We investigated whether @ months of androgen suppression plus radiotherapy , with or without @ months of zoledronic acid , is more effective than @ months of neoadjuvant androgen suppression plus radiotherapy with or without zoledronic acid .


We did an open-label , randomised , @ factorial trial in men with locally advanced prostate cancer ( either T@a N@ M@ prostatic adenocarcinomas with prostate-specific antigen -LSB- PSA -RSB- @ g/L and a Gleason score of @ , or T@b-@ N@ M@ tumours regardless of PSA and Gleason score ) .


We randomly allocated patients by computer-generated minimisation -- stratified by centre , baseline PSA , tumour stage , Gleason score , and use of a brachytherapy boost -- to one of four groups in a @:@:@:@ ratio .


Patients in the control group were treated with neoadjuvant androgen suppression with leuprorelin ( @ mg every @ months , intramuscularly ) for @ months ( short-term ) and radiotherapy alone ( designated STAS ) ; this procedure was either followed by another @ months of androgen suppression with leuprorelin ( intermediate-term ; ITAS ) or accompanied by @ months of zoledronic acid ( @ mg every @ months for @ months , intravenously ; STAS plus zoledronic acid ) or by both ( ITAS plus zoledronic acid ) .


The primary endpoint was prostate cancer-specific mortality .


This analysis represents the first , preplanned assessment of oncological endpoints , @ years after treatment .


Analysis was by intention-to-treat .


This trial is registered with ClinicalTrials.gov , number NCT@ .


Between Oct @ , @ , and Aug @ , @ , @ men were randomly assigned to STAS ( n = @ ) , STAS plus zoledronic acid ( n = @ ) , ITAS ( n = @ ) , and ITAS plus zoledronic acid ( n = @ ) .


Median follow-up was @ years ( IQR @-@ ) .


Cumulative incidences of prostate cancer-specific mortality were @ % ( @ % CI @-@ ) in the STAS group , @ % ( @-@ ) in the STAS plus zoledronic acid group , @ % ( @-@ ) in the ITAS group , and @ % ( @-@ ) in the ITAS plus zoledronic acid group .


Cumulative incidence of all-cause mortality was @ % ( @-@ ) , @ % ( @-@ ) , @ % ( @-@ ) , and @ % ( @-@ ) , respectively .


Neither prostate cancer-specific mortality nor all-cause mortality differed between control and experimental groups .


Cumulative incidence of PSA progression was @ % ( @-@ ) in the STAS group , @ % ( @-@ ) in the STAS plus zoledronic acid group , @ % ( @-@ ) in the ITAS group , and @ % ( @-@ ) in the ITAS plus zoledronic acid group .


Compared with STAS , no difference was noted in PSA progression with ITAS or STAS plus zoledronic acid ; however , ITAS plus zoledronic acid reduced PSA progression ( sub-hazard ratio -LSB- SHR -RSB- @ , @ % CI @-@ ; p = @ ) .


Cumulative incidence of local progression was @ % ( @-@ ) in the STAS group , @ % ( @-@ ) in the STAS plus zoledronic acid group , @ % ( @-@ ) in the ITAS group , and @ % ( @-@ ) in the ITAS plus zoledronic acid group ; no differences were noted between groups .


Cumulative incidences of bone progression were @ % ( @-@ ) , @ % ( @-@ ) , @ % ( @-@ ) , and @ % ( @-@ ) , respectively .


Compared with STAS , STAS plus zoledronic acid increased the risk of bone progression ( SHR @ , @ % CI @-@ ; p = @ ) , but no differences were noted with the other two groups .


Cumulative incidence of distant progression was @ % ( @-@ ) in the STAS group , @ % ( @-@ ) in the STAS plus zoledronic acid group , @ % ( @-@ ) in the ITAS group , and @ % ( @-@ ) in the ITAS plus zoledronic acid group ; no differences were recorded between groups .


Cumulative incidence of secondary therapeutic intervention was @ % ( @-@ ) , @ % ( @-@ ) , @ % ( @-@ ) , and @ % ( @-@ ) , respectively .


Compared with STAS , ITAS plus zoledronic acid reduced the need for secondary therapeutic intervention ( SHR @ , @ % CI @-@ ; p = @ ) ; no differences were noted with the other two groups .


An interaction between trial factors was recorded for Gleason score ; therefore , we did pairwise comparisons between all groups .


Post-hoc analyses suggested that the reductions in PSA progression and decreased need for secondary therapeutic intervention with ITAS plus zoledronic acid were restricted to tumours with a Gleason score of @-@ , and that ITAS was better than STAS in tumours with a Gleason score of @ or lower .


Long-term morbidity and quality-of-life scores were not affected adversely by @ months of androgen suppression or zoledronic acid .


Compared with STAS , ITAS plus zoledronic acid was more effective for treatment of prostate cancers with a Gleason score of @-@ , and ITAS alone was effective for tumours with a Gleason score of @ or lower .


Nevertheless , these findings are based on secondary endpoint data and post-hoc analyses and must be regarded cautiously .


Long - term follow-up is necessary , as is external validation of the interaction between zoledronic acid and Gleason score .


STAS plus zoledronic acid can be ruled out as a potential therapeutic option .


Gender dysphoria is characterized by a strong discomfort with the gender assigned at birth and the urge to live as a member of the opposite gender .


The acquisition of phenotypic features of the desired gender requires the use of cross-sex hormones .


Female-to-male ( FtM ) transsexual persons are treated with testosterone to induce virilization .


The aim of the study was to assess the effects of three different testosterone formulations on body weight and composition and metabolic and bone parameters .


Forty-five FtM transsexuals were randomly assigned to receive testoviron depot ( i.m. : @mg/@ days ; n = @ ) , testosterone gel ( @mg/die ; n = @ ) , and testosterone undecanoate ( i.m. : @,@ mg every @ weeks for the first @ weeks and then every @ weeks , n = @ ) .


FtM individuals were studied before , at week @ , and at week @ of testosterone treatment .


Anthropometric , metabolic , bone , hematological , and biochemical parameters were evaluated at baseline and after @ months of treatment .


Lean body mass significantly increased and fat mass decreased in all groups .


No modifications were reported in fasting insulin and insulin sensitivity index .


High-density plasma lipoprotein levels declined significantly and low-density lipoprotein concentrations increased significantly in the three groups .


The activated partial thromboplastin time and factor I did not change while prothrombin time significantly increased in all groups .


At week @ , all subjects were amenorrheic and time to amenorrhea did not differ between the three groups .


Current general life satisfaction was increased in all subjects after @ year of treatment .


One-year testosterone administration in FtM transsexuals appears to be very safe with no differences among the testosterone formulations used .


Our study is preliminary , and the detection of subtle or long-term differences in the effects of the three formulations may require further larger and longer term studies in this and other populations .


Migraine shows gender-specific incidence and has a higher prevalence in females .


Gender plays an important role in the prevalence of migraine , but few studies have investigated the effect of gender on the cognitive functions of migraine patients .


This study investigated gender differences in the cognitive function of migraine patients without aura .


We recruited @ migraine patients ( @ females ; mean age @ y ) during the interictal period and @ healthy age-matched participants ( @ females ; mean age @ y ) .


We used an auditory oddball paradigm to analyze target processing using event-related potentials .


We investigated the N@ and P@ components .


The P@ amplitude was decreased in patients compared with the control , and this reduction was not modulated by gender .


These results of the P@ provided a new evidence for the dysfunction of cognitive function in migraine patients .


The N@ amplitude was larger for male than female migraine patients , and this gender effect was not found in the control group .


And those of N@ may explain that male patients have the super-sensitivity of cerebral function relevant to the early target-selection and response preparation .


Our findings emphasize the importance of considering gender when researching the cognitive function of migraine patients .


Data about the influence of the type of sedation on yield , complications , and tolerance of endobronchial ultrasound-guided transbronchial needle aspiration ( EBUS-TBNA ) are based mostly on retrospective studies and are largely inconsistent .


To determine whether the type of sedation influences the diagnostic yield of EBUS-TBNA , its complication rates , and patient tolerance .


Patients referred for EBUS-TBNA were randomized ( @:@ ) to undergo this procedure under general anesthesia ( GA ) or moderate sedation ( MS ) .


Pathologists were blinded to group allocation .


The main outcome was `` diagnostic yield , '' defined as the percentage of patients for whom EBUS-TBNA rendered a specific diagnosis .


One hundred and forty-nine patients underwent EBUS-TBNA , @ under GA and @ under MS. Demographic and baseline clinical characteristics were well balanced .


Two hundred and thirty-six lymph nodes ( LNs ) and six masses were sampled in the GA group ( average , @ @ sites/patient ) , and @ LNs and six masses in the MS group ( average , @ @ sites/patient ) ( P = @ ) .


