The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire .


Secondary outcomes include improvements in body image , physical and mental health , body weight , self-esteem , quality of life , and social contacts .


In addition , the participants ' motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured .


The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs .


This study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa , binge eating disorder and eating disorders not otherwise specified .


To compare the anaesthetic and convulsive effects of sevoflurane/remifentanil versus propofol/remifentanil combination in electroconvulsive therapy ( ECT ) .


In this prospective , randomized double-blind study , patients diagnosed with treatment-resistant depression were included for ECT .


Prior to treatment , @g/kg remifentanil was intravenously administered to all patients , followed by anaesthetic induction with either @ mg/kg propofol or @ % sevoflurane .


Following muscular paralysis with succinylcholine and hypnosis , bitemporal ECT was applied .


Vital signs , depth of sedation , recovery parameters , motor and electroencephalography ( EEG ) convulsion activity and postictal suppression index scores were recorded .


A total of @ sessions of ECT were administered to @ patients .


Heart rate was higher in the sevoflurane group than the propofol group .


Compared with the sevoflurane group , bispectral index level was lower in the propofol group during the induction period and higher during the recovery period .


Anaesthetic induction and recovery times were lower , and average motor and EEG convulsion activity was longer , in the propofol group than in the sevoflurane group .


Propofol/remifentanil is more successful compared with sevoflurane/remifentanil in anaesthesia management during ECT since it provides quick induction and recovery , longer seizure activity and stable haemodynamics .


The objective was to determine the separate and combined effects of hypoxia and inactivity/unloading on sleep architecture during a @-day period of confinement .


Ten subjects participated in three @-day trials in random order : hypoxic ambulatory ( HAMB ) , hypoxic bedrest ( HBR ) , and normoxic bedrest ( NBR ) .


During the HAMB and HBR trials , subjects were confined to a hypoxic facility .


The hypoxia profile was : simulated altitude of @,@ m on day @ , @,@ m on day @ , and @,@ m on day @ .


In the NBR and HBR trials , subjects maintained a horizontal position throughout the confinement period .


During each trial , sleep polysomnography was conducted one night prior to ( baseline ; altitude of facility is @ m ) and on the first ( NT@ , altitude @,@ m ) and tenth ( NT@ , altitude @,@ m ) night of the @-day intervention .


Average time in sleep stage @ decreased from NT@ to NT@ irrespective of trial .


Overall incidence and time spent in periodic breathing increased from NT@ to NT@ in both HAMB and HBR .


During NT@ , both HAMB and HBR reduced slow-wave sleep and increased light sleep , whereas NBR and HBR increased the number of awakenings/night .


There were fewer awakenings during HAMB than NBR .


Acute exposure to both hypoxia and bedrest ( HBR ) results in greater sleep fragmentation due to more awakenings attributed to bedrest , and lighter sleep as a result of reduced slow wave sleep caused by the hypoxic environment .


Peripheral opioid receptor targeting has been well established as a novel target in clinical pain management for acute and chronic peripheral inflammatory pain .


The physiochemical properties of the peripheral mu-opioid receptor agonist , loperamide HCl , limit the use of the free drug as an analgesic or anti-inflammatory agent , particularly for dermal delivery across intact skin .


Our objective was to manufacture an effective topical formulation containing loperamide using liposomal delivery that would allow loperamide to produce analgesia and anti-inflammatory effects , by penetrating the epidermis to reach peripheral opioid receptors within the dermis of intact skin .


A randomized , double blind , controlled animal trial .


Thirty-five adult male Wistar rats ( @ - @ g ) were randomly divided into @ groups : loperamide HCl-encapsulated liposomal gel , naloxone methiodide + loperamide HCl-encapsulated liposomal gel , free loperamide gel , empty liposomal gel , and @ % diclofenac gel ( Voltaren ) .


Diclofenac gel was used as a positive control as it is clinically used as a topical analgesic and anti-inflammatory drug .


Animals received an intraplantar injection of @ l Complete Freund 's Adjuvant ( CFA ) into the right hindpaw and experiments were performed @ days post-CFA injection , which corresponded to the peak inflammatory response .


All manufactured formulations were applied topically on both hind paws twice daily , whereas Voltaren gel was applied @ times a day in accordance with the manufacturer 's instructions .


The dose administered was @ l , which equated to @ mg of loperamide HCl for the loperamide HCl treatment groups ( low dose ) .


Naloxone methiodide ( @ mg/kg ) was administered via intraplantar injection , @ minutes prior to application of loperamide HCl-encapsulated liposomal gel to determine opioid receptor dependent activity .


An investigator blinded to the treatment administered assessed time course of the antinociceptive and anti-inflammatory effects using a paw pressure analgesiometer and plethysmometer , respectively .


Application of loperamide HCl in a liposomal gel formulation exerted analgesic and anti-inflammatory effects exclusively in peripheral painful inflamed tissue .


This formulation produced highly significant analgesic and anti-inflammatory effects over the @-hour time course studied following topical administration in rats with CFA-induced inflammation of the paw .


As expected , the diclofenac gel group showed significant antinociception over the duration of the study ; however , this effect was lower in comparison to the loperamide HCl liposomal gel formulation .


All other control groups showed no significant antinociceptive effects .


In addition , all control groups ( @ % diclofenac gel , free loperamide gel , and empty liposomal gel ) did not demonstrate a significant change in paw volume over @ hours .


In vivo studies were performed in the well-established rodent model of acute inflammatory pain .


We are currently studying this approach in chronic pain models known to have clinical activation of the peripheral immune-derived opioid response .


The study demonstrates that topically applied loperamide encapsulated within liposomal systems has improved therapeutic efficacy over conventional formulations for the local treatment of acute peripheral inflammatory pain conditions where the skin has remained intact .


Once in the inflamed peripheral tissue , loperamide provides analgesic and anti-inflammatory effects in a similar manner to peripheral endogenous opioids .


This preparation optimises the retention of drug at the site where action is required .


Remote ischemic preconditioning ( RIPC ) induced by transient limb ischemia confers multi-organ protection and improves exercise performance in the setting of tissue hypoxia .


We aimed to evaluate the effect of RIPC on exercise capacity in heart failure patients .


We performed a randomized crossover trial of RIPC ( @-minutes limb ischemia ) compared to sham control in heart failure patients undergoing exercise testing .


Patients were randomly allocated to either RIPC or sham prior to exercise , then crossed over and completed the alternate intervention with repeat testing .


The primary outcome was peak VO@ , RIPC versus sham .


A mechanistic substudy was performed using dialysate from study patient blood samples obtained after sham and RIPC .


This dialysate was used to test for a protective effect of RIPC in a mouse heart Langendorff model of infarction .


Mouse heart infarct size with RIPC or sham dialysate exposure was also compared with historical control data .


Twenty patients completed the study .


RIPC was not associated with improvements in peak VO@ ( @ + / -@ vs @ + / -@ mL/kg/min ; p = @ , sham and RIPC , respectively ) .


In our Langendorff sub-study , infarct size was similar between RIPC and sham dialysate groups from our study patients , but was smaller than expected compared to healthy controls ( @ % , @ % -LSB- sham , RIPC -RSB- vs @ % -LSB- controls -RSB- .


We observed less preconditioning among the subgroup of patients with increased exercise performance following RIPC ( p < @ ) .


In this pilot study of RIPC in heart failure patients , RIPC was not associated with improvements in exercise capacity overall .


However , the degree of effect of RIPC may be inversely related to the degree of baseline preconditioning .


These data provide the basis for a larger randomized trial to test the potential benefits of RIPC in patients with heart failure .


The minimal clinically important difference ( MCID ) is the smallest outcome change that has clinical significance .


Its use has not been established in the study of myasthenia gravis ( MG ) .


Patients from a published intravenous immunoglobulin ( IVIg ) vs. placebo study were studied .


One anchor-based and @ distribution-based techniques were used to identify quantitative myasthenia gravis score ( QMGS ) , repetitive nerve stimulation ( RNS ) , and single-fiber electromyography ( SFEMG ) MCID cut-offs .


Patients with a change-score exceeding MCID cut-offs were compared .


MCID cut-offs were below a QMGS change of @ .


Anchor-based and @ SEM cut-offs showed @ % vs. @ % responders ( P = @ ) , SD @ % vs. @ % responders ( P = @ ) , and effect size @ vs. @ ( P = @ ) in IVIg vs. placebo .


Anchor-based ( P = @ ) and effect-size ( P = @ ) MCID cut-offs did not show a difference between IVIg and placebo .


MCID methods did not produce meaningful RNS cut-offs .


QMGS MCID values provide clinically relevant information and are recommended in MG trials .


MCID analysis shows that improvement in MG patients treated with IVIg reflects clinically meaningful changes .


Nonalcoholic fatty liver disease is associated with hepatic inflammation .


An emerging technique to image inflammation is PET using the glucose tracer , ( @ ) F-FDG .


The purpose of this study was to determine whether in hepatic steatosis the liver accumulates FDG in excess of FDG physiologically exchanging between blood and hepatocyte .


Hepatic FDG uptake , as SUV = -LSB- voxel counts / administered activity -RSB- body weight ) , and CT density were measured in a liver region in images obtained @ minutes after injection of FDG in @ patients referred for routine PET/CT .


Maximum SUV ( region voxel with the highest count rate , SUVmax ) and average SUV ( SUVave ) were measured .


Blood FDG concentration was measured as the maximum SUV over the left ventricular cavity ( SUVLV ) .


SUVave was adjusted for hepatic fat using a formula equating percentage fat to CT density .


Patients were divided in subgroups on the basis of blood glucose ( < @ , @ to < @ , @ to < @ , @ to < @ , @ to < @ , and > @ mmol/L ) .


Hepatic steatosis was defined as CT density less than @ HU ( n = @ ) .


The percentage of hepatic fat increased exponentially with blood glucose .


SUVmax / SUVLV and fat-adjusted SUVave / SUVLV but not SUVave / SUVLV correlated with blood glucose .


Fat-adjusted SUVave was higher in patients with hepatic steatosis ( p < @ ) by ~ @ in all blood glucose groups .


There was a similar difference ( ~ @ ) in SUVmax ( p < @ ) but no difference in SUVave .


SUVmax / SUVLV and fat-adjusted SUVave / SUVLV correlated with blood glucose in patients with hepatic steatosis but not in those without .


SUVave / SUVLV correlated with blood glucose in neither group .


FDG uptake is increased in hepatic steatosis , probably resulting from irreversible uptake in inflammatory cells superimposed on reversible hepatocyte uptake .


Actinic keratosis ( AK ) may progress to squamous cell carcinoma .


In the case of normal or mildly photodamaged skin , lesion-directed treatments are considered valuable options despite poor published evidence of their therapeutic activity .


