Inmates who , prior to imprisonment , used heroin regularly were compared to those who did not use heroin regularly .


Self-reported smoking status was validated at baseline and each follow-up by measuring carbon monoxide levels .


Readings exceeding @ ppm were defined as indicating current smoking .


Over half ( @ % ) of the participants had ever used heroin while @ % regularly ( daily or almost daily ) used heroin in the year prior to entering prison .


Prisoners who regularly used heroin had significantly worse social determinants of health and smoking behaviours , including lower educational attainment , more frequent incarceration and earlier initiation into smoking .


Prisoners who regularly used heroin also used and injected other drugs significantly more frequently .


At @-month follow-up , the smoking cessation of prisoners who had regularly used heroin was also significantly lower than prisoners who did not regularly use heroin , a finding confirmed by logistic regression .


Regular heroin use prior to imprisonment is an important risk factor for unsuccessful attempts to quit smoking among prisoners and is also associated with worse social determinants of health , higher drug use , and worse smoking behaviours .


More effective and earlier smoking cessation interventions are required for particularly disadvantaged groups .


Telemonitoring has been advocated as a way of decreasing costs and improving outcomes , but no study has looked at true Medicare payments and @-day readmission rates in a randomized group of well treated patients .


The aim of this work was to analyze Medicare claims data to identify effects of home telemonitoring on medical costs , @-day rehospitalization , mortality , and health-related quality of life .


A total of @ subjects were randomized to usual-care and monitored groups and evaluated with the SF-@ and Minnesota Living With Heart Failure Questionnaire ( MLHF ) .


Hospitalizations , Medicare payments , and mortality were also assessed .


Monitored subjects transmitted weight , blood pressure , and heart rate , which were monitored by an experienced heart failure nurse practitioner .


Subjects were followed for @days ; @ subjects in the usual-care group ( @ hospitalizations ) and @ in the monitored group ( @ hospitalizations ) were hospitalized at least once ( P = @ ) .


There were no differences in Medicare payments for inpatient or emergency department visits , and length of stay was not different between groups .


There was no difference in @-day readmissions ( P = @ ) or mortality ( P = @ ) .


Scores for SF-@ and MLHF improved ( P < @ ) over time , but there were no differences between groups .


The percentage of patients readmitted within @days was lower with telemonitoring for the @st year , but this did not persist .


Telemonitoring did not result in lower total costs , decreased hospitalizations , improved symptoms , or improved mortality .


A decrease in @-day readmission rates for the @st year did not result in decreased total cost or better outcomes .


We evaluated whether providing health risk appraisal for Koreans ( KHRA ) in terms of ` health age ' during smoking cessation program would effectively help smokers quit smoking or not .


A total of @ male smokers aged between @-@ years old , registered for a smoking cessation program in a public health center in a city , were recruited and underwent a baseline survey from January @ to February @ .


They were then prospectively randomized to a conventional counseling group ( n = @ ) or a KHRA group ( n = @ ) , and received conventional counseling or KHRA-based counseling for six months .


Abstinence rates were identified through carbon monoxide measurement ( at the @th and @th weeks ) or urinary cotinine level ( at the @th week ) .


The abstinence rate confirmed by exhaled carbon monoxide was significantly higher in the KHRA group ( @ % ) than the control group ( @ % ) at the @th week ( absolute difference @ % , @ % CI : @ % -@ % ) .


However , there was no difference in abstinence rates between the two groups at the @th and @th weeks .


The predicting factors of @ week 's smoking cessation success were age , older than @ years old ( OR @ , @ % CI : @-@ @ ) , lower Fagerstrom Test for Nicotine Dependence score less than @ ( OR @ , @ % CI : @-@ @ ) , and higher Self Efficacy/Temptation score ( OR @ , @ % CI : @-@ @ ) .


Smoking cessation counseling with KHRA could be effective compared to conventional counseling in the short period of smoking cessation .


Further study is needed to evaluate the long-term efficacy of KHRA in tobacco dependence treatment and to establish the indication and target population of this tool .


The clinical relevance of evaluating right ventricular ( RV ) myocardial deformation in congenital heart disease is increasingly recognized .


The aim of this study was to explore , using three-dimensional ( @D ) speckle-tracking echocardiography , RV mechanics in terms of @D global area strain and mechanical dyssynchrony in adults with repaired tetralogy of Fallot .


Twenty patients ( @ men ) aged @ @ years and @ age-matched controls ( @ men ) were studied .


Global RV peak area strain and area strain-derived systolic dyssynchrony index ( SDI ) were determined using @D speckle-tracking echocardiography .


RV end-diastolic volume and end-systolic volume , ejection fraction ( EF ) , and pulmonary regurgitation fraction were measured in patients using cardiac magnetic resonance .


Coefficients of variation for intraobserver and interobserver measurements of RV global area strain were @ % and @ % , respectively , and those for SDI were @ % and @ % , respectively .


Compared with controls , patients had significantly lower global area strain ( P = @ ) and greater SDI ( P = @ ) .


The prevalence of RV mechanical dyssynchrony ( SDI > control mean + @ SDs ) in patients was @ % .


In patients , global area strain correlated inversely with SDI ( r = -@ , P = @ ) , RV end-diastolic volume ( r = -@ , P = @ ) , and RV end-systolic volume ( r = -@ , P = @ ) and positively with EF ( r = -@ , P = @ ) , while RV SDI correlated positively with RV end-systolic volume ( r = @ , P = @ ) , pulmonary regurgitation fraction ( r = @ , P = @ ) , and QRS duration ( r = @ , P = @ ) and negatively with RV EF ( r = -@ , P = @ ) .


Multivariate analysis showed that RV EF ( = @ , P = @ ) was a significant correlate of global area strain in patients .


In adults after tetralogy of Fallot repair , @D RV deformation is impaired in association with RV dyssynchrony , volume overloading , and reduced EF .


The aim of the study was to assess efficacy of high-doses ofantithrombin @ ( AT ) for treatment of septic shock in patients with an agranulocytosis .


Prospective , controlled study .


@ patients from @ to @ years old , with blood diseases complicated with septic shock Dates of study : from @ to @ .


The patients were randomized into two groups .


Group-@ included @ patients , who did not receive AT and group-@ included @ patients who received AT .


Demographic indicators , condition severity according to APACHE II , level of thrombocytopenia , levels ofplasma procalcitonin , interleukin-@ ( IL-@ ) and C-reactive protein ( CRP ) were the same in both groups .


Level of AT was decreased in both groups ; however it was higher in the group-@ ( @ % vs. @ % , p < @ ) .


In the group-@ , microorganisms were found in the blood of @ patients .


In the group-@ , the microorganisms were found in the blood of @ patients .


Inflammation markers were decreased after the treatment of septic shock in both groups ( p < @ ) .


The decreasing of procalcitonin in group-@ was from @ to @ ng/ml in @ days and from @ to @ ng/ml in @ days in group-@ .


The decreasing of CRP in group-@ was from @ to @ mg/l in @ days and from @ to @ mg/l in @ days in group-@ .


The decreasing of IL-@ in group-@ was from @ to @ pg/ml in @ days and from @ to @ pg/ml in @ days in group-@ .


A level of AT was increased only in group-@ ( under @ % per day ) .


@-day survival was higher in group-@ ( @ + / - @ % vs. @ + / - @ % , p < @ ) .


We did not find any complications of the treatment with AT concentrate .


Treatment of septic shock with high-doses of antithrombin III was effective and safe in patients with an agranulocytosis .


The literature on the effects of massage therapy on neck arthritis pain is mixed depending on the dose level , and it is also based on self-report .


In the present study an attempt was made to enhance the effects of weekly massage therapy by having the participants massage themselves daily .


And in addition to self-reports on pain , range of motion ( ROM ) and the associated ROM pain were assessed before and after the first massage session and pre-post the last session one month later .


Staff and faculty members at a medical school who were eligible for the study if they had neck arthritis pain were randomly assigned to a massage or a waitlist control group ( N = @ per group ) .


The massage group received moderate pressure massages weekly by a massage therapist plus daily self-massages .


The waitlist control group received the same schedule massages one month after being control subjects .


The massage group showed significant short-term reductions after the first and last day massages in self-reported pain and in ROM-associated pain as well as an increase in ROM .


Comparisons between the massage group ( N = @ ) and the control group ( N = @ ) on the last versus the first day data suggested significantly different changes including increased ROM and reduced ROM-associated pain for the massage group and reduced ROM and increased ROM-associated pain for the control group .


These changes occurred specifically for flexion and right and left lateral flexion motions .


These data highlight the importance of designing massage therapy protocols that target the most affected neck muscle groups and then assessing range of motion and related pain before and after the massage therapy .


Comparisons with other studies also suggest that moderate pressure may contribute to the massage effects , and the use of daily self-massages between sessions may sustain the effects and serve as a cost-effective therapy for individuals with neck arthritis pain .


Open mouthpiece ventilation is efficacious in patients with neuromuscular disease .


We used this ventilation technique in patients with exacerbations of COPD with mild to moderate acidosis .


The study was performed in @ respiratory monitoring care units .


Fifty subjects with exacerbations of COPD , breathing frequency > @ , PaCO@ > @ , and pH between @ and @ , as well as Kelly scale @ were enrolled .


Subjects were randomly assigned to receive noninvasive ventilation ( NIV ) via nasal mask or mouthpiece ventilation .


The primary outcome was improvement in arterial blood gases .


Arterial blood gases and breathing frequency were recorded @ h after the start of the enrollment and then after @ , @ , and @ h.


The duration of NIV , hospital stay , and acceptability of the interface ( mouthpiece or nasal mask ) using a Likert scale were assessed .


No subjects had deterioration of gas exchange .


The @ groups had similar trends in arterial blood gases and breathing frequency .


No differences in duration of NIV or hospital stay were noted .


However , a significant difference in acceptability was found : subjects preferred mouthpiece ventilation ( P < @ ) .


Open mouthpiece ventilation is a useful technique and may prevent further deterioration of gas exchange in COPD patients with mild to moderate acidosis ( similar to traditional NIV delivered by a nasal mask ) .


www.chictr.org registration ChiCTR-TRC-@ .


To evaluate the effectiveness of information and communication technologies in the undergraduate students ' pressure ulcer training as a learning tool , compared with traditional teaching methods .


Pressure ulcers constitute one of the great challenges faced by nursing professionals .


Currently , pressure ulcer training is based on traditional on-campus teaching , involving lecture-style classes with frequent use of photographs of the wounds .


This traditional training has some important weaknesses that can put the efficacy of the training at risk .


A randomised controlled trial was developed including undergraduate nursing students .


The intervention group used an adaptive self-learning e-learning tool developed by the research team ( ePULab ) for pressure ulcer assessment and treatment .


The control group received a traditional on-campus class on the same topic .


Pretest and post-test questionnaires were designed to assess the students ' ability in pressure ulcer diagnosis and treatment .