The diagnostic yield was @ % ( @ of @ ) and @ % ( @ of @ ) for the GA group and MS group , respectively ( P = @ ) .


The sensitivity was @ % in the GA group ( confidence interval , @-@ % ) and @ % in the MS group ( confidence interval , @-@ % ) ( P = @ ) .


EBUS was completed in all patients in the GA group , and in @ patients ( @ % ) in the MS group ( P = @ ) .


There were no major complications or escalation of care in either group .


Minor complications were more common in the MS group ( @ vs. @ % ) ( P < @ ) .


Most patients stated they `` definitely would '' undergo this procedure again in both groups ( P = @ ) .


EBUS-TBNA performed under MS results in comparable diagnostic yield , rate of major complications , and patient tolerance as under GA. .


Future prospective multicenter studies are required to corroborate our findings .


Clinical trial registered with www.clinicaltrials.gov ( NCT @ ) .


To describe the interindividual variability in physical function responses to supervised resistance and aerobic exercise training interventions in older adults .


Data analysis of two randomized , controlled exercise trials .


Community-based research centers .


Overweight and obese ( body mass index ( BMI ) @ kg/m@ ) sedentary men and women aged @ to @ ( N = @ ) .


Five months of @ d/wk of aerobic training ( AT , n = @ ) or @ d/wk of resistance training ( RT , n = @ ) .


Physical function assessments : global measure of lower extremity function ( Short Physical Performance Battery ( SPPB ) ) , @-m walk , peak aerobic capacity ( VO@ peak ) , and knee extensor strength .


On average , both exercise interventions significantly improved physical function .


For AT , there was a @ % increase in VO@ peak ; individual absolute increases varied from @ to @ mL/kg per minute , and four participants ( @ % ) showed no change or a decrease in VO@ peak .


For RT , knee extensor strength improved an average of @ % ; individual increases varied from @ to @ Nm , and @ participants ( @ % ) showed no change or a decrease in strength .


Usual gait speed , @-m walk time , chair rise time , and SPPB improved for the majority of AT participants and usual gait speed , chair rise time , and SPPB improved for the majority of RT participants , but there was wide variation in the magnitude of improvement .


Only change in @-m walk time with RT was related to exercise adherence ( correlation coefficient = -@ , P = @ ) .


Despite sufficient levels of adherence to both exercise interventions , some participants did not improve function , and the magnitude of improvement varied widely .


Additional research is needed to identify factors that optimize responsiveness to exercise to maximize its functional benefits in older adults .


People with multi-drug resistant tuberculosis ( MDR-TB ) in low-income countries face many problems during treatment , and cure rates are low .


The purpose of the study was ( a ) to identify and document the problems experienced by people receiving care for MDR-TB , and how they cope when support is not provided , to inform development of strategies ; ( b ) to estimate the effectiveness of two resultant strategies , counselling alone , and joint counselling and financial support , of increasing DOTS-plus treatment success under routine programme conditions .


A mixed-method study comprising a formative qualitative study , pilot intervention study and explanatory qualitative study to better understand barriers to completion of treatment for MDR-TB .


Participants were all people starting MDR-TB treatment in seven DOTS-plus centres in the Kathmandu Valley , Nepal during January to December @ .


The primary outcome measure was cure , as internationally defined .


MDR-TB treatment caused extreme social , financial and employment hardship .


Most patients had to move house and leave their job , and reported major stigmatisation .


They were concerned about the long-term effects of their disease , and feared infecting others .


In the resultant pilot intervention study , the two strategies appeared to improve treatment outcomes : cure rates for those receiving counselling , combined support and no support were @ % , @ % and @ % respectively .


Compared with no support , the ( adjusted ) risk ratios of cure for those receiving counselling and receiving combined support were @ ( @ % CI @ to @ ) and @ ( @ % CI @ to @ ) respectively .


The explanatory study demonstrated that patients valued both forms of support .


MDR-TB patients are extremely vulnerable to stigma and extreme financial hardship .


Provision of counselling and financial support may not only reduce their vulnerability , but also increase cure rates .


National Tuberculosis Programmes should consider incorporating financial support and counselling into MDR-TB care : costs are low , and benefits high , especially since costs to society of incomplete treatment and potential for incurable TB are extremely high .


Acute kidney injury often goes unrecognised in its early stages when effective treatment options might be available .


We aimed to determine whether an automated electronic alert for acute kidney injury would reduce the severity of such injury and improve clinical outcomes in patients in hospital .


In this investigator-masked , parallel-group , randomised controlled trial , patients were recruited from the hospital of the University of Pennsylvania in Philadelphia , PA , USA .


Eligible participants were adults aged @ years or older who were in hospital with stage @ or greater acute kidney injury as defined by Kidney Disease Improving Global Outcomes creatinine-based criteria .


Exclusion criteria were initial hospital creatinine @ mg/dL ( to convert to mol/L , multiply by @ ) or greater , fewer than two creatinine values measured , inability to determine the covering provider , admission to hospice or the observation unit , previous randomisation , or end-stage renal disease .


Patients were randomly assigned ( @:@ ) via a computer-generated sequence to receive an acute kidney injury alert ( a text-based alert sent to the covering provider and unit pharmacist indicating new acute kidney injury ) or usual care , stratified by medical versus surgical admission and intensive care unit versus non-intensive care unit location in blocks of @-@ participants .


The primary outcome was a composite of relative maximum change in creatinine , dialysis , and death at @ days after randomisation .


All analyses were by intention to treat .


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


Between Sept @ , @ , and April @ , @ , @,@ patients were screened .


@ eligible participants were assigned to the acute kidney injury alert group and @ were assigned to the usual care group .


Composite relative maximum change in creatinine , dialysis , and death at @ days did not differ between the alert group and the usual care group ( p = @ ) , or within any of the four randomisation strata ( all p > @ ) .


At @ days after randomisation , median maximum relative change in creatinine concentrations was @ % ( IQR @-@ ) in the alert group and @ % ( @-@ ) in the usual care group ( p = @ ) ; @ ( @ % ) patients in the alert group and @ ( @ % ) patients in usual care group had received dialysis ( odds ratio @ -LSB- @ % CI @-@ -RSB- ; p = @ ) ; and @ ( @ % ) patients in the alert group and @ ( @ % ) patients in the usual care group had died ( @ -LSB- @-@ -RSB- ; p = @ ) .


An electronic alert system for acute kidney injury did not improve clinical outcomes among patients in hospital .


To compare planning and patient rehabilitation using a @D dental planning software and dedicated surgical guides with conventional rehabilitation of partially or fully edentulous patients using flapless or mini-flap procedures and immediate loading .


Fifty-one fully or partially edentulous patients requiring at least @ implants to be restored with a single prosthesis , having at least @ mm of bone height and @ mm in bone width , had their implant rehabilitation planned on three-dimensional ( @D ) cone beam computed tomography ( CBCT ) scans using a dedicated software .


Afterwards they were randomised according to a parallel group study design into two arms : computer-guided implant placement aided with templates ( computer-guided group ) versus conventional implant placement without templates ( conventional group ) in three different centres .


Implants were to be placed flapless and loaded immediately ; if inserted with a torque over @ Ncm with reinforced provisional prostheses , then replaced , after @ months , by definitive prostheses .


Outcome measures , assessed by masked assessors were : prosthesis and implant failures , complications , peri-implant bone level changes , number of treatment sessions , duration of treatment , post-surgical pain and swelling , consumption of pain killers , treatment time , time required to solve complications , additional treatment cost , patient satisfaction .


Patients were followed up to @ year after loading .


Twenty-six patients were randomised to the conventional treatment and @ to computerguided rehabilitation .


No patient dropped out .


One provisional prosthesis failed , since one of the two supporting implants failed @ days after implantation in the conventional group ( P = @ ) .


Four patients of the conventionally loaded groups experienced one complication each , versus five patients ( @ complications ) in the computer-guided group ( P = @ ) .


There were no statistically significant differences between the two groups for any of the tested outcomes with the exception of more postoperative surgical pain ( P = @ ) and swelling ( P = @ ) at conventionally treated patients .


When treatment planning was made on @D CBTC scan using a dedicated software , no statistically significant differences were observed between computer-guided and a free-hand rehabilitations , with the exception of more postoperative pain and swelling at sites treated freehand because more frequently flaps were elevated .


This study is aimed to identify the expression of Notch family proteins in placentas from patients with early-onset severe preeclampsia .


The expression of Notch family proteins in placentas was investigated by immunohistochemistry , Western blotting , and real-time reverse transcription-polymerase chain reaction ( RT-PCR ) .


The profile of distribution of all Notch family proteins in placentas from patients with early-onset severe preeclampsia is similar to that in normal placentas .


All Notch family proteins are expressed in placental trophoblasts .


Moreover , Notch@ and Jagged@ ( Jag@ ) are detected in placental endothelial cells .


