In addition to the economic benefits of microfinance , there is evidence to suggest that it is an effective vehicle for improving health .


The parent study is a community-based trial to evaluate the effectiveness of a livestock microfinance intervention , Pigs for Peace ( PFP ) , on health and economic outcomes with households in @ villages in eastern Democratic Republic of Congo .


The analysis for this manuscript includes only baseline data from female participants enrolled in the ongoing parent study .


Multiple regression analysis was used to examine if livestock/animal asset value moderates the relationship between conflict-related traumatic events and current mental health symptoms .


The majority of women are @ years or older , married , have on average @ children in the home and have never attended school .


Nearly @ % of women report having at least one livestock/animal asset at baseline .


Over the past @ years , women report on average more than @ ( M = @ , SD @ ) traumatic events ( range @-@ ) .


Women reported symptoms consistent with PTSD with a mean score of @ ( SD = @ range @-@ ) and depression with a mean score of @ ( SD = @ , range @-@ @ ) .


The livestock/animal asset value by conflict-related traumatic events interaction was significant for both the PTSD ( p = @ ) and depression ( p = @ ) symptom models .


The study provides evidence of the moderating affect of livestock/animal assets on mental health symptoms for women who have experienced conflict .


The findings supports evidence about the importance of livestock/animal assets to economics in rural households but expands on previous research by demonstrating the psychosocial effects of these assets on women 's health .


Perioperative anxiety is a common and undesirable outcome in pediatric surgical patients .


The use of interactive tools to minimize perioperative anxiety is vastly understudied .


The main objective of the current investigation was to compare the effects of a tablet-based interactive distraction ( TBID ) tool to oral midazolam on perioperative anxiety .


We hypothesized that the TBID tool was not inferior to midazolam to reduce perioperative anxiety .


@ children , ages @-@ years , presenting for outpatient surgical procedures were prospectively randomized to oral midazolam ( @ mgkg ( -@ ) ; @ mg max ) or TBID .


The primary outcome was the change in anxiety level from baseline to parental separation and anesthetic induction .


Other data collected included emergence delirium , parental satisfaction , time-to-PACU discharge , and posthospitalization behavior .


The mean difference ( @ % CI ) in the increase of anxiety at parental separation between the TBID and the midazolam group was -@ ( -@ to -@ ) , P = @ , demonstrating superiority to midazolam group ( one-sided P = @ ) .


For children @-@ years , the mean difference ( @ % CI ) in anxiety at induction was significant between the TBID and midazolam groups , -@ ( -@ to -@ ) , P < @ .


The median ( IQR ) time-to-PACU discharge was @ ( @-@ ) min in the midazolam group and @ ( @-@ ) min in the TBID group , P = @ .


Decreased emergence delirium and increased parental satisfaction were also observed in the TBID group .


A TBID tool reduces perioperative anxiety , emergence delirium , and time-to-discharge and increases parental satisfaction when compared to midazolam in pediatric patients undergoing ambulatory surgery .


Many patients with coronary artery disease who are not candidates for revascularization have refractory angina despite standard medical therapy .


The balloon-expandable , stainless steel , hourglass-shaped , coronary-sinus reducing device creates a focal narrowing and increases pressure in the coronary sinus , thus redistributing blood into ischemic myocardium .


We randomly assigned @ patients with Canadian Cardiovascular Society ( CCS ) class III or IV angina ( on a scale from I to IV , with higher classes indicating greater limitations on physical activity owing to angina ) and myocardial ischemia , who were not candidates for revascularization , to implantation of the device ( treatment group ) or to a sham procedure ( control group ) .


The primary end point was the proportion of patients with an improvement of at least two CCS angina classes at @ months .


A total of @ % of the patients in the treatment group ( @ of @ patients ) , as compared with @ % of those in the control group ( @ of @ ) , had an improvement of at least two CCS angina classes at @ months ( P = @ ) .


The device was also associated with improvement of at least one CCS angina class in @ % of the patients in the treatment group ( @ of @ patients ) , as compared with @ % of those in the control group ( @ of @ ) ( P = @ ) .


Quality of life as assessed with the use of the Seattle Angina Questionnaire was significantly improved in the treatment group , as compared with the control group ( improvement on a @-point scale , @ vs. @ points ; P = @ ) .


There were no significant between-group differences in improvement in exercise time or in the mean change in the wall-motion index as assessed by means of dobutamine echocardiography .


At @ months , @ patient in the treatment group had had a myocardial infarction ; in the control group , @ patient had died and @ had had a myocardial infarction .


In this small clinical trial , implantation of the coronary-sinus reducing device was associated with significant improvement in symptoms and quality of life in patients with refractory angina who were not candidates for revascularization .


( Funded by Neovasc ; COSIRA ClinicalTrials.gov number , NCT@ . )


Observational reports have linked vitamin D with chronic urticaria , yet no randomized controlled trial has been conducted .


To determine whether high-dose vitamin D supplementation would decrease Urticaria Symptom Severity ( USS ) scores and medication burden in patients with chronic urticaria .


In a prospective , double-blinded , single-center study , @ subjects with chronic urticaria were randomized to high ( @,@ IU/d ) or low ( @ IU/d ) vitamin D@ supplementation for @ weeks .


All subjects were provided with a standardized triple-drug therapy ( cetirizine , ranitidine , and montelukast ) and a written action plan .


Data on USS scores , medication use , blood for @-hydroxyvitamin D , and safety measurements were collected .


Triple-drug therapy decreased total USS scores by @ % in the first week .


There was a further significant decrease ( @ % ) in total USS scores in the high , but not low , vitamin D@ treatment group by week @ .


Compared with low treatment , the high treatment group demonstrated a trend ( P = @ ) toward lower total USS scores at week @ , which was driven by significant decreases in body distribution and number of days with hives .


Beneficial trends for sleep quality and pruritus scores were observed with high vitamin D@ .


Serum @-hydroxyvitamin D levels increased with high vitamin D@ supplementation , but there was no correlation between @-hydroxyvitamin D levels and USS scores .


There was no difference in allergy medication use between groups .


No adverse events occurred .


Add-on therapy with high-dose vitamin D@ ( @,@ IU/d ) could be considered a safe and potentially beneficial immunomodulator in patients with chronic urticaria .


This study aimed to observe the preventive potential of different hydration solutions on contrast-induced nephropathy ( CIN ) after percutaneous coronary intervention .


We initially screened @ patients who were admitted to the Division of Cardiology , Beijing Anzhen Hospital between October @ and October @ .


The research subjects were randomly divided into four groups and were given : normal physiological saline ( PS ) , sodium bicarbonate ( SB ) , oral administration of PS + N-acetylcysteine ( NAC ) ( PS + NAC ) , or oral administration of SB + NAC ( SB + NAC ) .


These patients were administered a hypotonic nonionic contrast agent , and the incidence of CIN in each group was observed .


The total incidence rate of CIN was @ % , while the CIN incidence rates in the PS group , the SB group , the PS + NAC group and the SB + NAC group were @ , @ , @ and @ % , respectively .


The differences between these groups were not statistically significant ( P = @ ) , and for patients with diabetes and/or renal dysfunction , the incidence rates of CIN among the four groups did not show statistically significant differences ( P = @ , @ , @ ) .


Use of PS , SB , and NAC caused no significant reduction in the incidence of CIN , but in high-risk patients with diabetes and/or renal dysfunction , SB + NAC might be superior to the application of isotonic crystalloid solution .


Group treatment is delivered in youth correctional facilities , yet groups may be iatrogenic .


Few measures with demonstrated psychometric properties exist to track behaviors of individuals during groups .


The authors assessed psychometrics for the Group Process-Individual Level measure ( GP-IL ) of group treatment .


N = @ teens were randomized to @ of @ groups ( @ sessions each ) .


Adolescents , counselors , and observers rated teen behaviors at sessions @ and @ .


GP-IL assesses reinforcement for deviancy and positive behaviors , member rejection , and counselor connection and praise .


Internal consistency and @-month stability were demonstrated .


Concurrent validity is supported by correlations with measures expected to be associated with group behavior ( e.g. , coping skills ) .


Counselors and observers rated more deviancy during interactive skills-building groups versus didactic psychoeducational groups ( P @ ) .


Scales evidenced incremental validity .


GP-IL offers a sound method of tracking adolescent behaviors for professionals working with groups .


Counselors ratings were most reliable and valid overall .


A-type and B-type natriuretic peptides are established markers in chronic heart failure ( HF ) .


C-type natriuretic peptide ( CNP ) belongs to the same peptide family , but is predominantly localized in the endothelium .


The prognostic role of CNP in heart failure has not been established .


The aim of the study was to determine the prognostic power and clinical correlates of the N-terminal part of pro CNP ( NT-proCNP ) in patients with chronic HF .


In @ hospitalized heart failure patients , NT-proCNP levels were measured at hospital discharge .


The primary endpoint was a combined endpoint of all-cause mortality and HF hospitalization after @ months .


Heart failure with a preserved ejection fraction ( HFpEF ) was pre-defined as an LVEF > @ % .


Mean ( SD ) age was @ @ years , @ % were male , mean LVEF was @ @ % , and @ % had HFpEF .


In multivariate linear regression , NT-proCNP levels showed a positive correlation with NT-proBNP levels and parameters of renal function , whereas a negative correlation with female sex and vascular endothelial growth factor was observed .


After @ months follow-up , @ patients reached the combined endpoint .


We observed interaction between NT-proCNP and LVEF for outcome ( P = @ ) .


Multivariate analyses revealed NT-proCNP to be strongly predictive for the primary endpoint -LSB- hazard ratio ( HR ) @ , @ % confidence interval ( CI ) @-@ @ , P = @ ) in patients with HFpEF , but not in patients with a reduced ejection fraction ( HFrEF ) ( HR @ , @ % CI @-@ @ , P = @ ) .


Finally , reclassification showed significant additive value in patients with HFpEF ( P < @ ) , but not in those with HFrEF ( P = @ ) .


NT-proCNP is a strong independent marker for outcome in patients with HFpEF , but not in those with HFrEF .


Thousands of children are living with advanced cancer ; yet patient-reported outcomes ( PROs ) have rarely been used to describe their experiences .


We aimed to describe symptom distress in @ children age @ years or older with advanced cancer enrolled onto the Pediatric Quality of Life and Evaluation of Symptoms Technology ( PediQUEST ) Study ( multisite clinical trial evaluating an electronic PRO system ) .


Symptom data were collected using age - and respondent-adapted versions of the PediQUEST Memorial Symptom Assessment Scale ( PQ-MSAS ) at most once per week .


Clinical and treatment data were obtained from medical records .


Individual symptom scores were dichotomized into high/low distress .


Determinants of PQ-MSAS scores were explored using linear mixed-effects models .


