The mean portal pressure declined significantly in both groups , from @ mmHg ( range , @-@ mmHg ) to @ mmHg ( range , @-@ mmHg ) in the combination group ( P < @ ) , and from @ mmHg ( range , @-@ mmHg ) to @ mmHg ( range , @-@ mmHg ) in the propranolol monotherapy group ( P < @ ) .


However , the medication-induced pressure reduction did not differ significantly between the two groups -LSB- @ mmHg ( range , -@ -@ mmHg ) vs. @ mmHg ( range , -@ -@ mmHg ) , P = @ -RSB- .


The response rate ( @ % vs. @ % , P = @ ) and the reductions in mean blood pressure or heart rate also did not differ significantly between the combination and monotherapy groups .


The addition of candesartan ( an ARB ) to propranolol confers no benefit relative to classical propranolol monotherapy for the treatment of portal hypertension , and is thus not recommended .


Repeat infection with Chlamydia trachomatis is common and increases the risk of sequelae in women and HIV seroconversion in men who have sex with men ( MSM ) .


Despite guidelines recommending chlamydia retesting three months after treatment , retesting rates are low .


We are conducting the first randomised controlled trial to assess the effectiveness of home collection combined with short message service ( SMS ) reminders on chlamydia retesting and reinfection rates in three risk groups .


The REACT ( retest after Chlamydia trachomatis ) trial involves @ patients diagnosed with chlamydia : @ MSM , @ women and @ heterosexual men recruited from two Australian sexual health clinics where SMS reminders for retesting are routine practice .


Participants will be randomised to the home group ( @-month SMS reminder and home-collection ) or the clinic group ( @-month SMS reminder to return to the clinic ) .


Participants in the home group will be given the choice of attending the clinic if they prefer .


The mailed home-collection kit includes a self-collected vaginal swab ( women ) , UriSWAB ( Copan ) for urine collection ( heterosexual men ) , and UriSWAB plus rectal swab ( MSM ) .


The primary outcome is the retest rate at @-@ months after a chlamydia diagnosis , and the secondary outcomes are : the repeat positive test rate ; the reinfection rate ; the acceptability of home testing with SMS reminders ; and the cost effectiveness of home testing .


Sexual behaviour data collected via an online survey at @-@ months , and genotyping of repeat infections , will be used to discriminate reinfections from treatment failures .


The trial will be conducted over two years .


An intention to treat analysis will be conducted .


This study will provide evidence about the effectiveness of home-collection combined with SMS reminders on chlamydia retesting , repeat infection and reinfection rates in three risk groups .


The trial will determine client acceptability and cost effectiveness of this strategy .


Blueberries are a rich source of flavonoids and phenolic acids .


Currently , little information is available regarding the impact of processing on the bioavailability and the bioactivity of blueberry ( poly ) phenols .


In a randomized , controlled crossover trial , ten healthy volunteers consumed ( a ) blueberry-containing baked products , ( b ) an unprocessed blueberry drink containing the same amount of freeze-dried blueberry powder as used in the baked products , and ( c ) matched control baked products .


Endothelial function was measured as flow-mediated dilation ( FMD ) and plasma samples taken at baseline and at @ , @ , @ , and @ h postconsumption .


Although processing did not significantly change the total ( poly ) phenolic amount , the processed products contained significantly less anthocyanins ( -@ % ) , more chlorogenic acid ( @ % ) , no flavanol nonamers or decamers , and significantly more flavanol dimers and trimers ( @ % and @ % , respectively ) .


FMD increased after @ , @ , and @ h consumption of the baked products to a similar degree as the unprocessed blueberries , despite significant differences in the levels of individual plasma metabolites .


No changes were observed after the consumption of the control product .


Careful processing can preserve important biological activities of blueberries despite changing the blueberry ( poly ) phenol composition and plasma metabolite profile .


The aim of this study was to investigate safety , tolerance , relative exercise intensity , and muscle substrate oxidation during sessions performed on a Huber Motion Lab in coronary heart disease patients .


After an assessment of Vo@ peak , @ coronary heart disease patients participated in two different exercises performed in random order at @ % and @ % ( W@ and W@ ) of the maximal isometric voluntary contraction .


No significant arrhythmia or abnormal blood pressure responses occurred during either session , and no muscle soreness was reported within @ hrs posttest .


The authors found a difference between W@ and W@ sessions for mean ( standard deviation ) ventilation ( @ % -LSB- @ % -RSB- and @ % -LSB- @ % -RSB- of maximal ventilation , respectively ; P = @ ) and a small difference for mean ( standard deviation ) heart rate ( @ -LSB- @ -RSB- and @ -LSB- @ -RSB- beats/min , respectively ; P < @ ) .


When compared with the W@ , the W@ was associated with higher active energy expenditure ( @ -LSB- @ -RSB- and @ -LSB- @ -RSB- Kcal/min , respectively ; P < @ ) and a similar mean ( standard deviation ) oxygen uptake ( @ -LSB- @ -RSB- and @ -LSB- @ -RSB- ml/min per kilogram , respectively ; P = @ ) .


The qualitative percentages of carbohydrates and lipids oxidized were @ % and @ % , respectively , at W@ and @ % and @ % , respectively , at W@ .


Both protocols , which consisted of repeating @-sec phases of contractions with @ secs of passive recovery on the Huber Motion Lab , seemed to be well tolerated , safe , and feasible in this group of coronary heart disease patients .


To observe the impacts on endometrial and pregnancy outcomes treated with acupuncture and moxibustion in the patients of in vitro fertilization-embryo transfer ( IVF-ET ) and explore the application value , of acupuncture and moxibustion in IVF-ET treatment .


One hundred and fourteen patients of IVF-ET treated with standard long-term program at luteal phase were randomized into an observation group and a control group , @ cases in each one .


In the observation group , at the beginning of ovulatory induction , moxibustion was applied to Shenque ( CV @ ) and acupuncture was to Zhongji ( CV @ ) , Guanyuan ( CV @ ) , Qihai ( CV @ ) , Zigong ( EX-CA @ ) , Xuebai ( SP @ ) , etc. till the transfer time for one session of treatment .


Totally , @ sessions were required .


In the control group , no intervention of acupuncture and moxibustion was applied .


The endometrial morphology , subendometrial blood flow index , the levels of serum estradiol ( E@ ) , progesterone ( P ) and luteinizing hormone ( LH ) on the day of injection of human chorionic gonadotropin ( hCG ) , the dosage and time of gonadotropin ( Gn ) , oocyte count , high-quality embryo number , embryo cultivation rate and clinical pregnant rate were observed in the two groups .


The A type endometrial proportion on hCG day and high-quality embryo rate in the observation group were higher than those in the control group , indicating the significant differences ( both P < @ ) .


The difference in endometrial thickness on hCG day was not significant between the two groups ( P > @ ) .


In the observation group , endometrial hemodynamic index ( peak systolic blood velocity/end-diastolic blood velocity , S/D ) , resistive index ( RI ) and pulse index ( PI ) were lower than those in the control group ( P < @ , P < @ ) .


The levels of serum E@ and P on hCG day in the observation group were higher than those in the control group ( both P < @ ) .


The differences were not significant in Gn dose , Gn medication time , numbers of follicles > @ cm on hCG day , oocyte count , embryo cultivation rate and clinical pregnancy rate and LH level on hCG day between the two groups ( all P > @ ) .


In IVF-ET treatment , acupuncture and moxibustion affect estrogen level on hCG day , improve high-quality embryo rate , endometrial blood flow state and morphology so that the endometrial receptivity is increased and the method is expected to be the assistant therapeutic approach for the improvement of IVF-ET outcome .


The pilot study purpose was to determine the effects of a new standardized oral care protocol ( intervention ) to usual care practices ( control ) in poststroke patients .


This study is a randomized controlled clinical trial .


Fifty-one subjects were enrolled .


Subjects in the intervention group received oral care twice a day including tooth brushing , tongue brushing , flossing , mouth rinse , and lip care while control patients received usual oral care .


Subjects in the control and intervention groups showed improvement in their oral health assessments , swallowing abilities and oral intake .


There were no significant differences between the two groups .


Although not statistically significant , overall prevalence of methicillin-resistant Staphylococcus aureus and methicillin-sensitive Staphylococcus aureus colonization in the control group almost doubled ( from @ % to @ % ) , while colonization in the intervention group decreased ( from @ % to @ % ) .


These findings demonstrate the importance of oral care in the poststroke patient with dysphagia .


The current study assessed relations among maternal depressive symptoms , poorer youth diabetes adherence , and glycemic control .


Specifically , hypothesized mediating links of lowered expectations of parental involvement , less parental monitoring , and more conflict were examined .


Participants included @ mothers and their young adolescents , aged @-@ years ( M = @ years , SD = @ ) diagnosed with T@D .


Maternal depressive symptoms and outcome expectancies for maternal involvement were evaluated with self-report questionnaires .


Multisource , parent/youth , and multimethod assessment of adherence , parental monitoring , and conflict were evaluated during a baseline assessment from a larger randomized clinical trial .


The first hypothesized structural equation model demonstrated a good fit and indicated that more maternal depressive symptoms were directly associated with less parental monitoring and more conflict , which in turn each were associated with poorer adherence and glycemic control .


Although higher involvement expectancies were associated with more monitoring and less conflict , they were not associated with other model variables .


A second alternative model also fit the data well ; poorer youth adherence was associated with more conflict that in turn related to maternal depressive symptoms .


Two models were tested by which maternal depressive symptoms and poorer youth adherence were interrelated via less monitoring and more conflict .


Follow-up longitudinal evaluation can best characterize the full extent of these relations .


To evaluate the effectiveness of specialized physiotherapy methods measured by the BODE index in patients with COPD during hospitalization .


The study was conducted on a group of @ patients diagnosed with COPD , all under treatment at the clinical hospital in Wroclaw due to the exacerbation of their symptoms .


All patients were undergoing standard pharmacological treatment along with basic physiotherapy .


The subjects of the study were randomly divided between an experimental group of @ persons and a control group of @ persons .


Patients in the experimental group underwent a series of @ additional massage treatments performed over a period of a few days , aimed at reshaping the following muscles : the sterno-cleidomastoid , pectoralis major , pectoralis minor , trapezius , levator scapulae , rhomboids and serratus anterior .


Each massage lasted for @ minutes and consisted of stroking , grinding , vibration and kneading techniques .


Before and after therapy the patients were assessed based on the BODE index .


First , the patient 's BMI was calculated ( B ) .


Airflow obstruction ( O ) was determined by the percentage value of FEV@ while the MRC scale was used to evaluate a patient 's dyspnea ( D ) .


Exercise capacity ( E ) was measured by the distance a patient could cover in a @-minute walk test .


Each variable of the BODE index was ranked on a scale from @ to @ points except the BMI , for which was given either @ or @ point .


Analysis of the results showed a significant improvement of the BODE index in the experimental group while in the control group this ratio changed slightly .