Real-time RT-PCR showed that messenger RNA levels of Notch@ and Delta-like@ ( Dll@ ) in placentas from patients with early-onset severe preeclampsia are lower than that of normal placentas .


Western blotting showed a significant increase in Notch@ expression and a significant decrease in Notch@ expression in placentas from patients with early-onset severe preeclampsia relative to those in normal placentas .


The results suggest that Notch@ and Notch@ may play some roles in the pathogenesis of preeclampsia .


To compare the difference in the efficacy between acupuncture and oral administration of trazodone and the expressions of neurotransmitters in patients of insomnia differentiated as liver stagnation transforming into fire .


Seventy patients of insomnia differentiated as liver stagnation transforming into fire were randomized into an observation group and a control group , @ cases in each one .


In the observation group , acupuncture therapy was adopted at Shenmen ( HT @ ) , Baihui ( GV @ ) , Yintang ( GV @ ) , Hegu ( LI @ ) , Taichong ( LR @ ) , etc. .


The needles were retained for @ min each time .


The treatment was given once a day , the treatment of @ weeks made one session .


In the control group , trazodone , @ mg , oral administration , once a day , the treatment of @ weeks made one session .


Two sessions were required in the two groups .


The scores in Pittsburgh sleep quality index ( PSQI ) and Asberg rating scale for side effects ( SERS ) , the levels of neurotransmitters such as @-hydroxy tryptamine ( @-HT ) and norepinephrine ( NE ) and the expressions of protein kinase C ( PKC ) and brain-derived neurotrophic factor ( BDNF ) in peripheral blood were observed before and after treatment in the two groups .


PSQI score and SERS score after treatment were all decreased compared with those in both groups before treatment ( both P < @ ) .


After treatment , PSQI score and SERS score in the observation group were lower apparently than those in the control group ( both P < @ ) .


After treatment NE content and PKC level were decreased ; @-HT content and BDNF mRNA were increased compared with those in both groups before treatment ( all P < @ ) .


NE content and PKC level in the observation group were lower apparently than those in the control group ( both P < @ ) .


The serum @-HT content and BDNF mRNA expression in the observation group were higher than those in the control group separately ( both P < @ ) .


Acupuncture therapy improves the sleeping quality of patients of insomnia differentiated as liver stagnation transforming into fire , and reduces serum NE level and increases @-HT content and BDNF expression , which achieves the better efficacy as compared with the oral administration of trazodone .


It is one of the effective approaches to the treatment of insomnia differentiated as liver stagnation transforming into fire .


With the increase in the aging population , there is a pressing need to provide effective treatment options for individuals with Alzheimer 's disease ( AD ) .


Memantine is an N-methyl-D-aspartate receptor antagonist used to treat AD in > @ countries worldwide , and studies in the USA and Europe have shown it to be effective in improving language deficits ; however , there are currently no data on language improvements in Japanese patients treated with memantine .


To clarify the efficacy and safety of memantine in Japanese outpatients with moderate to severe AD , using a pooled analysis of two multicenter randomized placebo-controlled trials , a phase @ dose-finding study and a phase @ study .


The final analysis comprised @ patients ( @ receiving memantine and @ placebo ) .


Memantine produced better outcomes in terms of Severe Impairment Battery-Japanese version , Clinician 's Interview-Based Impression of Change plus-Japanese version , Behavioral Pathology in AD Rating Scale , and language scores , versus placebo .


The overall incidence of adverse events and adverse reactions was similar between groups .


In this pooled analysis of Japanese patients , memantine achieved better outcomes than placebo in terms of cognition , including attention , praxis , visuospatial ability and language , and behavioral and psychological symptoms , including activity disturbances and aggressiveness .


To improve effectiveness of future screen behaviour interventions , one needs to know whether an intervention works via the proposed mediating mechanisms and whether the intervention is equally effective among subgroups .


Parental regulation is identified as a consistent correlate of screen behaviours , but prospective evidence as well as the mediation role of parental regulation is largely lacking .


This study investigated post-intervention main effects on screen behaviours in the HEIA-intervention -- a Norwegian school-based multiple-behaviour study , as well as mediation effects of parental regulation by adolescents ' and parents ' report .


In addition , moderating effects of gender and weight status on the intervention and mediating effects were explored .


Participating schools were randomized to control ( n = @ ) or intervention ( n = @ ) condition .


Adolescents ( n = @ Control ; @ Intervention ) self-reported their weekday and weekend TV-viewing and computer/game-use .


Change in adolescents ' behaviours was targeted through school and parents .


Adolescents , mothers ( n = @ Control ; @ Interventions ) and fathers ( n = @ Control ; @ Intervention ) reported parental regulation of the screen behaviours post-intervention ( at @ month ) .


The product-of-coefficient test using linear regression analysis was conducted to examine main and mediating effects .


There was no intervention effect on the screen behaviours in the total sample .


Gender moderated effect on weekend computer/game-use , while weight status moderated the effect on weekday TV-viewing and computer/game-use .


Stratified analyses showed a small favourable intervention effect on weekday TV-viewing among the normal weight .


Parental regulation did not mediate change in the screen behaviours .


However , stronger parental regulation was associated with less TV-viewing and computer/game-use with effects being conditional on adolescents ' versus parental reports .


Parental regulation of the screen behaviours , primarily by the parental report , was associated with change in the respective behaviours .


Multiple behaviour intervention may not affect all equally well , and the effect may differ by weight status and gender .


In future interventions parents should be encouraged to regulate their adolescents ' TV-viewing and computer/game-use on both weekdays and weekends as parental regulation was identified as a determinant of these screen behaviours .


However , future intervention studies may need to search for more effective intervention strategies targeting parental regulation .


The paper describes recruitment results and characteristics of the UP-TECH clinical trial sample , including level of care services use , informal caregiver burden and its determinants .


UP-TECH is designed to test innovative care solutions for community-dwelling patients with moderate stage Alzheimer 's disease and their caregivers in Italy .


Four hundred and fifty patient-caregiver dyads were randomized into three arms receiving different combinations of services , composed of case management interventions , nurse visits , assistive technology and educational brochures .


The research nurses administered a questionnaire comprising an in-depth socio-demographic assessment and several clinical scales , such as Novak 's Caregiver Burden Inventory .


Analyses of baseline data were conducted using uni - and bi-variate statistics .


Linear regressions were computed to identify de-confounded correlates of caregiver burden .


Four hundred and thirty-eight patient-caregiver dyads were recruited and randomized .


In our sample , patients are predominantly women ( @ % ) , with an average age of @ years and a mean Mini-Mental State Examination score of @ .


Caregivers are mostly women ( @ % ) and offspring ( @ % ) , with a mean caregiver burden score of @ .


They provide more than @ hours of care per week , while receiving an almost negligible support from public services .


Factors associated with caregiver burden are female gender , kinship and the patient 's behavioral disturbances .


The most important factor associated with lower burden is the employment of a live-in care worker .


The paper provides a comprehensive description of moderate stage Alzheimer 's disease patients and their caregivers , suggesting useful markers of caregiver burden .


The well-balanced randomization assures the reliability of the study data-set for prospective evaluation of care strategies .


Right hemisphere stroke patients frequently experience spatial neglect , a severe lack of awareness for contralesional hemispace .


Although neglect counts among the strongest predictors for poor functional outcome after stroke , there is no established therapy , particularly not for the acute stage .


In a randomized controlled trial , we compared the combined treatment of hemifield eye patching and repetitive optokinetic stimulation in acute stroke patients with neglect to the spontaneous course .


Outcome measures were a neuropsychological test battery for neglect as well as scales of functional independence and clinical impairment .


Outcomes were assessed at baseline ( day @ ) , post treatment ( day @ ) , and at @-month follow-up ( day @ ) .


Final analysis included @ acute right hemisphere stroke patients with neglect ( @ enrolled , @ lost to follow-up ) allocated either to the treatment ( @ week hemifield eye patching and daily sessions of optokinetic stimulation , n = @ ) or the control group ( no neglect-specific treatment , n = @ ) .


At baseline , both groups did not differ in neuropsychological test performance , clinical impairment , or functional disability .


At the post treatment session , both groups had improved in all these measures , and results were stable or further improved at follow-up .


However , there was no significant difference in this change between the treatment and the control group .


An early intervention of combined hemifield eye patching and optokinetic stimulation in acute stroke patients with spatial neglect has no additive effect to the spontaneous remitting course of the disorder .


Hereditary hemorrhagic telangiectasia ( HHT ) is a dominantly inherited genetic vascular disorder in which epistaxis is the most frequent manifestation , responsible for high morbidity .


Management of this symptom has no standard , and local treatments are often aggressive .


Their efficacy is variable and has not been proven .


Anti-angiogenic drugs , such as bevacizumab , are a new treatment strategy .