During @ months of follow-up , PQ-MSAS was administered @ times : @ times in teens ( @ % self-report ) , @ times in children ages @ to @ years ( @ % child/parent report ) , and @ times in those ages @ to @ years ( parent reports ) .


Common symptoms included pain ( @ % ) , fatigue ( @ % ) , drowsiness ( @ % ) , and irritability ( @ % ) ; most scores indicated high distress .


Among the @ PQ-MSAS surveys administered in the last @ weeks of life , pain was highly prevalent ( @ % ; @ % with high distress ) .


Being female , having a brain tumor , experiencing recent disease progression , and receiving moderate - or high-intensity cancer-directed therapy in the prior @ days were associated with worse PQ-MSAS scores .


In the final @ weeks of life , receiving mild cancer-directed therapy was associated with improved psychological PQ-MSAS scores .


Children with advanced cancer experience high symptom distress .


Strategies to promote intensive symptom management are indicated , especially with disease progression or administration of intensive treatments .


To compare the tunnel enlargement of double-bundle ( DB ) anterior cruciate ligament reconstruction ( ACLR ) with and without suturing of autologous ruptured tissue to hamstring graft in patients with subacute anterior cruciate ligament injury .


Ten patients with subacute ( @ months after injury ) anterior cruciate ligament rupture were randomly allocated to undergo DB ACLR with suturing of the ruptured tissue to hamstring graft ( n = @ ) or conventional DB ACLR ( n = @ ) .


When autologous ruptured tissue was used , remnant ruptured tissue was then harvested , divided into @ pieces , placed between the loops at the distal and proximal portions of the graft , and secured with the suture .


As the primary endpoint , tunnel volume assessment by @-dimensional multi-detector row computed tomography ( MDCT ) was performed @ year after ACLR .


To assessthe efficacy of these procedures , the Lysholm score , anterior tibial translation ( measured with a KT-@ arthrometer -LSB- MEDmetric , San Diego , CA -RSB- ) , and rotational instability ( measured by the pivot-shift test ) were evaluated after @ years .


Tunnel volume enlargement between @ weeks and @ year after ACLR as assessed by @-dimensional MDCT was significantly less for ACLR using ruptured tissue than for conventional ACLR , especially at the femoral site ( P < @ ) .


However , the postoperative Lysholm score , anterior stability of the knee measured with the KT-@ arthrometer , and rate of negative manual pivot-shift test results did not differsignificantly between the @ groups .


There was no correlation to the clinical outcomes in terms of tunnel size .


The Lysholm score , anterior laxity measured with the KT-@ arthrometer , and rotational instability according to the pivot-shift test did not differ significantly between ACLR using ruptured tissue and the conventional technique .


However , ACLR using ruptured tissue produced less femoral tunnel enlargement as assessed by MDCT , warranting further long-term follow-up to elucidate its effectiveness .


Level II , prospective comparative study .


Epidemiologic studies have linked high consumption of red and processed meat with risk of developing type @ diabetes , whereas high dairy consumption has been associated with decreased risk , but interventions have been limited .


We compared the effects on insulin sensitivity of consuming a diet high in lean red meat with minimal dairy , a diet high in primarily low-fat dairy ( from milk , yogurt , or custard ) with no red meat , and a control diet that contained neither red meat nor dairy .


A randomized crossover study was undertaken with @ overweight and obese men and women divided into @ groups as follows : those with normal glucose tolerance and those with impaired fasting glucose or impaired glucose tolerance .


Participants followed the @ weight-stable dietary interventions for @ wk with glucose , insulin , and C-peptide measured by using oral-glucose-tolerance tests at the end of each diet .


Fasting insulin was significantly higher after the dairy diet than after the red meat diet ( P < @ ) with no change in fasting glucose resulting in a decrease in insulin sensitivity after the high-dairy diet ( P < @ ) as assessed by homeostasis model assessment of insulin resistance ( HOMA-IR ) .


A significant interaction between diet and sex was observed such that , in women alone , HOMA-IR was significantly lower after the red meat diet than after the dairy diet ( @ @ compared with @ @ , respectively ; P < @ ) .


Insulin sensitivity calculated by using the Matsuda method was @ % lower in women after the dairy diet than after the red meat diet ( P < @ ) with no difference between diets in men .


C-peptide was not different between diets .


In contrast to some epidemiologic findings , these results suggest that high consumption of dairy reduces insulin sensitivity compared with a diet high in lean red meat in overweight and obese subjects , some of whom had glucose intolerance .


This trial was registered at the Australian New Zealand Clinical Trials Registry as ACTRN@ .


The short latency stretch reflex ( SLR ) is well described , but the stimulus that evokes the SLR remains elusive .


One hypothesis states that reflex size is proportional to muscle fiber stretch , so in this study we examined the relationship between these @ parameters in human triceps surae muscles .


Achilles tendon taps and dorsiflexion stretches with different amplitudes and preactivation torques were applied to @ participants while electromyography and muscle fascicle length changes were recorded in soleus and medial gastrocnemius ( MG ) .


In response to tendon taps , neither fascicle length nor velocity changes were correlated with SLR size in either muscle , but accelerometer peaks were observed immediately after hammer-tendon contact .


Similar results were obtained after dorsiflexion stretches .


Muscle fascicle stretch is poorly correlated with SLR size , regardless of perturbation parameters .


We attribute the SLR trigger to the transmission of vibration through the lower limb , rather than muscle fiber stretch .


Ingestion of long-chain n-@ PUFA effectively decreases serum triacylglycerol ( TAG ) levels and increases the Omega-@ Index , defined as the % of EPA and DHA in erythrocyte fatty acids .


However , it remains unclear whether there is a relationship between the Omega-@ Index increase ( O@I increase ) and the TAG level decrease ( TAG ) .


We hypothesized that TAG reduction is strongly depended on Omega-@ Index increase .


Secondary analyses of data from a former double-blind placebo-controlled trial in which @ dyslipidemic statin-treated subjects were randomized to four capsules of fish oil daily either as re-esterified TAG or ethyl esters in identical doses ( @ g EPA +@ g DHA ) or corn oil as a placebo for a period of six month .


@ subjects fulfilled the criteria of the current study protocol and were included in the analyses .


A weak but significant negative correlation between O@I and TAG was observed ( r = -@ , p < @ ) .


However , the relation between O@I and serum TAG was not linear ( coefficients of determination R ( @ ) : @ ) .


After sub-grouping the study population into Omega-@ Index response groups , the group with a mean O@I of > @ % after six months of n-@ PUFA treatment demonstrated the greatest TAG reduction .


A weak association between Omega-@ Index increase and TAG level decrease was found .


This may be explained by highly fluctuating TAG levels , a large inter-individual difference in response of the Omega-@ Index , a cohort of subjects with only slightly elevated TAG levels and high Omega-@ Index values at baseline , and possibly to insufficient statistical power .


Since there was no strong association between Omega-@ Index increase and the TAG level decrease , we conclude that changes in serum TAG levels are not a viable substitute for the Omega-@ Index to monitor treatment with EPA and DHA .


Noninvasive ventilation has been recommended to decrease mortality among immunocompromised patients with hypoxemic acute respiratory failure .


However , its effectiveness for this indication remains unclear .


To determine whether early noninvasive ventilation improved survival in immunocompromised patients with nonhypercapnic acute hypoxemic respiratory failure .


Multicenter randomized trial conducted among @ critically ill immunocompromised patients , of whom @ ( @ % ) were receiving treatment for hematologic malignancies or solid tumors , at @ intensive care units ( ICUs ) in France and Belgium between August @ , @ , and January @ , @ .


Patients were randomly assigned to early noninvasive ventilation ( n = @ ) or oxygen therapy alone ( n = @ ) .


The primary outcome was day-@ mortality .


Secondary outcomes were intubation , Sequential Organ Failure Assessment score on day @ , ICU-acquired infections , duration of mechanical ventilation , and ICU length of stay .


At randomization , median oxygen flow was @ L/min ( interquartile range , @-@ ) in the noninvasive ventilation group and @ L/min ( interquartile range , @-@ ) in the oxygen group .


All patients in the noninvasive ventilation group received the first noninvasive ventilation session immediately after randomization .


On day @ after randomization , @ deaths ( @ % ) had occurred in the noninvasive ventilation group vs @ ( @ % ) in the oxygen group ( absolute difference , -@ -LSB- @ % CI , -@ to @ -RSB- ; P = @ ) .


Oxygenation failure occurred in @ patients overall ( @ % ) , @ ( @ % ) in the noninvasive ventilation group and @ ( @ % ) in the oxygen group ( absolute difference , -@ -LSB- @ % CI , -@ to @ -RSB- ; P = @ ) .


There were no significant differences in ICU-acquired infections , duration of mechanical ventilation , or lengths of ICU or hospital stays .


Among immunocompromised patients admitted to the ICU with hypoxemic acute respiratory failure , early noninvasive ventilation compared with oxygen therapy alone did not reduce @-day mortality .


However , study power was limited .


Whether the commonly used bacillus Calmette-Gurin ( BCG ) strains Connaught and Tice confer different treatment responses in non-muscle-invasive bladder cancer ( NMIBC ) is unknown .


To compare clinical efficacy , immunogenicity , and genetics of BCG Connaught and Tice .


A prospective randomized single-institution trial with treatment of @ high-risk NMIBC patients with BCG Connaught or Tice .


Patients were randomized to receive six instillations of BCG Connaught or Tice .


For experimental studies , BCG strains were compared in C@Bl/@ mice .


Bladders and lymphoid tissues were analyzed by cytometry and the latter cultivated to detect live BCG .


BCG genomic DNA was sequenced and compared with reference genomes .


Recurrence-free survival was the primary end point of the clinical study .


The Kaplan-Meier estimator was used for estimating survival and time-to-event end points .


Nonparametric tests served for the analysis of the in vivo results .


Treatment with BCG Connaught conferred significantly greater @-yr recurrence-free survival compared with treatment with BCG Tice ( p = @ ) .


Comparable numbers of patients experienced BCG therapy-related side effects in each treatment group ( p = @ ) .


In mice , BCG Connaught induced stronger T-helper cell @-biased responses , greater priming of BCG-specific CD@ ( + ) T cells , and more robust T-cell recruitment to the bladder than BCG Tice .


Genome sequencing of the BCG strains revealed candidate genes potentially involved in the differential clinical responses .


BCG strain may have an impact on treatment outcome in NMIBC immunotherapy .


We compared the efficacy of two commonly used bacillus Calmette-Gurin ( BCG ) strains for the treatment of NMIBC and found that treatment with BCG Connaught prevented recurrences more efficiently than BCG Tice .


Comparison of the immunogenicity of the two strains in mice indicated superior immunogenicity of BCG Connaught .


We also identified genetic differences that may explain the differential efficacy of the Connaught and Tice BCG strains .