The FEV@ and MRC parameters changed significantly only in the experimental group .


After a week of therapy the BODE index improved in both groups , but in the experimental group there was a significantly higher difference .


In the experimental group all BODE components except BMI improved highly significantly , whereas in the control group only exercise capacity was significantly improved .


The gold standard in ACL reconstructions has been the bone-patellar tendon-bone autograft fixed with interference screws .


This prospective , randomized clinical trial aimed to compare two methods of fixation for BPTB grafts : press-fit fixation vs. interference screw , over a @-month follow-up interval .


@ patients with an average age of @ years , between @ and @ , were treated for torn ACL .


@ patients underwent reconstruction with BPTB autograft with a press fit fixation technique , and in @ cases an interference screw was used .


At the time of final follow-up , @ patients in press-fit group and @ patients in interference screw group were evaluated in terms of return to pre-injury activity level , pain , knee stability , range of motion , IKDC score and complications .


At @-month follow-up , @ ( @ % ) and @ ( @ % ) in press-fit and screw group , respectively had good-to-excellent IKDC score ( p > @ ) .


The mean laxity assessed using a KT-@ arthrometer improved to @ and @ mm in press-fit and screw group , respectively .


Regarding Lachman and pivot shift test , there was a statistically significant improvement in the integrity of the ACL in both the groups , but no significant differences was noted between groups .


There were no significant differences in terms of femur circumference difference , effusion , knee range of motion , pain and complications .


The press-fit technique is an efficient procedure .


Its outcome was comparable with the interference screw group .


Furthermore it has unlimited bone-to-bone healing , no need for removal of hardware , ease for revision and cost effectiveness .


When used with standard diagnostic testing , point-of-care ultrasonography might improve the proportion of patients admitted with respiratory symptoms who are correctly diagnosed @ h after admission to the emergency department .


We therefore assessed point-of-care ultrasonography of the heart , lungs , and deep veins in addition to the usual initial diagnostic testing in this patient population .


In a prospective , parallel-group trial in the emergency department at Odense University Hospital , Odense , Denmark , patients ( @ years ) with a respiratory rate of more than @ per min , oxygen saturation of less than @ % , oxygen therapy , dyspnoea , cough , or chest pain were randomly assigned in a @:@ ratio with a computer-generated list to a standard diagnostic strategy ( control group ) or to standard diagnostic tests supplemented with point-of-care ultrasonography of the heart , lungs , and deep veins ( point-of-care ultrasonography group ) .


The primary endpoint was the percentage of patients with a correct presumptive diagnosis @ h after admission to the emergency department .


Only the physicians doing the primary clinical assessment and the auditors were masked .


Analyses were by intention to treat .


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


Between Dec @ , @ , and March @ , @ , @ patients were randomly assigned to the control group ( n = @ ) and point-of-care ultrasonography group ( n = @ ) .


@ patients in the point-of-care ultrasonography group and @ in the control group were analysed .


@ h after admission to the emergency department , @ patients ( @ % ; @ % CI @-@ ) in the point-of-care ultrasonography group versus @ ( @ % ; @-@ ) in the control group had correct presumptive diagnoses ( p < @ ) .


The absolute and relative effects were @ % ( @ % CI @-@ ) and @ ( @-@ ) , respectively .


No adverse events were reported .


Point-of-care ultrasonography is a feasible , radiation free , diagnostic test , which alongside standard diagnostic tests is superior to standard diagnostic tests alone for establishing a correct diagnosis within @ h.


It should therefore be considered for routine use as part of the standard diagnostic tests in the emergency department for patients admitted with respiratory symptoms .


The purpose of the current study is to examine the efficacy of Counselor-Assisted Problem Solving ( CAPS ) in improving caregiver adaptation following traumatic brain injury ( TBI ) .


In a randomized clinical trial comparing CAPS ( n = @ ) , an online problem-solving intervention with accompanying Web-based counseling sessions , with an information-based Internet Resource Comparison ( IRC ; n = @ ) program , participants included families of @ - to @-year-olds who had sustained a TBI in the past @ months .


Linear regression analyses were used to identify main effects and to examine whether caregiver education , race , or prior computer use moderated treatment efficacy .


Computer experience moderated postintervention improvements in caregiving self-efficacy following CAPS , Specifically , parents in CAPS with low levels of prior use reporting the greatest improvements .


CAPS participants who completed @ or more sessions reported greater reductions in depression than did the IRC ; however , the groups did not differ on global distress .


Findings support the potential utility of counselor-supported Web-based interventions particularly for individuals with limited computer expertise following adolescent TBI .


Digital plain radiographs of the pelvis are frequently performed in follow-up examinations of patients who received total hip arthroplasty ( THA ) or osteosynthesis ( OS ) .


Thus , the purpose was to reduce the radiation dose and to determine objective quality control criteria to ensure accurate assessment .


Institutional review board approval was obtained .


In this prospective randomized study , @ patients underwent X-ray examination of the pelvis as follow up after receiving THA or OS with standard and reduced dose .


The evaluation of the plain radiographs was conducted using the following criteria : bone-implant interface , implant-implant discrimination , implant-surface character and periarticular heterotopic ossification .


Two radiologists evaluated these criteria using a score ranging from @ ( definitely assessable ) to @ ( not assessable ) .


If a single criterion had been evaluated with a score of @ or more or more than @ criteria with @ points , the radiograph was scored as `` not assessable '' .


The study was designed as non-inferiority-trial .


Seven ( @ % ) examined X-rays were scored as not assessable .


There was no statistical inferiority between the examinations with standard ( @ mSv ) or reduced dose ( @ mSv ) .


Reduced dose only led to limitations in the evaluation of ceramic components with low clinical impact in most scenarios .


Plain radiography of the pelvis in patients with THA or OS can be performed with a dose reduction of about @ % without a loss of important information .


The obtained quality control criteria were clinically applicable .


We developed a tailored education program using a touch-screen computer for changing management behavior with asthmatic children and their caregivers .


The purpose of this study was to examine the effect of the tailored education program .


Caregivers including children with asthma were recruited during visits to a national children 's hospital and those whose month-long asthma condition on the JPAC ( Japanese Pediatric Asthma Program ) score was @ and below were included .


Caregivers were randomized to the tailored education ( intervention group ) or non-tailored education ( control group ) .


The intervention group underwent a patient education program using a touch-screen computer , and they received tailored messages generated by a computer program .


A research nurse and clinical psychologist used a computer-based resource to tailor the education messages and provided counseling using motivational interviewing for the caregivers including children with asthma .


The control group received only a booklet on asthma .


Forty-seven subjects aged @ to @ years were enrolled .


Forty-seven caregivers were randomized to the tailored education ( n = @ ) or non-tailored education ( n = @ ) group .


The results of two-way ANOVA showed that interactions between groups were observed in the score of JPAC and asthma knowledge for preschool children whose asthma onset was within one year and a half .


The main effects of time were observed in the total and subscale score of QOL ( Quality of Life ) and the total score of P-CASES ( Parental Childhood Asthma 's Self-efficacy Scale ) .


These findings indicate the benefit of a tailored education program to control symptoms in such caregivers .


( R , S ) - ketamine produces rapid and significant antidepressant effects in approximately @ % of patients suffering from treatment-resistant bipolar depression ( BD ) .


The genetic , pharmacological and biochemical differences between ketamine responders and non-responders have not been identified .


The purpose of this study was to employ a metabolomics approach , a global , non-targeted determination of endogenous metabolic patterns , to identify potential markers of ketamine response and non-response .


Plasma samples from @ BD patients were analyzed to produce metabolomic patterns .


The patients had received ketamine in a placebo-controlled crossover study and the samples were obtained @min post-administration at which time the patients were categorized as responders or non-responders .


Matching plasma samples from the placebo arm of the study were also analysed .


During the study , the patients were maintained on either lithium or valproate .


The metabolomic patterns were significantly different between the patients maintained on lithium and those maintained on valproate , irrespective of response to ketamine .


In the patients maintained on lithium , @ biomarkers were identified .


In responders , lysophosphatidylethanolamines ( @ ) and lysophosphatidylcholines ( @ ) were increased relative to non-responders .


The results indicate that the differences between patients who respond to ketamine and those who do not are due to alterations in the mitochondrial - oxidation of fatty acids .


These differences were not produced by ketamine administration .


The data indicate that pretreatment metabolomics screening may be a guide to the prediction of response and a potential approach to the individualization of ketamine therapy .


Many questions remain unanswered about the role of bariatric surgery for people with type @ diabetes mellitus ( T@DM ) .


To determine feasibility of a randomized clinical trial ( RCT ) and compare initial outcomes of bariatric surgery and a structured weight loss program for treating T@DM in participants with grades I and II obesity .


A @-month , @-arm RCT at a single center including @ participants aged @ to @ years with a body mass index ( calculated as weight in kilograms divided by height in meters squared ) of @ to @ and T@DM .


Roux-en-Y gastric bypass ( RYGB ) , laparoscopic adjustable gastric banding ( LAGB ) , and an intensive lifestyle weight loss intervention ( LWLI ) .


Primary outcomes in the intention-to-treat cohort were feasibility and effectiveness measured by weight loss and improvements in glycemic control .


Of @ potential participants who underwent screening , @ ( @ % ) were randomized .


Among the randomized participants , @ ( @ % ) had grade I obesity , and @ ( @ % ) were women .


Mean ( SD ) age was @ ( @ ) years and hemoglobin A@c level , @ % ( @ % ) .


After randomization , @ participants ( @ % ) refused to undergo their allocated intervention ( @ RYGB , @ LAGB , and @ LWLI ) , and @ RYGB participant was excluded for current smoking .


Twenty participants underwent RYGB ; @ , LAGB ; and @ , LWLI , with @-month retention rates of @ % , @ % , and @ % , respectively .


In the intention-to-treat cohort with multiple imputation for missing data , RYGB participants had the greatest mean weight loss from baseline ( @ % ; @ % CI , @-@ @ ) compared with LAGB ( @ % ; @ % CI , @-@ @ ) and LWLI ( @ % ; @ % CI , @-@ @ ) ( P < @ ) .


Partial and complete remission of T@DM were @ % and @ % , respectively , in the RYGB group and @ % and @ % , respectively , in the LAGB group ( P < @ and P = @ between groups for partial and complete remission ) , with no remission in the LWLI group .


Significant reductions in use of antidiabetics occurred in both surgical groups .


No deaths were noted .


The @ serious adverse events included @ ulcer treated medically in the RYGB group and @ rehospitalizations for dehydration in the LAGB group .


This study highlights several potential challenges to successful completion of a larger RCT for treatment of T@DM and obesity in patients with a body mass index of @ to @ , including the difficulties associated with recruiting and randomizing patients to surgical vs nonsurgical interventions .


Preliminary results show that RYGB was the most effective treatment , followed by LAGB for weight loss and T@DM outcomes at @ year .


: Periimplantitis is a bacterial complication after dental implants implantation .


