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Number of SABA fills during the past 12 months was categorized into low - to moderate - vs high-use groups .
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SABA groups were compared by the number of symptom days and nights , allergen sensitization , and exposures .
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Regression models were used to predict high SABA use .
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Mean number of SABA fills over 12 months was 3.12 .
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Unadjusted bivariate analysis showed that high SABA users were more than 5 times more likely to have an asthma hospitalization , almost 3 times more likely to have an asthma intensive care unit admission , and more than 3 times more likely to have prior specialty asthma care or positive cockroach sensitization than low to moderate SABA users .
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In the final regression model , for every additional inhaled corticosteroid fill , a child was 1.4 times more likely and a child with positive cockroach sensitization was almost 7 times more likely to have high SABA use when controlling for prior intensive care unit admission , receipt of specialty care , child age , and income .
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Providers should closely monitor SABA and controller medication use , allergen sensitization , and exposures in children with persistent asthma .
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ClinicalTrials.gov , identifier NCT01981564 .
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To compare the cardiopulmonary effects of intravenous ( IV ) and intramuscular ( IM ) medetomidine and butorphanol with or without MK-467 .
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Prospective , randomized experimental cross-over .
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Eight purpose-bred beagles ( two females , six males ) , 3-4 years old and weighing 14.5 1.6 kg ( mean SD ) .
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All dogs received four different treatments as follows : medetomidine 20 g kg ( -1 ) and butorphanol tartrate 0.1 mg kg ( -1 ) IV and IM ( MB ) , and MB combined with MK-467 ,500 g kg ( -1 ) ( MBMK ) IV and IM .
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Heart rate ( HR ) , arterial blood pressures ( SAP , MAP , DAP ) , central venous pressure ( CVP ) , cardiac output , respiratory rate ( fR ) , rectal temperature ( RT ) were measured and arterial blood samples were obtained for gas analysis at baseline and at 3 , 10 , 20 , 30 , 45 and 60 minutes after drug administration .
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The cardiac index ( CI ) , systemic vascular resistance index ( SVRI ) and oxygen delivery index ( DO2 I ) were calculated .
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After the follow-up period atipamezole 50 g kg ( -1 ) IM was given to reverse sedation .
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HR , CI and DO2 I were significantly higher with MBMK after both IV and IM administration .
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Similarly , SAP , MAP , DAP , CVP , SVRI and RT were significantly lower after MBMK than with MB .
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There were no differences in fR between treatments , but arterial partial pressure of oxygen decreased transiently after all treatments .
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Recoveries were uneventful following atipamezole administration after all treatments .
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MK-467 attenuated the cardiovascular effects of a medetomidine-butorphanol combination after IV and IM administration .
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To evaluate adherence to therapy in acne patients using mobile phones and Short Message Service ( SMS ) to communicate .
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160 patients were randomly assigned to two groups : the SMS group received 2 text messages twice a day for a period of 12 weeks ; the control group did not receive any messages .
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Before and after 12 weeks , the following evaluations were performed in all patients : digital photographs , the Global Acne Grading System , the Dermatology Life Quality Index , the Cardiff Acne Disability Index , the doctor-patient relationship evaluated through the Patient-Doctor Depth-of-Relationship Scale , and the adherence to treatment evaluated by asking patients how many days a week they had followed the therapy .
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For statistical analysis we used Student 's t test .
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The SMS group had a better improvement of all parameters compared to the control group .
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Adherence and compliance are higher for patients who are included in a strategy of control .
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Ondansetron , sometimes combined with acustimulation at PC6 ( Neiguan ) , is commonly used for preventing postoperative nausea and vomiting , but PC6 is not the only point that can be used for this purpose .
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To evaluate the combined effects of ondansetron and ST36 ( Zusanli ) acupuncture point injection on postoperative vomiting ( POV ) after laparoscopic surgery .
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A randomised , patient and assessor-blinded , placebo-controlled clinical study was conducted .
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One hundred and sixty patients undergoing laparoscopic surgery were randomly assigned to one of four groups : ( 1 ) group P ( placebo-control ) : intravenous normal saline + bilateral non-acupuncture point injection of vitamin B1 ( n = 40 ) ; ( 2 ) group O ( ondansetron ) : intravenous ondansetron + bilateral ST36 sham injection ( n = 40 ) ; ( 3 ) group A ( acupuncture point injection ) : intravenous normal saline + bilateral acupuncture point injection at ST36 of vitamin B1 ( n = 40 ) ; ( 4 ) group C ( combination ) : intravenous ondansetron + bilateral acupuncture point injection at ST36 of vitamin B1 ( n = 40 ) .
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Interventions were made on arrival at the postanaesthesia care unit .
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The primary outcome was the incidence of POV within 24 h after the operation .
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Secondary outcomes included severity of vomiting , incidence of rescue treatment , patients ' satisfaction and the first anal exsufflation time 24 h after the operation .