Early clinical trials conducted primarily in Japan have shown that TAS-@ , an oral agent that combines trifluridine and tipiracil hydrochloride , was effective in the treatment of refractory colorectal cancer .


We conducted a phase @ trial to further assess the efficacy and safety of TAS-@ in a global population of such patients .


In this double-blind study , we randomly assigned @ patients , in a @:@ ratio , to receive TAS-@ or placebo .


The primary end point was overall survival .


The median overall survival improved from @ months with placebo to @ months with TAS-@ , and the hazard ratio for death in the TAS-@ group versus the placebo group was @ ( @ % confidence interval -LSB- CI -RSB- , @ to @ ; P < @ ) .


The most frequently observed clinically significant adverse events associated with TAS-@ were neutropenia , which occurred in @ % of those treated , and leukopenia , which occurred in @ % ; @ % of the patients who received TAS-@ had febrile neutropenia , and one death related to TAS-@ was reported .


The median time to worsening performance status ( a change in Eastern Cooperative Oncology Group performance status -LSB- on a scale of @ to @ , with @ indicating no symptoms and higher numbers indicating increasing degrees of disability -RSB- from @ or @ to @ or more ) was @ months with TAS-@ versus @ months with placebo ( hazard ratio , @ ; @ % CI , @ to @ ; P < @ ) .


In patients with refractory colorectal cancer , TAS-@ , as compared with placebo , was associated with a significant improvement in overall survival .


( Funded by Taiho Oncology-Taiho Pharmaceutical ; RECOURSE ClinicalTrials.gov number , NCT@ . )


To assess whether standardised packs of the form introduced in Australia are associated with a reduction in acute craving and/or an increase in motivation to stop , and to replicate previous findings on perceptions of packaging , perceptions of smokers using it and perceived effects on behaviour .


Following abstinence of at least @ h , @ regular and occasional smokers were randomised to exposure to their own cigarette package , another branded package or a standardised package .


Craving ( QSU-brief ) , motivation to stop , both at baseline and post-exposure .


Ratings of @ attributes concerning package design , perceived smoker characteristics and effects on behaviour , post-exposure only .


For craving , a mixed model ANCOVA showed a significant interaction of packaging and time of measurement ( F ( @,@ ) = @ , p < @ , partial ( @ ) = @ ) .


There was no significant main effect or interaction for motivation to stop smoking ( p = @ ) .


The standardised pack was perceived to be significantly less appealing and less motivating to buy cigarettes , smokers using them were perceived as less popular and cigarettes from them expected to taste worse .


Standardised cigarette packaging may reduce acute ( hedonic ) craving and is associated with more negative perceptions than branded packaging with less prominent health warnings .


Unguided nasojejunal feeding tube insertion success rates are low .


Controversy persists about how to safely and efficiently perform enteral nutrition ( EN ) in critically ill patients .


This study explores an innovative blind nasointestinal tube ( NIT ) insertion method and compares nasogastric and nasointestinal feeding .


Seventy critically ill patients admitted to the intensive care unit ( ICU ) were divided randomly into a nasogastric tube group ( NGT ; n = @ ) and an NIT group ( NIT ; n = @ ) .


After bedside NGT and blind-type NIT insertion , tube position was assessed and EN was started on day @ .


Patients ' nutritional status parameters , mechanical ventilation duration , average ICU stay , nutritional support costs , and feeding complications were compared .


Pre-albumin and transferrin levels on days @ and @ were significantly higher in the NIT group than in the NGT group ( p < @ , p < @ ) .


Bloating , diarrhea , upper gastrointestinal bleeding , and liver damage did not differ significantly between groups ( p > @ ) .


Interleukin-@ and tumor necrosis factor - levels and APACHE II score were significantly lower in the NIT group than in the NGT group ( p < @ , p < @ ) .


Reflux and pneumonia incidences , mechanical ventilation duration , average ICU stay length , and nutritional support costs were significantly lower in the NIT group than in the NGT group ( p < @ ) .


Blind bedside NIT insertion is convenient and its use can effectively improve nutritional status , reduce feeding complications , and decrease nutritional support costs of critically ill patients .


The common cold and other viral airway infections are highly prevalent in the population , and their treatment often requires the use of medications for symptomatic relief .


Paracetamol is as an analgesic and antipyretic ; chlorphenamine is an antihistamine ; and phenylephrine , a vasoconstrictor and decongestant .


This randomized , double-blind , placebo-controlled trial sought to evaluate the efficacy and safety of a fixed-dose combination of paracetamol , chlorphenamine and phenylephrine in the symptomatic treatment of the common cold and flu-like syndrome in adults .


This study enrolled @ individuals aged @ to @years who had moderate to severe flu-like syndrome or common cold .


After clinical examination and laboratory tests , individuals were randomly assigned to receive the fixed-dose combination ( @ ) or placebo ( @ ) , five capsules per day for @ to @hours .


The primary efficacy endpoint was the sum of the scores of @ symptoms on a four-point Likert-type scale .


To evaluate treatment safety , the occurrence of adverse events was also measured .


Mean age was @ ( @ ) years in the placebo group and @ ( @ ) in the treatment group .


There were @ women and @ men in the placebo group , and @ women and @ men in the treatment group .


Comparison of overall symptom scores in the two groups revealed a significantly greater reduction in the treatment group than in the placebo group ( p = @ ) .


Analysis at the first @ dose intervals ( @h of treatment ) showed a greater reduction of symptom scores in the treatment group than in the placebo group ( p < @ ) .


The number and distribution of adverse events were similar in both groups .


A fixed-dose combination of paracetamol , chlorphenamine and phenylephrine was safe and more effective than placebo in the symptomatic treatment of the common cold or flu-like syndrome in adults .


Some evidence suggests that proton pump inhibitors ( PPIs ) are an under-appreciated risk factor for hypomagnesemia .


Whether hospitalization with hypomagnesemia is associated with use of PPIs is unknown .


We conducted a population-based case-control study of multiple health care databases in Ontario , Canada , from April @ to March @ .


Patients who were enrolled as cases were Ontarians aged @ years or older hospitalized with hypomagnesemia .


For each individual enrolled as a case , we identified up to four individuals as controls matched on age , sex , kidney disease , and use of various diuretic classes .


Exposure to PPIs was categorized according to the most proximate prescription prior to the index date as current ( within @ days ) , recent ( within @ to @ days ) , or remote ( within @ to @ days ) .


We used conditional logistic regression to estimate the odds ratio for the association of outpatient PPI use and hospitalization with hypomagnesemia .


To test the specificity of our findings we examined use of histamine H@ receptor antagonists , drugs with no causal link to hypomagnesemia .


We studied @ patients hospitalized with hypomagnesemia and @,@ matched controls .


Current PPI use was associated with a @ % increased risk of hypomagnesemia ( adjusted odds ratio , @ ; @ % CI @-@ @ ) .


In a stratified analysis , the risk was particularly increased among patients receiving diuretics , ( adjusted odds ratio , @ ; @ % CI @-@ @ ) and not significant among patients not receiving diuretics ( adjusted odds ratio , @ ; @ % CI @-@ @ ) .


We estimate that one excess hospitalization with hypomagnesemia will occur among @,@ outpatients treated with a PPI for @ days .


Hospitalization with hypomagnesemia was not associated with the use of histamine H@ receptor antagonists ( adjusted odds ratio @ ; @ % CI @-@ @ ) .


Limitations of this study include a lack of access to serum magnesium levels , uncertainty regarding diagnostic coding of hypomagnesemia , and generalizability of our findings to younger patients .


PPIs are associated with a small increased risk of hospitalization with hypomagnesemia among patients also receiving diuretics .


Physicians should be aware of this association , particularly for patients with hypomagnesemia .


Please see later in the article for the Editors ' Summary .


Delayed-onset muscle soreness ( DOMS ) often occurs after unaccustomed eccentric exercise and reduces exercise performance .


We aimed to study the preventive effects of saffron and indomethacin on the biochemical and functional indicators of DOMS after @-session eccentric exercise .


A @-day , randomized , double-blind , placebo-controlled , pretest-posttest design .


Controlled research laboratory .


Thirty-nine nonactive male university students randomly divided into saffron ( n = @ ) , indomethacin ( n = @ ) , and control ( n = @ ) groups .


Saffron group received @ capsule containing dried saffron powder ( n = @ , @ mg/d ) , indomethacin group received @ mg indomethacin ( n = @ , @ mg thrice a day ) , and control group ( n = @ ) received placebo capsules , @ week before and @ days after eccentric exercise .


Ten days before and @ , @ , and @ hours after muscle soreness protocol , the maximum isometric and isotonic forces , plasma creatine kinase ( CK ) , plasma lactate dehydrogenase ( LDH ) , perceived pain , knee range of movement , and thigh circumference were measured .


Muscle soreness protocol was performed with a weight load equal to @ % of the maximum isotonic force in @ sessions with @ repetitions and @-minute rest in between .


This study shows that @-day supplementation with @ mg saffron significantly decreased the CK and LDH concentrations ( P < @ ) .


In the saffron group , there was no decline in maximum isometric and isotonic forces after eccentric exercise , but a significant decline in the isometric force was observed in the control group ( P < @ ) .


No pain was reported in the saffron group , whereas the indomethacin group experienced pain before @ hours ( P < @ ) .


Results obtained from the current novel research indicate a strong preventive effect of @-day supplementation with saffron on the DOMS .


The saffron can be used to prevent DOMS and alleviate the DOMS symptoms .


The evaluation of new long-lasting insecticidal bed nets ( LLINs ) is coordinated by the WHO Pesticide Evaluation Scheme ( WHOPES ) .


In @ , Netprotect was granted WHOPES interim recommendation after Phase I and II evaluations .


Present study evaluates Netprotect in a Phase III trial in rural Cambodia .


A randomized , prospective longitudinal study design was used to assess the performance of Netprotect over a period of three years , using conventionally-treated nets and a WHOPES recommended LLIN ( PermaNet @ ) as positive controls .


The primary outcomes were the physical integrity , insecticide content and cone bioassay performance using .


The baseline deltamethrin concentration of @ % of Netprotect nets were below the tolerance limit while @ % of PermaNet @ nets were above the target dose limits .


By @ months Netprotect retained @ % while PermaNet @ retained @ % of baseline insecticide dose .


Moreover the proportion of the inactive deltamethrin R-alpha isomer in the Netprotect nets was @ % at the baseline and increased to @ % after three years while it was low and almost constant for PermaNet @ ( @-@ % ) .


Only @ % of Netprotect met the WHO criteria for bio-efficacy after three years while at least @ % is required .


Moreover Netprotect nets failed for the WHOPES criteria after @ and @ months .


The reference LLIN met the WHOPES criteria throughout the study .


Over the entire three years the reference LLIN did obtain significant higher mosquito mortality than Netprotect .