Photodynamic therapy ( PDT ) implies the use of low-power laser in combination with appropriate photosensitizer to increase the detoxification of the implant surfaces .


Little information exists about PDT in the treatment of periimplantitis .


A randomized comparative case-control study has been conducted with @ patients and @ controls to compare the efficacy of antimicrobial PDT versus surgical therapy in patients with periimplantitis , who have received dental implants with rough surfaces .


In the surgery group , mucoperiosteal flap surgery was used with scaling on implant surfaces and debridement of granulation tissue .


Microbiologic testing was evaluated before and after intervention treatment , at @ and @ weeks in the study subjects .


Total anaerobic counts of bacteria did not differ significantly between patients assigned to receive PDT and those assigned to receive surgical therapy ( mean , @ % and @ % , respectively ) .


PDT was associated with a significant decrease in bleeding scores ( P = @ ) as well as inflammatory exudation ( P = @ ) .


Treatment with PDT in patients with periimplantitis was not associated with major reduction of total anaerobic bacteria on the rough surfaces of dental implants as compared with surgical therapy .


A significantly lower proinflammatory index of periimplantitis was observed in the PDT group at @ weeks of follow-up .


In multicomponent interventions it is important to examine the implementation of each component to enable valid assessments of the effectiveness of each component .


Many studies do not systematically document , evaluate and report the level of implementation and there is a lack of systematic approaches to conduct process evaluation studies to guide researchers and evaluators .


The aim of this study was to present a systematic approach to plan process evaluation of the implementation of randomised multicomponent interventions .


Building on existing process evaluation frameworks and concepts , we developed a six-step protocol : @ .


Brainstorm of processes necessary for full implementation and potential barriers and facilitators to implementation ; @ .


Application of process evaluation concepts to ensure inclusion of important implementation processes ; @ .


Measurement of proximal outcomes ; @ .


Identification of relevant data sources ; @ .


Selection of methods and timing of data collection of process measures ; @ .


Development of instruments .


The protocol was applied to the Boost study , a multicomponent school-based dietary intervention .


The protocol was readily applicable for planning process evaluation of environmental and educational intervention components in a school setting .


The protocol ensures systematic assessment of the implementation processes that are crucial for interpretation of intervention effects .


To compare the outcomes of multifocal toric intraocular lens ( IOL ) implantation and standard nontoric multifocal IOL implantation combined with peripheral corneal relaxing incisions ( PCRIs ) in patients with moderate preexisting corneal astigmatism .


Moorfields Eye Hospital NHS Foundation Trust , London , United Kingdom .


Prospective randomized controlled trial .


Patients with visually significant cataract in both eyes who desired spectacle independence and had corneal astigmatism ( @ to @ diopters -LSB- D -RSB- ) had multifocal toric IOL implantation in @ eye and a nontoric multifocal IOL combined with PCRIs ( Donnenfeld nomogram ) in the contralateral eye .


Outcome measures were visual acuity , astigmatic vector reduction , digital toric IOL axis determination , spectacle need , and patient satisfaction .


Thirty patients were enrolled .


Three months postoperatively , the mean residual refractive astigmatism was @ D @ ( SD ) in the toric IOL group and @ @ D in the PCRI group .


The mean uncorrected distance visual acuity was @ @ in the toric IOL group and @ @ in the PCRI group and the mean uncorrected near visual acuity , @ @ and @ @ , respectively .


The mean absolute misalignment from the intended axis was @ @ degrees .


The rotation was within @ degrees in @ % of all cases and within @ degrees in all cases .


On the questionnaire , @ % of all patients said they required spectacles only when reading for a long time .


Although refractive astigmatism decreased in both groups , multifocal toric IOL implantation was predictable with good rotational stability .


The purpose of this study was to examine the methodological integrity , sample size requirements , and short-term preliminary clinical outcomes of manual and manipulative therapy ( MMT ) in addition to a rehabilitation program for symptomatic knee osteoarthritis ( OA ) .


This was a pilot study of an assessor-blinded , randomized , parallel-group trial in @ independent university-based outpatient clinics .


Participants with knee OA were randomized to @ groups : @ MMT sessions alone , training in rehabilitation followed by a home rehabilitation program alone , or MMT plus the same rehabilitation program , respectively .


Six MMT treatment sessions ( provided by a chiropractic intern under supervision or by an experienced chiropractor ) were provided to participants over the @-week treatment period .


The primary outcome was a description of the research methodology and sample size estimation for a confirmatory study .


The secondary outcome was the short-term preliminary clinical outcomes .


Data were collected at baseline and @weeks using the Western Ontario and McMasters Osteoarthritis Index questionnaire , goniometry for knee flexion/extension , and the McMaster Overall Therapy Effectiveness inventory .


Analysis of variance was used to compare differences between groups .


Eighty-three patients were randomly allocated to @ of the @ groups ( @ , @ , and @ , respectively ) .


Despite @ dropouts , the data from @ participants were available for analysis with @ % of scores missing .


A minimum of @ patients is required for a confirmatory @-arm trial including the respective interventions , accounting for cluster effects and a @ % dropout rate .


Statistically significant and clinically meaningful changes in scores from baseline to week @ were found for all groups for the Western Ontario and McMasters Osteoarthritis Index ( P @ ) , with a greater change in scores for MMT and MMT plus rehabilitation .


Between-group comparison did not reveal statistically significant differences between group scores at week @ for any of the outcome measures ( P @ ) .


This pilot trial suggests that a confirmatory trial is feasible .


There were significant changes in scores from baseline to week @ across all groups , suggesting that all @ treatment approaches may be of benefit to patients with mild-to-moderate knee OA , justifying a confirmatory trial to compare these interventions .


To assess , in a school-located adolescent vaccination program that billed health insurance , the program costs , the proportion of costs reimbursed , and the likelihood of vaccination .


During the @-@ school year , vaccination clinics were held for sixth - to eighth-grade students at seven Denver public schools .


Vaccine administration and purchase costs were compared with reimbursement by insurers .


Multivariate analyses were used to compare the likelihood of vaccination among students in intervention schools with students in control schools who did not participate in the program , with analyses stratified by grade ( sixth grade vs. seventh-eighth grades ) .


Fifteen percent ( @ of @,@ ) of students attending intervention schools were vaccinated at school-located vaccination clinics .


Among students vaccinated at school , @ % were uninsured , @ % publicly insured , and @ % privately insured .


Estimated vaccine administration costs were $ @ per vaccine dose .


Seventy-eight percent of vaccine purchase costs and @ % of vaccine administration costs were reimbursed by insurers ; @ % of total program costs were reimbursed .


Sixth-grade students in intervention schools were more likely than those in control schools to receive tetanus-diphtheria-acellular pertussis ( risk ratio -LSB- RR -RSB- , @ ; @ % confidence interval -LSB- CI -RSB- , @ , @ ) , meningococcal conjugate ( RR , @ ; CI , @ , @ ) , and human papillomavirus ( for females only , RR , @ ; CI , @ , @ ) vaccines during the @-@ school year , with similar results for seventh - to eighth-grade students .


Although school-located adolescent vaccination with billing appears feasible and likely to improve vaccination rates , improvements in insurance coverage and reimbursement rates may be needed for the long-term financial sustainability of such programs .


To examine protocol adherence to structured intensive management in the Valsartan Intensified Primary carE Reduction of Blood Pressure ( VIPER-BP ) study involving @ primary care clinics and @ randomized participants .


Prospective criteria for assessing adherence to treatment prescription , uptitration , and visit attendance at @ , @ , @ , and @ weeks postrandomization were applied to @ intervention participants .


Protocol adherence scores of @-@ ( least to most adherent ) were compared to blood pressure ( BP ) control during @ weeks of follow-up .


Mean age was @ years , @ ( @ % ) were men , and @ ( @ % ) had longstanding hypertension .


Clinic attendance dropped from @ ( week @ ) to @ % ( week @ ) and pharmacological instructions were followed for @ % ( baseline ) to @ % at week @ ( uptitration failures commonly representing protocol deviations ) .


Overall , @-week BP levels and BP target attainment ranged from @/@ and @ % to @/@ mmHg and @ % in those participants subject to the highest ( n = @ , @ % ) versus least ( n = @ , @ % ) per protocol adherence , respectively ; adjusted relative risk ( RR ) @ per unit protocol adherence score , @ % confidence interval ( CI ) @-@ @ ; for achieving BP target ( P < @ ) .


Participants with a per protocol score of @ or @ ( @/@ , @ % ) were @-fold ( @ % CI @-@ @ ; P < @ ) more likely to achieve their individual BP target compared with usual care .


Clinics equipped with a practice nurse significantly influenced protocol adherence ( adjusted RR @ , @ % CI @-@ @ ; P = @ ) and individual BP control ( RR @ , @ % CI @-@ @ ; P = @ ) .


There is considerable potential for structured care management to improve BP control in primary care , especially when optimally applied .


Rheumatoid arthritis ( RA ) is associated with heightened mortality due to atherosclerotic cardiovascular disease ( CVD ) .


Inflammatory pathways in RA negatively affect vascular physiology and promote metabolic disturbances that contribute to CVD .


We hypothesized that the peroxisome proliferator activated receptor - ( PPAR - ) pioglitazone could promote potent vasculoprotective and anti-inflammatory effects in RA .


One hundred forty-three non-diabetic adult RA patients ( @ % female , age @ @ -LSB- mean SD -RSB- ) on stable RA standard of care treatment were enrolled in a randomized , double-blind placebo controlled crossover trial of @ mg daily pioglitazone versus placebo , with a @-month duration/arm and a @-month washout period .


Pulse wave velocity of the aorta ( PWV ) , brachial artery flow mediated dilatation ( FMD ) , nitroglycerin mediated dilatation ( NMD ) , microvascular endothelial function ( reactive hyperemia index -LSB- RHI -RSB- ) , and circulating biomarkers of inflammation , insulin resistance , and atherosclerosis risk all were quantified .


RA disease activity was assessed with the @-Joint Count Disease Activity Score ( DAS-@ ) C-reactive protein ( CRP ) and the Short Form ( @ ) Health Survey quality of life questionnaire .


When added to standard of care RA treatment , pioglitazone significantly decreased pulse wave velocity ( ie , aortic stiffness ) ( P = @ ) , while FMD and RHI remained unchanged when compared to treatment with placebo .


Further , pioglitazone significantly reduced RA disease activity ( P = @ ) and CRP levels ( P = @ ) , while improving lipid profiles .


The drug was well tolerated .


Addition of pioglitazone to RA standard of care significantly improves aortic elasticity and decreases inflammation and disease activity with minimal safety issues .


The clinical implications of these findings remain to be established .


The relation between inflammatory markers , adiposity and disease is under extensive study .


Here we tested the hypothesis that the immunomodulatory protein pentraxin @ ( PTX@ ) is associated with adiposity in the general population .