The aim of this single-centre , open-label , prospective , nonsponsored , randomized , controlled clinical trial was to compare CO@ laser ablation with cryotherapy in the treatment of isolated AKs of the face and scalp .


Patients with isolated ( @ ) AKs of the face and scalp were randomized to receive CO@ laser ablation or cryotherapy .


After @days , the overall complete remission ( CR ) rates of patients and lesions were assessed and correlated with thickness grade .


Two hundred patients with a total number of @ AKs were enrolled .


The CR rates of lesions after @months were @ % with cryotherapy and @ % with CO@ laser ablation .


Thicker lesions were significantly more responsive to cryotherapy ( P = @ ) .


Seventy-three patients ( @ % ) had CR of all lesions @months after cryotherapy and @ ( @ % ) after laser ablation .


At @months after treatment the number of patients with CR was reduced to @ with cryotherapy and @ with laser ablation .


The rate of patients and lesions with CR is similar after @months , but more patients remain in stable remission for @months after cryotherapy .


Cryotherapy is more effective for thick lesions .


The cosmetic outcome was good or excellent in almost all patients .


To investigate changes in student food selection and consumption in response to the new National School Lunch Program meal patterns during fall @ .


Eight elementary and four intermediate schools in one Houston area school district were matched on free/reduced-price meal eligibility and randomized into control or intervention conditions .


Both intervention and control school cafeterias served the same menu .


The intervention school cafeterias posted the new meal pattern daily ; students could select one fruit and two vegetable servings per reimbursable meal .


Control school students could only select the previous meal pattern : a total of two fruit and vegetable servings per meal .


Students were observed during lunch : student sex and foods selected/consumed were recorded .


Diet analysis software was used to calculate energy/food groups selected/consumed .


Cochran-Mantel-Haenszel tests examined differences in the percent of students selecting each meal component by condition , controlling for sex , grade , and school free/reduced-price meal eligibility .


Analysis of covariance assessed differences in amount of energy/food groups selected and consumed , and differences in percent of food groups consumed .


Observations were conducted for @,@ elementary and @ intermediate students .


Compared with students in the control schools , significantly more intervention elementary and intermediate school students selected total ( P < @ , P < @ ) and starchy vegetables ( P < @ , P < @ ) ; more intervention intermediate school students selected fruit ( P < @ ) , legumes ( P < @ ) , and protein foods ( P < @ ) .


There were significantly greater amounts of these foods selected and consumed , but no differences in the proportion of the foods consumed by condition .


Fewer calories were consumed by elementary and intermediate school intervention students .


More intervention students selected fruit and vegetables at lunch and consumed them compared with control condition students .


Future studies with larger and more diverse student populations are warranted .


Cigarette smoking is a well-known risk factor for development of coronary artery disease ( CAD ) .


However , some studies have suggested a `` smoker 's paradox , '' meaning neutral or favorable outcomes in smokers who have developed CAD , especially myocardial infarction ( MI ) .


The study aimed to examine the association of smoking status with clinical outcomes in the randomized controlled SYNTAX ( SYNergy Between PCI With TAXUS and Cardiac Surgery ) trial at @-year follow-up .


Detailed smoking history was collected at baseline , @-month , @-year , @-year , and @-year follow-up .


The composite endpoints included death/MI/stroke ( primary endpoint ) plus major adverse cardiac and cerebrovascular events ( MACCE ) ( combination of death/MI/stroke and target lesion revascularization ) according to patient smoking status .


The comparison of @-year clinical outcomes between the groups according to smoking status was performed with Cox regression using smoking status at baseline or smoking as a time-dependent covariate .


A sizeable proportion ( n = @ , @ % ) of patients had changing smoking status during @-year follow-up .


One in @ patients with complex CAD was smoking at baseline .


However , @ % stopped after revascularization while others continued to smoke .


Smokers had worse clinical outcomes due to a higher incidence of recurrent MI in both revascularization arms .


Smoking was an independent predictor of the composite endpoint of death/MI/stroke ( hazard ratio -LSB- HR -RSB- : @ ; @ % confidence interval -LSB- CI -RSB- : @ to @ ; p = @ ) and MACCE ( HR : @ ; @ % CI : @ to @ ; p = @ ) .


Smoking is associated with poor clinical outcomes after revascularization in patients with complex CAD .


This places further emphasis on efforts at smoking cessation to improve revascularization benefits .


( SYNTAX Study : TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries ; NCT@ ) .


Tasisulam sodium ( hereafter referred to as tasisulam ) is a novel , highly albumin-bound agent that demonstrated activity in a phase @ melanoma study .


In this open-label phase @ study , patients with AJCC stage IV melanoma received tasisulam ( targeting an albumin-corrected exposure of @-@ h ( hour ) .


g/mL on day @ ) or paclitaxel ( @ mg/m ( @ ) on days @ , @ , and @ ) every @ days as second-line treatment .


The study was placed on clinical hold after randomization of @ patients when a safety review indicated an imbalance of possibly drug-related deaths in the tasisulam arm .


Efficacy results for tasisulam versus paclitaxel revealed a response rate of @ % versus @ % , a median progression-free survival of @ months versus @ months ( P = @ ) , and a median overall survival of @ months versus @ months ( P = @ ) .


The most common drug-related grade @ laboratory toxicities ( graded according to Common Terminology for Adverse Events -LSB- version @ -RSB- ) were thrombocytopenia ( @ % ) for patients treated with tasisulam and neutropenia/leukopenia ( @ % ) among those receiving paclitaxel .


There were @ possibly related deaths reported to occur on the study , with the majority occurring during cycle @ in the setting of grade @ myelosuppression , all in the tasisulam arm .


Investigation of the unexpectedly high rate of hematologic toxicity revealed a subset of patients with low tasisulam clearance , leading to drug accumulation and high albumin-corrected exposure in cycle @ .


Although the study was stopped early because of safety issues in the tasisulam arm , tasisulam was considered unlikely to be superior to paclitaxel , and paclitaxel activity in the second-line treatment of melanoma was much lower than expected .


The toxicity imbalance was attributed to an unexpectedly low tasisulam clearance in a subset of patients , underscoring the importance of pharmacokinetic monitoring of compounds with complex dosing , even in late-phase studies .


To study the effect of transcutaneous acupoint electrical stimulation ( TAES ) on stress who received propofol target controlled infusion ( TCI ) general anesthesia in brain surgery .


Totally @ neurosurgical patients of I-II grade ( ASA grading ) in our hospital were randomly divided into the TAES group ( T group ) and the control group ( C group ) , @ in each group .


All patients received intravenous anesthesia by propofol TCI .


The TAES intervention was adopted in those of C group .


Electrodes were only applied to corresponding acupoints without electric stimulation .


The arterial blood was withdrawn before TAES ( T@ ) , before anesthesia ( T@ ) , before cutting ( T@ ) , at @ min after encephalic incision ( T@ ) , immediately after incisions suture ( T@ ) , at about @ min after removing tracheal catheters ( T@ ) to detect beta-endorphin ( beta-EP ) , cortisol ( COR ) , adrenalin ( E ) , blood sugar ( Glu ) .


The heart rate ( HR ) and mean arterial pressure ( MAP ) were recorded .


The total time of surgery , anesthesia , total infusion amount , blood lost amount , and urine amount were recorded .


In both groups , HR , MAP , COR , and E at T@ were lower than at T@ significantly ( P < @ ) .


beta-EP in group C at T@ was lower than at T@ significantly ( P < @ ) .


HR , MAP , COR in group C at T@ were higher than at T@ significantly ( P < @ ) .


HR , MAP , E , and Glu in group C at T@ and T@ were higher than at T@ significantly ( P < @ ) .


beta-EP in group T at T@ and T@ were higher than at T@ significantly ( P < @ ) .


HR , COR , E , Glu , and beta-EP in group T at T@ and T@ were higher than at T@ significantly ( P < @ ) .


Between groups , comparing with the time point T@ , the amplitude of variation of MAP , COR , and E at T@ in group C were significantly less ( P < @ ) ; the amplitude of variation of HR , MAP , and COR at T@ in group C were less significantly , when compared with the time point T@ ( P < @ ) ; the amplitude of variation of HR , MAP , COR , E , and Glu at T@ and T@ in group C were less significantly , when compared with the time point T@ ( P < @ ) .


When comparing the two groups , the amplitude of variation of beta-EP at time points of T@ , T@ , T@ , and T@ in group T were larger than at T@ in group C ( P < @ ) .


TAES could reduce stress and stabilize the internal environment when used in brain surgery with propofol TCI general anesthesia .


Although axillary surgery is still considered to be a fundamental part of the management of early breast cancer , it may no longer be necessary either as treatment or as a guide to adjuvant treatment .


The authors conducted a single-center randomized trial ( INT@/@ ) to determine the impact of avoiding axillary surgery in patients with T@N@ breast cancer and planning chemotherapy based on biological factors of the primary tumor on long-term disease control .


From June @ to June @ , @ patients aged @ years to @ years with T@N@ breast cancer were randomized to either quadrantectomy with ( QUAD ) or without ( QU ) axillary lymph node dissection ; a total of @ patients finally were evaluated .


All patients received radiotherapy to the residual breast only .


Chemotherapy for patients in the QUAD treatment arm was determined based on lymph node status , estrogen receptor status , and tumor grade .


Chemotherapy for patients in the QU treatment arm was based on estrogen receptor status , tumor grade , and human epidermal growth factor receptor @ and laminin receptor status .


Overall survival ( OS ) was the primary endpoint .


Disease-free survival ( DFS ) and rate and time of axillary lymph node recurrence in the QU treatment arm were the secondary endpoints .


After a median follow-up of > @ years , the estimated adjusted hazards ratio of the QUAD versus QU treatment arms for OS was @ ( @ % confidence interval , @-@ @ ; P = @ ) and was @ ( @ % confidence interval , @-@ @ ; P = @ ) for DFS .


Of the @ patients in the QU treatment arm , @ ( @ % ) experienced axillary lymph node recurrence .


The median time to axillary lymph node recurrence from breast surgery was @ months ( interquartile range , @ months-@ @ months ) .


Patients with T@N@ breast cancer did not appear to benefit in terms of DFS and OS from immediate axillary lymph node dissection in the current randomized trial .


The biological characteristics of the primary tumor appear adequate for guiding adjuvant treatment .


Apha-@ agonists are combined with local anesthetics to extend the duration of regional anesthesia .


We evaluated the effect of combining dexmedetomidine with levobupivacine with respect to duration of motor and sensory block and duration of analgesia .


Sixty patients scheduled for elective forearm and hand surgery were divided into two equal groups in a randomized double blind fashion .


The patients received brachial plexus block via supraclavicular route with the help of nerve stimulator .