The physical integrity was based on the proportionate hole index and after three years , @ % of Netprotect and @ % of PermaNet @ were in a mediocre or poor state .


Netprotect did not meet the minimum WHO criteria for bio-efficacy after @ , @ and @ months .


The use of a reference LLIN as positive control was helpful for data interpretation .


However , for future three-year studies , it is essential that before initiating any study nets should be checked for their specifications and this for both the candidate LLIN as well as for the reference LLIN .


Moreover , to improve the accuracy of the success rate of the candidate LLIN more nets should be tested for their bio-efficacy at the end of the trial .


Accreditation of healthcare organizations is a widely used method to assess and improve quality of healthcare .


Our aim was to determine the effectiveness of improvement plans in practice accreditation of primary care practices , focusing on cardiovascular risk management ( CVRM ) .


A two-arm cluster randomized controlled trial with a block design was conducted with measurements at baseline and follow-up .


Primary care practices allocated to the intervention group ( n = @ ) were instructed to focus improvement plans during the intervention period on CVRM , while practices in the control group ( n = @ ) could focus on any domain except on CVRM and diabetes mellitus .


Primary outcomes were systolic blood pressure < @ mmHg , LDL cholesterol < @ mmol/l and prescription of antiplatelet drugs .


Secondary outcomes were @ indicators of CVRM and physician 's perceived goal attainment for the chosen improvement project .


No effect was found on the primary outcomes .


Blood pressure targets were reached in @ % of patients in the intervention and @ % of patients in the control group ; cholesterol target levels were reached in @ % and @ % respectively ; antiplatelet drugs were prescribed in @ % in both groups .


Six secondary outcomes improved : smoking status , exercise control , diet control , registration of alcohol intake , measurement of waist circumference , and fasting glucose .


Participants ' perceived goal attainment was high in both arms : mean scores of @ and @ on the @-point scale .


The focus of improvement plans on CVRM in the practice accreditation program led to some improvements of CVRM , but not on the primary outcomes .


ClinicalTrials.gov NCT@ .


The purpose of the study was to compare the efficacy and adverse events of dezocine with that of fentanyl or placebo for the control of emergence agitation .


@ children scheduled for adenotonsillectomy under sevoflurane anesthesia were allocated randomly into @ of the @ groups to receive dezocine @ mgxkg ( -@ ) ( group D , n = @ ) , fentanyl @ gkg ( -@ ) ( group F , n = @ ) , or saline ( group S , n = @ ) just before the end of anesthesia .


Emergence agitation scores were assessed .


Postoperative pain scores , awakening and extubation times , and the incidence of adverse effects were recorded .


Emergence agitation scores , the incidence of emergence agitation and severe emergence agitation were significantly lower in groups D and F than in group S ( p = @ , p = @ , and p = @ , respectively ) .


The postoperative pain scores were lower in groups D and F as compared to group S ( p = @ ) .


Awakening and extubation times in groups D and F were longer than that of group S ( p = @ and p = @ , respectively ) .


The overall incidence of postoperative complications was higher in group F compared to that in groups D and S ( p = @ ) .


In children undergoing adenotonsillectomy under sevoflurane anesthesia , a single IV injection of dezocine @ mgxkg ( -@ ) and fentanyl @ gkg ( -@ ) were comparable in decreasing the incidence and severity of emergence agitation .


However , the use of dezocine was associated with a lower incidence of postoperative side effects .


Crohn 's disease-related inflammation is characterized by reduced activity of the immunosuppressive cytokine transforming growth factor @ ( TGF-@ ) due to high levels of SMAD@ , an inhibitor of TGF-@ signaling .


Preclinical studies and a phase @ study have shown that an oral SMAD@ antisense oligonucleotide , mongersen , targets ileal and colonic SMAD@ .


In a double-blind , placebo-controlled , phase @ trial , we evaluated the efficacy of mongersen for the treatment of persons with active Crohn 's disease .


Patients were randomly assigned to receive @ , @ , or @ mg of mongersen or placebo per day for @ weeks .


The primary outcomes were clinical remission at day @ , defined as a Crohn 's Disease Activity Index ( CDAI ) score of less than @ , with maintenance of remission for at least @ weeks , and the safety of mongersen treatment .


A secondary outcome was clinical response ( defined as a reduction of @ points or more in the CDAI score ) at day @ .


The proportions of patients who reached the primary end point were @ % and @ % for the @-mg and @-mg mongersen groups , respectively , as compared with @ % for the placebo group ( P < @ ) .


There was no significant difference in the percentage of participants reaching clinical remission between the @-mg group ( @ % ) and the placebo group .


The rate of clinical response was significantly greater among patients receiving @ mg ( @ % ) , @ mg ( @ % ) , or @ mg ( @ % ) of mongersen than among those receiving placebo ( @ % ) ( P = @ , P < @ , and P < @ , respectively ) .


Most adverse events were related to complications and symptoms of Crohn 's disease .


We found that study participants with Crohn 's disease who received mongersen had significantly higher rates of remission and clinical response than those who received placebo .


( Funded by Giuliani ; EudraCT number , @-@-@ . )


To compare efficacy differences between fire filiform needle combined with mild moxibustion and gabapentin combined with sham acupuncture for postherpetic neuralgia ( PHN ) .


One hundred cases of PHN were randomly divided into a needle group and a medicine group , @ cases in each one .


In the needle group , pricking method of fire filiform needle was given at the Ashi points , and then mild moxibustion was applied for @ min .


In the medicine group , the oral administration of gabapentin capsule and sham acupuncture at non-acupoints in the distal end of lesions were applied .


The treatment was required for @ days in both groups .


The visual analogue score ( VAS ) was recorded before treatment and on the @st day , @nd day , @rd day , @th day , @th day and @th day of treatment .


The most severity of pain within last @ h , preset severity of pain , immediate analgesia effect and starting time of pain relief were observed , also the efficacy was assessed and improvement of symptoms was observed in the follow-up visit .


The total effective rate was @ % ( @/@ ) in the fire filiform needle group , which was superior to @ % ( @/@ ) in the medicine group ( P < @ ) .


Compared with medicine group , the VAS of the most severity of pain within last @ h was obviously reduced after the @nd treatment in the fire filiform needle group while that of present severity of pain was relieved after the @st treatment ( both P < @ ) .


The immediate analgesia effect in the fire filiform needle group was obviously superior to that in the medicine group in the first three times of treatment ( all P < @ ) .


The average time of pain relief was ( @ + / - @ ) days in the fire filiform needle group , which was significantly earlier to ( @ + / - @ ) days in the medicine group ( P < @ ) .


@ cases were cured in the fire filiform needle group in the follow-up visit , which was superior to @ cases in the medicine group ( P < @ ) .


The improvement of VAS , pain range and sleep quality in the needle group were also superior to those in the medicine group ( all P < @ ) .


The direct medical cost in the fire filiform needle group was ( @ + / - @ ) yuan , which was significantly lower than ( @ + / - @ ) yuan in the medicine group ( P < @ ) .


There was only one case of adverse effect in the medicine group during the treatment .


The fire filiform needle combined with mild moxibustion could obviously relieve the pain in PHN patients , which has superior immediate analgesia effect and pain relieving time compared with gabapentin , which also has less adverse effects and cheap cost .


In this study , we evaluated the clinical relevance of serum drug levels and antidrug antibodies ( ADAbs ) with regard to response to treatment , as well as to relapse upon treatment discontinuation , in peripheral spondyloarthritis ( pSpA ) patients treated with adalimumab .


The study included @ pSpA patients treated with adalimumab for either @ weeks ( n = @ ) or @ weeks ( n = @ ) in a randomized controlled trial .


Patients achieving inactive disease measured by Ankylosing Spondylitis Disease Activity Score ( ASDAS ) at the end of the treatment period were classified as responders .


Clinical characteristics , serum trough adalimumab levels and ADAbs were assessed at the end of the treatment period and at follow-up ( upon relapse or , in absence of relapse , at @ weeks after discontinuation ) .


Serum adalimumab levels measured @ weeks after the last adalimumab administration ranged from < @ to @ g/ml , with a median of @ g/ml .


These levels were associated with neither response to treatment or disease activity measurements at the end of treatment nor with the occurrence of relapse and time to relapse after discontinuation of treatment .


Antiadalimumab ADAbs were present in @ % of the patients at end of treatment and in @ % at follow-up after treatment discontinuation , indicating that ADAbs were masked by the presence of the drug in some patients .


However , ADAbs at the end of treatment and at follow-up were not different between responders and nonresponders and were not associated with relapse upon discontinuation of treatment .


There is no clear association between adalimumab serum levels or antiadalimumab ADAbs with clinical response to treatment or with relapse upon treatment discontinuation in pSpA .


Individuals with gambling or substance-use disorders exhibit similar functional alterations in reward circuitry suggestive of a shared underlying vulnerability in addictive disorders .


Additional research into common and unique alterations in reward-processing in substance-related and non-substance-related addictions may identify neural factors that could be targeted in treatment development for these disorders .


To investigate contextual reward-processing in pathological gambling , a slot-machine fMRI task was performed by three groups ( with pathological gambling , cocaine dependence and neither disorder ; N = @ each ) to determine the extent to which two groups with addictions ( non-substance-related and substance-related ) showed similarities and differences with respect to each other and a non-addicted group during anticipatory periods and following the delivery of winning , losing and ` near-miss ' outcomes .


Individuals with pathological gambling or cocaine dependence compared to those with neither disorder exhibited exaggerated anticipatory activity in mesolimbic and ventrocortical regions , with pathological-gambling participants displaying greater positive possible-reward anticipation and cocaine-dependent participants displaying more negative certain-loss anticipation .


Neither clinical sample exhibited medial frontal or striatal responses that were observed following near-miss outcomes in healthy comparison participants .


Alterations in anticipatory processing may be sensitive to the valence of rewards and content-disorder-specific .


Common and unique findings in pathological gambling and cocaine dependence with respect to anticipatory reward and near-miss loss processing suggest shared and unique elements that might be targeted through behavioral or pharmacological interventions in the treatment of addictions .


Oral isotretinoin ( ISO ) is the gold standard for severe nodular acne .


However , as some patients are unwilling or unable to take , or are intolerant to , ISO , other options are needed .


To compare efficacy and safety of oral ISO vs. doxycycline @ mg plus adapalene @ % / benzoyl peroxide @ % gel ( D+A / BPO ) in severe nodular acne over @ weeks .


This was a multicentre , randomized , controlled , noninferiority investigator-blinded study involving @ subjects .


D+A / BPO showed a significantly earlier onset of action in reducing nodules , papules/pustules and total lesions at week @ .


ISO was superior in reducing nodules ( @ % vs. @ % ) , papules/pustules ( @ % vs. @ % ) and total lesions ( @ % vs. @ % ; all P < @ ) at week @ .