Serum PTX@ concentrations , body mass index ( BMI ) , waist circumference ( WC ) and fat depots , as quantified by dual-energy X-ray absorptiometry and magnetic resonance imaging , were assessed in three community-based cohorts : ULSAM , n = @ , mean age @ years ; PIVUS , n = @ , mean age @ years , women @ % ; and the NORDIET-trial , n = @ , mean age @ years , women @ % .


Participants were re-examined after @ years ( PIVUS , n = @ ) or following a @-week randomized controlled dietary intervention ( NORDIET ) .


PTX@ levels were inversely associated with BMI and WC as well as with total and visceral fat ( P < @ for all ; adjusted for age , inflammatory biomarkers and cardiovascular risk factors ) .


The association between PTX@ and BMI appeared even stronger in nonobese individuals .


A decrease in BMI over @ years as well as weight loss following the NORDIET intervention were associated with increased serum PTX@ concentrations ( P < @ ) .


These consistent data support an inverse association between circulating PTX@ and anthropometrical measures , calling for further mechanistic studies of the link between PTX@ and fat .


Low colo-rectal anastomoses have a relevant risk of leakage .


The protective stomas ( ileostomy or colostomy ) have always been utilized to reduce the complications due to anastomotic leakage .


The stoma not only causes relevant morbidity but also needs a second operation to be closed , with an added risk of complications .


For this reason we planed and carried out a temporary percutaneous ileostomy by a jejunal probe introduced in the distal ileum , that can be removed without a surgical procedure and with negligible complications .


The ALPPI trial is a randomized controlled , open , parallel , equivalence multicenter study .


Patients undergoing elective laparoscopic or laparotomic surgery for rectal cancer with extraperitoneal anastomosis , will be randomly allocated to undergo either lateral ileostomy or percutaneous ileostomy by exclusion probe .


The primary endpoint is the protection of the extraperitoneal colo-rectal anastomosis in terms of incidence of symptomatic and asymptomatic anastomotic leakages .


The secondary endpoints are the evaluation of complications due to the placement and the removal of the exclusion probe for percutaneous ileostomy .


The ALPPI trial is designed to provide the surgical community with an evidence based new technique in the protection of low colo-rectal anastomosis , alternative to the conventional stomas .


To evaluate the short-term efficacy of agents containing KNO@ or casein phosphopeptide - amorphous calcium phosphate ( CPP-ACP ) in the treatment of dentin hypersensitivity .


UltraEZ , containing KNO@ and MI Paste , containing CPP-ACP were applied in this study .


The dentin hypersensitivity of @ subjects was established by a tactile stimulus with a Yeaple preasure probe , and the degree of hypersensitivity was measured using a visual analogue scale ( VAS ) .


The patients were divided into four groups : A , B , C and D , using a random number table .


UltraEZ , a placebo of UltraEZ , MI Paste , and a placebo of MI Paste were applied to group A , B , C and D respectively for @ weeks .


Dentin hypersensitivity was measured using VAS before the treatment ( baseline ) , on day @ , @ , and @ during the treatment , and on day @ and @ posttreatment .


The efficacy of UltraEZ on dentin hypersensitivity was significantly better than that of the corresponding placebo group on day @ during the treatment , whereas the efficacy of MI Paste exhibited better than that of the placebo group on day @ during the treatment .


However , there were no differences between the efficacy of the two agents on day @ during the treatment , day @ or day @ posttreatment .


Both UltraEZ and MI Paste had a significant effect on dentin hypersensitivity .


UltraEZ showed quicker effects than MI Paste , but MI Paste had a greater sustained action after treatment than UltraEZ .


This prospective randomized study compared acute and chronic anterior cruciate ligament ( ACL ) reconstruction using ligament advanced reinforcement system ( LARS ) artificial ligament in young active adults with a @-year follow-up .


Fifty-five patients were enrolled in this study and divided into two groups based on the elapsed time between the injury and reconstruction : the acute group ( @-@ weeks ) and the chronic group ( @-@ months ) .


The clinical outcomes were evaluated using the Lysholm knee scoring scale , the Tegner activity rating , a KT-@ Arthrometer , and the International Knee Documentation Committee ( IKDC ) scoring system .


Isokinetic strength of the quadriceps and hamstring was assessed using the Biodex System @ isokinetic dynamometer .


Anterior laxity was decreased and quadriceps/hamstring muscle strength was increased in the acute group compared to the chronic group ( p > @ ) .


There were no statistically significant differences in Lysholm scores , Tegner activity scores , and the IKDC evaluation form between the two groups .


These results suggest that earlier ACL reconstruction using a LARS artificial ligament may provide an advantage in the treatment and rehabilitation of ACL rupture .


The protein leverage hypothesis requires specific evidence that protein intake is regulated more strongly than energy intake .


The objective was to determine ad libitum energy intake , body weight changes , appetite profile , and nitrogen balance in response to @ diets with different protein-to-carbohydrate + fat ratios over @ consecutive days , with beef as a source of protein .


A @-arm , @-d randomized crossover study was performed in @ men and @ women -LSB- mean SD age : @ @ y ; body mass index ( in kg/m ) : @ @ -RSB- with the use of diets containing @ % , @ % , and @ % of energy ( En % ) from protein , predominantly from beef .


Energy intake was significantly lower in the @En % - protein condition ( @ @ MJ/d ) than in the @En % - protein ( @ @ MJ/d ) and @En % - protein ( @ @ MJ/d ) conditions ( P = @ ) , stemming largely from lower energy intake during meals ( P = @ ) .


Hunger ( P = @ ) and desire to eat ( P = @ ) ratings were higher and fullness ratings were lower ( P = @ ) in the @En % - protein condition than in the @En % - protein and @En % - protein conditions .


Nitrogen excretion was lower in the @En % - protein condition ( @ @ g/@ h ; P = @ ) and was higher in the @En % - protein condition ( @ @ g/@ h ; P = @ ) compared with the @En % - protein condition ( @ @ g/@ h ) .


Nitrogen balance was maintained in the @En % - protein condition and was positive in the @En % - and @En % - protein conditions ( P = @ ) .


Complete protein leverage did not occur because subjects did not consume to a common protein amount at the expense of energy balance .


Individuals did underconsume relative to energy requirements from high-protein diets .


The lack of support for protein leverage effects on a low-protein diet may stem from the fact that protein intake was sufficient to maintain nitrogen balance over the @-d trial .


To compare hyperfractionation versus standard fractionation for T@N@ vocal cord carcinoma in a randomized controlled trial .


Patients with T@ vocal cord cancer were stratified by substage ( T@a vs T@b ) and randomly assigned to receive either hyperfractionation ( HFX ) to @ Gy in @ fractions of @ Gy given twice a day , or standard fractionation ( SFX ) to @ Gy in @ fractions given once a day .


The trial was designed to detect a @ % reduction in the local failure hazard rate with @ % statistical power .


Between April @ and July @ , a total of @ patients were enrolled .


Of @ patients analyzable for outcomes , @ % were male , @ % had a Karnofsky performance status of @-@ , and @ % had T@a tumor .


Median follow-up for all surviving patients was @ years ( range , @-@ @ years ) .


The @-year local control ( LC ) rate was @ points higher but not statistically significant ( P = @ for HFX -LSB- @ % -RSB- vs SFX -LSB- @ % -RSB- ) , corresponding to a @ % hazard rate reduction .


The @-year disease-free survival ( DFS ) was @ % versus @ % ( P = @ ) and overall survival ( OS ) was @ % versus @ % ( P = @ ) .


HFX was associated with higher rates of acute skin , mucosal , and laryngeal toxicity .


Grade @-@ late effects were similar with a @-year cumulative incidence of @ % ( @ % -@ % ) after SFX and @ % ( @ % -@ % ) after HFX .


The @-year local control was modestly higher with HFX compared to SFX for T@ glottic carcinoma , but the difference was not statistically significant .


These results are consistent with prior studies of hyperfractionation showing a benefit in local control .


Substaging by T@a versus T@b carries prognostic value for DFS and OS .


For cost and convenience reasons other altered fractionation schedules have been adopted in routine practice .


Surgery followed by radiotherapy and concomitant and adjuvant temozolomide is standard therapy in newly diagnosed glioblastoma multiforme ( GBM ) .


Bevacizumab combined with irinotecan produces impressive response rates in recurrent GBM .


In a randomized phase II study , we investigated the efficacy of neoadjuvant bevacizumab combined with irinotecan ( Bev-Iri ) versus bevacizumab combined with temozolomide ( Bev-Tem ) before , during and after radiotherapy in newly diagnosed GBM .


After surgery , patients were randomized to Bev-Iri or Bev-Tem for eight weeks , followed by standard radiotherapy ( @ Gy/@ fractions ) and concomitant Bev-Iri or Bev-Tem followed by adjuvant Bev-Iri or Bev-Tem for another eight weeks .


Bev-Iri : Bevacizumab and irinotecan were given every @ days before , during and after radiotherapy .


Bev-Tem : Bevacizumab was given as in Bev-Iri and temozolomide was given for five days every four weeks before and after radiotherapy and once daily during radiotherapy .


The primary endpoint was response after neoadjuvant chemotherapy and a pre-specified response rate of @ % or more was considered of interest for future studies .


Secondary endpoints were progression-free survival ( PFS ) and toxicity .


The response rate was @ % ( @ % CI @-@ % ) for Bev-Tem ( n = @ ) and @ % ( @ % CI @-@ % ) for Bev-Iri ( n = @ ) ( p = @ ) .


Median PFS was @ and @ months for Bev-Tem and Bev-Iri , respectively .


Hematological toxicity was more frequent with Bev-Tem including one death from febrile neutropenia whereas non-hematological toxicity was manageable .


Only the Bev-Tem arm met the pre-specified level of activity of interest .


Our results did not indicate any benefit from Bev-Iri in first-line therapy as opposed to Bev-Tem in terms of response and PFS .


Lifetime prevalence of amphetamine-induced psychotic disorder is reported as being up to @ % for methamphetamine ( MA ) abusers .


Approximately @ % of those with a baseline DSM-IV diagnosis of substance-induced psychosis are diagnosed with primary psychosis at one-year follow-up .


Evidence on the treatment of amphetamine psychosis is very limited .


To investigate the efficacy of risperidone versus aripiprazole in treatment of amphetamine-induced psychotic symptoms .


In a double-blind study , @ participants were randomly allocated to either aripiprazole @mg or risperidone @mg daily over a six-week trial .


Positive and negative symptoms of psychosis were assessed using the Scale for Assessment of Negative Symptoms ( SANS ) and the Scale for Assessment of Positive Symptoms ( SAPS ) at baseline and completion of the trial .


SANS and SAPS scores decreased significantly in both groups .


Mean SAPS score reduction in risperidone and aripiprazole group was @ and @ , respectively , after trial course ( p < @ ) .


Mean SANS score reduction in risperidone and aripiprazole group was @ and @ , respectively ( p = @ ) .