The educational intervention based on the use of the ePULab tool produced significantly better learning acquisition results than those obtained by traditional lecture-style classes : the total score improved in the control group from @ ( SD @ ) -@ ( SD @ ) after the lecture , whereas in the intervention group , the knowledge score changed from @ ( SD @ ) -@ ( SD @ ) ( p = @ ) with the use of ePULab .


The results show a higher effectiveness of the devised e-learning approach for education on management of pressure ulcers .


Our results reveal the suitability of the ePULab e-learning tool as an effective instrument for training on assessment of and treatment for pressure ulcers and its potential impact on clinical decision-making .


The ARTemis trial was developed to assess the efficacy and safety of adding bevacizumab to standard neoadjuvant chemotherapy in HER@-negative early breast cancer .


In this randomised , open-label , phase @ trial , we enrolled women ( @ years ) with newly diagnosed HER@-negative early invasive breast cancer ( radiological tumour size > @ mm , with or without axillary involvement ) , at @ centres in the UK .


Patients were randomly assigned via a central computerised minimisation procedure to three cycles of docetaxel ( @ mg/m ( @ ) once every @ days ) followed by three cycles of fluorouracil ( @ mg/m ( @ ) ) , epirubicin ( @ mg/m ( @ ) ) , and cyclophosphamide ( @ mg/m ( @ ) ) once every @ days ( D-FEC ) , without or with four cycles of bevacizumab ( @ mg/kg ) ( Bev + D-FEC ) .


The primary endpoint was pathological complete response , defined as the absence of invasive disease in the breast and axillary lymph nodes , analysed by intention to treat .


The trial has completed and follow-up is ongoing .


This trial is registered with EudraCT ( @-@-@ ) , ISRCTN ( @ ) , and ClinicalTrials.gov ( NCT@ ) .


Between May @ , @ , and Jan @ , @ , we randomly allocated @ participants to D-FEC ( n = @ ) and Bev + D-FEC ( n = @ ) .


@ patients were available for the primary endpoint analysis .


Significantly more patients in the bevacizumab group achieved a pathological complete response compared with those treated with chemotherapy alone : @ ( @ % , @ % CI @-@ ) of @ patients in the Bev + D-FEC group compared with @ ( @ % , @-@ ) of @ patients in the D-FEC group ( p = @ ) .


Grade @ and @ toxicities were reported at expected levels in both groups , although more patients had grade @ neutropenia in the Bev + D-FEC group than in the D-FEC group ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) .


Addition of four cycles of bevacizumab to D-FEC in HER@-negative early breast cancer significantly improved pathological complete response .


However , whether the improvement in pathological complete response will lead to improved disease-free and overall survival outcomes is unknown and will be reported after longer follow-up .


Meta-analysis of available neoadjuvant trials is likely to be the only way to define subgroups of early breast cancer that would have clinically significant long-term benefit from bevacizumab treatment .


To observe the clinical effect of electroacupuncture ( EA ) combined with sitting training for cerebral palsy ( CP ) children with parafunctional sitting position .


A total of @ parafunctional sitting CP child patients were randomly and equally divided into sitting training ( control ) group and EA plus sitting training ( EA ) group .


The sitting training included assistant-sitting , legs-crossing-sitting , sitting with one-leg extending , long-term sitting , balancing-sitting , chair-climbing , and pron and hand-supporting , twice daily .


EA ( @ Hz , a tolerable strength ) was applied to Mingmen ( GV @ ) , Jizhong ( GV @ ) , Shenshu ( BL @ ) , and Pishu ( BL @ ) for @ min , once daily .


Both sitting training and EA treatment were conducted @ times a week and continuously for a month .


Twenty-items of sitting functions ( @ - @ point scaling ) of Gross Motor Function Measure ( GMFM ) were used to evaluate the infantile patients ' motor function and Nimodipine-method was employed to assess the curative effect .


The sitting function scores were significantly increased in both control and EA groups compared with pre-treatment in the same one group ( P < @ ) , and were apparently higher in the EA group than in the control group ( P < @ ) , suggesting a better therapeutic effect of EA plus sitting training .


EA plus sitting training intervention was better for the spastic and hypotonic patterns of CP patients than the other patterns in the therapeutic effect ( P < @ ) .


Of the two @ cases of CP children in the control and EA groups , @ ( @ % ) and @ ( @ % ) experienced marked improvement , @ ( @ % ) and @ ( @ % ) were effective , and @ ( @ % ) and @ ( @ % ) failed , with the effective rates being @ % and @ % respectively .


Acupuncture intervention combined with sitting training is better than sitting training intervention alone in improving cerebral palsy children with parafunctional sitting position , especially for the spastic and hypotonic CP patients .


The population-based `` Asymptomatic Polyvascular Abnormalities in Community ( APAC ) Study was designed to examine prevalence and associations of asymptomatic polyvascular abnormalities ( APA ) in a general population .


In this report , the objectives , design and baseline data of the APAC study are described .


The study included @,@ participants ( @ % women ) with an age of @ + years who were randomly selected from the population of the Kailuan Study which included @,@ employees and retirees of the Kailuan Co. Ltd , a large coal mine industry located in Tangshan , Hebei , China .


Exclusion criteria were previous cerebral stroke , transient ischemic attacks and coronary heart disease .


In @ and @ , information on potential cardiovascular risk factors was collected and all participants underwent transcranial Doppler sonography , measurement of the ankle brachial index , and bilateral carotid duplex sonography .


In a first follow-up examination in @/@ , retinal photography and spectral-domain optical coherence tomography were additionally performed .


In a planned long-term follow-up , data from clinical examinations and laboratory tests and the occurrence of cardiovascular or cerebrovascular events will be collected to build up a predicting model for the risk of ischemic events .


At baseline , mean age of the participants was @ @ years , and men showed a significantly ( P < @ ) higher prevalence of arterial hypertension ( @ % vs. @ % ) and hyperlipidemia ( @ % vs. @ % ) and a higher blood homocysteine concentration ( @ @ mol/L versus @ @ mol/L ) .


The APAC is the first study to prospectively evaluate the relationship between intracranial arterial stenosis , retinal nerve fiber layer changes , retinal microvascular signs , and the eventual development of cerebrovascular or cardiovascular events .


Vilazodone is a potent serotonin ( @-HT ) reuptake inhibitor and @-HTA receptor partial agonist approved by the US Food and Drug Administration for the treatment of major depressive disorder ( MDD ) in adults .


This study evaluated the efficacy and tolerability of vilazodone in the treatment of MDD .


This @-week , randomized ( @:@ ) , double-blind , placebo-controlled , parallel-group , fixed-dose study conducted from January @ to February @ compared vilazodone @ mg/d with placebo in outpatients with DSM-IV-TR-diagnosed MDD .


The primary efficacy measure was Montgomery-Asberg Depression Rating Scale ( MADRS ) total score change from baseline to week @ analyzed by a mixed-effects model for repeated measures on the intent-to-treat population ( placebo = @ , vilazodone = @ ) .


Secondary efficacy outcomes were Clinical Global Impressions-Severity of Illness ( CGI-S ) Scale score change from baseline and MADRS sustained response rate ( total score @ for at least the last @ consecutive double-blind visits ) .


Approximately @ % of patients completed the study .


Least squares mean differences ( @ % CI ) were statistically significant for vilazodone versus placebo on MADRS ( -@ -LSB- -@ to -@ -RSB- , P < @ ) and CGI-S ( -@ -LSB- -@ to -@ -RSB- , P < @ ) change from baseline ; statistically significant improvements versus placebo occurred at week @ and persisted for the study duration .


The MADRS sustained response rate was @ % for placebo and @ % for vilazodone ( P < @ ) .


Patients taking vilazodone versus placebo had higher rates of diarrhea and nausea ; most incidences were mild in severity .


Weight increase and sexual dysfunction adverse events were low in both groups .


A large and significant treatment effect on the MADRS and statistically significant improvement on the CGI-S demonstrated meaningful depressive symptom improvements .


Vilazodone was generally well tolerated .


Endoscopic biliary drainage is the palliative treatment of choice in patients with malignant hilar biliary obstruction .


Contrast injection can lead to cholangitis , whereas air cholangiography may have a lesser incidence of cholangitis .


The objective of the present study is to prospectively compare the efficacy and safety of air vs. dye cholangiogram in malignant hilar biliary obstruction .


Patients with type II and III malignant hilar biliary stricture were included in a prospectively randomized manner at a tertiary care center .


Unilateral self-expanding metal stent was placed in patients with a malignant hilar block using either air or dye as a contrast medium .


Outcome measures were successful deployment , successful drainage , early complications , and procedure-related and @-day mortality .


Forty-nine patients were randomized to air cholangiogram ( @ patients , group A ) or dye cholangiogram ( @ patients , group B ) .


Most of the patients had type II stricture ( @ in group A and @ in group B ) .


Successful stenting and drainage were achieved in @ ( @ % ) and @ ( @ % ) in group A and @ ( @ % ) and @ ( @ % ) ( p = ns ) , respectively .


Cholangitis developed in @ ( @ % ) and @ ( @ % ) in group A and B , respectively ( p < @ ) .


There was no procedure-related or @-day mortality .


Use of air cholangiography was as safe and as effective as dye cholangiography in patients with malignant hilar biliary obstruction , and it decreased the risk of post-ERCP cholangitis .


To compare oxygen cost ( mLkg ( -@ ) m ( -@ ) ) and cardiovascular response ( beats/m ) and oxygen consumption ( mLkg ( -@ ) min ( -@ ) ) and heart rate ( beats/min ) to stair ascending and descending with walkers , with canes , and without assistive devices ( ADs ) in older adults .


Descriptive , repeated measures .


Indoor stairway .


Convenience sample of able-bodied volunteers , non-AD users ( N = @ ; mean age , @ @ y ; mean body mass , @ @ kg ; mean height , @ @ cm ) .


Participants performed @ randomized trials of stair ascending and descending at their own self-selected speed with @ ADs : single-point cane , standard walker ( SW ) , and wheeled walker ( WW ) .


They also performed unassisted stair ascending and descending .


Each trial consisted of a @-minute steady-state session followed by a @-minute data collection period .


Steady-state expired ventilations were collected in Douglas bags for metabolic analysis .


Oxygen cost ( mLkg ( -@ ) m ( -@ ) ) , heart rate ( HR ) response ( beats/m ) , oxygen consumption ( mLkg ( -@ ) min ( -@ ) ) , and HR ( beats/min ) were compared for each trial of stair ascending and descending using analysis of variance repeated measures ( P < @ ) .


Greater oxygen cost ( per meter ) was found for stair ascending and descending using the single-point cane ( @ % ) , SW ( @ % ) , and WW ( @ % ) compared with unassisted stair ascending and descending ( P < @ ) .


Increased HR response ( per meter ) was found for stair ascending and descending using the single-point cane ( @ % ) , SW ( @ % ) , and WW ( @ % ) compared with unassisted stair ascending and descending ( P < @ ) .


However , oxygen consumption ( per minute ) and HR ( per minute ) were not significantly increased during stair ascending and descending with the ADs compared with unassisted stair ascending and descending .


Participants stair ascended and descended at significantly ( P < @ ) reduced speeds during trials with the ADs .