In group L ( n = @ ) @cc of levobupivacaine with @ml of isotonic saline and in group LD ( n = @ ) @cc of levobupivacine with @ ml of ( @ microgram ) of dexmedetomidine was given .


Duration of motor and sensory block and time to first rescue analgesia were recorded .


Data analysis was done by SPSS version @ -LSB- SPSS Inc ILLINOIS , USA , @ -RSB- .


Categorical variables were analyzed using Pearson `` s Chi-square test .


Normally distributed numerical variables were analyzed using unpaired `` t '' test .


Skewed numerical variables within the group were analyzed using Man-Whitney `` U '' test .


All tests were two tailed .


Statistical significance was defined as P < @ .


Sensory and motor block durations were longer in group LD as compared to L ( P < @ ) .


Duration of analgesia was significantly longer in group LD as compared to group L ( p < @ ) .


Dexmedetomidine added to levobupivacaine in supraclavicular brachial plexus block prolongs the duration of block and the duration of postoperative analgesia .


To investigate the correlation between regulatory T ( Treg ) cells and postmenopausal osteoporosis and the antiosteoporotic effect of @,@-dihydroxyvitamin D@ -LSB- @,@ ( OH ) D -RSB- in relation to Treg cells .


Fifty female BALB/c mice were randomly divided into five groups : the basal control ( BAS ) , Sham , ovariectomy ( OVX ) , OVX + diethylstilbestrol ( OVX+DES ) , and OVX +@,@ ( OH ) D. Tibias were harvested and processed with decalcification for quantitative bone histomorphometry .


Femurs were stained by immunohistochemistry to detect Foxp@ protein expression .


Spleens were used to detect Treg and Foxp@ gene expression by flow cytometry and quantitative RT-PCR , respectively .


In comparison with the Sham group , a significant decrease was found in the OVX group in such indices as trabecular bone volume/total tissue area ( BV/TV ) , trabecular number ( Tb.N ) and trabecular thickness ( Tb.Th ) .


@,@ ( OH ) Dand DES partly prevented the decrease in BV/TV , Tb.N , Tb.Th in OVX mice .


Treg cell number , Foxp@ mRNA expression in spleen and Foxp@ protein expression in femur significantly decreased in the OVX-treated group compared with those in the sham group .


@,@ ( OH ) @Dand DES significantly increased Treg cell number and Foxp@ expression .


Treg cells and Foxp@ gene expression were related to bone histomorphometric parameters .


The decrease in Treg cell numbers is relevant to the postmenopausal osteoporosis .


The antiosteoporosis of @,@ ( OH ) Dis related to regulatory T cells .


Dexmedetomidine-induced bradycardia or hypotension has recently attracted considerable attention because of potentially grave consequences , including sinus arrest and refractory cardiogenic shock .


A route other than intravenous injection or a low dose may help minimize cardiovascular risks associated with dexmedetomidine .


However , few studies have addressed the clinical effects of low-dose intramuscular dexmedetomidine as premedication .


Forty American Society of Anesthesiologists physical status I adult patients undergoing suspension laryngoscopic surgery were randomized to receive intramuscular dexmedetomidine ( @ gkg-@ ) or midazolam ( @ mgkg-@ ) @ minutes prior to anaesthesia induction .


The sedative , hemodynamic , and adjuvant anaesthetic effects of both premedications were assessed .


The levels of sedation ( Observer 's Assessment of Alertness/Sedation scales ) and anxiety ( visual analog score ) at pre-induction , and the times to eye-opening and extubation , were not different between the groups .


The heart rate response following tracheal intubation and extubation , and mean arterial pressure responses after extubation , were attenuated in the dexmedetomidine group compared to the midazolam group .


No bradycardia or hypotension was noted in any patients .


Propofol target concentrations at intubation and at start and completion of surgery were decreased in the dexmedetomidine group , whereas no difference in respective remifentanil levels was detected .


This study provides further evidence that dexmedetomidine premedication in low dose ( @ gkg-@ ) by intramuscular route can induce preoperative sedation and adjuvant anaesthetic effects without clinically significant bradycardia or hypotension .


To determine which nostril is more suitable for nasotracheal intubation in patients with normal patency of both nostrils .


Prospective , randomized clinical trial .


Operating room of a university medical center .


@ ASA physical status @ and @ patients scheduled for elective oral surgery requiring general anesthesia with nasotracheal intubation .


Patients were randomized to two groups to undergo nasotracheal intubation through the right nostril ( Group R ; n = @ ) or the left nostril ( n = @ ) .


Standard traditional nasotracheal intubation was performed using the Macintosh laryngoscope .


Tube rotation was attempted for alignment toward the glottis , and Magill forceps were then used to assist intubation , as necessary .


Epistaxis was inspected in the pharynx after the tube tip was passed through the nasal cavity and @ minutes after nasotracheal intubation was completed .


Intubation time was the interval between when the anesthesiologist opened the patient 's mouth with the cross finger maneuver and when the tube was connected to the anesthetic circuit after nasotracheal completion .


The frequency of epistaxis was significantly lower in Group R than Group L ( P = @ ) .


Although there was no significant difference in nasal passage time between two groups , the intubation time in Group R ( @ @ sec ) was shorter than in Group L ( @ @ sec ; P = @ ) .


Nasal intubation via the right nostril is more safely performed than with the left nostril .


Because of less epistaxis and faster intubation .


Many patients with high blood pressure ( BP ) do not have antihypertensive medications appropriately intensified at clinician visits .


We investigated whether an online spaced-education ( SE ) game among primary care clinicians can decrease time to BP target among their hypertensive patients .


A @-arm randomized trial was conducted over @ weeks among primary care clinicians at @ hospitals .


Educational content consisted of @ validated multiple-choice questions with explanations on hypertension management .


Providers were randomized into @ groups : SE clinicians were enrolled in the game , whereas control clinicians received identical educational content in an online posting .


SE game clinicians were e-mailed @ question every @ days .


Adaptive game mechanics resent questions in @ or @ days if answered incorrectly or correctly , respectively .


Clinicians retired questions by answering each correctly twice consecutively .


Posting of relative performance among peers fostered competition .


Primary outcome measure was time to BP target ( < @/@ mm Hg ) .


One hundred eleven clinicians enrolled .


The SE game was completed by @ % of clinicians ( @/@ ) , whereas @ % of control clinicians ( @/@ ) read the online posting .


In multivariable analysis of @ @ hypertensive periods among @ @ patients , the hazard ratio for time to BP target in the SE game cohort was @ ( @ % confidence interval , @-@ @ ; P = @ ) .


The number of hypertensive episodes needed to treat to normalize one additional patient 's BP was @ .


The number of clinicians needed to teach to achieve this was @ .


An online SE game among clinicians generated a modest but significant reduction in the time to BP target among their hypertensive patients .


Understanding attitudes to mental health issues can inform public health interventions .


However , low response rates may contribute to nonresponse bias .


In a randomized controlled trial we examined the effect of sending a prenotification postcard before the questionnaire and the placement of a short message on the survey envelope ( teaser ) on response rates to a mailed questionnaire about bulimia nervosa `` mental health literacy '' .


Questionnaires were mailed to @,@ adults ( @ % female and @ % male ) aged @-@years .


In a @ ( pre-notification-present ; absent ) by @ ( teaser-present ; absent ) design , questionnaire recipients were randomly allocated to the experimental strategies .


Outcomes considered were response rate , response time , and cost .


The overall response rate was @ % .


Significant main effects showed higher response rates for the use of prenotification ( present = @ % ; absent = @ % ) , among female participants , and older participants .


A significant interaction of teaser by gender indicated lower response rates for men who received the teaser but not for women .


Older participants returned the questionnaire more promptly than younger participants .


Females-but not males-who received the teaser were slower to return the questionnaire .


Higher response rates for participants receiving the postcard compensated for increased costs , particularly for males and older participants .


Response rates to a mental health postal survey can be increased through the use of prenotification .


Endothelial function is an independent predictor of prognosis in heart failure ( HF ) subjects .


Statins , beyond their lipid lowering role , exert beneficial effect in patients with atherosclerosis .


In the present study we examined the impact of low and intermediate dose atorvastatin treatment on endothelial function , bone marrow-derived endothelial progenitor cells ( EPC ) mobilization and inflammatory status according to HF patient status .


We studied the effect of @ weeks administration of atorvastatin in @ patients with ischemic HF .


The study was carried out on two separate arms , one with atorvastatin @mg/d and one with atorvastatin @mg/d ( randomized , double-blind , cross-over design ) .


The number of circulating CD@ ( + ) / CD@ ( + ) / KDR ( + ) EPCs was evaluated by flow cytometry .


Endothelial function was evaluated by flow mediated dilation ( FMD ) in the brachial artery .


Serum levels of tumor necrosis factor alpha ( TNF - ) were measured by ELISA .


Treatment with atorvastatin @mg/d significantly increased circulating EPC ( p = @ ) , FMD ( p = @ ) and reduced TNF - ( p = @ ) compared to baseline .


Similarly , treatment with atorvastatin @mg/day increased circulating EPC ( p = @ ) , FMD ( p = @ ) and reduced TNF - ( p = @ ) compared to baseline .


Interestingly , with @mg/day atorvastatin treatment the increase in EPC was higher in subjects categorized as NYHA class II compared to subjects categorized as NYHA class III ( p = @ ) .


Our results confirmed the distinct impact of atorvastatin treatment on the restoration of endothelial function due to EPC mobilization in ischemic HF subjects .


Moreover , these findings provide the potential clinical significance of EPC status monitoring to individualize treatment in HF subjects .


We investigated skin microcirculation and its association with HbA@c and the incidence of ischaemic foot ulcer in patients with type @ diabetes formerly randomised ( @-@ ) to intensified conventional treatment ( ICT ) or standard treatment ( ST ) with insulin for a mean of @ years .


We re-determined the skin microcirculation of @ patients ( ICT @ vs ST @ ) from the original Stockholm Diabetes Intervention Study with iontophoresis topically applied with the following vasoactive stimuli : acetylcholine ( ACh ) ( endothelial-dependent vasodilatation ) , sodium nitroprusside ( SNP ) ( endothelial-independent vasodilatation ) , and capsaicin ( C-nociceptive-dependent vasodilatation ) .


HbA@c levels ( mean of @ values/patient ) were prospectively collected between @ and @ and tested for association with skin microcirculation .


The patients were followed until first hospitalisation for an ischaemic foot ulcer or until @ .


During the median @years of follow-up , three patients developed ischaemic foot ulcers in the ICT group compared with ten in the ST group ( logrank , p = @ ) .


At the time of iontophoresis , HbA@c was lower in the ICT group ( median @mmol/mol -LSB- minimum-maximum @-@mmol / mol -RSB- ) compared with the ST group ( @mmol/mol -LSB- @-@mmol / mol -RSB- , p < @ ) ( DCCT : ICT @ % -LSB- @-@ @ % -RSB- vs ST @ % -LSB- @-@ @ % -RSB- ) .