Half as many subjects for D+A / BPO compared with ISO had treatment-related , medically relevant adverse events ( @ events in @ % of subjects vs. @ in @ % of subjects , respectively ) .


D+A / BPO was noninferior to ISO in the intent-to-treat population -LSB- @ % confidence interval ( CI ) -@ to @ ( P = @ ) ; @ % vs. @ % of subjects , respectively -RSB- and per-protocol population -LSB- @ % CI @-@ ( P = @ ) ; @ % vs. @ % of subjects , respectively ) , based on the composite efficacy/safety end point .


D+A / BPO showed a favourable composite efficacy/safety profile compared with ISO .


This combination is an alternative to ISO in patients intolerant to , or unable or unwilling to take , oral ISO , and is an option for treatment of severe nodular acne .


We aimed to compare the performance of novices with three-dimensional ( @D ) versus two-dimensional ( @D ) laparoscopy using Fundamentals of Laparoscopic Surgery ( FLS ) tasks .


Fifty-six novices with no uncorrected visual problems were randomly allocated to @D and @D groups .


All candidates practiced FLS tasks on a box trainer until they achieved proficiency .


Their performance was assessed by considering completion time , number of repetitions , and number of errors following the validated FLS proficiency criteria .


Twenty-five participants in each group completed the training curriculum .


The median performance time ( in minutes ) for the @D group was @ , which was less than that of the @D group of @ min ( P = @ ) .


The median numbers of repetitions and errors were lower for the @D group versus the @D group : @ versus @ ( P = @ ) and @ versus @ ( P < @ ) , respectively .


Stereoscopic vision improved accuracy in laparoscopic skills for novices , which was manifested in reduced numbers of repetitions and errors .


However , it does not affect the global performance time across all tasks .


Pro-inflammatory cytokines including tumor necrosis factor alpha ( TNF - ) , interleukin-@ ( IL-@ ) and interleukin-@ ( IL-@ ) play an important role in the development of hematopoietic stem cell transplantation ( HSCT ) complications .


We explored the effect of Selenium as an antioxidant and anti-inflammatory agent on pro-inflammatory cytokines levels in HSCT candidates .


Plasma concentrations of TNF - , IL-@ and IL-@ were measured in @ patients from a double-blind , randomized , placebo-controlled study .


In both groups , there were @ patients with median age of @years .


Patients received oral Se tablets ( @ mcg ) or placebo twice daily beginning from the first day of high dose chemotherapy ( HDC ) through @days after HSCT .


Cytokine levels were determined before starting HDC ( prior to first dose of Se ) , @ and @days after HSCT .


Plasma levels of TNF - were not significantly different between Se and control group ( P = @ ) .


IL-@ levels were similar between two groups ( P = @ ) .


No significant differences were detected in IL-@ levels between Se and control group ( P = @ ) .


Selenium had no effect on pro-inflammatory cytokines levels in patients undergoing HSCT .


It is likely that earlier initiation and/or larger doses of Se are required to affect inflammatory cytokines significantly .


Sleep deprivation may be particularly detrimental to intensive care unit ( ICU ) patients .


Polysomnography has demonstrated abnormal sleep in medical and surgical ICU populations .


Both environmental factors and circadian disruption have been implicated .


We hypothesized that patients in a neurologic ICU would demonstrate similar sleep disturbances and that a combination of sleep-promoting interventions would increase sleep time .


Twelve patients were enrolled in this pilot-randomized , controlled , study in a neurologic ICU .


For adult patients undergoing continuous EEG for clinical purposes , noise-cancelling headphones and eye masks were worn , and an oral dose of melatonin was administered for @ days , or until EEG was stopped .


Sleep was scored according to standard criteria ; EEG was characterized and analyzed quantitatively .


Sixty-five percent of the patients ' recordings were unscorable based on accepted standardized criteria ; therefore , sleep measures could not be compared .


For those with sleep that could be scored , total sleep time was normal , although sleep was fragmented and time spent in slow-wave or rapid eye movement sleep was notably decreased .


Patients with unscorable recordings had worse injury severity measures , absent or significantly slower posterior dominant rhythm , and less coherence of posterior faster frequencies .


Clinical outcomes were similar between intervention and control groups .


Although sleep-promoting interventions were feasible , sleep quantification based on currently accepted criteria limited the ability to score sleep .


Similar to other ICUs , sleep in the neurologic ICU is abnormal ; patients with unscorable sleep-like states have greater injury severity .


This study was limited by strict enrollment criteria .


A reliable method to quantify sleep and sleep-like states in the ICU is needed .


Ultrasound ( US ) and low-level laser therapy ( LLLT ) are commonly employed for myofascial trigger points ( MTP ) despite lack of evidence for usage as stand-alone treatments .


The aim of the study was to determine , on MTP of the upper trapezius muscle ( uTM ) , the effects of US and LLLT per se , as delivered in accordance with the procedures reported by surveys about their usage among physiotherapists .


Design was set as a double-blind , randomized , placebo-controlled study .


Sixty participants with at least one active MTP in uTM ( @ women and @ men ; mean age @ years ) were recruited and randomly assigned to one out of five groups : active US ( n = @ ) , placebo US ( n = @ ) , active LLLT ( n = @ ) , placebo LLLT ( n = @ ) and no therapy ( control , n = @ ) .


The participants and outcome assessor were blinded to the group assignment and therapy delivered .


Three outcome measures were assessed at baseline , after a @-week treatment and @weeks after the end of the intervention ( follow-up ) : pressure pain threshold , subjective pain on a numerical rating scale and muscle extensibility performing a cervical lateral flexion .


All subjects assigned to the intervention groups were treated five times weekly for overall @ treatments given .


Two-way ANOVA was used to compare differences before and after intervention and among groups at each time-point .


After the @-week intervention , all groups showed pressure pain threshold , numerical rating scale and cervical lateral flexion significant improvements ( p < @ ) , which were confirmed at the follow-up .


When performing multiple comparisons , controls scored significantly less than both the active therapies and placebos , whereas no differences were detected between active therapies and placebos .


Ultrasound and LLLT provided significant improvements in pain and muscle extensibility , which were superior to no therapy but not to placebos , thus raising concerns about the suitability , both economically and ethically , of administering such common physical modalities as stand-alone treatments in active MTP of the uTM .


Integrated Treatment ( IT ) has proved effective in treating patients with Substance Use Disorders ( SUD ) co-occurring with severe Mental Disorders ( MD ) , less is known about the effectiveness of IT for patients with SUD co-occurring with less severe MD.The aim of this study was to investigate the effectiveness of IT for patients with SUD co-occurring with anxiety and/or depression on the following parameters :@ .


The use of substances , as measured by the Alcohol Use Identification Test ( AUDIT ) , the Drug Use Identification Test ( DUDIT ) , and the Addiction Severity Index ( EuropASI ) @ .


The severity of psychiatric symptoms , as measured by the Symptom Check List @ r ( SCL @R ) @ .


The client 's motivation for changing his/her substance use behaviour , as measured by the Substance Abuse Treatment Scale ( SATSr ) .


This is a group randomized clinical trial comparing the effectiveness of IT to treatment as usual in Community Mental Health Centres ( CMHCs ) .


Five CMHCs were drawn to the Intervention Group ( IG ) and four CMHCs to the Control Group ( CG ) .


The allocation to treatment conditions was not blinded .


New referrals were screened with the AUDIT and the DUDIT .


Those who scored above the cut-off level of these instruments were assessed with the Structured Clinical Interview for DSM-IV @ and @ .


We included patients with anxiety and/or depression together with one or more SUDs .


We included @ patients in the IG and @ in the CG .


A linear multilevel model was used .


Both groups reduced their alcohol and substance use during the trial , while there was no change in psychiatric symptoms in either group .


However , the IG had a greater increase in motivation for substance use treatment after @ months than had the CG with an estimate of @ , p = @ , CI@ % ( @ ; @ ) ( adjusted analyses ) .


There were no adverse events .


Integrated treatment is effective in increasing the motivation for treatment amongst patients with anxiety and/or depression together with SUD in outpatient clinics .


Early detection of colorectal cancer ( CRC ) using fecal occult blood test ( FOBT ) reduces mortality , yet screening adherence remains low .


Enhancing FOBT adherence in a field experiment , using Implementation Intentions ( II ) technique .


Participants were randomly assigned to a standard care group or to II experimental group .


A test kit was mailed to @,@ HMO-insured members in two waves in @ .


eligible persons aged @-@ who underwent the test the year before .


A sample of @ participants was interviewed over the telephone for possible cognitive and background moderators .


Leaflet attached to the test kit containing an `` if-then '' condition and planning instructions of when , where , and how .


Test performance at @ and @ months following mailing of the test kit , retrieved from HMO 's computerized database ( @-@ ) .


Adherence in the experimental group ranged @ % -@ % higher than in the control group .


Within @ months of kits ' mailing , test uptake for the two waves was @ % and @ % for experiment and control , respectively ( ( @ ) = @ , p = @ ) .


The difference remained significant after controlling for age , gender , marital status , and wave ( OR = @ , @ % CI = @ , @ , p < @ ) .


Test performance was related to cognitive and background variables .


No interaction was found among cognitive or background variables and the intervention .


II technique is useful in increasing adherence to CRC screening , even in a mailed form rather than a face-to-face experimental situation .


Mailed II is an inexpensive and effective method , applicable for public health .


Because the diagnosis and treatment of carotid artery disease may reduce the rate of stroke , the aim of this study was to determine whether a diet intervention was associated with incident carotid artery disease .


Participants were @ @ postmenopausal women aged @ to @ years who were randomly assigned to either the intervention or comparison group in the Women 's Health Initiative Diet Modification Trial .


Incident carotid artery disease was defined as an overnight hospitalization with either symptoms or a surgical intervention to improve flow .


After a mean follow-up of @ years from @ to @ , there were @ ( @ % ) incident carotid artery events .


In contrast to the comparison group , the risk of incident carotid disease did not differ from those assigned to the intervention group ( hazard ratio , @ ; @ % confidence interval , @-@ @ ) .


In secondary analysis , there was no significant effect of the intervention on the risk for incident carotid disease during the @ years of postintervention follow-up from @ to @ ( hazard ratio , @ ; @ % confidence interval , @-@ @ ) and no significant effect during cumulative follow-up from @ to @ ( hazard ratio , @ ; @ % confidence interval , @-@ @ ) .


Among postmenopausal women , a dietary intervention aimed at reducing total fat intake and encouraging increased intake of fruit , vegetables , and grains did not significantly change the risk for incident carotid artery disease .


Novel nicotine delivery products , such as electronic cigarettes ( e-cigarettes ) , have dramatically grown in popularity despite limited data on safety and benefit .


In contrast , the similar U.S. Food and Drug Administration ( FDA ) - approved nicotine inhaler is rarely utilized by smokers .