Both aripiprazole and risperidone were effective for patients diagnosed with amphetamine-induced psychotic disorder .


However , risperidone had the greater effect on positive psychotic symptoms while patients with negative symptoms may respond better to aripiprazole .


There is a case for further studies evaluating the efficacy of atypical antipsychotics in this disorder .


Concomitant administration of erlotinib with standard chemotherapy does not appear to improve survival among patients with non-small-cell lung cancer ( NSCLC ) , but preliminary studies suggest that sequential administration might be effective .


To assess the efficacy and tolerability of second-line sequential administration of erlotinib and docetaxel in advanced NSCLC .


In an open-label phase II trial , patients with advanced NSCLC , EGFR wild-type or unknown , PS @-@ , in whom initial cisplatin-based chemotherapy had failed were randomized to sequential erlotinib @ mg/d ( day @-@ ) + docetaxel ( @ mg/m ( @ ) d@ ) ( arm ED ) or docetaxel ( @ mg/m ( @ ) d@ ) alone ( arm D ) ( @-day cycle ) .


The primary endpoint was the progression-free survival rate at @ weeks ( PFS @ ) .


Secondary endpoints included PFS , overall survival ( OS ) , the overall response rate ( ORR ) and tolerability .


Based on a Simon optimal two-stage design , the ED strategy was rejected if the primary endpoint was below @/@ patients at the end of the two Simon stages .


@ patients were randomized ( median age : @ years , PS @/@/@ : @/@/@ patients ; males : @ % ) .


The ED strategy was rejected , with only @ of @ patients achieving PFS@ in arm ED at the end of stage @ and @ of @ patients in arm D.


In arms ED and D , respectively , median PFS was @ and @ months and median OS was @ and @ months .


Sequential erlotinib and docetaxel was not more effective than docetaxel alone as second-line treatment for advanced NSCLC with wild-type or unknown EGFR status .


The immunogenicity , reactogenicity and safety of the @ - valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine ( PHiD-CV ) were evaluated in a cohort of Nigerian infants included in a study conducted in Mali and Nigeria ( ClinicalTrials.gov identifier : NCT@ ) .


In this open , randomised , controlled study , @ healthy infants received combined diphtheria-tetanus-whole-cell pertussis-hepatitis B / Haemophilus influenzae type b vaccine ( DTPw-HBV/Hib ) and oral poliovirus vaccine ( OPV ) co-administered with PHiD-CV ( PHiD-CV group ) or without PHiD-CV ( control group ) at @-@-@ weeks of age .


Pneumococcal antibody responses and opsonophagocytic activity were measured and adverse events were recorded .


One month post-dose @ , for each of the vaccine pneumococcal serotypes , e `` @ % of PHiD-CV recipients had an antibody concentration e `` @ ug/mL compared to < @ % ( except for serotypes @ -LSB- @ % -RSB- and @F -LSB- @ % -RSB- ) in the control group .


For each of the vaccine pneumococcal serotypes , e `` @ % of infants in the PHiD-CV group had an OPA titre e `` @ , compared to % @ % ( except for serotype @F -LSB- @ % -RSB- ) in the control group .


Anti-protein D antibody geometric mean antibody concentrations were @ EL.U / mL in the PHiD-CV group and @ EL.U / mL in the control group .


For each DTPw-HBV/Hib antigen antibody seroprotection/seropositivity rates were e `` @ % .


Tolerability was generally comparable between the PHiD-CV and control vaccination groups .


PHiD-CV co-administered with routine vaccines was immunogenic for all vaccine pneumococcal serotypes and protein D in Nigerian infants .


Vaccine tolerability was generally comparable between the PHiD-CV and control groups .


These results suggest PHiD-CV can be co-administered with other vaccines included in the National Programme on Immunisation .


Post-thrombotic syndrome ( PTS ) is a serious complication of deep vein thrombosis ( DVT ) of the leg that affects @-@ % of patients .


Once a patient experiences PTS there is no treatment that effectively reduces the debilitating complaints .


Two randomised controlled trials showed that elastic compression stocking ( ECS ) therapy after DVT for @ months can reduce the incidence of PTS by @ % .


However , it is unclear whether all patients benefit to the same extent from ECS therapy or what the optimal duration of therapy for individual patients should be .


ECS therapy is costly , inconvenient , demanding and sometimes even debilitating .


Tailoring therapy to individual needs could save substantial costs .


The objective of the IDEAL DVT study , therefore , is to evaluate whether tailoring the duration of ECS therapy on signs and symptoms of the individual patient is a safe and effective method to prevent PTS , compared with standard ECS therapy .


A multicentre , single-blinded , allocation concealed , randomised , non-inferiority trial .


A total of @ consecutive patients with acute objectively documented proximal DVT of the leg are randomised to either standard duration of @ months or tailored duration of ECS therapy following an initial therapeutic period of @ months .


Signs and symptoms of PTS are recorded at regular clinic visits .


Furthermore , quality of life , costs , patient preferences and compliance are measured .


The primary outcome is the proportion of patients with PTS at @ months .


Based on current knowledge the standard application of ECS therapy is questioned .


The IDEAL DVT study will address the central questions that remain unanswered : Which individual patients benefit from ECS therapy and what is the optimal individual treatment duration ?


Primary ethics approval was received from the Maastricht University Medical Centre .


Results of the study will be disseminated via peer-reviewed publications and presentations at scientific conferences .


To evaluate the effect of newly designed positively aspherized progressive addition lenses ( PA-PALs ) , which reduce both lag of accommodation and hyperopic defocus on the peripheral retina , on the progression of early-onset myopia .


Positively aspherized-PALs have near addition and high positive distance zone aspherization comparable to the addition power .


One hundred ninety-seven children were enrolled , @ to @ years of age , with spherical equivalent refraction from -@ to -@ diopters ( D ) .


The children were randomized to receive one of three lenses : single vision lenses ( SVLs ) , PA-PALs with +@ D addition , or PA-PALs with +@ D addition .


Follow-up visits occurred every @ months for @ years .


The primary outcome was myopia progression evaluated by cycloplegic autorefraction .


One hundred sixty-nine ( @ % ) children completed the follow-up .


Statistical analysis of adjusted progression rates showed a mean ( SE ) progression of -@ @ D in the control group wearing SVLs at the @-month visit .


Statistically significant ( P = @ ) retardation of myopia progression ( @ @ D during @-month period or reduction ratio of @ % ) by +@ D add PA-PALs relative to the SVLs was found , which was within the range of the percentage efficacy of myopia retardation by the conventional PALs in earlier trials over the same follow-up period .


Nearly all retardation occurred in the first @ months with no significant efficacy in the second year .


Positively aspherized-PALs with +@ D addition showed negligible efficacy .


To the extent that has been tested and that can be tolerated by wearers of spectacle lenses , the high positive aspherization of the distance zone added to PALs does not enhance their therapeutic efficacy in slowing myopia progression .


( http://www.anzctr.org.au/ number , ACTRN@ ) .


To study the clinical effects of hypoxia preconditioning ( HPC ) and its effects on serum neuroglobin ( NGB ) and S-@B level in the patients undergoing intracranial aneurysm surgery .


Forty patients scheduled to intracranial aneurysm surgery were randomly.divided into @ groups : HPC group ( n = @ ) and control group ( n = @ ) .


The patients in HPC group were treated with @ cycles of deoxidation-reoxygenation after intubation .


The time of deoxidation in each HPC cycle was recorded , while vital signs were also recorded in each corresponding time point .


Blood samples were obtained from exsanguinate radial artery and jugular bulb section at the end of each HPC cycle and corresponding time points during operation to measure serum level of NGB and S@B protein and to analysis blood gas .


During HPC process , the patients in group HPC experienced mild hypoxia and CO@ retention .


With the times of HPC increasing , CO@ retention degree became heavier ( P < @ ) while hypoxia improved , the patients need more time to make SpO@ from @ % to @ % ( P < @ ) .


From T@ to T@ ( the end of the third reoxygenation , during skull opened and aneurysm dipped , skull closed ) , NGB in group HPC was higher than that in control ( P < @ ) , but S-@B level was not different between HPC and control group ( P > @ ) .


HPC could induce compensatory ability of the body to hypoxia , which might be related to the up-regulation of NGB expression .


The purpose of this study was to assess pulmonary lesion detection , diagnostic confidence , and noise reduction in sparse-sampled ( SpS ) computed tomographic ( CT ) data of submillisievert ( SubmSv ) chest CT reconstructed with iterative reconstruction technique ( IRT ) .


This Human Insurance Portability and Accountability-compliant , institutional review board-approved prospective study was performed using SpS-SubmSv IRT chest CT in @ non-obese patients ( body-mass index , @-@ kg/m ; age range , @-@ years ) .


Written informed consent was obtained .


The patients were scanned at standard-dose CT ( mean -LSB- SD -RSB- volumetric CT dose index , @ -LSB- @ -RSB- mGy ; mean -LSB- SD -RSB- dose-length product , @ @ mGycm ; and mean -LSB- SD -RSB- effective dose , @ -LSB- @ -RSB- mSv ) and at SubmSv dose ( @ -LSB- @ -RSB- mGy , @ -LSB- @ -RSB- mGycm , @ -LSB- @ -RSB- mSv , respectively ) on a Philips @-slice CT scanner with double z-sampling .


Sparse angular sampling data were reconstructed using @ % of the angular projections from the SubmSv sinogram to reduce the number of views and radiation dose by approximately @-fold .


Hence , the patients were scanned and then , simulation-based sparse sampling was performed with a resultant dose hypothetical SpS scan estimated mathematically ( @ mSv ) .


From each patient data , @ digital imaging and communications in medicine series were generated : SpS-SubmSv with IRT , fully sampled SubmSv filtered back projection ( FBP ) , and fully sampled standard-dose FBP ( SD-FBP ) .


Two radiologists independently assessed these image series for detection of lung lesions , visibility of small structures , and diagnostic acceptability .


Objective noise was measured in the thoracic aorta , and noise spectral density was obtained for SpS-SubmSv IRT , SubmSv-FBP , and SD-FBP .


The SpS-SubmSv IRT resulted in @ % ( @ / @ mSv ) and @ % ( @ / @ mSv ) dose reduction , when compared with the fully sampled SubmSv-FBP and SD-FBP , respectively .


Images of SpS-SubmSv displayed all @ lesions ( most < @ cm , @ lung nodules , @ ground glass opacities , @ emphysema ) seen on the SubmSv-FBP and SD-FBP data sets .


Lesion margins with sparse-sampled data were deemed acceptable compared with both SubmSv-FBP and SD-FBP .


Overall diagnostic confidence was maintained with SpS-SubmSv IRT despite the presence of minor pixilation artifacts in @ of @ cases .


The SpS-SubmSv IRT showed @ % and @ % noise reduction when compared with SubmSv-FBP ( P < @ ) and SD-FBP ( P < @ ) , respectively , with no significant change in Hounsfield unit values ( P > @ ) .