Stimulated blood flow was higher in the ICT vs ST group with significantly increased perfusion units ( PU ) for : ACh ( @ PU -LSB- @-@ @ PU -RSB- vs @ PU -LSB- @-@ @ PU -RSB- , p < @ ) ; SNP ( @ PU -LSB- @-@ @ PU -RSB- vs @ PU -LSB- @-@ @ PU -RSB- , p = @ ) ; and capsaicin ( @ PU -LSB- @-@ @ PU -RSB- vs @ PU -LSB- @-@ @ PU -RSB- , p < @ ) .


HbA@c was associated with vasodilatation induced by ACh ( b = -@ , p < @ ) and capsaicin ( b = -@ , p = @ ) .


HbA@c was independently associated with ACh ( b = -@ , p < @ ) and capsaicin-induced vasodilatation ( b = -@ , p < @ ) .


Improved glycaemic control in patients with type @ diabetes is associated with an improvement in skin microcirculation and with a lower incidence of ischaemic foot ulcers .


Autonomic dysfunction is an important mechanism that could explain many symptoms observed in fibromyalgia ( FM ) .


Exercise is an effective treatment , with benefits potentially mediated through changes in autonomic modulation .


Strengthening is one of the less studied exercises in FM , and the acute and chronic effects of strengthening on the autonomic system remain unknown .


The objective of this study was to assess the chronic effects of strengthening exercises ( STRE ) on autonomic modulation , pain perception and the quality of life ( QOL ) of FM patients .


Eighty sedentary women with FM ( ACR @ ) were randomly selected to participate in STRE or flexibility ( FLEX ) exercises in a blinded controlled trial .


The intensity of STRE was set at @ % of the estimated load of @ Repetition Maximum ( RM ) in @ different exercises .


Outcomes were Visual Analog Scale ( VAS ) for pain , Heart Rate Variability ( HRV ) analysis , treadmill test , the sit and reach test ( Wells and Dillon 's Bench ) , maximal repetitions test and handgrip dynamometry ; and quality of life by the Fibromyalgia Impact Questionnaire ( FIQ ) , the Beck and Idate Trait-State Inventory ( IDATE ) , a short-form health survey ( SF-@ ) .


The STRE group was more effective to strength gain for all muscles and pain control after @ and @ weeks ( p < @ ) .


The FLEX group showed higher improvements in anxiety ( p < @ ) .


Both groups showed improvements in the QOL , and there was no significant difference observed between the groups .


There was no change in the HRV of the STRE and FLEX groups .


Strengthening exercises show greater and more rapid improvements in pain and strength than flexibility exercises .


Despite the benefits in fitness , pain , depression , anxiety and quality of life , no effect was observed on the autonomic modulation in both groups .


This observation suggests that changes in autonomic modulation are not a target tobe clinically achieved in fibromyalgia .


A prospective study was performed .


To test the hypothesis that different pedicle screw insertion positions would increase the likelihood of superior adjacent segment degeneration ( ASD ) .


Lumbar fusion surgery is a widely accepted treatment of lumbar diseases , such as lumbar stenosis , trauma , tumor , and spondylolisthesis .


Fusion and clinical success rates have increased because of improvements in instrumentation and bone graft material .


In contrast , numerous complications and problems of fusion surgery have been reported , with ASD being one of the most important .


This prospective study included @ patients with low-grade isthmic spondylolisthesis .


From January @ to December @ , patients were randomized underwent posterolateral fusion using @ different pedicle screw insertion positions .


The patients were followed up postoperatively and were assessed with regard to radiological and clinical outcomes .


Radiological outcomes were assessed mainly on the basis of disc degeneration , facet joint degeneration , and bone fusion .


Clinical outcomes were evaluated mainly with the use of visual analogue scale for pain and the Oswestry Disability Index .


A total of @ of @ ( @ % ) patients were available for at least @-year radiological and clinical follow-up data : @ % ( @/@ ) patients in group A and @ % ( @/@ ) patients in group B. Bone fusion was achieved in all patients at the last follow-up .


ASD was proven in @ ( @ % ) of @ patients .


The incidences of radiographical and symptomatic ASD were @ % ( @/@ ) and @ % ( @/@ ) , respectively .


The incidence of ASD in group B was significantly lower than that in group A. Results of clinical outcomes showed lower visual analogue scale and Oswestry Disability Index scores in @ groups than preoperative scores , but group B had greater improvement on the Oswestry Disability Index scores than group A in patients with ASD .


The degeneration of superior adjacent segment is closely related to the position of the pedicle screws during lumbar fusion surgery .


The position of the pedicle screw farther from the facet joint surface can reduce the degeneration of superior adjacent segment .


To evaluate the clinical efficacy and safety of acupuncture and moxibustion for the treatment of active Crohn 's disease ( CD ) .


Ninety-two patients were equally and randomly divided into the treatment group and received herb-partitioned moxibustion combined with acupuncture , and the control group received wheat bran-partitioned moxibustion combined with superficial acupuncture .


The patients received three treatment sessions per week for @ wk and were followed up for @ wk .


The main outcome was evaluated using the CD Activity Index ( CDAI ) score , and the secondary outcomes were evaluated using laboratory indicators such as hemoglobin ( HGB ) , C-reactive protein ( CRP ) , erythrocyte sedimentation rate , quality-of-life , endoscopic ratings , and intestinal histology scores .


The CDAI scores of both the treatment and control groups were significantly reduced after treatment compared with those measured before treatment .


However , the degree of improvement in the treatment group was significantly greater than that of the control group .


The improvement in symptoms in patients of the treatment group was sustained at follow-up , whereas that of the control group was not .


The overall efficacy of the treatment was significantly greater than that of the control .


Both groups demonstrated significant improvements in quality-of-life ratings after treatment , but the improvement was significantly greater in the treatment group than in the control group .


In addition , the patients in the treatment group showed significantly increased HGB and significantly decreased CRP levels and histopathological scores at the end of treatment , whereas the control group did not exhibit significant changes .


Moxibustion with acupuncture provided significant therapeutic benefits in patients with active CD beyond the placebo effect and is therefore an effective and safe treatment for active CD .


Closed minimal extracorporeal circulation ( MECC ) systems currently do not represent the standard of surgical care for open-heart surgery .


Yet , considering the beneficial results reported for coronary artery bypass graft ( CABG ) surgery , we used an MECC system in aortic valve replacement ( AVR ) and analysed the effects on intraoperative microvascular perfusion in comparison with conventional open extracorporeal circulation ( CECC ) .


In the current study , we analysed alterations in microvascular perfusion at @ predefined time points ( T@-T@ ) during surgical AVR utilizing orthogonal polarization spectral ( OPS ) imaging .


Twenty patients were randomized for being operated on utilizing either MECC or CECC .


Changes in functional capillary density ( FCD , cm/cm ( @ ) ) , mircovascular blood flow velocity ( mm/s ) and vessel diameter ( m ) were analysed by a blinded investigator .


After the start of extracorporeal circulation and aortic cross-clamping ( T@ ) , both groups showed a significant drop in FCD , but with a significantly higher FCD in the MECC group ( @ @ cm/cm in the CECC group vs @ @ cm/cm in the MECC group , P = @ ) .


During the late phase of the cardiopulmonary bypass ( CPB ) ( T@ ) , the FCD was still significantly depressed in both treatment groups ( @ @ cm/cm in the CECC group , P < @ vs ` T@ ' ; @ @ cm/cm in the MECC group , P < @ versus ` T@ ' ) .


After termination of CPB ( T@ ) , the FCD recovered in both groups to baseline values .


Microvascular blood flow velocity tended to remain at a higher level in the MECC group , whereas haemodilution during CPB was significantly reduced in the MECC group .


The use of MECC in AVR did not affect procedural safety and , resulted in beneficial preservation of microvascular blood flow velocity and significantly reduced haemodilution during CPB .


In contrast to CABG surgery , the use of MECC did not improve FCD during surgical AVR .


Clinical advantages possibly resulting from attenuated haemodilution and preservation of microvascular blood flow velocity require further validation in larger patient cohorts .


To compare pelvic ultrasound simulators ( PSs ) with live models ( LMs ) for training in transvaginal sonography ( TVS ) .


The authors conducted a prospective , randomized controlled trial of @ eligible medical students trained in TVS in @-@ with either a PS or an LM .


A patient educator was used for LM training .


Simulated intrauterine and ectopic pregnancy models were used for PS training .


Students were tested using a standardized patient who evaluated their professionalism .


A proctor , blinded to training type , scored their scanning technique .


Digital images were saved for blinded review .


Students rated their training using a Likert scale ( @ = not very well ; @ = very well ) .


The primary outcome measure was students ' overall performance on a @-point assessment tool for professionalism , scanning technique , and image acquisition .


Poisson regression and Student t test were used for comparisons .


A total of @ students participated ( @ trained using a PS ; @ using an LM ) .


Mean overall test scores were @ % for the PS group and @ % for the LM group ( P = @ ) .


A significant difference was identified in scanning technique ( PS , @ % versus LM , @ % ; P = @ ) and image acquisition ( PS , @ % versus LM , @ % ; P = @ ) .


None was observed for professionalism .


The PS group rated their training experience at @ , whereas the LM group rated theirs at @ ( P < @ ) .


Simulators do not perform as well as LMs for training novices in TVS , but they may be useful as an adjunct to LM training .


Expectancies regarding treatment assignment may influence outcomes in placebo-controlled trials above and beyond actual treatment assignment .


For smoking pharmacotherapies , guessing enrollment in the active medication treatment is associated with higher abstinence rates .


However , placebo-controlled trials of smoking pharmacotherapies rarely assess perceived treatment assignment and those that do only collect this information after reaching full dosage .


To determine the temporal relationship between treatment expectancies and smoking-related variables , we assessed the impact of treatment guess during a placebo-controlled laboratory study of varenicline on measures of craving , smoking reward , and smoking reinforcement .


We hypothesized that treatment guess at mid-titration would influence smoking-related measures at full dosage , above and beyond actual medication effects .


We also explored factors related to guess stability and differences in blind fidelity between mid-drug titration and full dosage .


Eighty-eight participants completed laboratory assessments at baseline , mid-titration , and full dosage that involved self-report and behavioral measures of tonic craving , cue-provoked craving , smoking reward , and smoking reinforcement .


Participants guessed treatment assignment at mid-titration and full dosage .


Generalized linear models confirmed that , beyond actual treatment assignment , treatment guess improved model fit for both self-report and behavioral smoking-related measures .


Further , accuracy of treatment guess improved from titration to full dosage , and specific demographic factors ( e.g. , gender , race ) were associated with type of treatment guess and guess stability across time .