Understanding this paradox could be helpful to determine the potential for e-cigarettes as an alternative to tobacco smoking .


To compare the e-cigarette with the nicotine inhaler in terms of perceived benefits , harms , appeal , and role in assisting with smoking cessation .


A cross-over trial was conducted from @ to @ PARTICIPANTS/INTERVENTIONS : Forty-one current smokers age @ and older used the e-cigarette and nicotine inhaler each for @ days , in random order , with a washout period in between .


Thirty-eight participants provided data on product use , perceptions , and experiences .


The Modified Cigarette Evaluation Questionnaire ( mCEQ ) measured satisfaction , reward , and aversion .


Subjects were also asked about each product 's helpfulness , similarity to cigarettes , acceptability , image , and effectiveness in quitting smoking .


Cigarette use was also recorded during the product-use periods .


The e-cigarette had a higher total satisfaction score ( @ vs. @ -LSB- p < @ -RSB- ; range for responses @-@ ) and higher reward score ( @ vs. @ -LSB- p < @ -RSB- ; range for responses @-@ ) than the inhaler .


The e-cigarette received higher ratings for helpfulness , acceptability , and `` coolness . ''


More subjects would use the e-cigarette to make a quit attempt ( @ % ) than the inhaler ( @ % ) ( p < @ ) .


Eighteen percent ( @/@ ) of subjects abstained from smoking during the @-day periods using the e-cigarette vs. @ % ( @/@ ) using the inhaler ( p = @ ) .


The e-cigarette was more acceptable , provided more satisfaction , and had higher perceived benefit than the inhaler during this trial .


E-cigarettes have the potential to be important nicotine delivery products owing to their high acceptance and perceived benefit , but more data are needed to evaluate their actual efficacy and safety .


Providers should be aware of these issues , as patients will increasingly inquire about them .


Open label studies have shown repetitive transcranial magnetic stimulation to be effective in reducing tics .


To determine whether @ sessions of continuous theta burst stimulation ( cTBS ) over supplementary motor area ( SMA ) given over @ days may reduce tics and motor cortical network activity in Tourette syndrome/chronic tic disorders .


This was a randomized ( @:@ ) , double-blind , sham-controlled trial of functional MRI ( fMRI ) - navigated , @ Hz cTBS at @ % of resting motor threshold ( RMT ) over SMA in @ patients ages @-@ years .


Comorbid ADHD ( n = @ ) , OCD ( n = @ ) , and stable concurrent medications ( n = @ ) were permitted .


Neuro-navigation utilized each individual 's event-related fMRI signal .


Primary clinical and cortical outcomes were : @ ) Yale Global Tic Severity Scale ( YGTSS ) at one week ; @ ) fMRI event-related signal in SMA and primary motor cortex ( M@ ) during a finger-tapping motor task .


Baseline characteristics were not statistically different between groups ( age , current tic/OCD/ADHD severities , tic-years , number of prior medication trials , RMT ) .


Mean YGTSS scores decreased in both active ( @ @ to @ @ ) and sham ( @ @ to @ @ ) groups .


However , no significant difference in video-based tic severity rating was detected between the two groups .


Two-day post-treatment fMRI activation during finger tapping decreased significantly in active vs. sham groups for SMA ( P = @ ) , left M@ ( P = @ ) , and right M@ ( P < @ ) .


No serious adverse events occurred .


Active , fMRI-navigated cTBS administered in @ sessions over @ days to the SMA induced significant inhibition in the motor network ( SMA , bilateral M@ ) .


However , both groups on average experienced tic reduction at @ days .


Larger sample size and protocol modifications may be needed to produce clinically significant tic reduction beyond placebo effect .


Androgen deprivation therapy ( ADT ) is associated with significant bone loss and an increase in fracture risk among prostate cancer survivors ( PCS ) .


We investigated whether impact + resistance training could stop ADT-related declines in bone mineral density ( BMD ) among PCS on ADT .


We randomized @ PCS ( mean age , @ yr ) currently prescribed ADT to participate in @ yr of impact + resistance training ( Prevent Osteoporosis with Impact + Resistance ( POWIR ) ) or in an exercise placebo program of stretching exercise ( FLEX ) .


Outcomes were proximal femur ( total hip , femoral neck , and greater trochanter ) and spine ( L@-L@ ) BMD ( gcm ) and bone turnover markers ( serum osteocalcin ( ngmL ) and urinary deoxypyrodinoline cross-links ( nmolmmol Cr ) ) .


Retention in the @-yr study was @ % and median attendance to supervised classes was @ % in POWIR and @ % in FLEX .


No study-related injuries were reported .


There were no significant differences between groups for average L@-L@ BMD or for BMD at any hip site .


When examining individual vertebrae , POWIR has a significant effect on preservation of BMD ( -@ % ) at the L@ vertebrae compared with losses ( -@ % ) in FLEX ( P = @ ) .


Impact + resistance training was a safe and acceptable form of exercise for older PCS on ADT .


Among our limited sample , POWIR did not appear to have a clinically meaningful effect on hip or spine BMD , but some evidence of skeletal adaptation to resistance + impact training in an androgen-deprived state was apparent .


Future studies need to be conducted on a larger sample of patients and should consider modifications to POWIR that could further enhance loading across the spine and at the hip to preserve BMD at these clinically relevant sites .


To compare the differences in the clinical efficacy on post-stroke speech disorder between scalp electric acupuncture ( EA ) under anatomic orientation combined with rehabilitation training and simple rehabilitation training .


Sixty patients of post-stroke speech apraxia were randomized into an observation group and a control group , @ cases in each one .


In the observation group , under anatomic orientation , the scalp EA was adopted to the dominant hemisphere Broca area on the left cerebrum .


Additionally , the speech rehabilitation training was combined .


In the control group , the speech rehabilitation training was simply , used .


The treatment lasted for @ weeks totally .


The speech movement program module in the psychological language assessment and treatment system of Chinese aphasia was used for the evident of efficacy assessment .


The scores of counting , singing scale , repeating phonetic alphabet , repeating monosyllable and repeating disyllable were observed in the patients of the two groups .


The assessment was done separately on the day of grouping and @ weeks after treatment .


In @ weeks of treatment , the scores of counting , singing scale , repeating phonetic alphabet , repeating monosyllable and repeating disyllable were all improved as compared with those before treatment in the two groups ( all P < @ ) .


The results in the observation group were better than those in the control group ( all P < @ ) .


The total effective rate was @ % ( @/@ ) in the observation group , superior apparently to @ % ( @/@ ) in the control group ( P < @ ) .


The scalp EA under anatomic orientation combined with ' speech rehabilitation training obviously improves speech apraxia in stroke patients so that the speech disorder cani be relieved .


The efficacy is better than that in simple rehabilitation training .


Effective pharmacotherapies to treat methamphetamine ( MA ) dependence have not been identified , and behavioral therapies are marginally effective .


Based on behavioral studies demonstrating the potential efficacy of aerobic exercise for improving depressive symptoms , anxiety , cognitive deficits , and substance use outcomes , the study described here is examining exercise as a potential treatment for MA-dependent individuals .


This study is randomizing @ participants with MA dependence at a residential treatment facility for addictive disorders to receive either a thrice-weekly structured aerobic and resistance exercise intervention or a health education condition .


Recruitment commenced in March , @ .


Enrollment and follow-up phases are ongoing , and recruitment is exceeding targeted enrollment rates .


Seeking evidence for a possibly effective adjunct to traditional behavioral approaches for treatment of MA dependence , this study is assessing the ability of an @-week aerobic and resistance exercise protocol to reduce relapse to MA use during a @-week follow-up period after discharge from residential-based treatment .


The study also is evaluating improvements in health and functional outcomes during and after the protocol .


This paper describes the design and methods of the study .


To compare the efficacy and side effects of induction chemotherapy with vinorelbine plus cisplatin ( NP ) or docetaxel plus cisplatin ( TP ) combined with concurrent chemoradiotherapy in treating locally advanced nasopharyngeal carcinoma ( NPC ) .


From January @ to December @ , @ patients with locally advanced nasopharyngeal carcinoma treated in our department were randomized into NP group ( @ patients ) or TP group ( @ patients ) .


Both groups received two cycles of induction chemotherapy and concurrent chemoradiotherapy .


After three weeks of induction chemotherapy , the patients received concurrent chemoradiotherapy .


The chemotherapy was recycled every three weeks .


Two groups were treated with intensity-modulated radiation therapy .


The short-term efficacy of NP group was similar to that of TP group .


The @-year overall survival rates , disease-free-survival rates , locoregional relapse-free survival rates and distant metastasis-free survival rates in the NP and TP groups were @ % and @ % , @ % and @ % , @ % and @ % , @ % and @ % , respectively ( P > @ ) .


The occurrence rates of leucopenia , anemia and acute mucositis were significantly higher in the TP group than those in the NP group ( P < @ ) .


The gastrointestinal toxicity , dermatitis and liver toxicity were similar in the two groups .


The efficacy of NP regimen induction chemotherapy plus concurrent chemordiotherapy for advanced NPC is similar to that of TP regimen .


The toxicity of the NP regimen is lower than that of NP regimen , tolerable , and with a good compliance .


Depressive disorders occur in @ to @ % of the adolescents and are associated with a high burden of disease , a high risk of recurrence and a heightened risk for development of other problems , like suicide attempts .


The effectiveness of cognitive behaviour therapy ( CBT ) , cost-effectiveness of this treatment and the costs of illness of clinical depression in adolescents are still unclear .


Although several Randomized Controlled Trials ( RCT ) have been conducted to establish the efficacy of CBT , the effectiveness has not been established yet .


Aim of this study is to conduct a RCT to test the effectiveness of CBT and to establish the cost-effectiveness of CBT under rigorous conditions within routine care provided by professionals already working in mental health institutions .


CBT is investigated with a multi-site , RCT using block randomisation .


The targeted population is @ clinically referred depressed adolescents aged @ to @years old .


Adolescents are randomly assigned to the experimental ( N = @ , CBT ) or control condition ( N = @ , TAU ) .


Four assessments ( pre , post , follow up at @ and @months ) and two mediator assessments during treatment are conducted .


Primary outcome measure is depression diagnosis based on a semi-structured interview namely the K-SADS-PL .


Secondary outcome measures include depressive symptoms , severity and improvement of the depression , global functioning , quality of life , suicide risk , comorbidity , alcohol and drug use , parental depression and psychopathology , parenting and conflicts .


Costs and treatment characteristics will also be assessed .


Furthermore , moderator and mediator analyses will be conducted .


This trial will be the first to compare CBT with TAU under rigorous conditions within routine care and with a complex sample .


Furthermore , cost-effectiveness of treatment and cost-of-illness of clinical depression are established which will provide new insights on depression as a disorder and its treatment .