Its systemic administration in patients with HHT improves liver damage-related symptoms and epistaxis .


To limit the systemic adverse effects of bevacizumab and to ease administration , a local administration seems suitable .


To evaluate the tolerance of increasing doses of bevacizumab administered as a nasal spray in patients with HHT-related epistaxis .


Secondary objectives were to study the bioavailability and efficacy of bevacizumab against epistaxis when given as a nasal spray .


Phase @ , randomized , double-blind , placebo-controlled , monocentric study performed sequentially ( dose escalation ) on @ groups of @ patients .


Each group was made up of @ verum and @ placebos .


Five increasing doses of bevacizumab nasal spray ( @ mg/mL ) were evaluated : @ , @ , @ , @ and @ mg .


A total of @ patients were included between October @ and October @ .


Bevacizumab nasal spray was well tolerated in all patients and the drug was not detected in their serum .


No dose limiting toxicity was observed .


No efficacy was observed at any dose in this study .


Based on these results , bevacizumab nasal spray is a safe treatment of epistaxis in HHT .


However , a randomized Phase @ study is needed to determine its efficacy .


Bipolar depression is one of the most serious psychiatric conditions .


In addition , sleep disturbance in bipolar disorder is common , and therapeutic agents restoring sleep disturbances in bipolar disorder patients will be clinically beneficial .


In the current study , we compared the effect of quetiapine XR with lithium on depressive symptoms and sleep in bipolar depression patients during @ weeks of trial .


An open-label , randomized comparison of sleep-activity and depressive symptoms between @-week quetiapine XR monotherapy and lithium monotherapy for bipolar depression was conducted .


Each assessment consisted of HDRS-@ , Clinical Global Impression-severity ( CGI-S ) , and self-reported Pittsburgh Sleep Quality Index ( PSQI ) .


Actigraphy-measured sleep parameters were assessed .


A total of @ patients ( @ years ; gender : male @ , female @ ) with bipolar depression were screened out .


Out of @ patients , six patients were excluded before randomization .


After randomization , seven patients were withdrawn .


Twenty-nine patients with more than two visits after randomization ( lithium group : @ , quetiapine XR group : @ , mean age : @ , gender : male @ , female @ ) were included in the final analysis .


In both groups , Hamilton Depression Rating Scale ( HDRS ) scores were significantly decreased at weeks @ , @ , @ , @ , and @ compared with baseline .


Remission rate ( HDRS@ ) in the quetiapine XR was significantly higher than that of the lithium group .


In the quetiapine XR group , PSQI scores at weeks @ , @ , @ , @ , and @ was significantly decreased compared with baseline .


Sleep efficiency at weeks @ and @ was significantly increased .


WASO at week @ was significantly decreased .


First , the present study was conducted with the relatively small number of study subjects .


Second , bias could have affected the study results due to its open-label design .


Third , study subjects were made up of high proportion of bipolar II disorder patients .


Quetiapine XR monotherapy was more effective in treating bipolar depression than lithium .


In particular , quetiapine XR treatment improved both subjective and objective sleep quality in patients with bipolar depression .


However , relationship between favorable sleep quality and depressive symptom improvement were limited .


To analyse the clinical significance and related factors of thirst and xerostomia and to find methods to alleviate thirst and xerostomia in maintenance hemodialysis ( MHD ) patients .


Forty-two MHD patients were included for observational study and eleven patients were enrolled for crossover trial .


Thirst was assessed by @-mm visual analog scales ( VAS ) and dialysis thirst inventory ( DTI ) .


Meanwhile , xerostomia was assessed by VAS and xerostomia inventory ( XI ) .


Depression , kidney disease quality of life ( KDQOL ) , salivary flow rates and inter dialytic weight gain ( IDWG ) were measured .


Data were analyzed by ANOVA and correlation coefficient was used to assess the correlations between continuous variables .


The results of crossover trial were investigated by two-sample T-tests .


Strong positive correlations among DTI , VAS thirst score , XI and VAS xerostomia score were found ( P = @ ) .


Daily IDWG was positively correlated with VAS thirst score ( r = @ , P = @ ) and DTI ( r = @ , P = @ ) .


UWS ( unstimulated whole saliva ) was negatively correlated with VAS xerostomia score ( r = -@ , P = @ ) .


Residual urine output was negatively correlated with DTI ( r = -@ , P = @ ) , VAS xerostomia score ( r = -@ , P = @ ) and XI ( r = -@ , P = @ ) .


In the crossover trial , DTI , XI , IDWG@d , IDWG@d , VAS thirst and xerostomia score were significantly reduced by the use of chewing gum ( P = @ , @ , @ , @ , @ , @ ) .


The VAS thirst score , DTI and IDWG@d were significantly reduced by receiveing straw ( P = @ , @ , @ ) .


Thirst and xerostomia might affect the quality of life in MHD patients .


Both chewing gum and straw could decrease thirst and IDWG .


Cytarabine plays a pivotal role in the treatment of patients with acute myeloid leukemia ( AML ) .


Most centers use @ to @ days of cytarabine at a daily dose of @ to @ mg/m ( @ ) for remission induction .


Consensus has not been reached on the benefit of higher dosages of cytarabine .


The European Organisation for Research and Treatment of Cancer ( EORTC ) and Gruppo Italiano Malattie Ematologiche dell ' Adulto ( GIMEMA ) Leukemia Groups conducted a randomized trial ( AML-@ ; Combination Chemotherapy , Stem Cell Transplant and Interleukin-@ in Treating Patients With Acute Myeloid Leukemia ) in @,@ newly diagnosed patients with AML , age @ to @ years , comparing remission induction treatment containing daunorubicin , etoposide , and either standard-dose ( SD ) cytarabine ( @ mg/m ( @ ) per day by continuous infusion for @ days ) or high-dose ( HD ) cytarabine ( @,@ mg/m ( @ ) every @ hours by @-hour infusion on days @ , @ , @ , and @ ) .


Patients in complete remission ( CR ) received a single consolidation cycle containing daunorubicin and intermediate-dose cytarabine ( @ mg/m ( @ ) every @ hours for @ days ) .


Subsequently , a stem-cell transplantation was planned .


The primary end point was survival .


At a median follow-up of @ years , overall survival was @ % for patients randomly assigned to SD cytarabine and @ % for those randomly assigned to HD cytarabine ( log-rank test P = @ ; multivariable analysis P = @ ) .


For patients younger than age @ years , survival was @ % and @ % , respectively ( P = @ ; multivariable analysis P = @ ) , and for patients age @ to @ years , survival was @ % and @ % , respectively ( P = @ ) .


CR rates were @ % and @ % , respectively ( P < @ ) and were @ % and @ % for patients younger than age @ years ( P = @ ) and @ % and @ % for patients age @ years and older ( P = @ ) .


Patients of all ages with very-bad-risk cytogenetic abnormalities and/or FLT@-ITD ( internal tandem duplication ) mutation , or with secondary AML benefitted from HD cytarabine .


HD cytarabine produces higher remission and survival rates than SD cytarabine , especially in patients younger than age @ years .


Laparoscopic sphincter preservation for low rectal cancer is challenging because of the high risk of positive circumferential resection margin .


We hypothesized that perineal dissection of the distal rectum may improve quality of surgery , compared with the conventional abdominal dissection .


Between @ and @ , @ patients with low rectal cancer ( < @ cm from the anal verge ) suitable for sphincter preservation were randomized between perineal and abdominal low rectal dissection .


Surgery included laparoscopic mobilization of the left colon with high rectal dissection .


Distal rectal dissection was performed laparoscopically in the abdominal group and transanally in the perineal group .


The primary endpoint was quality of surgery ( circumferential resection margin , mesorectum grade , and lymph nodes ) .


Secondary end points were morbidity and conversion .


The rate of positive circumferential resection margin decreased significantly after perineal compared with abdominal low rectal dissection , @ % versus @ % ( P = @ ) .


The mesorectum grade and the number of lymph nodes analyzed did not differ between the @ groups .


There was no difference in surgical morbidity ( @ % vs @ % ; P = @ ) and conversion ( @ % vs @ % ; P = @ ) between perineal and abdominal rectal dissection .


Multivariate analysis showed that abdominal rectal dissection was the only independent factor of positive circumferential resection margin ( odds ratio = @ ; @ % confidence interval : @-@ @ ; P = @ ) .


Perineal rectal dissection reduces the risk of positive circumferential resection margin , as compared with the conventional abdominal dissection in low rectal cancer .


This suggests the perineal rectal dissection as a new standard in laparoscopic sphincter-saving resection for low rectal cancer .


The objective of this prospective , multicenter study was to assess @-year changes in sinonasal symptoms and health care use after office-based multisinus balloon dilation .


Adults diagnosed with chronic or recurrent acute rhinosinusitis per the @ adult sinusitis guidelines were enrolled in this Institutional Review Board-approved study .