This research should aid clinicians by providing evidence to base recommendations on regarding AD usage when encountering stairs during home and community ambulation .


Nonalcoholic fatty liver disease ( NAFLD ) is one of the commonest liver disorders .


Obesity , insulin resistance , lipid peroxidation and oxidative stress have been identified amongst the possible hits leading to the onset and progression of this disease .


Nutritional evaluation of NAFLD patients showed a lower-than-recommended intake of vitamin E. Vitamin E is a family of @ isoforms , @ tocopherols and @ tocotrienols .


Alpha-tocopherol has been widely investigated in liver diseases , whereas no previous clinical trial has investigated tocotrienols for NAFLD .


Aim of the study was to determine the effects of mixed tocotrienols , in normalising the hepatic echogenic response in hypercholesterolaemic patients with ultrasound-proven NAFLD .


Eighty-seven untreated hypercholesterolaemic adults with ultrasound-proven NAFLD were enrolled and randomised into control group ( n = @ ) and tocotrienols group ( n = @ ) .


The treatment , either mixed tocotrienols @ mg twice daily or placebo , had a @-year duration.Normalisation of hepatic echogenic response , being the trial primary aim , was used in sample size calculations .


The data were assessed according to intention to treat principle as primary outcome .


Per protocol analysis was also carried out as secondary outcome measurement .


Thirty and @ participants concluded the study in the tocotrienols and placebo group respectively .


Alpha-tocopherol levels were within the normal range for all subjects .


As primary outcome , the normalisation of hepatic echogenic response was significantly higher for the tocotrienols treated group compared to the placebo group in the intention to treat analysis ( P = @ ; @ % CI = @-@ @ ) .


As secondary objective , the per protocol assessment also showed significant rate of remission ( P = @ ; @ % CI = @-@ @ ) .


Worsening of NAFLD grade was recorded in two patients in the placebo group , but none in the group treated with tocotrienols .


No adverse events were reported for both groups .


This is the first clinical trial that showed the hepatoprotective effects of mixed palm tocotrienols in hypercholesterolemic adults with NAFLD .


Patients with diabetes mellitus are at increased risk for microvascular complications .


Early changes in microcirculation are characterized by hyperperfusion ( e.g. in the retina and kidney ) and increased pulse wave reflection leading to increased aortic pressure .


We investigated the effects of the DPP-@-inhibitor saxagliptin on early retinal microvascular changes .


In this double-blind , controlled , cross-over trial @ patients ( without clinical signs of microvascular alterations ) with type-@ diabetes ( mean duration of @ years ) were randomized to receive placebo or @mg saxagliptin for @ weeks .


Retinal arteriolar structure and retinal capillary flow ( RCF ) at baseline and during flicker-light exposure was assessed by scanning laser Doppler flowmetry .


Central hemodynamics were assessed by pulse wave analysis .


Postprandial blood glucose ( @ versus @ mmol/L ; p = @ ) and HbA@c ( @ ( @ ) versus @ % ( @ mmol/mol ) ; p < @ ) were significantly reduced with saxagliptin treatment compared to placebo .


RCF was significantly reduced after treatment with saxagliptin ( @ versus @ AU ; p = @ ) .


This was most pronounced in a subgroup of patients ( n = @ ) with a fall in postprandial blood glucose ( @ versus @ AU ; p = @ ) .


No significant changes in RCF were seen during flicker-light exposure between placebo and saxagliptin , but the vasodilatory capacity increased two-fold with saxagliptin treatment .


Central augmentation pressure tended to be lower after treatment with saxagliptin ( p = @ ) , and central systolic blood pressure was significantly reduced ( @ versus @ mmHg ; p = @ ) .


Our data suggest that treatment with saxagliptin for @ weeks normalizes retinal capillary flow and improves central hemodynamics in type-@ diabetes .


To observe the clinical efficacy of treating chronic hepatitis B liver fibrosis ( CHBLF ) in different stages by syndrome typing and different activating blood removing stasis methods ( ABRSM ) .


Totally @ CHBLF patients of vital qi deficiency blood stasis syndrome ( VQDBSS ) treated at the Department of Liver Diseases , Xiyuan Hospital , China Academy of Chinese Medical Sciences from July @ to December @ , were randomly assigned to the treatment group and the control group , @ in each group .


Those in the treatment group were treated by self-formulated decoctions for activating blood nourishing blood ( ABNB ) , activating blood removing stasis ( ABRS ) , and activating blood softening hard mass ( ABSHM ) according to their stages of disease conditions ( mild , moderate , and severe ) .


Those in the control group were treated with Compound Biejia Ruangan Tablet ( CBRT ) .


Integrals of Chinese medical syndromes , liver functions -LSB- mainly including alanine aminotransferase ( ALT ) , albumin/globulin ( A / G ) -RSB- , ultrasonographic examinations of liver ( mainly including echoes of liver , width of spleens , width of portal vein ) , four indicators of serum hepatic fibrosis -LSB- including serum hyaluronic acid ( HA ) , laminin ( LN ) , type IV collagen ( IV-C ) , type III collagen peptide ( P-III-P ) -RSB- were statistically analyzed .


The therapeutic course was @ months for all .


Compared with before treatment in the same group , the integrals of Chinese medical syndromes both decreased after treatment in the two groups ( P < @ ) .


The width of spleens decreased in the treatment group more obviously after treatment than before treatment ( P < @ ) .


Compared with the control group , the integrals of Chinese medical syndromes and the width of spleens were more obviously improved in the treatment group , showing statistical difference ( P < @ ) .


Compared with before treatment in the same group , levels of ALT , HA , and LN significantly decreased , and the level of A/G significantly increased after treatment in the two groups , showing statistical difference ( P < @ ) .


Compared with the control group , the A/G level , HA , and LN were more obviously improved in the treatment group , showing statistical difference ( P < @ ) .


The total effective rate was @ % in the treatment group and @ % in the control group , showing statistical difference ( P < @ ) .


Treating CH-BLF in different stages by ABRSM got better effect than using CBRT alone .


It could favorably improve clinical symptoms of CHBLF patients and their serum biochemical indicators .


Atherosclerotic peripheral arterial disease ( PAD ) is prevalent affecting up to @ % of the population aged @ years or older .


Endovascular intervention for the treatment of limb ischemia has become the first line therapy but in Pakistan it is in embryonic stage due to dearth of trained persons and dedicated centres .


This study was conducted to evaluate procedural success and early outcome of endovascular treatment of peripheral vascular disease .


A prospective single arm multicentre study was conducted at the National Institute of Cardiovascular Disease and National Medical Centre , Karachi , Pakistan from January @ to June @ .


A total of @ patients were enrolled in the study that underwent endovascular treatment .


Out of @ patients @ ( @ % ) had critical limb ischemia ( CLI ) as per TASC II classification ( A to D ) and @ ( @ % ) had carotid lesion with history of TIA .


Patients of acute limb ischemia and stroke were excluded .


Ankle brachial index ( ABI ) was classified as normal ( @-@ @ ) , mild ( @-@ @ ) , moderate ( @-@ @ ) , severe .


Outcome was taken as immediate success and symptoms , amputation of limb among CLI patients and incidence of stroke in patients with carotid artery lesion at end of six months .


Among aortoiliac , femoropopliteal and tibioperoneal lesions , tibioperoneal lesions at six months were found to be more symptomatic @ ( @ % ) and amputation @ ( @ % ) .


Two carotid lesions at follow up were asymptomatic without stroke .


Endovascular treatment of peripheral vascular lesions , i.e. , aortoiliac , femoropopliteal tibioperoneal and carotid lesions were satisfactory in immediate outcome .


Tibioperoneal lesions were more symptomatic and limb amputation at six months .


The purpose of the study was to characterize and compare participants ' experiences of peer-facilitated versus clinician-facilitated recovery groups for veterans with mental illness .


We analyzed qualitative data from @ interviews with veterans who participated in mental health recovery groups led by peer or clinician facilitators .


Subtle differences in group structure , participation/communication and utility/relevance between peer - and clinician-facilitated groups were identified .


Participants experienced both peer and clinician facilitators as helpful in promoting recovery , though they appeared to do this in different ways .


Peer and clinician facilitators offer different strengths in the promotion of mental health recovery .


Research indicates that death thoughts that occur in response to health threats affect subsequent health behaviour .


The present study examined the effects of mortality salience on HIV testing .


After reading an article that was intended to make them perceive that they had high or low vulnerability to HIV , participants wrote about death or an aversive control topic .


Participants then indicated their intentions to get tested for HIV and were given the opportunity to take an HIV test at the end of the study .


Results showed that mortality salience increased testing behaviour among participants who were made to feel vulnerable to HIV , but decreased testing behaviour among participants who were not made to feel vulnerable to HIV infection .


This research suggests that HIV prevention programmes must carefully consider how the association many people make between HIV and death may interact with people 's perceptions of their vulnerability to HIV infection to affect their willingness to engage in preventative behaviours .


Bapineuzumab , a humanized anti-amyloid-beta monoclonal antibody , is in clinical development for the treatment of Alzheimer 's disease .


We conducted two double-blind , randomized , placebo-controlled , phase @ trials involving patients with mild-to-moderate Alzheimer 's disease -- one involving @ carriers of the apolipoprotein E ( APOE ) @ allele and the other involving @ noncarriers .


Bapineuzumab or placebo , with doses varying by study , was administered by intravenous infusion every @ weeks for @ weeks .


The primary outcome measures were scores on the @-item cognitive subscale of the Alzheimer 's Disease Assessment Scale ( ADAS-cog@ , with scores ranging from @ to @ and higher scores indicating greater impairment ) and the Disability Assessment for Dementia ( DAD , with scores ranging from @ to @ and higher scores indicating less impairment ) .


A total of @ carriers and @ noncarriers were included in the efficacy analysis .


Secondary outcome measures included findings on positron-emission tomographic amyloid imaging with the use of Pittsburgh compound B ( PIB-PET ) and cerebrospinal fluid phosphorylated tau ( phospho-tau ) concentrations .


There were no significant between-group differences in the primary outcomes .


At week @ , the between-group differences in the change from baseline in the ADAS-cog@ and DAD scores ( bapineuzumab group minus placebo group ) were -@ ( P = @ ) and -@ ( P = @ ) , respectively , in the carrier study ; the corresponding differences in the noncarrier study were -@ ( P = @ ) and @ ( P = @ ) with the @-mg-per-kilogram dose of bapineuzumab and @ ( P = @ ) and @ ( P = @ ) with the @-mg-per-kilogram dose .


The major safety finding was amyloid-related imaging abnormalities with edema among patients receiving bapineuzumab , which increased with bapineuzumab dose and APOE @ allele number and which led to discontinuation of the @-mg-per-kilogram dose .


Between-group differences were observed with respect to PIB-PET and cerebrospinal fluid phospho-tau concentrations in APOE @ allele carriers but not in noncarriers .


Bapineuzumab did not improve clinical outcomes in patients with Alzheimer 's disease , despite treatment differences in biomarkers observed in APOE @ carriers .