Video laparoscopic bariatric surgery is the preferred surgical technique for treating morbid obesity .


However , pneumoperitoneum can pose risks to the kidneys by causing a decrease in renal blood flow .


Furthermore , as in other surgical procedures , laparoscopic bariatric surgery triggers an acute inflammatory response .


Neutrophil gelatinase-associated lipocalin is an early and accurate biomarker of renal injury , as well as of the inflammatory response .


Anesthetic drugs could offer some protection for the kidneys and could attenuate the acute inflammatory response from surgical trauma .


The objective of this study was to compare the effects of two types of anesthetics , propofol and sevoflurane , on the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in laparoscopic bariatric surgery .


Sixty-four patients scheduled for laparoscopic bariatric surgery were randomized into two anesthesia groups and were administered either total intravenous anesthesia ( propofol ) or inhalation anesthesia ( sevoflurane ) .


In the perioperative period , blood samples were collected at three time points ( before anesthesia , @ hours after pneumoperitoneum and @ hours after pneumoperitoneum ) and urine output was measured for @ hours .


Acute kidney injuries were evaluated by examining both the clinical and laboratory parameters during the postoperative period .


The differences between the groups were compared using non-parametric tests .


ReBEC ( http://www.ensaiosclinicos.gov.br/rg/recruiting/ ) : RBR-@wt@fy


None of the patients developed an acute kidney injury during the study and no significant differences were found between the serum neutrophil gelatinase-associated lipocalin levels of the groups during the perioperative period .


The choice of anesthetic drug , either propofol or sevoflurane , did not affect the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in laparoscopic bariatric surgery .


To compare postprandial efficacy in type @ diabetic patients given mitiglinide and sitagliptin , both of which are known to improve postprandial hyperglycemia , by using continuous glucose monitoring ( CGM ) .


Eleven patients with type @ diabetes were given mitiglinide @ mg three times a daily or sitagliptin @ mg once a day for @ month and were hospitalized for @ days and evaluated by CGM .


On discharge , they were crossed over to the other regimen for @ month of treatment/@ days of evaluation .


The CGM data were used to compare each parameter for glycemic variability .


The patients were @ @ ( mean SD ) years old , and had HbA@c value @ @ % .


The pre-meal glucose levels before lunch were significantly lower with mitiglinide than with sitagliptin ( @ @/@ @ mg/dl , p = @ ) .


The AUC measuring over @ mg/dl @ h after breakfast ( mitiglinide @ @/sitagliptin @ @ mg/dlmin , p = @ ) and lunch ( mitiglinide @ @/sitagliptin @ @ , p = @ ) was significantly lower with mitiglinide than with sitagliptin .


A CGM-based comparison showed that mitiglinide and sitagliptin were different in their glucose-lowering effects , where mitiglinide significantly improved hyperglycemia after breakfast and lunch , and significantly lowered pre-meal glucose levels before lunch , compared to sitagliptin .


To test recommended implantable cardioverter defibrillator ( ICD ) follow-up methods by ` in-person evaluations ' ( IPE ) vs. ` remote Home Monitoring ' ( HM ) .


ICD patients were randomized @:@ to automatic HM or to Conventional monitoring , with follow-up checks scheduled at @ , @ , @ , @ , and @ months post-implant .


Conventional patients were evaluated with IPE only .


Home Monitoring patients were assessed remotely only for @ year between @ and @ month evaluations .


Adherence to follow-up was measured .


HM and Conventional patients were similar ( age @ years , @ % male , left ventricular ejection fraction @ % , primary prevention @ % , DDD @ % ) .


Conventional management suffered greater patient attrition during the trial ( @ vs. @ % in HM , P = @ ) .


Three month follow-up occurred in @ % in both groups .


There was @ % adherence ( @ of @ checks ) in @ % Conventional vs. @ % HM ( P < @ ) .


Between @ and @ months , HM exhibited superior ( @ ) adherence to scheduled follow-up -LSB- incidence of failed follow up was @ of @ ( @ % ) in HM vs. @ of @ ( @ % ) in Conventional , P < @ -RSB- and punctuality .


In HM ( daily transmission success rate median @ % ) , transmission loss caused only @ of @ ( @ % ) failed HM evaluations between @ and @ months ; others resulted from clinic oversight .


Overall IPE failure rate in Conventional -LSB- @ of @ ( @ % ) exceeded that in HM -LSB- @ of @ ( @ % ) , P < @ -RSB- by @ % , i.e. HM patients remained more loyal to IPE when this was mandated .


Automatic remote monitoring better preserves patient retention and adherence to scheduled follow-up compared with IPE .


After the advent of the GreenLight XPS ( @ W ) @ nm laser , photoselective vapo-enucleation of the prostate could compete with holmium laser enucleation of the prostate as a size independent procedure .


We assessed whether photoselective vapo-enucleation of the prostate-XPS is not less effective than holmium laser enucleation of prostate for improvement of lower urinary tract symptoms secondary to benign prostatic hyperplasia .


A randomized controlled noninferiority trial comparing holmium laser enucleation of the prostate to photoselective vapo-enucleation of the prostate-XPS @ W was conducted .


I-PSS , flow rate , residual urine , prostate specific antigen and prostate volume changes as well as perioperative and late adverse events were compared .


Noninferiority of I-PSS at @ year was evaluated using a @-sided test at @ % level of significance .


The statistical significance of other comparators was assessed at the ( @-sided ) @ % level .


Overall @ and @ patients were included in the holmium laser enucleation and photoselective vapo-enucleation of the prostate groups , respectively .


Operative time , hospital stay and time to catheter removal were comparable between the groups .


There was significant , comparable improvement in I-PSS and post-void residual urine volume at @ , @ and @ months .


After @ months prostate size reduction was significantly higher in the holmium laser enucleation of prostate group ( @ % vs @ % , p = @ ) .


At @ months maximum urine flow rate was significantly higher in the holmium laser enucleation of prostate group ( @ @ vs @ @ ml per second , p = @ ) .


Re-intervention was needed in @ and @ cases in the holmium laser enucleation and photoselective vapo-enucleation of the prostate groups , respectively ( p = @ ) .


Mean estimated cost per holmium laser enucleation of prostate procedure was significantly lower than per photoselective vapo-enucleation of the prostate procedure .


Compared to holmium laser enucleation of prostate , GreenLight XPS laser photoselective vapo-enucleation of the prostate is safe , noninferior and effective in treatment of benign prostatic hyperplasia .


The rate of hyponatremia is higher in hospitalized cancer patients than in hospitalized patients without cancer and is associated with poor clinical outcomes .


The availability of V@ receptor antagonists has been a major breakthrough in the management of hyponatremia , but its efficacy and safety in treating hyponatremia in patients with cancer is not known .


Adult patients with cancer who were admitted to The University of Texas MD Anderson Cancer Center with nonhypovolemic hyponatremia ( @-@ mmol/L ) were randomized to receive either tolvaptan or placebo in a double-blind , placebo-controlled , adaptive , randomized trial .


Both groups received the standard of care for hyponatremia , except that patients were allowed to drink to thirst .


A preplanned Data Safety Monitoring Board analysis of @ of @ randomized patients who completed the study revealed that the primary endpoint of hyponatremia correction was met by @ of @ patients who received tolvaptan and by @ of @ patients who received placebo ( @ % vs @ % ; P < @ ) , which met the study stopping rule for superiority .


The secondary endpoints between the tolvaptan and placebo groups ( meanstandard deviation ) for length of stay ( @ days vs @ days , respectively ) and change in the Mini-Mental State Examination score ( -@ vs @ , respectively ) were not significantly different .


No overcorrection of serum sodium ( > @ mmol/L per day ) was noted in the tolvaptan group , and the main adverse events noted were dry mouth , polydipsia , and polyuria , leading to @ % study withdrawal .


Although tolvaptan was effective for correcting hyponatremia in patients with cancer , studies with a larger sample size will be required to confirm the current findings , including the outcomes of secondary endpoints .


Remifentanil is a powerful analgesic with fast onset and ultra-short duration of action .


Its context-sensitive half-time is consistently short even after a prolonged infusion .


Remifentanil is effective for providing better postoperative analgesia , but this method is not generally accepted in Japan .


The present study was conducted to document efficacy and safety of low-dose remifentanil infusion in postoperative patients .


Forty patients undergoing abdominal surgery were studied prospectively .


They were randomly assigned to either remifentanil ( @ microg x kg ( -@ ) x min ( -@ ) ) or placebo group .


Postoperatively all patients received continuous epidural anesthesia with lidocaine and IV patient-controlled analgesia with fentanyl .


Flurbiprofen was administered only when no pain relief was achieved .


Visual analogue scale ( VAS ) , requirement of fentanyl and flurbiprofen , and the incidence of remifentanil-related adverse effects ( respiratory depression , nausea , vomiting , pruritus ) were examined at @ hourly intervals for @ hours .


There are no statistical differences between two groups in pain scores .


No adverse events including respiratory depression occurred throughout the study in both groups .


Remifentanil infusion at @ microg x kg ( -@ ) x min ( -@ ) can safely be used without any serious adverse events , while it may not be enough for postoperative analgesia .


The best dosage of this drug for postoperative analgesia remains to be elucidated .


To assess the effect of Eutectic Mixture of Local Anaesthetics cream and rattle on soothing the vaccination pain on four-month-infants .


The single blind randomised clinical trial was conducted from May @ to February @ at a clinic under the Gonabad University of Medical Sciences , Iran , and comprised four-month infants who were selected randomly and divided into three groups .


In one group , @g of eutectic mixture of local anaesthetics cream was rubbed on the injection spot before administration ; for the other group , the rattle was shaken from @s to @s before injection .


The last group consisted of controls .


The infants were filmed after vaccination .


Afterward , a pain questionnaire was filled out by a trained observer .


SPSS @ was used for statistical analysis .


Of the @ subjects in the study @ ( @ % ) each were in the cream and rattle groups , while the rest ( @ % ) were in the control group .


The severity of the pain before intervention in the control , cream and rattle groups was @ + / - @ , @ + / - @ and @ + / - @ respectively , which were not statistically significant ( p < @ ) .


Likewise , the mean severity of pain at the moment of intervention in the three above groups were @ + / - @ , @ + / - @ and @ + / - @ respectively , which was significantly different ( p < @ ) .


The severity of pain @seconds after the intervention in the groups was @ + / - @ , @ + / - @ and @ + / - @ respectively , which were not statistically different ( p < @ ) .


The eutectic mixture of local anaesthetics cream and shaking rattle were effective in attenuating pain of vaccination among the infants , but the latter was not as significant as the former .


Oral budesonide @ mg/day represents first-line treatment of mild-to-moderately active ileocolonic Crohn 's disease .


However , there is no precise recommendation for budesonide dosing due to lack of comparative data .