These results reinforce the importance of assessing perceived treatment assignment repeatedly during placebo-controlled trials and suggest that treatment expectancies during titration can affect outcomes once full dosage has been reached .


We evaluated chr@q@ @ organic cation transporter gene ( SLC@A@ , SLC@A@ , SLC@A@ ) variation and response to smoking cessation therapies .


The corresponding proteins are low-affinity transporters of choline , acetylcholine and monoamines , and smoking cessation pharmacotherapies expressed in multiple tissues .


We selected @ common polymorphisms for mega-regression analysis .


We assessed additive model association of polymorphisms with @-day point prevalence abstinence overall and by assigned pharmacotherapy at end of treatment and at @ months among European-ancestry participants of @ randomized controlled trials adjusted for demographic , population genetic , and trial covariates .


Initial results were obtained in @ trials with @,@ participants .


Nominally statistically significant associations of @ SLC@A@ polymorphisms were observed : ( @ ) with rs@ at @ months , overall ( -LSB- c. @T > G ; p.Ser@Ala -RSB- , OR = @ , @ % CI = @-@ @ , p = @ ) , and among those randomized to nicotine replacement therapy ( NRT ) ( OR = @ , @ % CI = @-@ @ , p = @ ) ; and ( @ ) with rs@ ( c@-@A > T ) among those randomized to varenicline ( OR = @ , @ % CI = @-@ @ , p = @ , OR = @ , @ % CI = @-@ @ , p = @ ) at end of treatment and @ months .


Individuals randomized to NRT from a seventh trial were genotyped for rs@ ; rs@ was associated with a nominally statistically significant effect on abstinence overall at @ months among @,@ participants ( OR = @ , @ % CI = @-@ @ , p = @ ) .


The functional OCT@ Ser@Ala polymorphism is nominally statistically significantly associated with abstinence among European-ancestry treatment-seeking smokers after adjustments for pharmacotherapy , demographics , population genetics , and without adjustment for multiple testing of @ SNPs .


Replication of these preliminary findings in additional randomized controlled trials of smoking cessation therapies and from multiple continental populations would describe another pharmacogenetic role for SLC@A@/OCT@ .


Presbyphonia is common among elderly individuals , yet few studies have evaluated behavioral treatment approaches for presbyphonia .


The primary aim of this study was to assess the short-term efficacy of two types of voice therapy-vocal function exercises ( VFE ) and phonation resistance training exercise ( PhoRTE ) therapy-in the treatment of presbyphonia .


The secondary aim was to determine if differences in adherence and treatment satisfaction existed between the two therapy approaches .


Prospective , randomized , controlled .


Preliminary data from @ elderly participants with presbyphonia randomly assigned to VFE , PhoRTE , or a no-treatment control group ( CTL ) were analyzed .


Before and after a @-week intervention period , participants completed the Voice-Related Quality of Life ( V-RQOL ) questionnaire and a perceived phonatory effort ( PPE ) task .


Additionally , participants receiving treatment completed weekly practice logs and a posttreatment satisfaction questionnaire .


Preliminary data revealed VFE and PhoRTE groups demonstrated a significant improvement in V-RQOL scores .


However , only PhoRTE demonstrated a significant reduction in PPE , as suggested by the study 's causal model .


The CTL group did not demonstrate significant changes .


Numerically , VFE registered slightly greater adherence to home practice recommendations than did PhoRTE , but PhoRTE perceived greater treatment satisfaction than VFE .


Findings provide new evidence regarding the efficacy of voice therapy exercises in the treatment of age-related dysphonia and suggest PhoRTE therapy as another treatment method for improved voice-related quality of life and reduced perceived vocal effort in this population .


To determine whether a flexible vaccination regimen provides protection against challenge exposure with a virulent Leptospira borgpetersenii serovar Hardjo isolate .


Fifty-five @-week-old calves seronegative for antibodies against L borgpetersenii serovar Hardjo .


Calves were assigned to @ groups and administered @ doses of adjuvant ( control calves ; n = @ ) , @ dose of serovar Hardjo bacterin and @ dose of adjuvant ( @ ) , or @ doses of the serovar Hardjo bacterin ( @ ) ; there was a @-week interval between dose administrations .


Three weeks after the second dose , all calves were challenge exposed by use of conjunctival instillation of a heterologous strain of L borgpetersenii serovar Hardjo for @ consecutive days .


Urine samples for leptospiral culture were collected for @ weeks after challenge exposure ; at that time , all calves were euthanized and kidney samples collected for leptospiral culture .


Antibody titers increased in both leptospiral-vaccinated groups of calves .


A significant increase in antibody titers against L borgpetersenii serovar Hardjo was detected after administration of the second dose of L borgpetersenii serovar Hardjo bacterin and challenge exposure .


In @ of @ adjuvant-treated control calves , serovar Hardjo was isolated from both urine and kidney samples .


Leptospira borgpetersenii serovar Hardjo was not isolated from the urine or kidney samples obtained from any of the @ remaining calves that received @ dose of bacterin or the @ remaining calves that received @ doses of bacterin .


Protection in young calves was induced by vaccination with @ or @ doses of a serovar Hardjo bacterin .


An athlete is thought to reduce head acceleration after impact by contracting the cervical musculature , which increases the effective mass of the head .


To compare the odds of sustaining higher magnitude in-season head impacts between athletes with higher and lower preseason performance on cervical muscle characteristics .


Cohort study ; Level of evidence , @ .


Forty-nine high school and collegiate American football players completed a preseason cervical testing protocol that included measures of cervical isometric strength , muscle size , and response to cervical perturbation .


Head impact biomechanics were captured for each player using the Head Impact Telemetry System .


A median split was used to categorize players as either high or low performers for each of the following outcome measures : isometric strength ( peak torque , rate of torque development ) , muscle size ( cross-sectional area ) , and response to cervical perturbation ( stiffness , angular displacement , muscle onset latency ) .


The odds of sustaining moderate and severe head impacts were computed against the reference odds of sustaining mild head impacts across cervical characteristic categorizations .


Linemen with stronger lateral flexors and composite cervical strength had about @ times ' increased odds of sustaining moderate linear head impacts rather than mild impacts compared with weaker linemen .


Players who developed extensor torque more quickly had @ times the increased odds of sustaining severe linear head impacts ( odds ratio -LSB- OR -RSB- , @ ; @ % CI , @-@ @ ) rather than mild head impacts .


However , players with greater cervical stiffness had reduced odds of sustaining both moderate ( OR , @ ; @ % CI , @-@ @ ) and severe ( OR , @ ; @ % CI , @-@ @ ) head impacts compared with players with less cervical stiffness .


The study findings showed that greater cervical stiffness and less angular displacement after perturbation reduced the odds of sustaining higher magnitude head impacts ; however , the findings did not show that players with stronger and larger neck muscles mitigate head impact severity .


To develop a new radiography-based score to assess the potential of bacteria to cause odontogenic infections derived from the occurrence of bacteria at small or large radiographical lesions .


The patients analyzed were a sub-population from a large randomized clinical trial comparing moxifloxacin and clindamycin in the treatment of inflammatory infiltrates and odontogenic abscesses .


Routine radiographs were used to analyze the area of the periapical radiolucent lesions .


Lesions were stratified by their radiographically measured area as large ( > @ mm ( @ ) ) or small ( @ mm ( @ ) ) .


A risk ratio was calculated for each species from the frequency of their occurrence in large vs in small lesions .


Fifty-one patients , @ with abscesses and @ with infiltrates , were evaluated .


Overall , the radiographical lesion areas ranged from @-@ @ mm ( @ ) ( median = @ mm ( @ ) ) .


An increased risk ( risk ratio > @ ) to occur at large abscess lesions was observed for Prevotella ( P. ) oralis , P. buccae , P. oris , P. intermedia , Fusobacterium nucleatum and Streptococcus ( Strep . )


anginosus group .


An increased risk to occur at large infiltrate lesions was found for Strep .


salivarius , Strep .


parasanguis , Strep .


anginosus group , Capnocytophaga spp. , Neisseria ( N. ) sicca , Neisseria spp. , Staphylococcus ( Staph . )


aureus , P. intermedia , P. buccae , Prevotella spp .


and P. melaninogenica .


The radiography-based score suggests that certain Prevotella spp. , F. nucleatum and Strep .


anginosus groups play a crucial role in the pathogenesis of odontogenic abscesses , and that various streptococci , Neisseria spp. , Capnocytophaga spp. , Staph .


aureus and Prevotella spp .


are involved in the pathogenesis of odontogenic infiltrates .


The role of fixed airflow obstruction ( FAO ) in asthma is unclear .


To assess the relationship between FAO and clinical features of asthma and the effect of FAO on treatment response .


Post hoc descriptive analysis of data stratified by FAO category ( screening post-albuterol FEV@/FVC < lower limit of normal -LSB- LLN -RSB- -LSB- FAO + -RSB- or LLN -LSB- FAO - -RSB- ) from two @-week , randomized , placebo-controlled studies of budesonide/formoterol or the monocomponents in mild-moderate ( study I ; aged @ years ; NCT@ ; placebo run-in ) or moderate-severe ( study II ; @ years ; NCT@ ; budesonide run-in ) asthma patients .


At baseline , FAO + versus FAO - patients were more likely male and had longer asthma duration and worse pulmonary function .


During the treatment period , lung function and asthma control measures with placebo were generally worse in FAO + versus FAO - patients .


Budesonide was effective on most end points in both FAO + and FAO - patients .


In contrast to FAO - patients , FAO + patients were unresponsive to formoterol monotherapy in both study populations .


Consistently greater improvements in most end points ( including worsening of asthma as predefined by specific lung function parameters or clinical symptoms ) were observed moving from formoterol to budesonide to budesonide/formoterol in both FAO + and FAO - patients , with generally greater than additive effects on lung function with budesonide/formoterol in FAO + patients .


FAO + patients tended to be more impaired and at greater risk for an asthma event versus FAO - patients .


While FAO + patients were non-responsive to formoterol monotherapy , they retained responsiveness to budesonide and had the greatest lung function and control responses to budesonide/formoterol that were similar to or greater than responses of FAO - patients .


Inhibition of inflammatory cytokines may have therapeutic effects in diabetic retinopathy ( DR ) .


To compare aqueous and vitreous levels of @ inflammatory cytokines in patients treated preoperatively with topical ketorolac tromethamine , @ % , or placebo before pars plana vitrectomy for complications related to proliferative DR ( PDR ) .


A prospective , randomized , placebo-controlled , patient-masked interventional study performed in a university academic hospital included @ eyes from @ patients undergoing pars plana vitrectomy for complications of PDR .


Eyes were randomized to ketorolac tromethamine , @ % ( Acuvail ) , or placebo @ times daily for @ days before pars plana vitrectomy .