( Funded by Janssen Alzheimer Immunotherapy and Pfizer ; Bapineuzumab @ and @ ClinicalTrials.gov numbers , NCT@ and NCT@ , and EudraCT number , @-@-@ . )


Currently , the reference standard used to clinically assess sexual function among women is a qualitative questionnaire .


Hence , a generalised and quantitative measurement tool needs to be available as an alternative .


This study investigated whether an electromyography ( EMG ) measurement technique could be used to help quantify women 's sexual function .


A preliminary intervention study was conducted on @ female subjects , who were randomised into a control ( n = @ ) and an intervention ( n = @ ) group .


Intervention involved a set regimen of pelvic floor muscle exercises ( Kegel ) and the control group did not have any treatment .


All subjects were asked to answer a validated , self-rated Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire ( PISQ ) .


EMG measurements of the pelvic floor muscles ( PFM ) and the abdominal muscles were taken from all women at recruitment and @ weeks after study commencement .


After @ weeks , most of the subjects in the control group did not display any noted positive difference in either PISQ score ( @/@ ) or in their muscle strength ( @/@ ) .


However , a noted progressive difference were observed in subjects who were placed in the Kegel group ; PISQ score ( @/@ ) and muscles strength ( @/@ ) .


The noted difference in the Kegel group subjects was that if progress is observed in the sexual function , improvement is also observed in the strength of at least @ types of muscles ( either abdominal or PFM muscles ) .


Thus , EMG measurement is a potential technique to quantify the changes in female sexual function .


Further work will be conducted to validate this assumption .


Interventions utilizing vibration may increase bone mass and size which may reduce forearm fractures in children .


This randomized controlled pilot trial tested the feasibility , compliance and efficacy of forearm loading regimes in an after-school program in pre-pubertal children aged @-@ years .


A @-week randomized controlled trial incorporated high ( HMMS ; N = @ ) and low ( LMMS ; N = @ ) magnitude mechanical stimulation vibration , floor exercises ( N = @ ) , and controls ( N = @ ) .


Radial bone measures by DXA and pQCT were compared at the end of intervention ( @-weeks ) and @-months post-intervention ( @-months post ) .


Percent changes were significantly greater in floor vs. control for ultra-distal areal BMD by DXA at @-weeks ( @ % -LSB- -@,@ -RSB- vs.-@ % -LSB- -@ , -@ -RSB- respectively , p = @ ) and @-months post ( @ % -LSB- @,@ -RSB- vs -@ % -LSB- -@,@ -RSB- , p = @ ) and in HMMS vs. controls for trabecular vBMD by pQCT at @-weeks ( @ % -LSB- @ , @ -RSB- , vs. -@ % -LSB- -@ , -@ -RSB- , p = @ ) .


Children exposed to HMMS showed positive changes in cortical BMC , area , and cortical vBMD after @ weeks that remained @ months post-intervention .


Children exposed to floor exercise showed positive changes in cortical BMC , area , and periosteal circumference @-months post-intervention .


Controls had decreased trabecular BMD , but increased bone area and periosteal circumference .


Exposure to floor exercise and HMMS increased trabecular aBMD and vBMD in the radius .


We investigated whether the Src inhibitor saracatinib ( AZD@ ) improved efficacy of weekly paclitaxel in platinum-resistant ovarian cancer .


Patients with platinum-resistant ovarian , fallopian tube or primary peritoneal cancer were randomised @ : @ to receive @-week cycles of weekly paclitaxel ( wPxl ; @ mg/m ( @ ) / week @ with @-week break ) plus saracatinib ( S ; @ mg o.d. ) or placebo ( P ) continuously , starting @ week before wPxl , until disease progression .


Patients were stratified by taxane-free interval ( < @ versus @ months/no prior taxane ) .


The primary end point was progression-free survival ( PFS ) rate at @ months .


Secondary end points included overall survival ( OS ) and response rate ( RR ) .


A total of @ patients , median age @ years , were randomised .


Forty-three ( @ % ) had received > @ lines of prior chemotherapy .


The @-month PFS rate was @ % ( wPxl + S ) versus @ % ( wPxl + P ) ( P = @ ) .


Median PFS was @ versus @ months ( hazard ratio @ , @ % confidence interval @-@ @ ; P = @ ) .


RR ( complete + partial ) was @ % ( wPxl + S ) versus @ % ( wPxl + P ) , P value = @ .


Grade @/@ adverse events were @ % versus @ % ( P = @ ) ; the most frequent G@/@ toxicities were vomiting ( @ % saracatinib versus @ % placebo ) , abdominal pain ( @ % versus @ % ) and diarrhoea ( @ % versus @ % ) .


Febrile neutropenia was more common in the saracatinib arm ( @ % ) than placebo ( @ % ) .


Response , PFS and OS were all significantly ( P < @ ) better in patients with taxane interval @ months/no prior taxane ( n = @ ) than those < @ months ( n = @ ) , regardless of randomisation .


Saracatinib does not improve activity of weekly paclitaxel in platinum-resistant ovarian cancer .


Taxane-free interval of @ months/no prior taxane was associated with better outcome in both groups .


Gastroesophageal reflux disease ( GERD ) is a common condition associated with symptoms as heart burn , regurgitation , chest pain , and gastrointestinal discomfort .


PPC-@ is a new pharmacological agent that can modulate acid-sensing ion channel activity , potentially leading to reduction in the pain signal .


In healthy volunteers the esophagus was sensitized with acid to mimic GERD with the aims : @ ) to assess the efficacy of a single bolus of PPC-@ locally applied to the esophagus using multimodal pain stimulations , and @ ) to assess the safety profile of PPC-@ .


The study was a randomized , double-blinded , placebo-controlled , crossover trial in healthy males .


Esophageal electrical , thermal , mechanical , and chemical stimulations were performed , pain perception was rated , and referred pain areas were drawn .


Sensitization was induced by intraluminal esophageal acid perfusions .


Adverse events were registered .


Twenty-five healthy males completed the study ( mean age @ @ years ) .


About @ min after drug administration , PPC-@ increased the volume tolerated at moderate pain during mechanical stimulation compared to placebo ( difference @ , @ % CI : @-@ @ , p = @ ) , but there was no effects on thermal - , electrical - , and chemical-induced pain ( all p > @ ) .


PPC-@ did not affect referred pain areas to any stimulation ( all p > @ ) .


Ten participants reported adverse events during the placebo treatment period , and nine participants reported adverse events during the PPC-@ treatment period ( p = @ ) .


Sensitization to mechanical stimulation of the esophagus was reduced by PPC-@ compared to placebo .


The overall safety and tolerability of PPC-@ was acceptable .


Thus , PPC-@ may play a role in the future treatment of patients with GERD .


Otitis media with effusion ( OME ) or middle ear effusion ( MEE ) is a common cause of hearing difficulty in children .


MEE must be detected early and managed properly to prevent conductive hearing loss in children .


It was aimed to compare results of laser myringotomy and conventional myringotomy in terms of hearing improvement , recurrence of MEE and time to put ventilation tube .


This randomized control trial was conducted from February @ to April @ .


Children of @ years age or older with MEE were included in the study .


These children were investigated with Pure tone audiometry ( PTA ) and tympanometry to confirm conductive hearing loss .


X-Ray nasopharynx lateral view was performed for adenoids .


Sixty-six patients were randomly assigned in to @ groups , ( @ ) treated with laser myringotomy and ( @ ) treated with classical myringotomy .


The ears were evaluated for MEE , for presence of perforation and level of hearing .


A total of @ ears in @ patients underwent intervention .


Middle ear effusion cleared in @ out of @ ears with laser myringotomy ( LM ) as compared to@ out of @ ears with incisional myringotomy .


The perforation was still patent in @ ears treated with LM while it was found closed in all @ ears with conventional myringotomy after @ weeks .


The hearing level improved with LM by @-@ dB after first @ months .


The aim of management in otitis media with effusion is ventilation of tympanic cavity .


Laser myringotomy is a best alternative to conventional one .


It also has comparable results with ventilation tubes ( VT ) .


The ears with refractory or recurrent MEE should have VT insertion .


One of the concerns in the use of propofol is the pain on injection of the drug .


Many attempts were made to prevent such pain , none of which has been reasonably successful .


We hypothesized that the pain is attenuated when the patient is directed to concentrate on counting numbers while propofol is injected .


Ninety-one patients undergoing elective surgery under general anesthesia were enrolled .


They were randomly assigned to counting or non-counting group .


Patients in counting group were instructed to verbally count numbers backwards starting @ when propofol was injected , while patients in non-counting group were injected propofol without any instructions .


The size of the i.v. cannula , the temperature of the drug , and speed by which the drug was injected were controlled .


No premedication was given .


We interviewed the patients after the surgery and scored the pain on propofol injection , the pain on the placement of the iv cannula , and the anxiety level on entering the operating room .


There was no significant difference in the incidence of pain on injection of propofol ( @ % and @ % in the counting and the non-counting group , respectively ) .


A multiple logistic-regression analysis revealed that the significant factors to cause pain on the injection of propofol were age and the degree of pain on inserting intravenous line .


Intensive counting did not reduce the incidence of pain on injection of propofol .


Age and the degree of pain on inserting intravenous cannula can be a useful predictor for an intolerable pain on injection of propofol .


To observe the clinical effedt of auricular pressure combined with Chinese herbal medicine for amblyopia .


A total of @ child patients with amblyopia were randomly divided into Chinese herbal medicine ( control ) and herbal medicine + auricular pressure ( treatment ) groups , with @ patients in each group .


The patients in the control group were treated with Chinese medical herbs as Danggui ( Radix Angelicae Sinensis ) , Gouqizi ( Fructus Lycii ) , Baijuhua ( Flos Chrysanthemi ) , Baizhu ( Rhizoma Atractylodis Macrocephalae ) , Shudi ( Radix Rehmanniae Proeparata ) , Baishao ( Radix Paeoniae Alba ) , etc. according to syndrome differentiation , while the patients in the treatment group were treated by auricular pressure of otopoints Yan ( Eye ) , Gan ( Liver ) , Shen ( Kidney ) , Xin ( Heart ) , Mu @ ( Eye-@ ) , Mu @ ( Eye-@ ) , and Pi ( Spleen ) and herbal medicines ( being the same to the control group ) .


The treatment was conducted for @ months .


After the treatment , the clinical effect , improvement degree of vision , onset time of improvement , and recurrence rate in the @ and @ months ' follow-up visit were analyzed .


Of the @ and @ eyes in the treatment and control groups , @ and @ were basically cured , @ and @ had marked improvement , @ and @ were improved , @ and @ failed in the treatment , with the effective rates being @ % and @ % , respectively .


In comparison with pre-treatment , the visual acuity in both control group and treatment group were improved ( P < @ ) .


The numbers of children who had improvement of visual acuity after @ weeks , one month in the control group and treatment group were @ and @ eyes , @ and @ eyes , respectively .


The recurrence rate @ months after the treatment was @ % in the control group and @ % in the treatment group .