Noise-spectral density showed that SpS-SubmSv IRT gives a linear decrease over frequency in the semilog plot and an exponential decrease of noise power over frequency compared with SubmSv-FBP and SD-FBP .


More than @ % dose reduction could be achieved with one-fourth sparse-sampled and SubmSv chest CT examination when reconstructed with IRT .


Chest CT dose at one fourth of a millisievert with SpS is possible with optimal lesion detection and diagnostic confidence for the evaluation of pulmonary findings .


A number of interventions for at-risk children have shown benefits for children 's hypothalamic-pituitary-adrenal axis activity immediately after treatment .


It is critical to examine whether such changes are maintained over time , given that physiological regulation is implicated in later mental and physical health outcomes .


To examine whether differences in diurnal cortisol production between children receiving the active parenting intervention and children in the control group persisted at a preschool follow-up ( approximately @ years following intervention ) .


Between-subject comparison of cortisol patterns among @ groups of children ( experimental and control groups ) involved with Child Protective Services following allegations of neglect .


The participants included @ children ( @ % female ) between @ and @ months of age ( mean -LSB- SD -RSB- , @ -LSB- @ -RSB- months ) who had been previously randomly assigned to either the Attachment and Biobehavioral Catch-up ( ABC ) intervention ( n = @ ) or the control intervention ( n = @ ) .


The experimental ABC intervention focused on @ aims : increasing parental nurturance to child distress , increasing synchronous interactions , and decreasing frightening parental behavior .


The control intervention provided educational information about child development to parents .


Both interventions were manualized and involved @ sessions implemented by a trained parent coach in the families ' homes or other places of residence .


Salivary cortisol samples collected at waking and bedtime for children on @ separate days .


Analyses revealed significant differences in cortisol production at the preschool follow-up , such that children in the ABC intervention group showed more typical patterns of cortisol production than children in the control intervention group .


Specifically , children in the ABC group exhibited higher mean ( SD ) log-transformed morning levels than children in the control group ( -@ -LSB- @ -RSB- vs -@ -LSB- @ -RSB- g/dL , respectively -LSB- to convert to nanomoles per liter , multiply by @ -RSB- ; = @ ; P = @ ) .


Bedtime cortisol levels did not differ significantly between the ABC and DEF groups ( mean -LSB- SD -RSB- , -@ -LSB- @ -RSB- vs -@ -LSB- @ -RSB- g/dL , respectively ; @ = -@ ; P = @ ) .


Those in the ABC group showed a steeper decline in cortisol across the day ( mean , -@ g/dL ) than those in the control group , who showed a blunted cortisol rhythm ( mean , -@ g/dL ) ( = -@ ; P = @ ) .


Differences in cortisol production between the experimental and control groups persisted at the preschool follow-up and resembled differences initially observed @ months following intervention .


This is encouraging evidence that the ABC intervention for Child Protective Services-referred children may have long-lasting effects on a physiological stress system critical for health and adjustment .


Middle Eastern female immigrants are at an increased risk of vitamin D deficiency and their response to prescribed vitamin D dosages may not be adequate and affected by other factors .


The objectives were to determine vitamin D deficiency and its determinants in Middle Eastern women living in Auckland , New Zealand ( Part-I ) , and to determine serum @-hydroxyvitamin D ( serum-@ ( OH ) D ) response to two prescribed vitamin D dosages ( Part-II ) in this population .


Women aged @ ( n = @ ) participated in a cross-sectional pilot study during winter ( Part-I ) .


In Part-II , women aged @-@ years ( n = @ ) participated in a randomised , double-blind placebo-controlled trial consuming monthly either @,@ , @,@ IU vitamin D@ or placebo for @ months ( winter to summer ) .


All women in Part-I and @ % women in Part-II had serum-@ ( OH ) D < @nmol/l .


Serum-@ ( OH ) D was higher in prescribed vitamin D users than nonusers ( P = @ ) and in Iranians than Arab women ( P = @ ; Part-I ) .


Mean ( s.d. ) serum-@ ( OH ) D increased in all groups ( time effect , P < @ ) and differed between groups ( time dosage interaction , P < @ ; @,@ IU : from @ to @ nmol/l ; @,@ IU : @ to @ nmol/l ; placebo : @ to @ nmol/l ) .


Only @ % and @ % achieved serum-@ ( OH ) D@nmol/l with @,@ and @,@ IU/month , respectively .


Predictors of @-month change in serum-@ ( OH ) D were dose ( B-coefficients .


e. ; @ , P < @ ) , baseline serum-@ ( OH ) D ( -@ , P < @ ) and body fat percentage ( -@ , P = @ ) .


Vitamin D deficiency/insufficiency is highly prevalent in this population .


Monthly @,@ IU vitamin D for @ months is more effective than @,@ IU in achieving serum-@ ( OH ) D @nmol/l ; however , a third of women still did not achieve these levels .


Growing , small , peripheral , pulmonary nodules in patients at high risk for lung cancer lead to requests for video-assisted thoracoscopic ( VATS ) resection for pathologic diagnosis .


The purpose of this randomized controlled trial was to determine if preoperative localization using percutaneously placed computed tomography ( CT ) - guided platinum microcoils decreases the need for thoracotomy or VATS anatomic resection ( segmentectomy/lobectomy ) for diagnosis .


Patients with undiagnosed nodules of @ mm or less were randomized to either no localization or preoperative microcoil localization .


Coils were placed with the distal end deep to the nodule and the superficial end coiled on the visceral pleural surface with subsequent visualization by intraoperative fluoroscopy and VATS.Nodules were removed by VATS wedge excision using endostaplers .


The primary outcome was a VATS wedge excision for pathologic diagnosis of the nodule without the need for either thoracotomy or VATS anatomic resection .


Sixty patients were randomized and @ underwent surgery between March @ and June @ .


Twenty-nine underwent microcoil localization and @ did not .


The baseline characteristics ( age , sex , forced expiratory volume in the first second of expiration , nodule size/depth ) were similar .


The coil group had a higher rate of successful diagnosis with VATS wedge resection alone ( @/@ vs @/@ ; P < @ ) , decreased operative time to nodule excision ( @ @ vs @ @ minutes ; P < @ ) , and reduced stapler firings ( @ @ vs @ @ ; P = @ ) with no difference in total costs .


Pathologic diagnoses included @ benign nodules , @ primary lung malignancies , and @ metastases .


There were no clinically significant complications related to the coil placement or wedge resection .


Preoperative CT-guided microcoil localization decreases the need for thoracotomy or VATS anatomic resection for the diagnosis of small peripheral pulmonary nodules .


Glycolic acid ( GA ) peels are frequently performed as adjuvants to the treatment of facial acne .


There have been few clinical trials reported of GA peels for acne in people with darker skin .


To determine the safety and efficacy of GA peels in the treatment of moderate acne vulgaris in Asian skin .


In this prospective , randomized , double-blind , placebo-controlled , split-face clinical trial , @ patients with moderate acne were treated with @ % GA ( pH @ ) on half of the face and placebo on the other half .


The procedure was performed five times at @-week intervals .


The GA sides had statistically significant reductions in acne lesions at each time point from baseline values .


There were statistically significant differences between the GA and placebo sides .


The GA sides had better responses for noninflammatory lesions than for inflammatory lesions .


In bioengineering measurements , sebum levels were statistically significantly reduced after the initiation of therapy on both sides at weeks @ and @ , but there were no statistically significant differences between the two sides .


Forty percent GA peels significantly improved moderate acne in this study .


It is effective and safe in Asians .


Self-management is promoted as a strategy for improving outcomes for serious mental illness as well as for chronic general medical conditions .


This study evaluated the feasibility and effectiveness of an eight-month program combining training in self-management for both psychiatric and general medical illness , including embedded nurse care management .


Participants were @ middle-aged and older adults ( mean age = @ @ ) with serious mental illness and chronic general medical conditions who were randomly assigned to receive integrated Illness Management and Recovery ( I-IMR ) ( N = @ ) or usual care ( N = @ ) .


Feasibility was determined by attendance at I-IMR and nurse sessions .


Effectiveness outcomes were measured two and six months after the intervention ( ten - and @-month follow-ups ) and included self-management of psychiatric and general medical illness , participation in psychiatric and general medical encounters , and self-reported acute health care utilization .


I-IMR participants attended @ @ I-IMR and @ @ nurse sessions , with @ % attending at least ten I-IMR and five nurse sessions .


Compared with usual care , I-IMR was associated with greater improvements in participant and clinician ratings for psychiatric illness self-management , greater diabetes self-management , and an increased preference for detailed diagnosis and treatment information during primary care encounters .


The proportion of I-IMR participants with at least one psychiatric or general medical hospitalization decreased significantly between baseline and ten - and @-month follow-ups .


I-IMR is a feasible intervention for this at-risk group and demonstrated potential effectiveness by improving self-management of psychiatric illness and diabetes and by reducing the proportion of participants requiring psychiatric or general medical hospitalizations .


To compare contrast sensitivity , visual acuity ( VA ) , and halos in subjects bilaterally implanted with @ of @ FDA-approved presbyopia-correcting intraocular lenses .


Prospective , randomized , partially masked , multicenter clinical trial .


Seventy-eight subjects were randomized sequentially for bilateral implantation with the Crystalens AO ( Bausch & Lomb Surgical ) , AcrySof IQ ReSTOR +@ ( Alcon Laboratories ) , or Tecnis Multifocal ( Abbott Medical Optics ) lenses .


Subjects were evaluated through visit @ ( @ to @months after surgery ) with the following monocular and binocular assessments : high - and low-contrast VA , contrast sensitivity without glare , halos or starbursts , defocus curves , optical scatter , retinal point spread function , and safety .


The Crystalens AO and ReSTOR +@ demonstrated better monocular and binocular contrast sensitivity without glare at low to mid spatial frequencies compared with the Tecnis Multifocal lens .


Binocular uncorrected distance VA was not significantly different between the @ lenses .


The Crystalens AO had significantly better binocular low-contrast distance-corrected VA than the ReSTOR +@ and better mean monocular low-contrast DCVA than the Tecnis Multifocal lens .


The Crystalens AO demonstrated significantly better monocular and binocular uncorrected and distance-corrected intermediate VA than the ReSTOR +@ or Tecnis Multifocal lenses .


The ReSTOR +@ lens had significantly better monocular and binocular uncorrected and distance-corrected near VA tested at @cm compared with the Crystalens AO and Tecnis Multifocal lens .


The Crystalens AO elicited significantly less halos than the Tecnis Multifocal lens and less optical scatter than the ReSTOR +@ or Tecnis Multifocal lens .


The Crystalens AO had statistically better uncorrected intermediate VA and distance-corrected intermediate VA than the ReSTOR +@ or Tecnis Multifocal lenses and fewer photic phenomenon than the Tecnis Multifocal lens .


Both multifocals had better distance-corrected near VA and uncorrected near VA than the Crystalens AO .


