs Questionnaire ( FABQS ) and a Visual Analogue Pain Scale ( VAS-pain ) .


There are significant interactions between treatment group and VAS-pain and the FABQS , showing a superior improvement in the intervention group , while no significant superiority is found for the SCL .


The experience of pain can be altered directly and not only through improvement of depression or general somatoform complaints .


The study replicates other research and increases the evidence base for this mode of treatment .


The treatment effect can be called specific as it is found additional to a multimodal inpatient care programme .


To investigate whether the @-year change in lens opacity severity on the Age-Related Eye Disease Study ( AREDS ) lens grading scale predicts progression to cataract surgery or loss of visual acuity by @ years .


Prospective cohort study within a randomized clinical trial of oral supplements .


The AREDS participants whose eyes were phakic at baseline and free of late age-related macular degeneration throughout the study .


Baseline and annual lens photographs of AREDS participants ( n = @/@ ; @ % ) were graded for severity of cataracts using the AREDS system for classifying cataracts from photographs .


Clinical examinations conducted semiannually collected data on cataract surgery and visual acuity .


Association of the change in lens opacities at @ years with these outcomes at @ years was analyzed with adjusted Cox proportional hazard models .


Progression of lens opacities on stereoscopic lens photographs at @ years , cataract surgery , and visual acuity loss of @ lines or more at @ years .


The adjusted hazard ratios ( HRs ) for association of progression to cataract surgery at @ years were : nuclear cataract increase of @ unit or more compared with less than @-unit change at @ years , @ ( @ % confidence interval -LSB- CI -RSB- , @-@ @ ; P < @ ) ; cortical cataract increase of @ % or more in lens opacity in the central @ mm of the lens compared with less than @ % increase at @ years , @ ( @ % CI , @-@ @ ; P = @ ) ; and posterior subcapsular cataract increase of @ % or more versus less than @ % in the central @ mm of the lens , @ ( @ % CI , @-@ @ ; P < @ ) .


Similarly , HRs of vision loss of @ lines or more at @ years for this degree of lens changes at @ years were the following : nuclear , @ ( @ % CI , @-@ @ ; P < @ ) ; cortical , @ ( @ % CI , @-@ @ ; P = @ ) ; and posterior subcapsular cataract , @ ( @ % CI , @-@ @ ; P < @ ) .


Two-year changes in severity of lens opacities on the AREDS lens grading scale are predictive of long-term clinically relevant outcomes , making them potential surrogate end points in follow-up studies .


Angiotensin receptor blockers ( ARBs ) inhibit activated hepatic stellate cell contraction and are thought to reduce the dynamic portion of intrahepatic resistance .


This study compared the effects of combined treatment using the ARB candesartan and propranolol versus propranolol monotherapy on portal pressure in patients with cirrhosis in a prospective , randomized controlled trial .


Between January @ and July @ , @ cirrhotic patients with clinically significant portal hypertension were randomized to receive either candesartan and propranolol combination therapy ( @ patients ) or propranolol monotherapy ( @ patients ) .


Before and @ months after the administration of the planned medication , the hepatic venous pressure gradient ( HVPG ) was assessed in both groups .


The dose of propranolol was subsequently increased from @ mg bid until the target heart rate was reached , and the candesartan dose was fixed at @ mg qd .


The primary endpoint was the HVPG response rate ; patients with an HVPG reduction of > @ % of the baseline value or to < @ mmHg were defined as responders .