The effective rate of the treatment group was significantly superior to that of the control group ( P < @ ) .


Auricular pressure combined with Chinese medical herb treatment is effective in improving visual acuity , and had a higher efficacy , faster action , and lower recurrence rate in amblyopia children in comparison with simple herbal medicine treatment .


Physical activity is mandatory if patients are to remain healthy and independent after stroke .


Maintenance of motor function , tone , grip strength , balance , mobility , gait , independence in personal and instrumental activities of daily living , health-related quality-of-life and an active lifestyle @ years post-stroke .


A prospective randomized controlled trial .


Four years post-stroke , @ of the @ participating persons were eligible for follow-up ; @ ( @ % ) from the intensive exercise group and @ ( @ % ) from the regular exercise group .


Both groups were performing equally well with no significant differences in total scores on the BI ( p = @ ) , MAS ( p = @ ) , BBS ( p = @ ) , TUG ( p = @ ) , @MWT ( p = @ ) , bilateral grip strength ( affected hand , p = @ ; non-affected hand , p = @ ) nor in the items of NHP ( p > @ ) .


Independence in performing the IADL was @ % , while @ % had help from relatives or community-based services .


This longitudinal study shows that persons with stroke in two groups with different exercise regimes during the first year after stroke did not differ in long-term outcomes .


Both groups maintained function and had a relatively active life style @ years after the acute incident .


The results underline the importance of follow-up testing and encouragement to exercise , to motivate and sustain physical activity patterns , to maintain physical function , not only in the acute but also in the chronic phase of stroke .


The objectives of this study were to determine the effects of the novel Buddhism-based walking meditation ( BWM ) and the traditional walking exercise ( TWE ) on depression , functional fitness , and vascular reactivity .


This was a randomized exercise intervention study .


The study was conducted in a university hospital setting .


Forty-five elderly participants aged @-@ years with mild-to-moderate depressive symptoms were randomly allocated to the sedentary control , TWE , and BWM groups .


The BWM program was based on aerobic walking exercise incorporating the Buddhist meditations performed @ times/week for @ weeks .


Depression score , functional fitness , and endothelium-dependent vasodilation as measured by the flow-mediated dilation ( FMD ) were the outcome measures used .


Muscle strength , flexibility , agility , dynamic balance , and cardiorespiratory endurance increased in both exercise groups ( p < @ ) .


Depression score decreased ( p < @ ) only in the BWM group .


FMD improved ( p < @ ) in both exercise groups .


Significant reduction in plasma cholesterol , triglyceride , high-density lipoprotein cholesterol , and C-reactive protein were found in both exercise groups , whereas low-density lipoprotein cholesterol , cortisol , and interleukin-@ concentrations decreased only in the BWM group .


Buddhist walking meditation was effective in reducing depression , improving functional fitness and vascular reactivity , and appears to confer greater overall improvements than the traditional walking program .


To observe the clinical effect of acupuncture for depression and to discuss its impact on the content of @-HT in patients with depression .


Eighty patients with depression were randomly divided into an acupuncture group and a western medication group ,@ cases in each one .


Acupuncture was applied in the acupuncture group , Siman ( KI @ ) , Shenshu ( BL @ ) , Guanyuan ( CV @ ) , Dazhui ( GV @ ) , Yinlingquan ( SP @ ) , Zusanli ( ST @ ) , Taichong ( LR @ ) , Yanglingquan ( GB @ ) and Jingming ( BL @ ) were selected , the intensive moxibustion was applied at G ( uanyuan ( CV @ ) .


Fluoxetine was treated with oral administration in the western medication group .


The treatments of six weeks were required in each group .


The Hamilton depression rating scale ( HAMD ) was applied to evaluate efficacy and serum @-HT was detected before and after treatment in the two groups .


After treatment , the scores of HAMD were decreased obviously in the two groups compared with those before treatment ( scores in the acupuncture group : @ @ vs @ @ ; scores in the western medication group : @ vs @ ) , and the differences were statistically significant ( both P < @ ) .


Between the two groups , the scores of HAMD in the acupuncture group at the end of the lst ,@ nd ,@ th ,@ th weeks were superior to those in the western medication group ( all P < @ ) .


The content of serum @-HT after treatment was increased markedly compared with that before treatment -LSB- the content in the acupuncture group : ( @ @ ) pg/mL vs ( @ @ ) pg/mL , the content in the western medication group : ( @ ) pg/mL vs ( @ ) pg / mL , both P < @ -RSB- .


But there was no statistic significance between the two groups ( P > @ ) .


The efficacy of acupuncture for depression is superior to that of western medication with fluoxetine .


Intermittent @-month cyclic administration might optimize the anabolic potential of teriparatide ( TPTD ) .


To determine whether @-month cyclical TPTD would produce a similar bone mineral density ( BMD ) response to daily therapy in treatment naive ( Rx-naive ) women and to confirm the results in alendronate ( ALN ) - treated ( ALN-Rx ) women over @ months .


Subjects participated in a randomized open-label study for @ years .


Osteoporosis clinical research center .


A total of @ postmenopausal women with osteoporosis in two cohorts : @ Rx-naive and @ ALN-Rx .


Within cohorts , women were randomized to daily TPTD for @ months or four @-month TPTD cycles , each followed by @ months off ( @ mo total TPTD ) .


BMD at @ months .


In Rx-naive women , BMD increased in the lumbar spine ( LS ) , total hip ( TH ) , trochanter ( Troch ) , and femoral neck ( FN ) in daily and cyclic groups ( within groups , P < @ , except cyclic FN , P = @ ) .


Increases were @-fold greater in daily vs cyclic groups ( LS , @ vs @ % ; TH , @ vs @ % ; Troch , @ vs @ % ; and FN , @ vs @ % ; group differences , all P < @ ) .


In daily vs cyclic groups , radius BMD declined ( -@ vs -@ % , respectively ; both P < @ ; group difference , P = @ ) and total bone mineral increased modestly ( @ % , P = @ ; vs @ % , P = @ ; group difference , not significant ) .


In ALN-Rx women , there were no group differences ( daily vs cyclic : LS , @ and @ % ; TH , @ and @ % ; Troch , @ and @ % ; FN , @ and @ % ; within groups , P < @ ; except cyclic FN , P = @ ) .


In daily and cyclic groups , radius BMD decreased ( -@ % -LSB- not significant -RSB- and -@ % -LSB- P < @ -RSB- , respectively ) , and total bone mineral increased @ and @ % ( both P < @ ) .


Cyclic TPTD over @ years improves BMD similarly to daily treatment in women who remain on ALN , despite only @ % of the TPTD dose .


However , there does not appear to be a BMD advantage to cyclic administration in treatment-naive women for up to @ months .


To report a trial protocol that evaluates the effectiveness of postnatal psychoeducation programme in improving maternal parental self-efficacy and social support and in reducing postnatal depression among primiparas .


Primiparas encounter physical , psychosocial and newborn care challenges in the early postnatal period .


However , primiparas do not receive adequate professional support after early discharge from hospitals , thus hindering their adaptation to new role as mothers and smooth transition to motherhood .


Postnatal psychoeducation programmes have been shown to be effective in improving pregnant women 's health .


However , there is a lack of theory-based , postnatal psychoeducation interventions for primiparas .


A randomized controlled trial of two-group pretest and repeated posttests is proposed .


The study will recruit a minimum of @ primiparas on the day of discharge from a Singaporean public hospital ( protocol approved in May @ ) .


Eligible participants will be randomly allocated to either a control group ( receiving routine care ) or an experimental group ( receiving a postnatal psychoeducation programme besides routine care ) .


Outcome measures include maternal parental self-efficacy , social support and postnatal depression .


Data will be collected at baseline ( on the day of discharge ) , @ and @weeks postpartum .


This will be the first study of its kind that will use rigorous study design to evaluate a theory-based innovative postnatal psychoeducation programme on maternal outcomes .


The study may identify a potentially effective way of enhancing primiparas ' self-efficacy and social support , which may in turn reduce their risk of postnatal depression .


The Sigma Theta Tau International Upsilon Eta Chapter funded this study .


To examine the efficacy and safety of otilonium bromide ( OB ) in treatment-sensitive functional irritable bowel syndrome ( IBS ) clinical parameters .


Ninety-three patients ( @ @ years , @ % female ) with IBS symptoms complying with Rome II criteria participated in this double-blind , placebo-controlled , randomised , dose-ranging phase I/II study .


Patients were administered OB @ mg ( n = @ ) , @ mg ( n = @ ) and @ mg ( n = @ ) tid or placebo ( n = @ ) in @ parallel groups for @ wk .


Primary efficacy variables included abdominal discomfort , intestinal habits , number of daily evacuations and stool consistency .


Secondary efficacy measures included return to regular intestinal habits and global discomfort .


Safety was also assessed .


Baseline clinical characteristics were similar among the @ groups .


Although individual parameters such as intensity and frequency of abdominal discomfort , bloating or pain were reduced by OB over the @ wk , no significant differences were observed between groups .


Similarly , no difference was observed between OB treatment or placebo for mucus in stool and incomplete or difficulty of evacuation .


However , evacuation frequency was significantly reduced after @ wk by @ mg OB compared to placebo ( -@ % for placebo vs -@ % for @ mg OB , P < @ ) .


While @ % of patients in the placebo group experienced regular intestinal habits after @ wk , this improvement was greater for patients treated with @ mg OB ( P < @ vs placebo ) .


Furthermore , a dose-dependent reduction in frequency of diarrhoea ( ( @ ) - test for trend = @ , P < @ ) and an increase in normal stool frequency was observed .


Combining individual variables into a global discomfort index revealed significant improvement among increasing OB doses , favouring @ mg ( P = @ ) and @ mg OB ( P = @ ) over placebo .


No difference was observed between frequency of adverse events for placebo vs OB .


This dose-ranging study demonstrates that OB at @ and @ mg can improve individual and global clinical symptoms of IBS compared to placebo over a @-wk period .


Chronic hemorrhagic radiation proctopathy is not uncommon after radiotherapy for cervical carcinoma .


The outcomes of several treatments have been variable .


Many studies demonstrate that topical treatment with @ % formalin is effective and safe .


However , a nonrandomized control study showed a high response rate and good tolerance in chronic radiation proctopathy patients treated with @ % formalin .


The optimal concentration of formalin therefore remains unclear .


To compare the effectiveness and safety of @ and @ % formalin for the treatment of chronic hemorrhagic radiation proctopathy , a prospective trial was conducted at the Department of Gynecology of the Affiliated Hospital of Binzhou Medical College from January @ to December @ .


One hundred and twenty patients with chronic hemorrhagic radiation proctopathy following radiotherapy for cervical carcinoma were recruited and randomized to receive @ or @ % formalin .


A standard protocol was followed for formalin application .


Symptom and rectoscopy scores were evaluated before and at @ weeks after treatment .


In the @ % formalin group , @ ( @ % ) and @ ( @ % ) patients showed an improvement in symptom score and rectoscopy score , respectively ( P = @ ) .


Symptom and rectoscopy scores decreased significantly after treatment in both the @ % formalin group and the @ % formalin group ( P < @ ) .