These findings may guide intraocular lens selection for individual patients seeking to optimize vision at specific vergences or lighting conditions .


This study sought to evaluate the efficacy of the isolated use of tacrolimus compared with the combined use of tacrolimus and olopatadine for the treatment of severe vernal keratoconjunctivitis ( VKC ) .


Twenty-one patients with severe VKC were randomized into two groups : one treated with @ % tacrolimus ointment combined with @ % olopatadine ophthalmic solution and the other with @ % tacrolimus ointment combined with placebo eye drops .


The clinical signs and symptoms were graded from @ to @ , and the efficacy of treatment was determined by the difference between the score at the beginning of treatment and after @ days .


The clinical impression of improvement as perceived by the evaluator and the self-assessment provided by the patient were scored at day @ of treatment and compared between the groups .


The scores for symptoms decreased between the assessments in both groups ( -@ in the experimental group ; -@ in the control group ) , with no significant difference between groups ( P = @ ) .


The scores for clinical signs decreased between the assessments in the experimental group ( -@ ) and increased in the control group ( @ ) but with no significant differences ( P = @ ) .


There was no significant difference between the groups regarding the self-assessment ( P = @ ) and the clinical impression of the evaluator ( P = @ ) .


The isolated use of tacrolimus and the combined use of tacrolimus and olopatadine seems to have the same efficacy , although controlled studies with larger samples are required to confirm this hypothesis .


The determination of dosing regimens for the treatment of malaria is largely empirical and thus a better understanding of the pharmacokinetic/pharmacodynamic properties of antimalarial agents is required to assess the adequacy of current treatment regimens and identify sources of suboptimal dosing that could select for drug-resistant parasites .


Mefloquine is a widely used antimalarial , commonly given in combination with artesunate .


Mefloquine pharmacokinetics was assessed in @ healthy adults and @ patients with Plasmodium falciparum malaria administered mefloquine in combination with artesunate .


Population pharmacokinetic modelling was conducted using NONMEM .


A two-compartment model with a single transit compartment and first-order elimination from the central compartment most adequately described mefloquine concentration-time data .


The model incorporated population parameter variability for clearance ( CL/F ) , central volume of distribution ( VC/F ) and absorption rate constant ( KA ) and identified , in addition to body weight , malaria infection as a covariate for VC/F ( but not CL/F ) .


Monte Carlo simulations predict that falciparum malaria infection is associated with a shorter elimination half-life ( @ versus @ h ) and T > MIC ( @ versus @ h ) .


This is the first known population pharmacokinetic study to show falciparum malaria to influence mefloquine disposition .


Protein binding , anaemia and other factors may contribute to differences between healthy individuals and patients .


As VC/F is related to the earlier portion of the concentration-time profiles , which occurs during acute malaria , and CL/F is more related to the terminal phase during convalescence after treatment , this may explain why malaria was found to be a covariate for VC/F but not CL/F .


Tinnitus occurs in a large part of the general population with prevalences ranging from @ % to @ % in an adult population .


One subtype is cervicogenic somatic tinnitus , arising from cervical spine dysfunctions , justifying cervical spine assessment and treatment .


This study aims to investigate the effect of a standardized physical therapy treatment , directed to the cervical spine , on tinnitus .


Additionally , a second aim is to identify a subgroup within the tinnitus population that benefits from physical therapy treatment .


This study is designed as a randomized controlled trial with delayed treatment design .


Patients with severe subjective tinnitus ( Tinnitus Functional Index ( TFI ) between @ and @ points ) , in combination with neck complaints ( Neck Bournemouth Questionnaire ( NBQ ) > @ points ) will be recruited from the University Hospital of Antwerp .


Patients suffering from tinnitus with clear otological etiologies , severe depression , traumatic cervical spine injury , tumors , cervical spine surgery , or conditions in which physical therapy is contra-indicated , will be excluded.After screening for eligibility , baseline data such as TFI , NBQ , and a set of cervical biomechanical and sensorimotor tests will be collected .


Patients are randomized in an immediate therapy group and in a group with a delayed start of therapy by @ weeks .


Patients will receive physical therapy with a maximum of @ sessions of @ min for a @-week program .


Data from the TFI and NBQ will be collected at baseline ( week @ ) , at the start of therapy ( weeks @ or @ ) , at the end of therapy ( weeks @ or @ ) , @ weeks after therapy ( weeks @ or @ ) , and @ months after therapy ( weeks @ or @ ) .


Secondary outcome measures will be collected at baseline and @ weeks after the therapy ( weeks @ or @ ) , as the maximal therapy effect on the cervical spine dysfunctions is expected at that moment .


This study is the first to investigate the effect of a standardized physical therapy treatment protocol on somatic tinnitus with a prospective comparative delayed design and with blinded evaluator for baseline , end of therapy , and @ and @ weeks after therapy .


Inflammation is involved in development , progression , and complications of atherosclerotic disease .


Clinical studies have indicated that the level of monocyte chemoattractant protein @ ( MCP-@ ) , IL-@ , and adhesion molecules correlates with the severity of atherosclerosis and can predict future cardiovascular events .


Experimental studies have shown pentoxifylline ( PTX ) reduces these factors in animal models .


The purpose of the present pilot study was to evaluate effect of PTX on a group of inflammatory biomarkers in patients with coronary artery disease ( CAD ) .


Forty patients with angiographically documented CAD , who fulfilled inclusion and exclusion criteria , were entered in the double-blind , randomized , pilot clinical study .


The patients were randomly given PTX ( @ mg three times daily ) or placebo ( @ tab/day ) for @ months .


Serum concentrations of MCP-@ , IL-@ , intercellular adhesion Molecule @ ( ICAM-@ ) , and vascular cell adhesion molecule @ ( VCAM-@ ) were measured before and at the end of intervention by enzyme-linked immunosorbant assay .


Our study showed that the serum levels of ICAM-@ and VCAM-@ was decreased in the study population after two-month treatment ( P < @ ) .


Based on the results of our pilot study , administration of PTX in CAD patients significantly decreases adhesion molecules levels .


The incremental prognostic value of high-sensitive troponin T ( hs-cTnT ) in heart failure ( HF ) beyond that of high-sensitivity C-reactive protein and amino-terminal probrain natriuretic peptide is debated .


We examined the prognostic value of hs-cTnT in a subgroup of patients from the Controlled Rosuvastatin Multinational Trial in HF ( CORONA ) study .


Hs-cTnT as a risk factor for the primary end point ( cardiovascular death , nonfatal myocardial infarction , and nonfatal stroke ; n = @ ) , as well as all-cause mortality ( n = @ ) , cardiovascular mortality ( n = @ ) , and the composite of cardiovascular mortality and hospitalization from worsening of HF ( n = @ ) , was investigated in @ patients ( @ years ; New York Heart Association -LSB- NYHA -RSB- class II-IV , ischemic systolic HF ) randomly assigned to @ mg rosuvastatin or placebo .


In multivariable analyses , adjusting for left ventricular ejection fraction , NYHA class , age , body mass index , diabetes mellitus , sex , intermittent claudication , heart rate , estimated glomerular filtration rate , apolipoprotein B/apolipoprotein A-@ ratio , amino-terminal probrain natriuretic peptide , high-sensitivity C-reactive protein , and hs-cTnT ( both dichotomized according to the @th percentile and as a continuous variable ) was associated with all end points ( primary end point : hazard ratio , @ and @ , respectively , per SD change ; P < @ ; all other end points : hazard ratio , @-@ @ ) .


However , improved discrimination as assessed by C-statistics was only seen for the primary end point and all-cause mortality .


Elevated hs-cTnT levels provide strong and independent prognostic information in older patients with chronic ischemic HF .


To assess the impact of listening to preferred music on relieving male patients ' pain and anxiety during flexible cystoscopy .


A total of @ male patients were admitted to our hospital for flexile cystoscopy by a single urologist between January @ and September @ and randomized to two equal groups .


Group @ included @ patients who could select and listen to their preferred music during flexible cystoscopy .


Group @ included @ patients who were unable to listen to the music .


All patients were administered the same amount of lidocaine ( @ mL ) for @ minutes for local anesthesia before flexible cystoscopy .


A visual analog scale ( VAS ) ranging from @ to @ was used to assess patients ' pain feeling after the cystoscopy procedure .


Anxiety levels were calculated according to the State Instrument of State-Trait Anxiety Inventory ( STAI-S ) , and the pulse rate were recorded @ minutes before and immediately after the procedure .


The duration of the procedure of each group were also analyzed .


Statistically significant differences were detected between group @ and group @ in the mean pain score on VAS ( @ @ vs @ @ , P = @ , Mann-Whitney U test ) , mean postprocedural State Anxiety Inventory pain score ( @ @ vs @ @ ) , and postprocedural pulse rate ( @ @ vs @ @ ) ( P < @ for both , t test ) .


Patients who listened to their preferred music experienced less discomfort and lower anxiety at cystoscopy .


Patient age , duration of the procedure , preprocedural STAI-S , and preprocedural pulse rate of each group were comparable .


Listening to preferred music during flexible cystoscopy is an easy way to improves male patients ' comfort and reduce their anxiety .


It could be recommended for male patients .


Postoperative sore throat is one of the most common problems after tonsillectomy .


Antibiotics remove the local flora and reduce inflammation and thus may reduce postoperative pain after tonsillectomy .


To assess the effect of topical sucralfate and clindamycin on local pain reduction after tonsillectomy in children aged @ to @ years .


Triple-blind randomized clinical trial of children aged @ to @ years with sleep apnea or snoring due to adenotonsillar hypertrophy and chronic airway obstruction or with chronic infections who were candidates for tonsillectomy at Besat Hospital , Hamadan University of Medical Sciences , from May to October @ .


Patients were randomly assigned to receive sucralfate mouthwash , clindamycin mouthwash , or placebo ( cellulose ) .


The oral cavity was washed before and immediately after surgery with @ mL of the prepared solution for @ minute and then suctioned .


Then , @ hours after surgery , the patients were asked to keep @ mL of the prepared mouthwash solution in their mouths for @ minute @ times a day for @ days .


Postoperative sore throat evaluated daily for @ days using the Faces Pain Scale-Revised .


Of @ patients enrolled , @ patients remained for analysis .


Patients in the placebo group had significantly higher mean ( SD ) throat pain scores than did patients in both drug groups on postsurgery days @ through @ .


Day @ scores were @ ( @ ) for placebo and @ ( @ ) for sucralfate and @ ( @ ) for clindamycin ( P = @ ) .


Pain scores were not significantly different on day @ .


Acetaminophen use was more common in the placebo group on days @ and @ ( @ and @ ) vs the sucralfate group ( @ and @ ) and the clindamycin group ( @ and @ ) ( P = @ and @ , respectively ) .


Bleeding on day @ was more common in the placebo group ( @ of @ ) vs none in the drug groups .


Food intolerance on day @ was less common in patients receiving sucralfate ( @ of @ ) than placebo ( @ of @ ) or clindamycin ( @ of @ ) ( P = @ ) .