Balloon dilation of the maxillary sinuses/ethmoid infundibula with or without frontal or sphenoid ostial dilation was performed in the physician 's office under local anesthesia .


Intraoperative procedure technical success and subject procedure tolerance were recorded .


Efficacy was assessed using the patient-reported @-item Sino-Nasal Outcome Test ( SNOT-@ ) and Rhinosinusitis Symptom Inventory ( RSI ) .


Complications and revision surgeries were also recorded .


A total of @ ostial dilations were attempted and @ were successfully completed ( @ % ) in @ subjects .


Mean procedure tolerance was @ @ ( @ = no pain ; @ = severe pain ) .


Clinically meaningful and statistically significant ( p < @ ) mean SNOT-@ symptom improvement was observed at @ and @ months and sustained through @ year .


The RSI treatment effect for all major rhinosinusitis symptoms was `` large '' and improvement in each was significant ( p < @ ) .


Compared with the previous @-year period , patients reported an average of @ fewer acute sinus infections ( p < @ ) , @ fewer antibiotic courses taken ( p < @ ) , and @ fewer sinus-related physician visits ( p < @ ) after balloon dilation .


No serious device or procedure-related adverse events occurred .


One subject ( @ % ) underwent revision surgery .


In-office , multisinus balloon dilation is safe , effective , and well tolerated .


Patients reported significant reductions in both sinonasal symptoms and health care use after balloon dilation .


Efficacy observed at @ and @ month follow-up was sustained through @ year with a very low rate of revision surgery .


This study was a part of the clinical trial NCT@ registered at www.clinicaltrials.gov .


The present study tested whether taking into account both the reflective and the impulsive processes of physical activity ( PA ) is helpful in understanding how , and for whom , PA-promoting messages will be ( in ) effective in changing behavior .


Participants ( N = @ ) were presented with a persuasive message promoting either PA ( experimental condition ) or healthy eating ( control condition ) .


Reflective intentions to be physically active were assessed both at baseline and after exposure to the message .


Impulsive approach tendencies toward PA ( IAPA ) and sedentary behaviors ( IASB ) were assessed using a manikin task .


The main outcome variable was accelerometer-assessed free time spent in moderate to vigorous physical activity ( MVPA ) over @ week after exposure to the message .


Although the PA-promoting message had no direct effect on MVPA , the results showed that ( a ) this message increased intentions to practice PA , notably among participants with low or moderate ( but not high ) baseline intentions ; ( b ) objective MVPA was positively predicted by postmessage PA intentions and IAPA , and negatively predicted by IASB ; and ( c ) postmessage PA intentions predicted MVPA for individuals with low or moderate ( but not high ) IASB .


A follow-up moderated mediation analysis corroborated these earlier results , showing that PA-promoting messages positively predicted MVPA through postmessage intentions only among individuals with low or moderate baseline intentions and low or moderate IASB .


By identifying @ boundary conditions , this study revealed important insights in explaining when PA-promoting messages will be effective to predict objective MVPA and when they will not .


Improving the use ( eg , initial visit and revisits ) of Internet-delivered interventions to promote healthy lifestyles such as non-smoking is one of the largest challenges in the field of eHealth .


Prompts have shown to be effective in stimulating reuse of Internet-delivered interventions among adults and adolescents .


However , evidence concerning effectiveness of prompts to promote reuse of a website among children is still scarce .


The aim of this study is to investigate ( @ ) whether prompts are effective in promoting reuse of an intervention website containing information on smoking prevention for children , ( @ ) whether the content of the prompt is associated with its effect in terms of reuse , and ( @ ) whether there are differences between children who do or do not respond to prompts .


The sample of this cluster-randomized study consisted of @ children ( aged @-@ years ) from @ Dutch primary schools , who were assigned to the experimental group of an Internet-delivered smoking prevention intervention study .


All participants completed a Web-based questionnaire on factors related to ( non - ) smoking .


Schools were randomized to a no-prompt group ( n = @ ) or a prompt group ( n = @ ) .


All children could revisit the intervention website , but only the children in the prompt group received email and SMS prompts to revisit the website .


Those prompt messages functioned as a teaser to stimulate reuse of the intervention website .


Reuse of the website was objectively tracked by means of a server registration system .


Repeated measures analysis of variance and linear regression analysis were performed to assess the effects of prompts on website reuse and to identify individual characteristics of participants who reuse the intervention website .


Children in the prompt group reused the intervention website significantly more often compared to children in the no-prompt group ( B = @ , P < @ ) .


Prompts announcing new animated videos ( F@ ,@ = @ , P = @ ) and games about ( non - ) smoking on the website ( F@ ,@ = @ , P = @ ) resulted in most reuse of the website .


Within the prompt group , children with a low socioeconomic status ( SES ) reused the intervention website more often ( B = @ , P < @ ) than children of high SES ( B = @ , P = @ ) .


Prompts can stimulate children to reuse an intervention website aimed at smoking prevention .


Prompts showed , furthermore , to stimulate children of a low SES slightly more to reuse an intervention website , which is often a difficult target group in terms of stimulating participation .


However , the number of revisits was quite low , which requires further study into how prompts can be optimized in terms of content and frequency to improve the number of revisits .


Radial artery catheterization is gaining popularity for diagnostic and interventional procedures .


Palpation technique is widely used for the procedure , but ultrasonography has been shown to increase catheterization success .


A recently described ultrasonography technique is termed ` dynamic needle tip positioning ' .


We aimed to compare the traditional palpation technique and dynamic needle tip positioning technique in regard to clinically relevant end points .


The study was conducted as a randomized , patient-blinded , crossover study .


Patients underwent bilateral radial artery catheterization using both techniques .


The primary end point of the study was needle manipulation time .


Additional end points were ( @ ) the number of skin perforations , ( @ ) the number of attempts targeting the vessel , ( @ ) the number of catheters placed in first attempt and ( @ ) the number of catheters used .


Forty patients were analyzed .


There was no significant difference in median needle manipulation time -LSB- @ s ( range @-@ s ) vs. @ s ( range @-@ s ) , P = @ -RSB- , although the variance was lower in the dynamic needle tip positioning group ( P < @ ) .


In the traditional palpation technique group , a higher number of skin perforations ( @ vs. @ , P = @ ) , catheters ( @ vs. @ , P = @ ) and attempts targeting the vessel ( @ vs. @ , P < @ ) were necessary compared with the ultrasonography dynamic needle tip positioning group .


First attempt success rate was significantly higher in the ultrasonography dynamic needle tip positioning group ( @/@ vs. @/@ , P < @ ) .


Ultrasonography guidance using the dynamic needle tip positioning technique for radial artery catheterization significantly improves clinically relevant aspects of the procedure .


Postoperative pain control after total knee arthroplasty ( TKA ) remains a great challenge .


The management of pain in the immediate postoperative period is one of the most critical aspects to allow speedier rehabilitation and reduce the risk of postoperative complications .


Recently , periarticular infiltration anesthesia has become popular , but the outcome is controversial .


Some studies have shown transient effects , `` rebound pain '' , or no effectiveness in pain control .


Continuous intra-articular infusion technique has been introduced to improve these transient effects , but more clinical studies are needed .


Furthermore , the potential risk of early periprosthetic joint infection is causing concerning .


We plan to compare continuous intra-articular infusion anesthesia with epidural infusion anesthesia after TKA to assess the effectiveness of this technique in reducing pain , in improving postoperative function , and to look at the evidence for risk of early infection .


This trial is a randomized , controlled study .


Patients ( n = @ ) will be randomized into two groups : to receive continuous intra-articular infusion anesthesia ( group C ) ; and epidural infusion anesthesia ( group E ) .


For the first @ postoperative days , pain at rest , active range of motion ( A-ROM ) , rescue analgesia and side effects will be recorded .


At @-month and @-month follow-up , A-ROM , C-reactive protein , erythrocyte sedimentation rate , and synovial fluid cell count and culture will be analyzed .


The results from this study will provide clinical evidence on the efficacy of a continuous intra-articular infusion technique in reducing pain , postoperative functional improvement and safety .


It will be the first randomized controlled trial to investigate infection risk with local anesthesia after TKA .


Observational studies have shown that attentional bias for smoking-related cues is associated with increased craving and relapse .


Laboratory experiments have shown that manipulating attentional bias may change craving .


Interventions to reduce attentional bias could reduce relapse in smokers seeking to quit .


We report a clinical trial of attentional retraining in treatment-seeking smokers .


This was a double-blind randomised controlled trial that took place in UK smoking cessation clinics .


Smokers interested in quitting were randomised to five weekly sessions of attentional retraining ( N = @ ) or placebo training ( N = @ ) using a modified visual probe task from one week prior to quit day .


Both groups received @ mg nicotine patches ( from quit day onwards ) and behavioural support .