Symptom score was correlated with rectoscopy score ( P < @ ) .


More patients in the @ % group suffered treatment-related complications than did those in the @ % group ( P = @ ) .


For the treatment of chronic hemorrhagic radiation proctopathy , @ % should be the preferred formalin concentration .


Erythropoietin ( EPO ) derivatives have been found to increase frataxin levels in Friedreich 's ataxia ( FRDA ) in vitro .


This multicenter , double-blind , placebo-controlled , phase II clinical trial aimed to evaluate the safety and tolerability of Lu AA@ ( carbamylated EPO ; CEPO ) .


Thirty-six ambulatory FRDA patients harboring > @ GAA repeats were @:@ randomly assigned to either CEPO in a fixed dose ( @ g thrice-weekly ) or placebo .


Safety and tolerability were assessed up to @ days after baseline .


Secondary outcome measures of efficacy ( exploration of biomarkers and ataxia ratings ) were performed up to @ days after baseline .


All patients received six doses of study medication .


Adverse events were equally distributed between CEPO and placebo .


There was no evidence for immunogenicity of CEPO after multiple dosing .


Biomarkers , such as frataxin , or measures for oxidative stress and ataxia ratings did not differ between CEPO and placebo .


CEPO was safe and well tolerated in a @-week treatment phase .


Secondary outcome measures remained without apparent difference between CEPO and placebo .


School-based health centers ( SBHCs ) may be an ideal setting to address obesity in adolescents because they provide increased access to a traditionally difficult-to-reach population .


The study evaluated the feasibility of adding a health educator ( HE ) to SBHC teams to provide support and increase the delivery of preventive services for overweight or obese adolescents .


Adolescents with BMI @ % recruited from two SBHCs were randomized to a control group ( CG ) or an intervention group ( IG ) .


Both groups received preventive services , including physical examinations and laboratory screening in the SBHC .


The educator met with the IG during the academic year , utilizing motivational interviewing techniques to set lifestyle goals .


Text messaging was used to reinforce goals between visits .


Eighty-two students ( @ years of age ; BMI , @ kg/m ( @ ) ) were enrolled in the IG and @ in the control group ( @ years of age ; BMI , @ kg/m ( @ ) ) .


Retention was @ % in the IG and @ % in the CG .


A total of @ % of the IG and @ % of the CG decreased or maintained BMI z-score ( less than @ increase ; p = @ ) .


Sports participation was higher in the CG ( @ % vs. @ % in the IG ; p = @ ) .


Mean BMI z-score change was -@ for students participating in sports vs. @ for those not ( p = @ ) .


This SBHC intervention showed successful recruitment and retention of participants and delivery of preventive services in both groups .


Meeting with an HE did not improve BMI outcomes in the IG .


Confounding factors , including sports participation and SBHC utilization , likely contributed to BMI outcomes .


No treatment has been approved by the U.S. Food and Drug Administration for eosinophilic esophagitis ( EoE ) .


We investigated the efficacy and safety of a new formulation of oral budesonide suspension ( OBS ) , a corticosteroid , in a prospective , placebo-controlled , dose-ranging study .


Subjects @-@ years old with symptoms of EoE and peak eosinophil counts @/high-power field at @ levels of the esophagus were randomly assigned to groups given placebo or low-dose , medium-dose , or high-dose OBS for @ weeks .


Doses and volumes were adjusted on the basis of patients ' age to cover the entire esophagus .


The primary efficacy end point was compound response to therapy ( peak eosinophil counts @/high-power field at all levels of the esophagus and @ % reduction in EoE symptom score ) .


Multiple safety parameters were evaluated .


Data from @ subjects who completed all efficacy assessments were included in the primary efficacy analysis .


At the end of @ weeks , there were significantly greater percentages of responders in groups given medium-dose OBS ( @ % , P = @ ) and high-dose OBS ( @ % , P = @ ) than in the group given placebo ( @ % ) ; there was no significant difference in percentages of responders between the low-dose OBS ( @ % ) and placebo groups ( P = @ ) .


The significant compound responses noted in the medium-dose and high-dose OBS groups were accounted for by the significant histologic responses ; in contrast , all @ groups ( including the placebo group ) had large symptom responses , and there was no significant difference in the percentage of subjects with a symptom response in either OBS group compared with the placebo group ( P @ ) .


There were no unexpected safety concerns or signals .


Peak eosinophil counts were significantly reduced throughout the esophagus in pediatric patients with EoE who were given medium-dose and high-dose OBS .


There was a large symptom response to placebo that was similar to symptom responses in the OBS groups ; symptom response did not distinguish OBS from placebo .


ClinicalTrials.gov number , NCT@ .


Vitamin D status may influence a spectrum of health outcomes , including osteoporosis , arthritis , cardiovascular disease , and cancer .


Vitamin D-binding protein ( DBP ) is the primary carrier of vitamin D in the circulation and regulates the bioavailability of @-hydroxyvitamin D. Epidemiologic studies have shown direct DBP-risk relations and modification by DBP of vitamin D-disease associations .


We aimed to characterize common genetic variants that influence the DBP biochemical phenotype .


We conducted a genome-wide association study ( GWAS ) of @ men through linear regression of single-nucleotide polymorphisms ( SNPs ) in the Illumina HumanHap@/@/@ array on fasting serum DBP , assuming an additive genetic model , with adjustment for age at blood collection .


We identified @ independent SNPs located in the gene encoding DBP , GC , that were highly associated with serum DBP : rs@ ( P = @ @ ) and rs@ ( P = @ @ ) .


For both SNPs , mean serum DBP decreased with increasing copies of the minor allele : mean DBP concentrations ( nmol/L ) were @ , @ , and @ for @ , @ , and @ copies of rs@ ( T ) , respectively , and @ , @ , and @ , respectively , for rs@ ( G ) .


DBP was also associated with rs@ ( P = @ @ ) in ST@GALNAC@ .


In this GWAS analysis , to our knowledge the first to examine this biochemical phenotype , @ variants in GC -- one exonic and one intronic -- were associated with serum DBP concentrations at the genome-wide level of significance .


Understanding the genetic contributions to circulating DBP may provide greater insights into the vitamin D binding , transport , and other functions of DBP and the effect of vitamin D status on health outcomes .


In this study we tried to assess the efficacy of topical emollients in the treatment of patients with PUVA-induced pruritus .


@ patients over @ years of age , who received PUVA treatment in the phototherapy unit , were included in the study .


Patients were randomly divided into two groups ; Group I was administered with a @ % urea lotion and Group II was administered with liquid petrolatum .


The follow-up period was minimum @ weeks .


During the first @ weeks , patients were administered topical emollients and received PUVA treatment together .


The next @ weeks , they continued PUVA treatment without any medication .


When time-dependent changes in the visual analogue scale scores for pruritus of both groups were considered , both treatment methods were found to be remarkably successful ( p < @ ) .


In addition , an insignificant group-time interaction was identified ( p = @ ) .


Topical emollients were found to be effective in the treatment of PUVA-induced pruritus .


Both forms of medication can be successfully administered and increase the patient 's compliance with medication .


Hypertension control rates remain suboptimal .


Pharmacists ' scope of practice is evolving , and their position in the community may be ideal for improving hypertension care .


We aimed to study the impact of pharmacist prescribing on blood pressure ( BP ) control in community-dwelling patients .


We designed a patient-level , randomized , controlled trial , enrolling adults with above-target BP ( as defined by Canadian guidelines ) through community pharmacies , hospitals , or primary care teams in @ communities in Alberta .


Intervention group patients received an assessment of BP and cardiovascular risk , education on hypertension , prescribing of antihypertensive medications , laboratory monitoring , and monthly follow-up visits for @ months ( all by their pharmacist ) .


Control group patients received a wallet card for BP recording , written hypertension information , and usual care from their pharmacist and physician .


Primary outcome was the change in systolic BP at @ months .


A total of @ patients ( mean age , @ years ; @ % male ) were enrolled .


Baseline meanSD systolic/diastolic BP was @/@ mm Hg .


The intervention group had a meanSE reduction in systolic BP at @ months of @ compared with @ mm Hg in the control group , an adjusted difference of @ mm Hg ( P = @ ) .


The adjusted odds of patients achieving BP targets was @ ( @ % confidence interval , @-@ @ in favor of the intervention ) .


Pharmacist prescribing for patients with hypertension resulted in a clinically important and statistically significant reduction in BP .


Policy makers should consider an expanded role for pharmacists , including prescribing , to address the burden of hypertension .


This prospective study was done to evaluate the efficacy of commercial fibrin glue application in the healing of patients with fistulas-in-ano from a short follow up period ( one year ) .


This randomized clinical trial of @ patients was performed during the period from January @ to July @ .


Nineteen men and seven women were treated for a fistula-in-ano with a commercial fibrin glue injection .


In the operating room , the patients underwent an anorectal examination under spinal anesthesia .


The external and internal fistula tract openings were then identified and the fistula tract was accurately curetted .


Fibrin glue was introduced by a loaded double-channel syringe into the external fistula opening until the fibrin glue tip could be seen emerging from the internal opening .


The initial success rate was @ % ( @/@ ) .


Recurrence rate was @ % ( @/@ ) .


Four patients underwent a re-application of fibrin glue and the fistulas of these patients closed .


Total recurrence rate was @ % ( @/@ ) .


The overall success rate was @ % ( @/@ ) .


Fibrin glue application was thus found to be an easy , safe , successful alternative treatment in the management of fistulas-in-ano .


Specifically , this therapeutic option demonstrated his efficacy for simple non-ramificated transsphincteric and intersphincteric fistulas .


Multicentric randomized clinical trials with more representative sample seem to be necessary to investigate the best patients to treat by fibrin glue injection and the optimal application technique to improve these results .


To investigate the efficacy of mouse nerve growth factor ( mNGF ) in treating occupational hand-arm vibration disease ( HAVD ) .


Sixty-four patients with HAVD were equally and randomly divided into treatment group and control group .


The control group was given Salvia miltiorrhiza Bunge and deproteinized extract of calf blood to improve circulation , and also given methylcobalamin tablets and vitamin B@ for neurotrophic treatment .


In addition to the above treatments for the control group , the treatment group was also given @ g/d mNGF by intramuscular injection for two courses ( @ weeks for each course ) with a @-day interval .


Both the treatment group and the control group showed significant improvements in clinical symptoms and signs ( hand numbness and pain , and reduced senses of touch , pain , and vibration ) , cold water loading test ( CWLT ) , and electroneuromyography ( ENMG ) after treatments ( P < @ ) .


And the treatment group had significantly more improvements than the control group ( P < @ ) .


mNGF can significantly improve hand numbness and pain , reduced senses of touch , pain , and vibration , CWLT , and ENMG , so it has better clinical effect and safety in treating HAVD .


Early diagnosis and treatment can improve the outcome of patients with HAVD .


To test if docosahexaenoic acid-enriched fish oil supplementation rectifies red cell membrane lipid anomaly in pregnant women with Type@ diabetes and their neonates , and alters fetal body composition .