A once-daily ( OD ) @ mg dose may improve adherence and thereby efficacy .


An eight-week , double-blind , double-dummy randomised trial compared budesonide @ mg OD versus @mg three-times daily ( TID ) in patients with mild-to-moderately active ileocolonic Crohn 's disease .


Primary endpoint was clinical remission defined as CDAI < @ at week @ ( last observation carried forward ) .


The final intent-to-treat population comprised @ patients ( @ -LSB- @ mg OD -RSB- , @ -LSB- @ mg TID -RSB- ) .


The confirmatory population for the primary endpoint analysis was the interim per protocol population ( n = @ ; @ -LSB- @ mg OD -RSB- , @ -LSB- @mg TID -RSB- ) , in which the primary endpoint was statistically non-inferior with budesonide @ mg OD versus @ mg TID .


Clinical remission was achieved in @ % versus @ % , a difference of -@ % ( @ % CI -LSB- -@ % ; @ % -RSB- ; p = @ for non-inferiority ) .


The mean ( SD ) time to remission was @ ( @ ) days versus @ ( @ ) days with budesonide @ mg OD versus @ mg TID , respectively .


In a subpopulation of @ patients with baseline SES-CD ulcer score @ , complete mucosal healing occurred in @ % ( @/@ ) on @ mg OD and @ % ( @/@ ) on @mg TID ; deep remission ( mucosal healing and clinical remission ) was observed in @ % ( @/@ ) and @ % ( @/@ ) of patients , respectively .


Treatment-emergent suspected adverse drug reactions were reported in @ % of @ mg OD and @ % of @ mg TID patients .


Budesonide at the recommended dose of @ mg/day can be administered OD without impaired efficacy and safety compared to @mg TID dosing in mild-to-moderately active Crohn 's disease .


Recent data have supported the use of an early exposure intervention to promote a reduction in acute stress and posttraumatic stress disorder ( PTSD ) symptoms after trauma exposure .


The present study explored a comprehensive predictive model that included history of trauma exposure , dissociation at the time of the trauma and early intervention , and physiological responses ( cortisol and heart rate ) to determine which variables were most indicative of reduced PTSD symptoms for an early intervention or treatment as usual .


Participants ( n = @ ) were randomly assigned to the early intervention condition ( n = @ ) or assessment-only condition ( n = @ ) while receiving care at the emergency department of a Level @ trauma center .


Follow-up assessments occurred at @ and @ weeks posttrauma .


Findings suggested that dissociation at the time of the @st treatment session was associated with reduced response to the early intervention .


No other predictors were associated with treatment response .


For treatment as usual , cortisol levels at the time of acute care and dissociation at the time of the traumatic event were positively associated with PTSD symptoms .


Dissociation at the time at which treatment starts may indicate poorer response to early intervention for PTSD .


Similarly , dissociation at the time of the event was positively related to PTSD symptoms in those who received treatment as usual .


The arterial blood gas measurement process is a painful and invasive procedure , often uncomfortable for both the patient and the physician .


Because the patient-related factors that determine the difficulty of the process can not be controlled , the physician-related factors and blood gas measurement techniques are a modifiable area of improvement that ought to be considered .


Many hospitals use insulin syringes or syringes washed with heparin for the purpose of blood gas measurement because they do not have blood gas-specific syringes .


In this prospective cross-sectional study , we aimed to compare safety-engineered blood gas syringes and conventional heparinized syringes used during the arterial blood gas extraction process in terms of ease of operation , the physician-patient satisfaction , laboratory appropriateness , and complications .


Our study included patients whose arterial blood gas needed to be measured in the emergency department and who agreed to participate in the study .


Patients were randomly divided into @ groups .


The arterial blood gas of the patients from the first group was measured by using conventional heparinized syringes , whereas safety-engineered blood gas syringes were used to measure the arterial blood gas of the patients from the second group .


The groups were compared in terms of demographic data , the number of attempts , the physician and patient satisfaction , early and late-term complications , and laboratory appropriateness of the taken sample .


A total of @ patients were included in our study in a @-month study period .


There were no significant differences between patients in terms of sex , age , weight , height , body mass index , and wrist circumference .


In addition , the number of attempts ( P = @ ) , patients ' pain level during the procedure ( P = @ ) , and the degree of difficulty of the procedure according to the patient ( P = @ ) and physician ( P = @ ) were not significantly different between the groups .


After arterial blood gas extraction procedure , @ patients ( @ % ) developed complications .


In the conventional heparinized syringe group , the complication rate ( n = @ ; @ % ) was significantly higher compared with the group that used safety-engineered blood gas syringes ( n = @ ; @ % ; P = @ ) .


Localized pain , which is one of the most common early complications , was more frequent in the conventional heparinized syringe group ( @ % ) .


Complications in women ( P = @ ) and local pain ( P = @ ) developed lesser in the second group that used safety-engineered blood gas syringes , and the patient-physician satisfaction was higher in that group , as well .


In the evaluation @ hours after the procedure , the ratios of infection and local hematoma were higher in the conventional heparinized syringe group ( P = @ and P < @ ) .


In this study , we did not find any significant differences between the conventional heparinized syringes and safety-engineered blood gas syringes in terms of ease of operation , physician and patient satisfaction , and appropriateness of the taken sample .


However , patients whose arterial blood gas was extracted by using safety-engineered blood gas syringes felt less pain and experienced fewer infections and hematomas at their puncture site .


Transmembrane tumor necrosis factor ( TNF ) - , found on monocytes , is a body 's key defense against cancer .


In patients with type @ diabetes mellitus ( DM ) and metabolic syndrome , immunity is suppressed , resulting in a high risk of several inflammatory disorders and cancer .


Seventeen patients with type @ DM and metabolic syndrome were supplemented with either @ mg of elemental zinc/day or placebo for eight weeks .


Transmembrane TNF -- expressing monocytes and lymphocytes , and plasma TNF - levels were analyzed before and after supplementation .


The present study revealed that zinc supplementation significantly increased the proportion of monocytes expressing transmembrane TNF - .


While the plasma TNF - levels and TNF - expressing lymphocytes were not significantly altered in the zinc-treated and placebo groups , higher proportion of TNF - bound monocytes were observed in the zinc-treated group .


Because functional transmembrane TNF - was shown to be implicated in defense mechanisms , these findings suggest that zinc supplementation may benefit immune response against cancer in patients with DM and metabolic syndrome .


To assess the interobserver agreement in @ patients with hepatocellular carcinoma ( HCC ) before and @ month after intra-arterial therapy ( IAT ) using two semi-automated methods and a manual approach for the following functional , volumetric and morphologic parameters : ( @ ) apparent diffusion coefficient ( ADC ) , ( @ ) arterial phase enhancement ( AE ) , ( @ ) portal venous phase enhancement ( VE ) , ( @ ) tumor volume , and assessment according to ( @ ) the Response Evaluation Criteria in Solid Tumors ( RECIST ) , and ( @ ) the European Association for the Study of the Liver ( EASL ) .


This HIPAA-compliant retrospective study had institutional review board approval .


The requirement for patient informed consent was waived .


Tumor ADC , AE , VE , volume , RECIST , and EASL in @ index lesions was measured by three observers .


Interobserver reproducibility was evaluated using intraclass correlation coefficients ( ICC ) .


P < @ was considered to indicate a significant difference .


Semi-automated volumetric measurements of functional parameters ( ADC , AE , and VE ) before and after IAT as well as change in tumor ADC , AE , or VE had better interobserver agreement ( ICC = @-@ @ ) compared with manual ROI-based axial measurements ( ICC = @-@ @ ) .


Semi-automated measurements of tumor volume and size in the axial plane before and after IAT had better interobserver agreement ( ICC = @-@ @ ) compared with manual size measurements ( ICC = @-@ @ ) , and interobserver agreement for change in tumor RECIST size was also higher using semi-automated measurements ( ICC = @ ) compared with manual measurements ( ICC = @ ) .


EASL measurements of tumor enhancement in the axial plane before and after IAT ( ( ICC = @-@ @ ) , and changes in EASL after IAT ( ICC = @ ) had good interobserver agreement .


Semi-automated measurements of functional changes assessed by ADC and VE based on whole-lesion segmentation demonstrated better reproducibility than ROI-based axial measurements , or RECIST or EASL measurements .


Telemedicine is one approach to managing patients with chronic illness .


Several telephone-based monitoring studies of diabetes patients have shown improved glycosylated hemoglobin ( HbA@c ) , blood pressure ( BP ) , and low-density lipoprotein ( LDL ) levels .


The purpose of this study was to evaluate an investigational in-home telemetry device for improving glucose and BP control over @ months for patients with type @ diabetes .


The device was used to transmit weekly blood glucose , weight , and BP readings to a diabetes care manager .


We conducted a two-arm , parallel-comparison , single-blind , randomized controlled trial among Kaiser Permanente Northern California members @-@ years old with type @ diabetes mellitus and entry HbA@c levels between @ % and @ % .


Participants were randomly assigned to either the telemonitoring arm or the usual care arm .


We observed very small , nonsignificant changes in fructosamine ( telemonitoring , -@ mol ; usual care , -@ mol ) and systolic BP ( telemonitoring , -@ mm Hg ; usual care , -@ mm Hg ) from baseline to @ weeks in both groups .


At @ months , we observed no significant intergroup differences in change from baseline for HbA@c , fructosamine , or self-efficacy .


However , LDL cholesterol in the telemonitoring arm decreased more than in the usual care arm ( -@ mg/dL versus -@ mg/dL ; P = @ ) .


Although HbA@c improved significantly over @ months in both groups , the difference in improvement between the groups was not significant .


This lack of significance may be due to the relatively healthy status of the volunteers in our study and to the high level of care provided by the care managers in the Santa Rosa , CA clinic .


Further study in subgroups of less healthy diabetes patients is recommended .


To investigate the effect of low glycemic index ( LGI ) carbohydrate meal on subjective , metabolic and physiological responses , and endurance performance in the Ramadan fasted state .


During Ramadan , @ Muslim men , in a randomized and crossover design , ingested for the sahur meal ( i.e. , last meal before commencement of the day 's fast ) , either LGI ( glycemic index = @ ) or mixed ( CON ; @ ) meal of equivalent macro-nutrient .


At @h post-prandial , subjects completed a @min continuous run .


There were no significant differences between the two meals for ratings in perceived satiety , fullness , appetite and mood states .


During steady-state exercise , there were no significant differences in metabolic and physiological measures .


In the time-trial , distance ran was significantly lower in LGI versus CON meal trial , but with a corresponding lower perceived exertion in the LGI trial .


Compared to CON , ingesting LGI as the sahur meal did not provide any metabolic , physiological or performance benefits during endurance run performed @h post-prandial in Ramadan fasted state .


Varenicline was developed to aid smoking cessation by reducing smoking reinforcement .