Primary outcomes included change in attentional bias reaction times four weeks after quit day on the visual probe task and craving measured weekly using the Mood and Physical Symptoms Scale .


Secondary outcomes were changes in withdrawal symptoms , time to first lapse and prolonged abstinence .


No attentional bias towards smoking cues was found in the sample at baseline ( mean difference = @ ms , @ % CI = -@ , @ ) .


Post-training bias was not significantly lower in the retraining group compared with the placebo group ( mean difference = -@ ms , @ % CI = -@ , @ ) .


There was no difference between groups in change in craving ( p = @ ) and prolonged abstinence at four weeks ( risk ratio = @ , @ % CI = @ , @ ) .


Taken with one other trial , there appears to be no effect from clinic-based attentional retraining using the visual probe task .


Attentional retraining conducted out of clinic may prove more effective .


During team athletic events , athletic trainers commonly provide fluids with water bottles .


When a limited number of water bottles exist , various techniques are used to deliver fluids .


To determine whether fluid delivered via water-bottle administration influenced fluid consumption and hydration status .


Crossover study .


Outdoor field ( @ C @ C ) .


Nineteen participants ( @ men , @ women , age = @ @ years , height = @ @ cm , mass = @ @ kg ) were recruited from the university and local running clubs .


The independent variable was fluid delivery with @ levels : self-administration with mouth-to-bottle direct contact ( SA-DC ) , self-administration with no contact between mouth and bottle ( SA-NC ) , and external administration with no contact between the mouth and the bottle ( EA-NC ) .


Participants warmed up for @ minutes before completing @ exercise stations , after which an ad libitum fluid break was given , for a total of @ breaks .


We measured the fluid variables of total volume consumed , total number of squirts , and average volume per squirt .


Hydration status via urine osmolality and body-mass loss , and perceptual variables for thirst and fullness were recorded .


We calculated repeated-measures analyses of variance to assess hydration status , fluid variables , and perceptual measures to analyze conditions across time .


The total volume consumed for EA-NC was lower than for SA-DC ( P = @ ) and SA-NC ( P = @ ) .


The total number of squirts for SA-DC was lower than for SA-NC ( P = @ ) .


The average volume per squirt for EA-NC was lower than for SA-DC ( P = @ ) and SA-NC ( P = @ ) .


Participants arrived ( @ @ mOsm/L ) and remained ( @ @ mOsm/L ) hydrated , with no difference between conditions ( P = @ ) ; however , the EA-NC condition lost more body mass than did the SA-DC condition ( P = @ ) .


There was no main effect for condition on thirst ( P = @ ) or fullness ( P = @ ) .


External administration of fluid decreased total volume consumed via a decreased average volume per squirt .


The SA-DC method requires fewer squirts within a specific time frame .


Fluid breaks every @ minutes resulted in maintenance of euhydration ; however , loss of body mass was influenced by fluid administration .


Athletic trainers should avoid external administration to promote positive hydration behaviors .


When fluid is self-administered , individual bottles may be the best clinical practice because more volume can be consumed per squirt .


To compare the effects of alfaxalone and propofol on intraocular ( IOP ) pressure in the canine eye .


Twenty-three healthy adult dogs .


Dogs were randomized to receive intravenous propofol ( n = @ ) or alfaxalone ( n = @ ) until loss of jaw tone , @ min after intravenous premedication ( acepromazine @-@ @ mg/kg and hydromorphone @-@ @ mg/kg ) .


IOP was measured at baseline ( BL ) , @ min postpremedication ( postpremed ) , loss of jaw tone ( postinduct ) , and immediately following orotracheal intubation ( postintub ) .


Between - and within-treatment effects were analyzed with two-way and one-way repeated measures ANOVA with Bonferroni 's post hoc test , respectively .


P < @ was considered significant .


No significant IOP differences were detected between alfaxalone or propofol groups at any time point ( P > @ ) .


Propofol : IOP did not change between BL ( @ @ mmHg ) and postpremed ( @ @ mmHg , P > @ ) , or postinduct ( @ @ mmHg ) and postintub ( @ @ mmHg , P > @ ) , but differed significantly between BL and postinduct ( P < @ ) , and postintub ( P < @ ) .


Alfaxalone : IOP did not change between BL ( @ @ mmHg ) and postpremed ( @ @ mmHg , P > @ ) , or postinduct ( @ @ mmHg ) and postintub ( @ @ mmHg , P > @ ) , but differed significantly between BL and postinduct ( P < @ ) , and postintub ( P < @ ) .


These data show a potentially clinically significant increase in IOP following induction with propofol or alfaxalone , but no difference between agents .


Infantile colic is a painful condition in the first months of infancy .


Acupuncture is used in Scandinavia as a treatment for infantile colic .


A randomized controlled trial was carried out with the aim of testing the hypothesis that acupuncture treatment has a clinically relevant effect for this condition .


A prospective , blinding-validated , randomized controlled multicentre trial in general practice .


Research assistants and parents were blinded .


@ GPs ' offices in Southern Norway .


Three days of bilateral needling of the acupuncture point ST@ , with no treatment as control .


@ patients were recruited ; @ patients were excluded , and @ randomized ; @ diaries and @ interviews were analysed .


Difference in changes in crying time during the trial period between the intervention and control group .


The blinding validation questions showed a random distribution with p = @ and @ , indicating true blinding .


We found no statistically significant difference in crying time reduction between acupuncture and control group at any of the measured intervals , nor in the main analysis of differences in changes over time ( p = @ ) .


There was a tendency in favour of the acupuncture group , with a non-significant total baseline-corrected mean of @ minutes ( @ % CI -@ to + @ ) difference in crying time between the groups .


This was not considered clinically relevant , according to protocol .


This trial of acupuncture treatment for infantile colic showed no statistically significant or clinically relevant effect .


With the current evidence , the authors suggest that acupuncture for infantile colic should be restricted to clinical trials .


Endometrial biopsy is a common procedure for the investigation of many gynecological disorders including abnormal uterine bleeding , postmenopausal bleeding , abnormal cytology and infertility .


Most women experience some degree of discomfort and pain during the procedure .


Pain may occur during dilation of the cervix for insertion of the catheter and during endometrial biopsy , which further aggravates pain by inducing uterine contraction .


To determine pain levels during endometrial biopsy by comparing intrauterine instillation of levobupivacaine or lidocaine with placebo in a randomized , double-blinded trial in pre - and postmenopausal women .


Ninety patients were allocated to either control or experimental groups before endometrial biopsy .


The trial medication was intrauterine anesthesia , either @ mL @ % saline ( control group ) , or @ mL @ % levobupivacaine or @ % lidocaine ( experimental groups ) .


Resident doctors used the same endometrial biopsy technique to minimize the risk of technical variation .


All tissue specimens were sent for cytopathological examination .


The pathologists , who were blinded to the study solution , analyzed all tissue specimens .


The primary outcome measure was pain experienced during the procedure .


Pain was assessed using a @ cm visual analogue pain scale .


All observed adverse effects were recorded until the patients were discharged .


Pain scores of the intrauterine lidocaine and levobupivacaine groups were found to be significantly lower than the control group .


There was no difference between the levobupivacaine and lidocaine groups with regard to pain scores .


There was a moderately positive correlation between pain scores and endometrial thickness .


No complications were observed due to the procedure .


Most of the biopsy results were proliferative and secretory endometrium .


Insufficient material causing inconclusive results was observed mostly in the control group .


Transcervical intrauterine topical instillation of levobupivacaine or lidocaine causes pain relief during endometrial biopsy .


However , further studies are needed to evaluate the effectiveness of intrauterine anesthesia , to determine optimal concentration , volume and waiting time according to the type of local anesthetic agent , and to assess the applicability of the method to other intrauterine procedures .


The present study aimed to compare the effectiveness of the treatment programs of home-based exercise with and without self-manual therapy in individuals with knee osteoarthritis ( knee OA ) in community .


Forty-three participants with knee OA were randomly assigned in groups .


All participants received the same home-based exercise program with or without self-manual therapy over @ weeks .


Outcome measures were pain intensity , range of motions , six-minute walk test distance , the knee injury and osteoarthritis outcome score ( KOOS ) , short-form @ ( SF-@ ) and satisfaction .


The results showed that the self-manual therapy program significantly decreased pain at @ weeks , increased flexion and extension at @ and @ weeks , and improved the KOOS in pain item and SF-@ in physical function and mental health items .


The home-based exercise group showed significant increase of the six-minute walk distance at @ and @ weeks , improvements in the KOOS in pain and symptom items and SF-@ in the physical function and role-emotional items .


Overall , the results favored a combination of self-manual therapy and home-based exercise for patients with knee OA , which apparently showed superior benefits in decreasing pain and improving active knee range of motions .