Women with Type@ diabetes ( n = @ ; @ fish oil , @ placebo ) and healthy women ( n = @ ; @ fish oil , @ placebo ) were supplemented from the first trimester until delivery .


Blood fatty acid composition , fetal biometric and neonatal anthropometric measurements were assessed .


A total of @ women completed the trial .


The women with Type@ diabetes who took fish oil compared with those who received placebo had higher percentage of docosahexaenoic acid in red cell phosphatidylethanolamine in the third trimester ( @ % vs. @ % , P = @ ) and at delivery ( @ % vs. @ % , P = @ ) .


Similarly , the neonates of the women with Type@ diabetes supplemented with the fish oil had increased docosahexaenoic acid in the red cell phosphatidylethanolamine ( @ % vs. @ % , P = @ ) and plasma phosphatidylcholine ( @ % vs. @ % , P = @ ) .


Docosahexaenoic acid-rich fish oil had no effect on the body composition of the fetus and neonates of the women with Type@ diabetes .


A daily dose of @mg of docosahexaenoic acid was effective in ameliorating red cell membrane docosahexaenoic acid anomaly in pregnant women with Type@ diabetes and neonates , and in preventing the decline of maternal docosahexaenoic acid during pregnancy .


We suggest that the provision of docosahexaenoic acid supplement should be integrated in the antenatal care of pregnant women with Type@ diabetes .


Type @ diabetes is a major health problem in many countries including India .


Yoga may be an effective type @ diabetes prevention strategy in India , particularly given its cultural familiarity .


This was a parallel , randomized controlled pilot study to collect feasibility and preliminary efficacy data on yoga for diabetes risk factors among people at high risk of diabetes .


Primary outcomes included : changes in BMI , waist circumference , fasting blood glucose , postprandial blood glucose , insulin , insulin resistance , blood pressure , and cholesterol .


We also looked at measures of psychological well-being including changes in depression , anxiety , positive and negative affect and perceived stress .


Forty-one participants with elevated fasting blood glucose in Bangalore , India were randomized to either yoga ( n = @ ) or a walking control ( n = @ ) .


Participants were asked to either attend yoga classes or complete monitored walking @-@ days per week for eight weeks .


Randomization and allocation was performed using computer-generated random numbers and group assignments delivered in sealed , opaque envelopes generated by off-site study staff .


Data were analyzed based on intention to treat .


This study was feasible in terms of recruitment , retention and adherence .


In addition , yoga participants had significantly greater reductions in weight , waist circumference and BMI versus control ( weight -@ vs. @ , p = @ ; waist circumference -@ vs. @ , p < @ ; BMI -@ vs. @ , p = @ ) .


There were no between group differences in fasting blood glucose , postprandial blood glucose , insulin resistance or any other factors related to diabetes risk or psychological well-being .


There were significant reductions in systolic and diastolic blood pressure , total cholesterol , anxiety , depression , negative affect and perceived stress in both the yoga intervention and walking control over the course of the study .


Among Indians with elevated fasting blood glucose , we found that participation in an @-week yoga intervention was feasible and resulted in greater weight loss and reduction in waist circumference when compared to a walking control .


Yoga offers a promising lifestyle intervention for decreasing weight-related type @ diabetes risk factors and potentially increasing psychological well-being .


To compare the effects of pelvic floor muscle training and watchful waiting on pelvic floor symptoms in a primary care population of women aged @ years and over with symptomatic mild pelvic organ prolapse .


Randomised controlled trial .


Dutch primary care .


Women aged @ years or over with symptomatic mild prolapse ( leading edge above the hymen ) were identified by screening .


Exclusion criteria were current prolapse treatment or treatment in the previous year , malignancy of pelvic organs , current treatment for another gynaecological disorder , severe/terminal illness , impaired mobility , cognitive impairment , and insufficient command of the Dutch language .


Pelvic floor muscle training versus watchful waiting .


The primary outcome was change in bladder , bowel , and pelvic floor symptoms measured with the Pelvic Floor Distress Inventory-@ ( PFDI-@ ) , three months after the start of treatment .


Secondary outcomes were changes in condition specific and general quality of life , sexual function , degree of prolapse , pelvic floor muscle function , and patients ' perceived change in symptoms .


Of the @ women who were randomised to pelvic floor muscle training ( n = @ ) or watchful waiting ( n = @ ) , @ ( @ % ) completed follow-up .


Participants in the intervention group improved by ( on average ) @ ( @ % confidence interval @ to @ ) points more on the PFDI-@ than did participants in the watchful waiting group ( P = @ ) .


Of women in the pelvic floor muscle training group , @ % ( @/@ ) reported an improvement in overall symptoms from the start of the study compared with @ % ( @/@ ) in the watchful waiting group ( P < @ ) .


Other secondary outcomes showed no significant difference between the groups .


Although pelvic floor muscle training led to a significantly greater improvement in PFDI-@ score , the difference between the groups was below the presumed level of clinical relevance ( @ points ) .


Nevertheless , @ % of the participants in the intervention group reported an improvement of overall symptoms .


More studies are needed to identify factors related to success of pelvic floor muscle training and to investigate long term effects.Trial registration Dutch Trial Register ( www.trialregister.nl ) identifier : NTR@ .


Two single-center , four-way , single-dose , crossover studies assessed the systemic exposure , systemic pharmacodynamics ( PD ) , and safety profile of the closed triple fluticasone furoate / umeclidinium/vilanterol ( FF/UMEC/VI ) therapy compared with dual therapies .


These are the first studies where pharmacokinetic ( PK ) profile assessment was possible for this inhaled triple fixed-dose combination product .


Healthy volunteers were randomized to receive @ consecutive inhalations ( each administered as a single dose ) via a single ELLIPT dry powder inhaler : in study @ ( CTT@/NCT@ ) , FF/UMEC/VI at total doses of @/@/@ g , FF/UMEC @/@ g , UMEC/VI @/@ g , or FF/VI @/@ g ; in study @ ( @/NCT@ ) , FF/UMEC/VI at total doses of @/@/@ g or @/@/@ g , FF/VI @/@ g , or UMEC/VI @/@ g. PK and PD parameters and safety were assessed .


Of @ subjects , @ % completed both studies and received all planned treatments .


Total systemic exposure was similar for FF , UMEC , and VI when administered as a triple therapy compared with FF/VI and UMEC/VI .


No clinically significant systemic PD findings were detected .


The incidence of adverse events was low and similar across treatment arms .


Systemic exposure to all three components of the closed triple therapy , following single-dose delivery , was similar to that seen with the dual therapies FF/VI and UMEC/VI .


The delivered lung dose and safety profile of all three agents , delivered via a single inhaler , are expected to be similar to those of the dual therapies .


The Coping with Persistent Pain , Effectiveness Research into Self-management ( COPERS ) trial assessed whether a group-based self-management course is effective in reducing pain-related disability in participants with chronic musculoskeletal pain .


This article describes the statistical analysis plan for the COPERS trial .


COPERS was a pragmatic , multicentre , unmasked , parallel group , randomised controlled trial .


This article describes ( a ) the overall analysis principles ( including which participants will be included in each analysis , how results will be presented , which covariates will be adjusted for , and how we will account for clustering in the intervention group ) ; ( b ) the primary and secondary outcomes , and how each outcome will be analysed ; ( c ) sensitivity analyses ; ( d ) subgroup analyses ; and ( e ) adherence-adjusted analyses .


Current maintenance therapies for asthma require twice-daily dosing .


Vilanterol ( VI ) is a novel long-acting beta@ agonist , under development in combination with fluticasone furoate , a new inhaled corticosteroid ( ICS ) .


Findings from a previous @-week study suggested that VI has inherent @-hour activity and is therefore suitable for once-daily dosing .


The study described here was a double-blind , double-dummy , randomised , placebo-controlled trial , the aim of which was to assess the efficacy of once-daily VI compared with placebo in patients with persistent asthma .


The primary endpoint was change from baseline in @-hour weighted mean forced expiratory volume in @second after @weeks of treatment vs. placebo .


An active control arm received salmeterol ( SAL ) twice daily .


All patients were maintained on a stable background dose of ICS .


Patients ( n = @ ) received VI , placebo or SAL ( @:@:@ ) .


For the primary endpoint , substantial improvements in lung function were seen with VI ( @ml ) , SAL ( @ml ) and placebo ( @ml ) .


There were no statistically significant treatment differences between either the VI ( @ml , P = @ ) or SAL ( -@ ml , P = @ ) groups and placebo .


Both active treatments were well tolerated , with similarly low rates of treatment-related adverse events compared with placebo .


No treatment-related serious adverse events occurred .


This study failed to show a treatment difference between VI and placebo for the primary endpoint , in the presence of a placebo response of unforeseen magnitude .


Because the placebo response was so large , it is not possible to draw meaningful conclusions from the data .


The reason for this magnitude of effect is unclear but it may reflect increased compliance with the anti-inflammatory therapy regimen during the treatment period .


The randomized , double-blinded , placebo-controlled study evaluated the administration of local infiltration of magnesium combined with ropivacaine to reduce pain scores after pediatric adenotonsillectomy .


Sixty one subjects received @ml solution contained @ % ropivacaine plus @mg/kg magnesium sulphate ( Group M+R ) , @ml @ % ropivacaine ( Group R ) or @ml solution contained @mg/kg magnesium sulphate ( Group M ) .


Pain scores in the ward and at home , analgesics received after operation and the adverse effects were recorded .


Compared with group M , patients in group M+R and group R had lower pain scores , less emergence agitation and increased time for first analgesic request .


Group M+R had no benefit in reducing pain scores after adenotonsillectomy compared with group R.


Pre-emptive peritonsillar infiltration of magnesium sulphate @mg/kg combined with @ % ropivacaine could n't improve analgesia for pediatric adenotonsillectomy compared with @ % ropivacaine alone .


However , Group M+R had less incidence of emergence agitation .


Compared with group M , both of group M+R and group R had better postoperative analgesia .


Dietary determinants of hepatic steatosis , an important precursor for nonalcoholic fatty liver disease , are undefined .


We explored the roles of sugar and fat intake as determinants of hepatic steatosis and visceral obesity in overweight adolescents at risk of type @ diabetes .


This was a cross-sectional study of dietary patterns and adipose tissue distribution in @ overweight adolescents ( aged : @ @ y ; body mass index z score : @ @ ) .


Main outcome measures were hepatic steatosis ( @ % fat : water ) measured by magnetic resonance spectroscopy and visceral obesity ( visceral-to-subcutaneous adipose tissue ratio @ ) measured by magnetic resonance imaging .


Main exposure variables were dietary intake and habits assessed by the Harvard Youth Adolescent Food Frequency Questionnaire .


Hepatic steatosis and visceral obesity were evident in @ % and @ % of the sample , respectively .


Fried food consumption was more common in adolescents with hepatic steatosis than in adolescents without hepatic steatosis ( @ % compared with @ % ; P = @ ) .