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The incidence of POV within 24 h postoperative period in each group was P 33 % ; O 11 % , A 9 % and C 6 % .
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Outcomes for all intervention groups were significantly better than that for placebo ( p < 0.01 ) .
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For the three interventions compared with placebo , the numbers needed to treat ( NNTs ) were O , NNT = 5 ; A , NNT = 5 and C , NNT = 4 .
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The secondary outcomes also demonstrated greater benefits of the combined regimen , with improvement seen in all the measures .
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Ondansetron , acupuncture , and ondansetron and acupuncture combined are effective prophylaxis for POV .
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The impact of sugar-sweetened beverages ( SSB ) on lipid metabolism when consumed in moderate amounts by normal weight subjects is debated .
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The objective of the study was to investigate the effect of different types of sugars in SSB on fatty acid metabolism ( ie , fatty acid synthesis and oxidation ) in healthy young men .
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Thirty-four normal-weight men were studied in a randomized crossover study .
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Four isocaloric 3-week interventions with SSB were performed in random order : medium fructose ( MF ; 40 g/d ) ; high fructose ( HF ; 80 g/d ) , high sucrose ( HS ; 80 g/d ) , and high glucose ( HG ; 80g/d ) .
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Fasting total plasma fatty acid composition was measured after each intervention .
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Acylcarnitines were measured in the fasting state and after a euglycemic hyperinsulinemic clamp in nine subjects .
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The relative abundance of palmitate ( 16:0 ) and the molar fatty acid ratio of palmitate to linoleic acid ( 16:0 to18 :2 ) as markers of fatty acid synthesis were increased after HF [ relative abundance of palmitate : 22.97 % 5.51 % ( percentage of total fatty acids by weight SD ) ] and MF ( 26.1 % 1.7 % ) compared with HS ( 19.40 % 2.91 % , P < .001 ) , HG ( 19.43 % 3.12 % , P < .001 ) , or baseline ( 19.40 % 2.79 % , P < .001 ) .
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After HS and HG , the relative abundance of palmitate was equal to baseline .
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Fasting palmitoylcarnitine was significantly increased after HF and HS ( HF and HS vs. HG : P = .005 ) , decreasing after inhibition of lipolysis by insulin in the clamp .
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When consumed in moderate amounts , fructose but not sucrose or glucose in SSB increases fatty acid synthesis ( palmitate ) , whereas fasting long-chain acylcarnitines are increased after both fructose and sucrose , indicating an impaired - oxidation flux .
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Little is known about global patterns of critical care unit ( CCU ) care and the relationship with outcomes in patients with acute decompensated heart failure ( ADHF ) .
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Whether a ward or a CCU admission is associated with better outcomes is unclear .
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Patients in the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure ( ASCEND-HF ) trial were initially hospitalized in a ward or CCU ( coronary or intensive care unit ) .
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Sites were geographically classified : Asia-Pacific ( AP ) , Central Europe ( CE ) , Latin America ( LA ) , North America ( NA ) , and Western-Europe ( WE ) .
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The primary outcome of 30-day all-cause mortality or all-cause hospital readmission was adjusted using a two-stage multivariable logistic regression model with a generalized estimated equation that took sites within each country as a nested random factor .
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Overall , 1944 ( 38.2 % ) patients were admitted to a CCU and 3150 ( 61.8 % ) to a ward , and this varied by region : 50.6 % AP , 63.3 % CE , 60.7 % WE , 22.1 % LA , and 28.6 % NA .
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The 30-day death or readmission rate was 15.2 % in ward patients and 17.0 % in CCU patients ( risk-adjusted Odds Ratio [ OR ] 1.44 : 95 % CI , 1.14-1 .82 ) .
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Compared with CCU patients in NA ( 24.1 % 30-day event rate ) , the primary outcomes were : AP ( 10.4 % , Odds Ratio [ OR ] 0.63 ; 95 % confidence Interval [ CI ] , 0.35 to 1.15 ) , CE ( 10.4 % , OR 0.56 : 95 % CI , 0.31 to 1.02 ) , LA ( 22.4 % , OR 0.60 : 95 % CI , 0.11 to 3.32 ) , and WE ( 11.2 % , OR 0.63 , 95 % CI , 0.25 to 1.56 ) .
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No regional differences in 30-day mortality were observed ; however , 30-day readmission rates were highest in NA sites .
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Management of patients with ADHF varies significantly , and after adjustment , CCU care was associated with higher risk of early mortality , not explained by international differences .
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These findings may help to improve the early decisions regarding risk stratification of patients hospitalized with ADHF .
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Hand-foot syndrome ( HFS ) is a frequently occurring adverse event associated with anticancer drugs .
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This study compares a newly introduced ointment containing several antioxidants and exhibiting high radical protection factor , which has been available on the German market since 2011 , with urea cream for prevention of HFS in patients treated with capecitabine .
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Patients with GI tumors or breast cancer treated with capecitabine were included in this randomized phase III study .