Central venous access devices in fluoropyrimidine therapy are associated with complications ; however , reliable data are lacking regarding their natural history , associated complications and infusion pump performance in patients with metastatic colorectal cancer .


We assessed device placement , use during treatment , associated clinical outcomes and infusion pump performance in the NO@ trial .


Device replacement was more common with FOLFOX-@ ( @-fluorouracil ( @-FU ) + oxaliplatin ) than XELOX ( capecitabine + oxaliplatin ) ( @ % vs @ % ) .


Baseline device-associated events and post-baseline removal - / placement-related events occurred more frequently with FOLFOX-@ than XELOX ( @ % vs @ % and @ % vs @ % ) .


Pump malfunctions , primarily infusion accelerations in @ % of patients , occurred within @-@ @ % of cycles .


Fluoropyrimidine-associated grade @/@ toxicity was increased in FOLFOX-@-treated patients experiencing a malfunction compared with those who did not ( @ out of @ vs @ out of @ patients ) , predominantly with increased grade @/@ neutropenia ( @ % vs @ % ) .


Febrile neutropenia rates were comparable between patient cohortsmalfunction .


Efficacy outcomes were similar in patient cohortsmalfunction .


Central venous access device removal or replacement was common and more frequent in patients receiving FOLFOX-@ .


Pump malfunctions were also common and were associated with increased rates of grade @/@ haematological adverse events .


Oral fluoropyrimidine-based regimens may be preferable to infusional @-FU based on these findings .


Primary care provides most of the evidence-based chronic disease prevention and screening services offered by the healthcare system .


However , there remains a gap between recommended preventive services and actual practice .


This trial ( the BETTER Trial ) aimed to improve preventive care of heart disease , diabetes , colorectal , breast and cervical cancers , and relevant lifestyle factors through a practice facilitation intervention set in primary care .


Pragmatic two-way factorial cluster RCT with Primary Care Physicians ' practices as the unit of allocation and individual patients as the unit of analysis .


The setting was urban Primary Care Team practices in two Canadian provinces .


Eight Primary Care Team practices were randomly assigned to receive the practice-level intervention or wait-list control ; @ physicians in each team ( @ physicians ) were randomly assigned to receive the patient-level intervention or wait-list control .


Patients randomly selected from physicians ' rosters were stratified into two groups : @ ) general and @ ) moderate mental illness .


The interventions involved a multifaceted , evidence-based , tailored practice-level intervention with a Practice Facilitator , and a patient-level intervention involving a one-hour visit with a Prevention Practitioner where patients received a tailored ` prevention prescription ' .


The primary outcome was a composite Summary Quality Index of @ evidence-based chronic disease prevention and screening actions with pre-defined targets , expressed as the ratio of eligible actions at baseline that were met at follow-up .


A cost-effectiveness analysis was conducted .


@ of @,@ ( @ % ) eligible patients participated .


On average , patients were eligible for @ ( SD @ ) actions at baseline .


In the adjusted analysis , control patients met @ % ( @ % CI : @ % to @ % ) of target actions , compared to @ % ( @ % CI : @ % to @ % ) receiving the practice-level intervention , @ % ( @ % CI : @ % to @ % ) receiving the patient-level intervention , and @ % ( @ % CI : @ % to @ % ) receiving both practice - and patient-level interventions ( patient-level intervention versus control , P < @ ) .


The benefit of the patient-level intervention was seen in both strata .


The extra cost of the intervention was $ @ CAN ( @ % CI : $ @ to $ @ ) per additional action met .


A Prevention Practitioner can improve the implementation of clinically important prevention and screening for chronic diseases in a cost-effective manner .


The aim of this study was to assess the impact of digital versus traditional drainage devices on chest tube removal and patient satisfaction .


A randomized trial of digital versus traditional devices after lobectomy/segmentectomy was conducted at @ international centers ( United Kingdom , Europe , Asia , United States ) .


Patients were managed with overnight suction followed by gravity drainage .


Chest tubes were removed when an air leak was not evident anymore and the drained fluid was less than @ mL/d .


The groups ( digital , @ patients ; traditional , @ patients ) were well matched for baseline and surgical characteristics .


There were @ lobectomies/bilobectomies and @ segmentectomies , @ of which were performed by video-assisted thoracic surgery ( VATS ) .


Patients randomized to digital systems had a significantly shorter air leak duration ( @ versus @ days ; p = @ ) , duration of chest tube placement ( @ versus @ days ; p = @ ) , and postoperative length of stay ( @ versus @ days ; p < @ ) .


Subjective end points revealed a perceived improved ability to arise from bed ( p = @ ) , system convenience for patients and personnel ( p = @ ) , and the potential for being comfortable when discharged home with the device ( p = @ ) .


A mean difference of @ days from air leak cessation to tube removal was observed , which was similar in the @ groups ( p = @ ) .


Multivariable regression analysis showed that duration of chest tube placement after air leak cessation was directly associated with the amount of fluid drained during the first @ hours ( p = @ ) and the duration of air leak ( p = @ ) , independent of hospital location .


Patients managed with digital drainage systems experienced a shorter duration of chest tube placement , shorter hospital stays , and higher satisfaction scores compared with those managed with traditional devices .


Pain after cesarean delivery is a leading cause of chronic pain and there are many attempts to reduce it without total success .


Gabapentin is effective in reducing acute and chronic pain with little experience in parturient .


The purpose of this study is to compare the effect of pre-emptive gabapentin with intrathecal fentanyl on reducing postoperative pain and morphine consumption in cesarean surgery .


Seventy-eight primiparous women who scheduled for non-emergency cesarean delivery were enrolled in the study and separated into two groups .


The control group received @ mg of heavy bupivacaine @ % plus @ g of fentanyl intrathecally and the case group received @ mg of gabapentin orally @ h before surgery and @ mg of heavy bupivacaine @ % intrathecally .


Data collection including blood pressure , heart rate , neonate sedation , Apgar score , visual analogous scale at several hours , at first , need to analgesic postoperatively .


In the fentanyl group , the need for analgesic drug was earlier , total dose of morphine in @ h and patient satisfaction was higher than the gabapentin group .


The mean visual analogous scale at several hours postoperatively in the fentanyl groups was significantly higher than the gabapentin groups ( P = @ ) .


Preemptive use of gabapentin is a safe and effective way to reduce postoperative pain and morphine consumption in parturients after cesarean surgery .


To evaluate the effect of dexmedetomidine on emergence agitation after oral and maxillofacial surgery .


Fifty five patients who went into recovery room after oral and maxillofacial surgery were randomly divided into @ groups : dexmedetomidine group ( n = @ ) and control group ( n = @ ) .


Patients in dexmedetomidine group were assigned to receive intravenous dexmedetomidine at a dose of @ g/kg when they came into recovery room .


Patients in control group were assigned to receive intravenous normal saline .


Emergence agitation was assessed and extubation time after operation was recorded .


Mean arterial pressure , heart rate , arterial oxygen saturation , Ramsay scale were recorded at the time point of entering the recovery room instantly ( T@ ) and @ minutes ( T@ ) , @ minutes ( T@ ) , @ minutes ( T@ ) , @ minutes ( T@ ) , @ minutes ( T@ ) after the patient came into recovery room .


Statistical analysis was performed using SAS @ software package .


The incidence of emergence agitation was significantly lower in the dexmedetomidine group ( @ % ) than in the control group ( @ % ) ( P < @ ) .


The Ramsay scale was significantly higher in dexmedetomidine group than in the control group at the time point of T@ , T@ , T@ , T@ ( P < @ ) .


The heart rate was significantly lower in dexmedetomidine group than in the control group at the time point of T@ , T@ , T@ , T@ , T@ ( P < @ ) .


Mean arterial pressure was significantly lower in dexmedetomidine group than in the control group at the time point of T@ , T@ ( P < @ ) .


There was no significant difference on extubation time between @ groups .


There was no postoperative respiratory depression in @ groups .


Intravenous dexmedetomidine at a dose of @ g/kg can reduce emergence agitation after oral and maxillofacial surgery with safety and efficacy .


The objective was to describe parent-reported child eating behavior and maternal parenting impact outcomes of an infant feeding intervention to reduce child obesity risk .


An assessor masked Randomized Controlled Trial ( RCT ) with concealed allocation of individual mother-infant dyads .


The NOURISH RCT enrolled @ first-time mothers ( mean age @ years , SD = @ ) with healthy term infants ( @ % female ) aged @ months ( SD = @ ) at baseline .


Outcomes were assessed @ months post-intervention when the children were @ years old .


Mothers reported on child eating behaviors using the Children 's Eating Behavior Questionnaire ( CEBQ ) , food preferences , and dietary intake using a @-hour telephone recall .


Parenting was assessed using five scales validated for use in Australia .


Intervention effects were evident on the CEBQ overall ( MANOVA P = @ ) and @/@ subscales : child satiety responsiveness ( P = @ ) , fussiness ( P = @ ) , emotional overeating ( P < @ ) , and food responsiveness ( P = @ ) .