There was no significant difference among the @ groups in numbers of episodes of nocturnal waking , halitosis , earache , nausea , and vomiting .


This trial indicated that topical sucralfate and clindamycin are safe drugs with no important adverse effects that can significantly reduce posttonsillectomy pain in children and help them return to normal life sooner .


Despite all the technological advances in orthodontics , orthodontic treatment still seems to involve some degree of discomfort and/or pain .


Pain control during orthodontic therapy is of great concern to both orthodontists and patients .


However , there has been limited research into controlling such pain .


The purpose of this work was to assess patient-perceived pain following fixed orthodontic treatment and to evaluate the comparative analgesic efficacy of non-steroidal anti-inflammatory drugs for controlling pain .


A total of @patients about to undergo fixed appliance orthodontic treatment were enrolled in this double-blind prospective study .


Patients were evenly and randomly distributed in a blinded manner to one of three groups as follows : paracetamol/acetaminophen @mg thrice daily ; placebo in the form of empty capsules ; and etoricoxib @mg once daily .


Drug administration began @h before initiating the bonding procedure and archwire placement , and given until the day@ .


The pain perceived was recorded by the patients on a linear and graded Visual Analogue Scale at time intervals of @h after insertion of the appliance ; @h thereafter and again at nighttime of the same day of the appointment ; @h later and on the @nd day at nighttime ; @h after the appointment and on day@ at nighttime .


Our results revealed that moderately intense pain is associated with routine orthodontic treatment , and that the amount of pain individuals perceive varies widely .


We observed statistically significant differences in the pain control among the three groups , and that etoricoxib @mg proved most efficient .


Etoricoxib @mg is highly efficacious for controlling pain during fixed orthodontic appliance therapy .


The use of drug-eluting stents ( DES ) in patients with non-ST-segment elevation acute coronary syndrome ( NSTE-ACS ) is controversial and not yet endorsed in clinical guidelines .


This was an a priori planned post hoc analysis involving @ NSTE-ACS patients from the randomised BASKET-PROVE trial ( sirolimus-eluting stent vs. everolimus-eluting stent vs. bare metal stent in large-vessel stenting ) .


The primary endpoint was the combined two-year rate of cardiovascular death or non-fatal myocardial infarction ( MI ) .


Secondary endpoints were each component of the primary endpoint , and clinically indicated target vessel revascularisation ( TVR ) and stent thrombosis .


Compared to patients with BMS , those treated with SES and EES had a strong trend towards lower two-year rates of the primary endpoint ( HR : @ -LSB- CI : @-@ @ -RSB- , p = @ , and HR : @ -LSB- CI : @-@ @ -RSB- , p = @ ) , and of TVR ( HR : @ -LSB- CI : @-@ @ -RSB- , p = @ ) and ( HR : @ -LSB- CI : @-@ @ -RSB- , p = @ ) .


When the SES and EES groups were combined and compared to BMS , significant reductions in both cardiovascular death/MI and TVR were found .


Compared with BMS , use of DES in NSTE-ACS patients undergoing stent implantation in large vessels was associated with a reduction in both TVR and the combined endpoint consisting of cardiovascular death/MI .


Thus , DES use improves both efficacy and safety .


These findings support the use of DES in NSTE-ACS patients .


Data are limited on the implementation of evidence-based multilevel interventions targeted at blood pressure ( BP ) control in hypertensive blacks who receive care in low-resource primary care practices .


Counseling African Americans to Control Hypertension is a cluster-randomized clinical trial in which @ community health centers were randomly assigned to the intervention condition ( IC ) or usual care ( UC ) .


Patients at the IC sites received patient education , home BP monitoring , and monthly lifestyle counseling , whereas physicians attended monthly hypertension case rounds and received feedback on their patients ' home BP readings and chart audits .


Patients and physicians at the UC sites received printed patient education material and hypertension treatment guidelines , respectively .


The primary outcome was BP control , and secondary outcomes were mean changes in systolic and diastolic BPs at @ months , assessed with an automated BP device .


A total of @ patients ( mean age , @ years ; @ % men , @ % obese , and @ % with diabetes mellitus ) were enrolled .


The BP control rate was similar in both groups ( IC = @ % versus UC = @ % ; odds ratio , @ -LSB- @ % confidence interval , @-@ @ -RSB- ; P = @ ) .


In prespecified subgroup analyses , the intervention was associated with greater BP control in patients without diabetes mellitus ( IC = @ % versus UC = @ % ; odds ratio , @ -LSB- confidence interval , @-@ @ -RSB- ) ; and small-sized community health centers ( IC = @ % versus UC = @ % ; odds ratio , @ -LSB- confidence interval , @-@ @ -RSB- ) .


A practice-based , multicomponent intervention was no better than UC in improving BP control among hypertensive blacks .


Future research on the implementation of behavioral modification strategies for hypertension control in low-resource settings should focus on the development of more efficient and tailored interventions in this high-risk population .


The fast development of e-learning and social forums demands us to update our understanding of e-learning and peer learning .


We aimed to investigate if higher , pre-defined levels of e-learning or social interaction in web forums improved students ' learning ability .


One hundred and twenty Danish medical students were randomized to six groups all with @ students ( eCases level @ , eCases level @ , eCases level @ + , eTextbook level @ , eTextbook level @ , and eTextbook level @ + ) .


All students participated in a pre-test , Group @ participated in an interactive case-based e-learning program , while Group @ was presented with textbook material electronically .


The @ + groups were able to discuss the material between themselves in a web forum .


The subject was head injury and associated treatment and observation guidelines in the emergency room .


Following the e-learning , all students completed a post-test .


Pre - and post-tests both consisted of @ questions randomly chosen from a pool of @ different questions .


All students concluded the study with comparable pre-test results .


Students at Level @ ( in both groups ) improved statistically significant compared to students at level @ ( p > @ ) .


There was no statistically significant difference between level @ and level @ + .


However , level @ + was associated with statistically significant greater student 's satisfaction than the rest of the students ( p > @ ) .


This study applies a new way of comparing different types of e-learning using a pre-defined level division and the possibility of peer learning .


Our findings show that higher levels of e-learning does in fact provide better results when compared with the same type of e-learning at lower levels .


While social interaction in web forums increase student satisfaction , learning ability does not seem to change .


Both findings are relevant when designing new e-learning materials .


Switch maintenance is an effective strategy in the treatment of advanced Non-Small Cell Lung Cancer ( NSCLC ) .


Pazopanib is an oral , multi-targeted tyrosine kinase inhibitor ( TKI ) .


EORTC @ evaluated pazopanib given as maintenance treatment following standard first line platinum-based chemotherapy in patients with advanced NSCLC .


Patients with non-progressive disease after @-@ cycles of chemotherapy were randomised to receive either pazopanib @mg/day or matched placebo until progression or unacceptable toxicity .


The primary end-point was overall survival and secondary end-points were progression-free survival ( PFS ) and safety .


A total of @ patients were planned to be randomised .


The trial was prematurely stopped following an early interim analysis , after @ patients were randomised to pazopanib ( n = @ ) or placebo ( n = @ ) .


Median age was @years in both arms .


Median overall survival was @ months for pazopanib and @ months for placebo ( adjusted hazard ratio ( HR ) @ -LSB- @ % confidence interval ( CI ) @-@ @ -RSB- ; p = @ ) .


Median PFS was @ months versus @ months ( HR @ , -LSB- @ % CI @-@ @ -RSB- , p = @ ) .


PFS rates at @ months were @ % and @ % respectively .


The majority of treatment-related adverse events ( AEs ) were grade @-@ .


Grade @-@ AEs ( pazopanib versus placebo ) were hypertension ( @ % versus @ % ) , neutropenia ( @ % versus @ % ) , and elevated SGPT ( @ % versus @ % ) .


Of the patients randomised to pazopanib , @ % withdrew due to a treatment-related AE .


Switch maintenance with pazopanib following platinum-based chemotherapy in advanced NSCLC patients had limited side-effects .


This study was stopped due to lack of efficacy by stringent criteria for PFS at a futility interim analysis .


Conventional food production commonly uses organophosphate ( OP ) pesticides , which can have negative health effects , while organic food is deemed healthier because it is produced without these pesticides .


Studies suggest that organic food consumption may significantly reduce OP pesticide exposure in children who have relatively higher pesticide exposure than adults due to their different diets , body weight , behaviour and less efficient metabolism .


A prospective , randomised , crossover study was conducted to determine if an organic food diet reduces organophosphate exposure in adults .


Thirteen participants were randomly allocated to consume a diet of at least @ % organic or conventional food for @ days and then crossed over to the alternate diet .


Urinary levels of six dialkylphosphate metabolites were analysed in first-morning voids collected on day @ of each phase using GC-MS/MS with detection limits of @-@ @ g/L .


The mean total DAP results in the organic phase were @ % lower than in the conventional phase ( M = @ -LSB- SD = @ -RSB- and @ -LSB- SD = @ -RSB- respectively , p = @ ) .


For total dimethyl DAPs there was a @ % reduction ( M = @ -LSB- SD = @ -RSB- and @ -LSB- SD = @ -RSB- respectively , p = @ ) .


Mean total diethyl DAP levels in the organic phase were half those of the conventional phase ( M = @ -LSB- SD = @ -RSB- and @ -LSB- SD = @ -RSB- respectively ) , yet the wide variability and small sample size meant the difference was not statistically significant .


The consumption of an organic diet for one week significantly reduced OP pesticide exposure in adults .


Larger scale studies in different populations are required to confirm these findings and investigate their clinical relevance .


Postpartum infections are polymicrobial and typically include Ureaplasma , an intracellular microbe that is treated by macrolides such as azithromycin .


The aim of this study was to evaluate the perinatal pharmacokinetics of azithromycin after a single preincision dose before cesarean delivery .


Thirty women who underwent scheduled cesarean delivery were assigned randomly to receive @ mg of intravenous azithromycin that was initiated @ , @ , or @ minutes before incision and infused over @ hour .


Serial maternal plasma samples were drawn from the end of infusion up to @ hours after the infusion .


Samples of amniotic fluid , umbilical cord blood , placenta , myometrium , and adipose tissue were collected intraoperatively .


Breast milk samples were collected @-@ hours after the infusion in @ women who were breastfeeding .


Azithromycin was quantified with high performance liquid chromatography separation coupled with tandem mass spectrometry detection .


Plasma pharmacokinetic parameters were estimated with the use of noncompartmental analysis and compartmental modeling and simulations .


The maximum maternal plasma concentration was reached within @ hour and exceeded the in vitro minimum inhibitory concentration ( MIC@ ) of @ ng/mL of Ureaplasma spp in all @ patients .


The concentrations were sustained with a half-life of @ hours .


The median concentration of azithromycin in adipose tissue was @ ng/g , which was below the MIC@ .


The median concentration in myometrium was @ ng/g , which exceeded the MIC@ .