Total fat intake ( = @ , P = @ ) and the consumption of > @ % of daily energy intake from fat ( OR : @ ; @ % CI : @ , @ ; P = @ ) were both positively associated with hepatic steatosis .


Available carbohydrate ( = @ , P = @ ) and the frequent consumption of soda were positively associated with visceral obesity ( OR : @ ; @ % CI : @ , @ ; P = @ ) .


Daily fiber intake was associated with reduced odds of visceral obesity ( OR : @ ; @ % CI : @ , @ ; P = @ ) but not hepatic steatosis .


Hepatic steatosis is associated with a greater intake of fat and fried foods , whereas visceral obesity is associated with increased consumption of sugar and reduced consumption of fiber in overweight and obese adolescents at risk of type @ diabetes .


To determine whether additional supplementation of tryptophan ( Trp ) and tyrosine ( Tyr ) improve serotonin and dopamine metabolism in individuals with phenylketonuria treated with large neutral amino acid ( LNAA ) tablets .


Ten adult individuals with phenylketonuria participated in a randomized , double-blind , placebo-controlled cross-over study consisting of three @-week phases : washout , treatment with LNAA tablets plus supplementation with either Trp and Tyr tablets or placebo , and LNAA tablets plus the alternate supplementation .


An overnight protocol to measure blood melatonin , a serotonin metabolite in the pinealocytes , and urine @-sulfatoxymelatonin and dopamine in first-void urine specimens was conducted after each phase .


Serum melatonin and urine @-sulfatoxymelatonin and dopamine levels were increased in the LNAA phase ( LNAA plus placebo ) compared with the washout phase .


Serum melatonin and urine @-sulfatoxymelatonin were not increased in the active phase ( LNAA plus Trp + Tyr ) compared with the LNAA phase , although plasma Trp : LNAA was increased compared with the LNAA phase .


Among @ subjects with a plasma Trp/LNAA > @ , a negative correlation between urine @-sulfatoxymelatonin and plasma phenylalanine levels was observed ( r = -@ ) .


Urine dopamine levels and plasma Tyr : LNAA were increased in the active phase compared with the LNAA phase .


Melatonin levels were not increased with the higher dose of Trp supplementation , but dopamine levels were increased with the higher dose of Tyr supplementation .


Serotonin synthesis appears to be suppressed by high phenylalanine levels at the Trp hydroxylase level .


In HIV-@-infected women , CD@ count declines occur during pregnancy , which has been attributed to hemodilution .


However , for women who have not initiated antiretroviral therapy , it is unclear if CD@ declines are sustained beyond pregnancy and accompanied by increased viral levels , which could indicate an effect of pregnancy on accelerating HIV-@ disease progression .


In a prospective study among @ HIV-@-infected antiretroviral therapy-naive women from @ African countries , we examined the effect of pregnancy on HIV-@ disease progression .


We used linear mixed models to compare CD@ counts and plasma HIV-@ RNA concentrations between pregnant , postpartum , and nonpregnant periods .


Women contributed @ person-years of follow-up , during which time @ women became pregnant .


In adjusted analysis , CD@ counts were an average of @ ( @ % confidence interval : @ to @ ) cells/mm lower during pregnant compared with nonpregnant periods and @ ( @ % confidence interval : @ to @ ) cells/mm lower during pregnant compared with postpartum periods ; these results were consistent when restricted to the subgroup of women who became pregnant .


Plasma HIV-@ RNA concentrations were not different between pregnant and nonpregnant periods ( P = @ ) or pregnant and postpartum periods ( P = @ ) .


Neither CD@ counts nor plasma HIV-@ RNA levels were significantly different in postpartum compared with nonpregnant periods .


CD@ count declines among HIV-@-infected women during pregnancy are temporary and not sustained in postpartum periods .


Pregnancy does not have a short-term impact on plasma HIV-@ RNA concentrations .


To assess the efficacy of surgical decompression < @ ( early ) versus @-@ hours ( late ) in thoracic/thoracolumbar traumatic spinal cord injury ( TSCI ) .


A randomized controlled trial ( RCT ) of @ T@-L@ TSCI patients including early ( n = @ ) and late ( n = @ ) surgical decompression was conducted in the neurosurgery department of Shahid Rajaee Hospital from September @ .


Pre - and postoperative American Spinal Injury Association ( ASIA ) Impairment Scale ( AIS ) , ASIA motor/sensory scores , length of hospitalization , complications , postoperative vertebral height restoration/rebuilding and angle reduction , and @-month loss of height restoration/rebuilding and angle reduction were evaluated .


Sixteen patients ( @ % ) had complete TSCI .


No AIS change was seen in @ ( @ % ) patients .


Complete TSCI patients had no motor improvement .


The AIS change in this group was solely due to increased sensory scores .


For incomplete TSCI , the mean motor score improved from @ ( @ ) to @ ( @ ) in early , and from @ ( @ ) to @ ( @ ) in late surgery .


One deep vein thrombosis was observed in each group .


There were @ wound infections , one CSF leak , one case of meningitis , and one decubitus ulcer in the late surgery group .


Six screw revisions were required .


Our primary results show overall AIS and motor score improvement in both groups .


Motor improvement was only observed in incomplete TSCI .


Two-grade improvements in AIS were seen in @ early , and one late surgery patient .


To compare visual outcomes and spectral-domain optical coherence tomography results following treatment with intravitreal ranibizumab ( IVR ) or IVR combined with intravitreal triamcinolone acetonide ( IVTA ) for macular edema ( ME ) secondary to central retinal vein occlusion ( CRVO ) .


This prospective , case-controlled study examined @ eyes ( @ patients ) with ME secondary to CRVO , which were treated with IVR ( @ mg , n = @ eyes ) or IVR ( @ mg ) and IVTA ( @mg , n = @eyes ) as the initial therapy .


Further intravitreal treatment was administered as necessary .


All @ patients completed at least @ months of follow-up .


At baseline , mean ( standard error ) best-corrected visual acuity ( BCVA ) was @ letters in the IVR group and @ letters in the IVR+IVTA group ( p = @ ) .


Significant improvement in BCVA over baseline was observed in both groups at all six study visits ( IVR group : p = @ , @ , @ , @ , @ , @ ; IVR+IVTA group : p = @ , @ , @ , @ , @ , @ ) , with no significant BCVA differences between groups .


Significant reduction in mean central subfield thickness , compared with baseline , was also observed in both groups at all six study visits ( IVR group , p = @ ; IVR+IVTA group , p = @ ) , with no significant difference between groups in the magnitude of macular thickness reduction .


The mean number of injections was significantly higher ( p = @ ) in the IVR group ( @ ) than in the IVR+IVTA group ( @ ) .


Treating ME secondary to CRVO with IVR or IVR+IVTA had similar effects on central macular thickness and BCVA in patients with ME secondary to CRVO over a @-month follow-up period .


The mean number of intravitreal injections was higher in the IVR group than in the IVR+IVTA group .


To evaluate the effect of Zhenggan Tang decoction on serum levels of leptin , adiponectin and insulin resistance on liver cirrhosis induced by chronic hepatitis B.


Sixty-six patients were recruited and randomly assigned either to a control group or to an intervention group , with @ cases in the treatment and @ in the control group respectively .


Patients in the control group received inosine tablets and vitamin C treatment while patients in the treatment group were given Zhenggan Tang decoction additionally .


After @ months of treatment , the serum levels of leptin and adiponectin were detected and the index of insulin resistance calculated .


There were no significant difference between the serum levels of leptin , adiponectin and the index of insulin resistance seen in the control group before and after the treatment .


Serum levels of leptin and adiponectin and the index of insulin resistance in treatment group were reduced significantly after the treatment ( P < @ ) .


There were significant difference in the serum levels of leptin and adiponectin between treat group and control group ( P < @ ) .


Zhenggan Tang decoction seemed to have reduced the serum levels of leptin , adiponectin and the index of insulin resistance among cirrhotic patients that induced by chronic hepatitis B.


Evidence from the literature suggests diminished acetylsalicylic acid ( ASA ) treatment efficacy in type @ diabetes ( DM@ ) .


High on-aspirin platelet reactivity ( HAPR ) in DM@ has been linked to poor glycemic and lipid control .


However , there are no consistent data on the association between HAPR and insulin resistance or adipose tissue metabolic activity .


The aim of this study was to assess the relationship between laboratory response to ASA and metabolic control , insulin resistance and adipokines in DM@ .


A total of @ DM@ patients treated with oral antidiabetic drugs and receiving @ mg ASA daily were included in the analysis .


Response to ASA was assessed by measuring serum thromboxane B@ ( TXB@ ) concentration and expressed as quartiles of TXB@ level .


The achievement of treatment targets in terms of glycemic and lipid control , insulin resistance parameters ( including Homeostatic Model Assessment-Insulin Resistance , HOMA-IR , index ) , and serum concentrations of high-molecular weight ( HMW ) adiponectin , leptin and resistin , were evaluated in all patients .


Univariate and multivariate logistic regression analyses were performed to determine the predictive factors of serum TXB@ concentration above the upper quartile and above the median .


Significant trends in age , body mass index ( BMI ) , HOMA-IR , HMW adiponectin concentration , C-reactive protein concentration and the frequency of achieving target triglyceride levels were observed across increasing quartiles of TXB@ .


In a multivariate analysis , only younger age and higher BMI were independent predictors of TXB@ concentration above the upper quartile , while younger age and lower HMW adiponectin concentration were predictors of TXB@ concentration above the median .


These results suggest that in DM@ , the most important predictor of HAPR is younger age .


Younger DM@ patients may therefore require total daily ASA doses higher than @ mg , preferably as a twice-daily regimen , to achieve full therapeutic effect .


Higher BMI and lower HMW adiponectin concentration were also associated with less potent ASA effect .


This is the first study to demonstrate an association of lower adiponectin concentration with higher serum TXB@ level in patients treated with ASA .


The effects of escitalopram ( @mg/d ) coadministration on plasma concentrations of aripiprazole and its active metabolite , dehydroaripiprazole , were studied in @ Japanese psychiatric patients and compared with those of paroxetine ( @mg/d ) coadministration .


The patients had received @-@mg / d of aripiprazole for at least @ weeks .


Patients were randomly allocated to one of @ treatment sequences : paroxetine-escitalopram ( n = @ ) or escitalopram-paroxetine ( n = @ ) .


Each sequence consisted of two @-week phases .


Plasma concentrations of aripiprazole and dehydroaripiprazole were measured using liquid chromatography with mass spectrometric detection .


Plasma concentrations of aripiprazole and the sum of aripiprazole and dehydroaripiprazole during paroxetine coadministration were @-fold ( @ % confidence intervals -LSB- CI -RSB- , @-@ @ , p < @ ) and @-fold ( @ % CI @-@ @ , p < @ ) higher than those values before the coadministration .


These values were not influenced by escitalopram coadministration ( @-fold , @ % CI @-@ @ and @-fold , @ % CI @-@ @ ) .


Plasma dehydroaripiprazole concentrations remained constant during the study .


The present study suggests that low doses of escitalopram can be safely coadministered with aripiprazole , at least from a pharmacokinetic point of view .