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The primary end point was prevention of HFS of any grade within 6 weeks of treatment as indicated by a standardized patient diary .
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The study had 80 % power to show a 20 % reduction of the incidence of HFS with the new ointment .
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Secondary end points included time to development of HFS greater than grade 1 , evaluation of capecitabine dose intensity , and quality of life analyses .
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A total of 152 patients were evaluable .
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In total , 47 of 152 patients experienced HFS ( 30.9 % ) , 39.5 % with the new ointment and 22.4 % in the urea arm ( stratified odds ratio , 2.37 ; P = .02 ) .
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Time to HFS greater than grade 1 was comparable , but time to any-grade HFS was significantly longer in the urea group ( P = .03 ) .
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Capecitabine dose intensity , time under study , and percentage of days with correct administration of study medication were identical , as were adverse events except for HFS .
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Skin-related quality of life was significantly worse in the group treated with the new ointment at the end of study treatment .
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This trial demonstrated that 10 % urea cream was superior to the new ointment at preventing HFS over the first 6 weeks of treatment with capecitabine .
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Atrial fibrillation ( AFib ) is common in heart failure ( HF ) with preserved ejection fraction ( HFpEF ) .
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Current AFib stroke risk prediction models include the presence of HF but do not specifically include HFpEF as a risk factor .
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Whether a history of AFib should be used to identify patients with HFpEF who are at risk has not been established .
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Baseline characteristics and outcomes of patients with HFpEF in the Irbesartan in Heart Failure with Preserved Ejection Fraction Trial were analyzed in relation to AFib .
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At baseline , 1209 ( 29.3 % ) had a history of AFib .
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Of these 557 ( 13.5 % ) had history of AFib alone , whereas 670 ( 16.2 % ) had both a history and AFib on ECG ; 2901 ( 70.3 % ) had neither .
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There were no significant differences in the risk of stroke between the 2 groups with a history of AFib who did or did not have AFib present on baseline ECG .
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During a median follow-up of 53 months , a fatal or nonfatal stroke occurred in 6.5 % ( 79/1209 ) patients with history of AFib compared with 3.9 % ( 114/2901 ) with no AFib .
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Having a history of AFib was independently associated with higher risk of stroke ( hazard ratio , 2.2 ; 95 % confidence interval , 1.6-3 .2 ; P < 0.0001 ) compared with those with no history of AFib .
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In patients with HFpEF , a history of AFib was common and independently associated with increased risk of stroke , regardless of whether AFib was present on ECG .
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Patients with HFpEF and a history of AFib should be considered at risk .
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Further studies are needed to determine whether this risk can be safely reduced .
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http://www.clinicaltrials.gov .
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Unique identifier : NCT000095238 .
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Selective kappa opioid receptor antagonism is a promising experimental strategy for the treatment of depression .
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The kappa opioid receptor antagonist , LY2456302 , exhibits ~ 30-fold higher affinity for kappa opioid receptors over mu opioid receptors , which is the next closest identified pharmacology .
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Here , we determined kappa opioid receptor pharmacological selectivity of LY2456302 by assessing mu opioid receptor antagonism using translational pupillometry in rats and humans .
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In rats , morphine-induced mydriasis was completely blocked by the nonselective opioid receptor antagonist naloxone ( 3mg/kg , which produced 90 % mu opioid receptor occupancy ) , while 100 and 300 mg/kg LY2456302 ( which produced 56 % and 87 % mu opioid receptor occupancy , respectively ) only partially blocked morphine-induced mydriasis .
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In humans , fentanyl-induced miosis was completely blocked by 50mg naltrexone , and LY2456302 dose-dependently blocked miosis at 25 and 60 mg ( minimal-to-no blockade at 4-10mg ) .
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We demonstrate , for the first time , the use of translational pupillometry in the context of receptor occupancy to identify a clinical dose of LY2456302 achieving maximal kappa opioid receptor occupancy without evidence of significant mu receptor antagonism .
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To compare the efficacy of an acupuncture regimen for persistent allergic rhinitis ( PER ) , aimed at improving a patient 's mind or Shen in Traditional Chinese Medicine , to that of a second-generation Hi-receptor antagonist , cetirizine hydrochloride .
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This multicenter , randomized , controlled clinical trial on PER will be conducted at three institutions in China .
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The total study period will be 9 weeks .
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After a 1-week preparatory screening period , 240 eligible participants with PER will be randomized to receive acupuncture or pharmacotherapy ( 1:1 ) for 4 weeks with a 4-week follow-up .
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The primary outcome will be changes in 7-day average total nasal symptom score .
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Secondary outcome measures include rhinoconjunctivitis quality of life questionnaire score and total non-nasal symptom score .
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The presence and seriousness of psychological and emotional impairments should be considered in therapeutic programs for allergic rhinitis .
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No clinical trial for treating allergic rhinitis via acupuncture regulation of psychological and emotional activities has been reported .
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The findings of the trial will allow us to determine the effects of the mind ( Shen ) - regulation treatment approach .
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