Undiluted aqueous and vitreous samples were taken at the time of surgery and immediately frozen at -@ C.


Aqueous and vitreous levels of prostaglandin E@ and @ other inflammatory cytokines implicated in the pathogenesis of DR.


Prostaglandin E@ , platelet-derived growth factor ( PDGF ) AA , eotaxin , vascular endothelial growth factor , interferon - inducible protein of @ kDa , monocyte chemoattractant protein @ , growth-related oncogene , interleukin @ , interleukin @ ( IL-@ ) , and tumor necrosis factor were detectable in the aqueous and vitreous of at least half of the eyes , and these cytokines were analyzed further .


Aqueous levels were lower in the ketorolac group for all cytokines detected , but only the difference in IL-@ was statistically significant ( @ % reduction ; P = @ ) .


Levels of IL-@ ( @ % reduction ; P = @ ) and PDGF-AA ( @ % reduction ; P = @ ) were significantly lower in the vitreous of patients treated with ketorolac .


Topical ketorolac tromethamine , @ % , significantly lowered aqueous IL-@ levels and vitreous IL-@ and PDGF-AA levels in this series of eyes , suggesting that it may cause meaningful inhibition of inflammatory cytokines implicated in the pathogenesis of DR.


The effects of the DASH ( Dietary Approaches to Stop Hypertension ) diet on inflammation in childhood metabolic syndrome ( MetS ) have still to be identified .


To examine the effects of the DASH diet on markers of systemic inflammation in adolescents with MetS .


In this randomized , cross-over clinical trial , @ postpubescent girls with MetS were randomly assigned to receive either the DASH diet menu cycles or usual dietary advice ( UDA ) for @ weeks .


After a @-week washout period , participants were crossed over to the alternate arm .


The DASH diet was designed to maintain the current body weight .


This diet contained high amounts of fruit , vegetables and low-fat dairy products and was low in saturated fats and cholesterol .


UDA consisted of general oral advice and written information about healthy food choices based on the Healthy Eating Plate .


Compliance to the DASH diet was assessed through quantification of plasma vitamin C levels .


Fasting venous blood samples were taken @ times from each participant : at baseline and at the end of each study arm .


Circulating levels of biomarkers of systemic inflammation were quantified according to standard protocols .


Mean ( SD ) age and weight of participants was @ years ( @ ) and @ kg ( @ ) , respectively .


Serum vitamin C levels tended to increase during the DASH phase compared with the UDA phase ( @ @ vs. -@ @ ng/dl , respectively , p = @ ) indicating a relatively good compliance to the DASH diet .


Adherence to the DASH diet , compared to the UDA , had a significant effect on serum high-sensitivity C-reactive protein levels ( p = @ ) .


This effect remained significant even after adjustment for weight changes and after further controlling for changes in lipid profiles .


We did not observe any significant effect of intervention on levels of serum tumor necrosis factor-alpha , interleukin ( IL ) -@ , IL-@ and adiponectin , in either the crude or adjusted models .


There were no significant group * time interactions for any dependent variable , except for IL-@ ; this was close to the significant level .


In summary , consumption of the DASH eating pattern for @ weeks may reduce circulating levels of hs-CRP among adolescents with MetS .


Other inflammatory markers were not affected by the DASH diet .


Abiraterone acetate plus prednisone significantly improved radiographic progression-free survival compared with placebo plus prednisone in men with chemotherapy-naive castration-resistant prostate cancer at the interim analyses of the COU-AA-@ trial .


Here , we present the prespecified final analysis of the trial , assessing the effect of abiraterone acetate plus prednisone on overall survival , time to opiate use , and use of other subsequent therapies .


In this placebo-controlled , double-blind , randomised phase @ study , @ asymptomatic or mildly symptomatic patients with chemotherapy-naive prostate cancer stratified by Eastern Cooperative Oncology performance status ( @ vs @ ) were randomly assigned with a permuted block allocation scheme via a web response system in a @:@ ratio to receive either abiraterone acetate ( @ mg once daily ) plus prednisone ( @ mg twice daily ; abiraterone acetate group ) or placebo plus prednisone ( placebo group ) .


Coprimary endpoints were radiographic progression-free survival and overall survival analysed in the intention-to-treat population .


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


At a median follow-up of @ months ( IQR @-@ @ ) , @ ( @ % ) of the prespecified @ death events for the final analysis had been observed : @ ( @ % ) of @ patients in the abiraterone acetate group and @ ( @ % ) of @ in the placebo group .


@ ( @ % ) patients initially receiving prednisone alone subsequently received abiraterone acetate plus prednisone as crossover per protocol ( @ patients ) or as subsequent therapy ( @ patients ) .


Overall , @ ( @ % ) patients in the abiraterone acetate group and @ ( @ % ) in the placebo group received subsequent treatment with one or more approved agents .


Median overall survival was significantly longer in the abiraterone acetate group than in the placebo group ( @ months -LSB- @ % CI @-@ @ -RSB- vs @ months -LSB- @-@ @ -RSB- ; hazard ratio @ -LSB- @ % CI @-@ @ -RSB- ; p = @ ) .


The most common grade @-@ adverse events of special interest were cardiac disorders ( @ -LSB- @ % -RSB- of @ patients in the abiraterone acetate group vs @ -LSB- @ % -RSB- of @ patients in the placebo group ) , increased alanine aminotransferase ( @ -LSB- @ % -RSB- vs four -LSB- < @ % -RSB- ) , and hypertension ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) .


In this randomised phase @ trial with a median follow-up of more than @ years , treatment with abiraterone acetate prolonged overall survival compared with prednisone alone by a margin that was both clinically and statistically significant .


These results further support the favourable safety profile of abiraterone acetate in patients with chemotherapy-naive metastatic castration-resistant prostate cancer .


Chronic low back pain is one of the four most common diseases in the world with great socioeconomic impact .


Supervised exercise therapy is one of the treatments suggested for this condition ; however , the recommendation on the best type of exercise is still unclear .


The Pilates method of exercise is effective in reducing pain and disability in these patients , as well as the analgesia promoted by interferential current .


Currently , the literature lacks information on the efficacy of the association of these two techniques in the short - and medium-term than performing one of the techniques isolated .


The objective of this study will be to evaluate the efficacy of adding interferential current to the Pilates method exercises for the treatment of patients with chronic nonspecific low back pain in the short - and medium-term .


This study will be a randomized controlled trial with two arms and blinded evaluator , conducted at an outpatient Physical Therapy Department in Brazil .


Patients with nonspecific chronic low back pain and pain equal to or greater than @ in the Pain Numerical Rating Scale ( @/@ ) will be randomly assigned to one of two groups : Group with active interferential current + Pilates ( n = @ ) will be submitted to the active interferential current associated to the modified Pilates exercises , and Group with sham interferential current + Pilates ( n = @ ) will be submitted to the sham interferential current associated with the modified Pilates exercises during @ sessions .


The outcomes pain intensity , pressure pain threshold , general and specific disability , global perceived effect and kinesiophobia will be evaluated by a blinded assessor at baseline , six weeks and six months after randomization .


Because of the study design , blinding of the participants and the therapists involved in the study will not be possible .


The results of this study could contribute to the process of clinical decision - making for the improvement of pain and disability in participants with nonspecific chronic low back pain .


To verify the regulatory effects of acupuncture on exercise tolerance in patients with chronic obstructive pulmonary disease ( COPD ) at stable phase .


Thirty cases of COPD were randomly divided into a treatment group ( @ cases ) and a placebo group ( @ cases ) .


Based on specified aerobic exercise , acupuncture was applied in the treatment group and placebo acupuncture was used in the placebo group .


The acupoints included Danzhong ( CV @ ) , Rugen ( ST @ ) , Guanyuan ( CV @ ) , Zhongwan ( CV @ ) , Tianshu ( ST @ ) and so on .


The needle did not penetrate into the skin for the placebo group .


The treatment was required for @ to @ times per week for totally @ weeks .


The indices of exercise tolerance , including @-min walking distance ( @-MWD ) , exercise time , maximum oxygen uptake ( VO@max ) forced expiratory volume in @ second ( FEV@ ) / forced vital capacity ( FVC ) , maximum ventilatory volume ( MVV ) , St. George respiratory questionnaire ( SGRQ ) were observed in two groups before and after treatment .


( @ ) Exercise tolerance : the differences of @-MWD and exercise time were statistically significant between groups , which were more superior in the treatment group ( both P < @ ) ; the VO@max was significantly increased after treatment in the treatment group ( P < @ ) , but there was no difference between two groups ( P > @ ) .


( @ ) Pulmonary ventilation function : the differences of FEV@ % , FEV@/FVC and MVV % were statistically significant between groups , which were more superior in the treatment group ( P < @ , P < @ ) ; ( @ ) SGRQ : the SGRQ was significantly improved after treatment in the treatment group ( P < @ ) , but there was no difference between two groups ( P > @ ) .


The acupuncture could improve the exercise tolerance in patients with chronic obstructive pulmonary disease at stable phase , and shorten the onset time of aerobic exercise .


Besides , acupuncture combined with aerobic exercise could effectively improve the pulmonary function .


Currently , task time and errors are often used as performance parameters in laparoscopic training .


Training with the focus on task time improvement alone results in fast , but possibly less controlled , instrument movements and therefore suboptimal tissue handling skills .


Twenty-five medical students were randomly assigned in two groups .


Both groups performed a tissue manipulation task six times .


During this training session , the time feedback group ( n = @ ) received real-time visual feedback of the task time .


The force feedback group ( n = @ ) received real-time visual feedback of the tissue manipulation force .


After the training sessions , participants in both groups performed an entirely different task without visual feedback .


Task time , force , and motion parameters of this posttest were used to compare the technical skills of the medical students .


The training data of the group that received force feedback showed a learning curve for the mean and max absolute force , max force area , force volume , task time , and path length of both instruments .


The data from the group that received time feedback showed a learning curve for the max force , task time , and path length of both instruments .


In the posttest , the parameters of mean absolute force ( p = @ ) , max force ( p = @ ) , and force volume ( p = @ ) showed a significant difference in favor of the group that received force feedback .


The learning curves and the posttest indicate that training with visual force feedback improves tissue handling skills with no negative effect on the task time and instrument motions .


Conventional laparoscopic training with visual time feedback improves instrument motion and task time , but it does not improve tissue manipulation skills .


To determine the association of body mass index ( BMI ) on complications , recurrence , and survival in GOG LAP@ , a randomized comparison of laparoscopic versus open staging in clinically early stage uterine cancer ( EC ) .


An ancillary data analysis of GOG LAP@ was performed .


Categorical variables were compared using Pearson chi-square test and continuous variables using the Wilcoxon-Mann-Whitney and Kruskal-Wallis tests by BMI group .


Survival was estimated using the Kaplan-Meier method .


Cox proportional hazards model was used to evaluate independent prognostic factors on survival .


Statistical tests were two-tailed with = @ , except where noted .


Statistical analyses utilized R programming language .


@ women were included .


BMI ( kg/m ( @ ) ) groups were < @ ( @ % ) , @-@ ( @ % ) , @-@ ( @ % ) , @-@ ( @ % ) , and @ ( @ % ) .


Stage ( p = @ ) , grade ( p < @ ) , and histology ( p = @ ) differed by BMI .


Obese women were less likely to have high risk ( HR ) disease ( + lymph nodes/ovaries/cytology ) or tumor features that met GOG@ high intermediate risk ( HIR ) criteria ( p < @ ) .


Adjuvant therapy ( p = @ ) and recurrence ( p = @ ) did not vary by BMI .


Hospitalization > @days , antibiotic use , wound infection , and venous thrombophlebitis were higher with BMI @ .


BMI ( p = @ ) , age ( p < @ ) , race ( p = @ ) , and risk group ( p < @ ) predicted all-cause mortality .


BMI was not predictive of disease-specific survival ( p = @ ) , but age ( p = @ ) and risk group ( p < @ ) were significant factors .


Obese women have greater surgical risk and lower risk of metastatic disease .


BMI is associated with all-cause but not disease-specific mortality , emphasizing the detrimental effect of obesity ( independent of EC ) , which deserves particular attention .


To evaluate the efficacy of corneal debridement in the treatment of clinically diagnosed cases of microsporidial keratoconjunctivitis .


Prospective , double-masked randomized clinical trial .


Patients with clinical features such as multifocal , coarse , raised , punctate , round to oval epithelial lesions in the cornea in slit-lamp examination with mild to moderate conjunctival congestion , suggestive of microsporidial superficial keratoconjunctivitis , were included in the prospective study .


All patients were randomized into @ groups .


Group @ patients underwent debridement with the help of a sterile # @ blade on a Bard-Parker handle , whereas only conjunctival swabs were taken from Group @ patients .


All patients were treated with ocular lubricants .


One hundred and twenty patients with clinical features suggestive of microsporidial superficial keratoconjunctivitis were included in the study .


The mean age was @ @ years ( Group @ ) and @ @ years ( Group @ ) ( P = @ ) .


The mean duration of symptoms was @ @ days ( Group @ ) and @ @ days ( Group @ ) ( P = @ ) .


Baseline characteristics showed no difference between the @ groups .


The primary outcome was the time from the presentation to complete resolution ( ie , absence of corneal lesions ) of the clinical signs and symptoms .


The secondary outcomes were final visual acuity and residual corneal side effects and/or scarring , if any .


The mean resolution time of the corneal lesions was @ @ days ( Group @ ) and @ @ days ( Group @ ) ( P = @ ) .


There was no significant difference in final visual outcome in the @ groups .


No serious side effects were observed .


Debridement does not have any significant advantage in terms of resolution of the corneal lesions and final visual outcome in cases of microsporidial keratoconjunctivitis .


Evidence regarding the cost-effectiveness of joint protection and hand exercises for the management of hand OA is not well established .


The primary aim of this study is to assess the cost-effectiveness ( cost-utility ) of these management options .


In addition , given the absence of consensus regarding the conduct of economic evaluation alongside factorial trials , we compare different analytical methodologies .


A trial-based economic evaluation to assess the cost-utility of joint protection only , hand exercises only and joint protection plus hand exercises compared with leaflet and advice was undertaken over a @ month period from a UK National Health Service perspective .


Patient-level mean costs and mean quality-adjusted life years ( QALYs ) were calculated for each trial arm .


Incremental cost-effectiveness ratios ( ICERs ) were estimated and cost-effectiveness acceptability curves were constructed .


The base case analysis used a within-the-table analysis methodology .


Two further methods were explored : the at-the-margins approach and a regression-based approach with or without an interaction term .


Mean costs ( QALYs ) were @ ( s.d. @ ) for leaflet and advice , @ ( s.d. @ ) for joint protection , @ ( s.d. @ ) for hand exercises and @ ( s.d. @ ) for joint protection plus hand exercises .


In the base case , hand exercises were the cost-effective option , with an ICER of @ per QALY gained .


Hand exercises remained the most cost-effective management strategy when adopting alternative methodological approaches .


This is the first trial evaluating the cost-effectiveness of occupational therapy-supported approaches to self-management for hand OA .


Our findings showed that hand exercises were the most cost-effective option .


Supervised consumption of opiate substitution treatment is standard practice in the UK yet little is known about the patient experience of this treatment modality .


This study aimed to assess the patient experience of receiving supervised compared with unsupervised consumption of methadone or buprenorphine .


A qualitative study utilising a grounded theory approach to analysis .


Participants ( @ ) were theoretically sampled from @ opioid-dependent patients entering a randomised controlled trial of opiate substitution treatment across four urban and community drug treatment services in England .


Multidisciplinary staff were recruited for interviews and focus groups ( @ ) .


Supervised consumption was accepted by patients , despite causing practical limitations and raising issues of privacy and stigma .


Patients recognised that establishing a daily routine away from illicit drugs was useful early in treatment .


However , having flexibility to move away from supervision was important .


Unsupervised patients reported that they ultimately preferred this treatment approach and appreciated the trust and sense of reward that unsupervised treatment bought .


Clinicians expressed confidence in supervised prescribing and reduced risk for their patients , but also concern that a minority of individuals may remain inappropriately supervised for lengthy time periods .


This study provides an important patient perspective and is the first in-depth qualitative investigation directly comparing supervision with unsupervised treatment to consider both patient and professional perspectives .


Overall , our qualitative findings suggest that flexibly timed discontinuation of supervision may have positive benefits .


To identify eyes of patients with diabetes type @ that show progression of retinal disease within a @-year period using noninvasive techniques .


Three hundred seventy-four type @ diabetic patients with mild nonproliferative diabetic retinopathy ( Early Treatment Diabetic Retinopathy Study -LSB- ETDRS -RSB- level @ or @ ) were included in a @-month prospective observational study to identify retinopathy progression .


Four visits were scheduled at @ , @ , @ , and @ months .


Microaneurysm ( MA ) activity using the RetmarkerDR and retinal thickness using spectral-domain optical coherence tomography ( SD-OCT ) were assessed by a central reading center at all visits and ETDRS severity level in the first and last visits .


Three hundred thirty-one eyes/patients completed the study .


Microaneurysm formation rate greater than or equal to @ was present in @ % of the eyes and MA turnover greater than or equal to @ in @ % at month @ .


Higher MA turnover values were registered in eyes that showed progression in ETDRS severity level ( P < @ ) .


There were also significant correlations between increased microaneurysm activity and increases in retinal thickness .


Spectral-domain OCT identified clinical macular edema in @ eyes/patients ( @ % ) and subclinical macular edema in @ eyes/patients ( @ % ) at baseline .


Progression of retinal thickening was registered in eyes that had either subclinical or clinical macular edema at baseline .


Changes in MA activity measured with RetmarkerDR and in central retinal thickness in eyes with mild nonproliferative diabetic retinopathy and diabetes type @ are able to identify eyes at risk of progression .


These eyes/patients should be selected for inclusion in future clinical trials of drugs targeted to prevent diabetic retinopathy progression to vision-threatening complications .


( ClinicalTrials.gov number , NCT@ . )


We evaluated the association between cardiovascular autonomic neuropathy , and erectile dysfunction and lower urinary tract symptoms in men with type @ diabetes .


Male type @ diabetes participants ( @ ) in the DCCT/EDIC were studied .


Cardiovascular autonomic neuropathy was assessed by standardized cardiovascular reflex tests including changes in respiratory rate variation with deep breathing , Valsalva maneuver ( Valsalva ratio ) and changes in supine to standing diastolic blood pressure .


Erectile dysfunction was assessed by a proxy item from the International Index of Erectile Function , and lower urinary tract symptoms were assessed with the AUASI ( American Urological Association Symptom Index ) .


Multivariable logistic regression models estimated the association between cardiovascular autonomic neuropathy and erectile dysfunction and/or lower urinary tract symptoms , adjusting for time weighted glycemic control , blood pressure , age and other covariates .


Men in whom erectile dysfunction and/or lower urinary tract symptoms developed during EDIC had a significantly lower respiratory rate variation and Valsalva ratio at DCCT closeout and EDIC year @/@ compared to those without erectile dysfunction or lower urinary tract symptoms .


In adjusted analysis , participants with cardiovascular autonomic neuropathy had @ greater odds of erectile dysfunction and lower urinary tract symptoms ( @ % CI @-@ @ ) .


These data suggest that cardiovascular autonomic neuropathy predicts the development of urological complications in men with long-standing type @ diabetes .


Studies evaluating the mechanisms contributing to these interactions are warranted for targeting effective prevention or treatment .


Physiotherapy treatment of frozen shoulder is varied , but most lack specific focus on the underlying disorder , which is the adhered shoulder capsule .


Although positive effects were found after physiotherapy , the recurrence and prolonged disability of a frozen shoulder are major factors to focus on to provide the appropriate treatment .


We wished to study the effectiveness of a shoulder countertraction apparatus on ROM , pain , and function in patients with a frozen shoulder and compare their results with those of control subjects who received conventional physiotherapy .


A total of @ participants were randomly assigned to an experimental group and a control group , with each group having @ participants .


The control group received physiotherapy and the experimental group received countertraction and physiotherapy .


The total treatment time was @ minutes a day for @ days per week for @ weeks .


The outcome measures used were goniometer measurements , VAS , and the Oxford Shoulder Score .


Improvements were seen in the scores for shoulder flexion ( @ @ at baseline increased to @ @ after intervention ) , abduction ROM ( @ @ at baseline increased to @ @ after intervention ) , and pain ( @ @ at baseline decreased to @ @ after intervention ) in the experimental group .


Sixty percent of the participants ( n = @ ) were improved to the fourth stage of satisfactory joint function according to the Oxford Shoulder Score in the experimental group compared with @ % ( n = @ ) in the control group ( p < @ ) .


Incorporating shoulder countertraction along with physiotherapy improves shoulder function compared with physiotherapy alone for the treatment of a frozen shoulder .


Additional studies are needed focusing on this concept to increase the generalizability of the counter-traction apparatus in various groups .


Level II , prospective comparative study .


See the Instructions for Authors for a complete description of levels of evidence .


In The Netherlands , excessive alcohol use ( e.g. , binge drinking ) is prevalent among adolescents .


Alcohol use in general and binge drinking in particular comes with various immediate and long term health risks .


Thus , reducing binge drinking among this target group is very important .


This article describes a two-arm Cluster Randomized Controlled Trial ( CRCT ) of an intervention aimed at reducing binge drinking in this target group .


The intervention is a Web-based , computer-tailored game in which adolescents receive personalized feedback on their drinking behavior aimed at changing motivational determinants related to this behavior .


The development of the game is grounded in the I-Change Model .


A CRTC is conducted to test the effectiveness of the game .


Adolescents are recruited through schools , and schools are randomized into the experimental condition and the control condition .


The experimental condition fills in a baseline questionnaire assessing demographic variables , motivational determinants of behavior ( attitude , social influences , self-efficacy , intention ) and alcohol use .


They are also asked to invite their parents to take part in a short parental component that focusses on setting rules and communicating about alcohol .


After completing the baseline questionnaire , the experimental condition continues playing the first of three game scenarios .


The primary follow-up measurement takes place after four months and a second follow-up after eight months .


The control condition only fills in the baseline , four and eight month follow-up measurement and then receives access to the game ( i.e. , a waiting list control condition ) .


The effectiveness of the intervention to reduce binge drinking in the previous @ days and alcohol use in the last week will be assessed .


Furthermore , intention to drink and binge drink are assessed .


Besides main effects , potential subgroup differences pertaining to gender , age , and educational background are explored .


The study described in this article gives insight into the effectiveness of a possible solution for a prominent public health issue in The Netherlands , which is binge drinking among @ to @ year old adolescents .


To compare clinical outcomes from outpatient with inpatient cervical prostaglandin E@ ripening for low risk labour induction .


Randomised controlled trial .


Two tertiary hospitals in Adelaide , Australia .


Women with uncomplicated term pregnancies , scheduled for induction of labour for reasons of post-dates or for social reasons .


Eight hundred and twenty-seven women were randomised at induction decision to an outpatient or inpatient group .


All women had CTG monitoring before and after vaginal PgE@ administration .


The inpatient women were admitted and the outpatient group was discharged home overnight with instructions to return if labour established or rupture of membranes occurred .


Next morning , outpatient women were admitted for rupture of membranes or further ripening .


After membrane rupture , both groups received routine care .


Oxytocin use , maternal and fetal outcomes , and whether planned outpatient management was achievable .


There were no significant differences in oxytocin use ( @ % difference , CI-@ @ to @ ) , caesarean sections ( -@ % difference , CI-@ @ to @ ) , epidural use ( @ % difference , CI-@ @ to @ ) , vaginal delivery within @ hours ( -@ % difference , CI-@ @ to @ ) or labour complications .


More than half of the randomised women did not receive the intervention as they laboured spontaneously , or did not require ripening .


The post-hoc analysis of women who received ripening also indicated no statistically significant differences in the patterns or results , with the exception of outpatient women having a longer mean length of active labour ( mean difference @ minutes , CI @-@ minutes ) .


Outpatient women who received ripening were diagnosed more frequently with non-reassuring CTG monitoring and hyperstimulation , with less than half of the women going home and remaining home overnight .


This study demonstrated no clinical advantage or disadvantage in prostaglandin E@ outpatient cervical ripening .


Uterine stimulation following prostaglandins may preclude a woman from going home or remaining at home overnight and may not be the best agent for outpatient ripening .


Microvascular alterations impair tissue oxygenation during sepsis .


A red blood cell ( RBC ) transfusion increases oxygen ( O@ ) delivery but rarely improves tissue O@ uptake in patients with sepsis .


Possible causes include RBC alterations due to prolonged storage or residual leukocyte-derived inflammatory mediators .


The aim of this study was to compare the effects of two types of transfused RBCs on microcirculation in patients with sepsis .


In a prospective randomized trial , @ patients with sepsis were divided into two separate groups and received either non-leukodepleted ( n = @ ) or leukodepleted ( n = @ ) RBC transfusions .


Microvascular density and perfusion were assessed with sidestream dark field ( SDF ) imaging sublingually , before and @ hour after transfusions .


Thenar tissue O@ saturation ( StO@ ) and tissue hemoglobin index ( THI ) were determined with near-infrared spectroscopy , and a vascular occlusion test was performed .


The microcirculatory perfused boundary region was assessed in SDF images as an index of glycocalyx damage , and glycocalyx compounds ( syndecan-@ , hyaluronan , and heparan sulfate ) were measured in the serum .


No differences were observed in microvascular parameters at baseline and after transfusion between the groups , except for the proportion of perfused vessels ( PPV ) and blood flow velocity , which were higher after transfusion in the leukodepleted group .


Microvascular flow index in small vessels ( MFI ) and blood flow velocity exhibited different responses to transfusion between the two groups ( P = @ and P = @ , respectively ) , with a positive effect of leukodepleted RBCs .


When within-group changes were examined , microcirculatory improvement was observed only in patients who received leukodepleted RBC transfusion as suggested by the increase in De Backer score ( P = @ ) , perfused vessel density ( P = @ ) , PPV ( P = @ ) , and MFI ( P = @ ) .


Blood flow velocity decreased in the non-leukodepleted group ( P = @ ) .


THI and StO@ upslope increased in both groups .


StO@ and StO@ downslope increased in patients who received non-leukodepleted RBC transfusions .


Syndecan-@ increased after the transfusion of non-leukodepleted RBCs ( P = @ ) .


This study does not show a clear superiority of leukodepleted over non-leukodepleted RBC transfusions on microvascular perfusion in patients with sepsis , although it suggests a more favorable effect of leukodepleted RBCs on microcirculatory convective flow .


Further studies are needed to confirm these findings .


Dermal fillers have continuingly been under development to increase safety , efficacy , and longevity .


Biostimulatory dermal fillers , such as calcium hydroxylapatite fillers , have already been shown to be superior in efficacy compared to nonanimal stabilized hyaluronic acid ( NASHA ) - based fillers .


In this randomized split-face study , we compared a novel biostimulatory polycaprolactone ( PCL ) - based dermal filler with a NASHA-based dermal filler , for safety , efficacy , and duration of cosmetic correction for the treatment of nasolabial folds ( NLFs ) .


Forty subjects received a PCL-based dermal filler in one of their NLFs , and a NASHA-based dermal filler on the contralateral side .


Efficacy was evaluated based on the Wrinkle Severity Rating Scale and Global Aesthetic Improvement Scale .


After @ , @ , and @months post-treatment , NLFs treated with the PCL-based dermal filler showed statistically significant improvements on the Wrinkle Severity Rating Scale and greater improvements on the GAIS compared to NLFs treated with the NASHA-based dermal filler .


Both products were found to be equally safe and well tolerated .


Our results suggest that PCL-based dermal fillers offer longer-lasting performance over NASHA-based dermal fillers in NLFs treatment .


A randomized , double-blind , placebo-controlled flexible-dose , parallel group trial was conducted at @ clinical investigational sites in the United States to examine the safety and efficacy of the selegiline transdermal system ( STS ) ( EMSAM ) in adolescents ( ages @-@ years ) meeting American Psychiatric Association , Diagnostic and Statistical Manual of Mental Disorders , @th ed .


( DSM-IV ) criteria for moderate to severe major depressive disorder ( MDD ) without psychotic features .


Adolescents ( n = @ ) with moderate to severe MDD were randomized to either STS ( n = @ ) or placebo ( n = @ ) .


Two hundred and fifteen ( @ % ) subjects completed the study and @ ( @ % ) reported discontinuation because of adverse events ( AEs ) .


The primary efficacy outcome measure was the mean change from baseline to end of study ( week @ last observation carried forward -LSB- LOCF -RSB- ) in the Children 's Depression Rating Scale-Revised ( CDRS-R ) total score .


Secondary outcome measures included end-point Clinical Global Impressions - Severity ( CGI-S ) and Clinical Global Impressions - Improvement ( CGI-I ) .


Patients on STS or placebo had a significant decline from baseline ( p < @ ) on their CDRS-R total score with mean reductionsSD as follows : STS @ ; placebo @ .


Both groups had similar response rates ( @ % vs. @ % ) defined as CGI-I of @ or @ at study end .


However , these between-group efficacy findings were without statistical significance .


The overall incidence of reported AEs was @ % for STS-treated patients and @ % for placebo-treated patients .


Most commonly reported AEs in STS or placebo groups were application site reactions ( STS = @ % ; placebo = @ % ) , headache ( STS = @ % ; placebo = @ % ) , and nausea ( STS = @ % ; placebo = @ % ) .


Treatment groups did not differ on any laboratory parameters , vital signs , or electrocardiogram ( ECG ) findings .


No suspected hypertensive crises were reported in the trial .


These data demonstrated that the STS was safe and well tolerated in this adolescent sample .


However , both STS-treated and placebo-treated subjects demonstrated a decline from baseline in depressive symptoms ( CDRS-R total score ) over the length of the study , without statistical superiority by either group .


Wind farm developments have been hampered by claims that sound from wind turbines causes symptoms and negative health reports in nearby residents .


As scientific reviews have failed to identify a plausible link between wind turbine sound and health effects , psychological expectations have been proposed as an explanation for health complaints .


Building on recent work showing negative expectations can create symptoms from wind turbines , we investigated whether positive expectations can produce the opposite effect , in terms of a reduction in symptoms and improvements in reported health .


@ participants were randomized to either positive or negative expectation groups and subsequently exposed to audible wind farm sound and infrasound .


Prior to exposure , negative expectation participants watched a DVD incorporating TV footage about health effects said to be caused by infrasound produced by wind turbines .


In contrast , positive expectation participants viewed a DVD that outlined the possible therapeutic effects of infrasound exposure .


During exposure to audible windfarm sound and infrasound , symptoms and mood were strongly influenced by the type of expectations .


Negative expectation participants experienced a significant increase in symptoms and a significant deterioration in mood , while positive expectation participants reported a significant decrease in symptoms and a significant improvement in mood .


The study demonstrates that expectations can influence symptom and mood reports in both positive and negative directions .


The results suggest that if expectations about infrasound are framed in more neutral or benign ways , then it is likely reports of symptoms or negative effects could be nullified .


To replicate the associations of leukocyte telomere length ( LTL ) with variants at four loci and to investigate their associations with coronary heart disease ( CHD ) and type II diabetes ( T@D ) , in order to examine possible causal effects of telomere maintenance machinery on disease aetiology .


Four SNPs at three loci BICD@ ( rs@ GC ) , @q@ @ ( rs@ GT ) , and OBFC@ ( rs@ CG , rs@ AC ) were genotyped in four studies comprised of @ subjects out of which @ had CHD and @ T@D .


Three SNPs ( rs@ CG , rs@G > T and rs@ GC ) at the TERC locus were genotyped in these four studies , in addition to an offspring study of @ healthy students .


For all samples , LTL had been measured using a real-time PCR-based method .


Only one SNP was associated with a significant effect on LTL , with the minor allele G of OBFC@ rs@ SNP being associated with longer LTL ( = @ , P = @ ) .


No SNPs were significantly associated with CHD or T@D .