Intervention children `` liked '' more fruits ( P < @ ) and fewer non-core foods and beverages ( P = @ , @ ) .


The intervention mothers reported greater `` autonomy encouragement '' ( P = @ ) .


Anticipatory guidance on protective feeding practices appears to have modest positive impacts on child eating behaviors that are postulated to reduce future obesity risk .


Metacognitive dysfunction has been widely recognized as a feature of schizophrenia .


As it is linked with deficits in several aspects of daily life functioning , improvement of metacognition may lead to improvement in functioning .


Individual psychotherapy might be a useful form of treatment to improve metacognition in patients with schizophrenia ; multiple case reports and a pilot study show promising results .


The present study aims to measure the effectiveness of an individual , manual-based therapy ( Metacognitive Reflection and Insight Therapy , MERIT ) in improving metacognition in patients with schizophrenia .


We also want to examine if improvement in metacognitive abilities is correlated with improvements in aspects of daily life functioning namely social functioning , experience of symptoms , quality of life , depression , work readiness , insight and experience of stigma .


MERIT is currently evaluated in a multicenter randomized controlled trial .


Thirteen therapists in six mental health institutions in the Netherlands participate in this study .


Patients are randomly assigned to either MERIT or the control condition : treatment as usual ( TAU ) .


If proven effective , MERIT can be a useful addition to the care for schizophrenia patients .


The design brings along some methodological difficulties , these issues are addressed in the discussion of this paper .


Juvenile myoclonic epilepsy ( JME ) is a young-onset electroclinical syndrome , characterized by myoclonic , generalized tonic-clonic , and possibly typical absence seizures .


Interictal electroencephalography ( EEG ) displays @-@ Hz spike/polyspike and wave pattern .


Photosensitivity is common .


Our aim was to explore the blood oxygen level-dependent ( BOLD ) response evoked by a highly provocative photic stimulus in a cohort of people with JME compared to a group of nonphotosensitive healthy controls , and to investigate the hemodynamic phenomena seen in patients with photosensitive JME .


We studied @ JME patients and @ healthy controls using EEG-functional magnetic resonance imaging ( fMRI ) performed during low luminance intermittent photic stimulation ( IPS ) .


The BOLD response to IPS was investigated both in JME and control groups .


In photosensitive JME subjects , we also performed a dynamic evaluation of BOLD signal changes evoked by the photoparoxysmal response ( PPR ) in a time frame ranging from @ s before the onset of the EEG paroxysm up until @ s afterward .


The IPS evoked a positive BOLD response in striate and extrastriate visual areas , which was less in JME patients than in controls .


Moreover , people with JME had a reduced positive BOLD response in the frontoparietal areas and putamen but a stronger negative BOLD response in the primary sensorimotor cortex ( SM@ ) and in cortical regions belonging to the default mode network ( DMN ) .


In JME , the dynamic evaluation of BOLD signal changes related to PPR revealed an early positive response in the putamen and SM@ , followed by BOLD signal decrements in the putamen , caudate nuclei , thalami , and SM@ .


Our results confirm the hypothesis that people with JME might have an altered interaction between the motor circuit and other neuronal networks , with prominent involvement of basal ganglia circuitry .


The PPR could be a final expression of pathogenic phenomena occurring in the striato-thalamocortical system , possibly a core feature of system epilepsy JME .


To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged @-@ at increased risk of falls and injuries and living in the community .


Pragmatic multicentre , two arm , parallel group , randomised controlled trial .


@ study sites in @ medium to large cities throughout France .


@ women aged @-@ , living in their own home , and with diminished balance and gait capacities , randomly allocated to the experimental intervention group ( exercise programme , n = @ ) or the control group ( no intervention , n = @ ) .


Weekly supervised group sessions of progressive balance training offered in community based premises for two years , supplemented by individually prescribed home exercises .


A geriatrician blinded to group assignment classified falls into one of three categories ( no consequence , moderate , severe ) based on physical damage and medical care .


The primary outcome was the rate of injurious falls ( moderate and severe ) .


The two groups were compared for rates of injurious falls with a `` shared frailty '' model .


Other outcomes included the rates of all falls , physical functional capacities ( balance and motor function test results ) , fear of falling ( FES-I ) , physical activity level , and perceived health related quality of life ( SF-@ ) .


Analysis was by intention to treat .


There were @ injurious falls in the intervention group and @ in the control group ( hazard ratio @ , @ % confidence interval @ to @ ) .


The difference in severe injuries ( @ in intervention group v @ in control group ) was of the same order of magnitude ( @ , @ to @ ) .


At two years , women in the intervention group performed significantly better on all physical tests and had significantly better perception of their overall physical function than women in the control group .


Among women who started the intervention ( n = @ ) , the median number of group sessions attended was @ ( interquartile range @-@ ) .


Five injurious falls related to the intervention were recorded .


A two year progressive balance retraining programme combining weekly group and individual sessions was effective in reducing injurious falls and in improving measured and perceived physical function in women aged @-@ at risk of falling.Trial registration ClinicalTrials.gov ( NCT@ ) .


We compared the efficacy of medical masks ( MM ) and N@ respirators ( N@ ) in preventing bacterial colonization/infection in healthcare workers ( HCWs ) .


A cluster randomized clinical trial ( RCT ) of @ hospital HCWs randomized to medical masks or N@ respirators , and compared to @ control HCWs , was performed in Beijing , China , during the winter season of @-@ .


Participants were followed for development of clinical respiratory illness ( CRI ) .


Symptomatic subjects were tested for Streptococcus pneumoniae , Bordetella pertussis , Chlamydia pneumoniae , Mycoplasma pneumoniae or Haemophilus influenza type B by multiplex polymerase chain reaction ( PCR ) .


The rate of bacterial colonization was @ % in the N@ group ( p = @ ) , @ % among medical mask users ( p < @ ) and @ % among the controls ( p = @ ) .


N@ respirators were significantly protective ( adjusted RR @ , @ % CI : @-@ @ ) against bacterial colonization .


Co-infections of two bacteria or a virus and bacteria occurred in up to @ % of HCWs , and were significantly lower in the N@ arm .


N@ respirators were significantly protective against bacterial colonization , co-colonization and viral-bacterial co-infection .


We showed that dual respiratory virus or bacterial-viral co-infections can be reduced by the use of N@ respirators .


This study has occupational health and safety implications for health workers .


Fever and neutropenia ( FN ) often complicate anticancer treatment and can be caused by potentially fatal infections .


Knowledge of pathogen distribution is paramount for optimal patient management .


Microbiologically defined infections ( MDI ) in pediatric cancer patients presenting with FN by nonmyeloablative chemotherapy enrolled in a prospective multicenter study were analyzed .


Effectiveness of empiric antibiotic therapy in FN episodes with bacteremia was assessed taking into consideration recently published treatment guidelines for pediatric patients with FN .


MDI were identified in a minority ( @ % ) of pediatric cancer patients with FN .


In patients with , compared with patients without MDI , fever -LSB- median , @ ( interquartile range : @-@ ) vs. @ ( interquartile range : @-@ ) days , P < @ -RSB- and hospitalization -LSB- @ ( @-@ ) vs. @ ( @-@ ) days , P < @ -RSB- lasted longer , transfer to the intensive care unit was more likely -LSB- @ of @ ( @ % ) vs. @ of @ ( @ % ) , P < @ -RSB- , and antibiotics were given longer -LSB- @ ( @-@ ) vs. @ ( @-@ ) days , P < @ -RSB- .


Empiric antibiotic therapy in FN episodes with bacteremia was highly effective if not only intrinsic and reported antimicrobial susceptibilities were considered but also the purposeful omission of coverage for coagulase-negative staphylococci and enterococci was taken into account -LSB- @ % ( @ % confidence interval : @-@ ) vs. @ % ( @ % confidence interval : @-@ @ ) , P = @ -RSB- .


MDI were identified in a minority of FN episodes but they significantly affected management and the clinical course of pediatric cancer patients .


Compliance with published guidelines was associated with effectiveness of empiric antibiotic therapy in FN episodes with bacteremia .


The efficacy and safety of certolizumab pegol ( CZP ) in moderate-to-severe Crohn 's disease were demonstrated in two @-week double-blind studies ( PRECiSE @ & @ ) .


To report the safety and efficacy outcomes of long-term , CZP therapy from PRECiSE @ , in which patients received treatment up to @years treatment .


Patients completing PRECiSE @ or @ were eligible to enter PRECiSE @ in which they received CZP @mg , open-label , every @weeks ( without additional induction therapy ) for up to @years , for up to @ doses from study start .


Safety ( adverse events , including infections and malignancies ) and efficacy ( Harvey-Bradshaw Index , faecal calprotectin , C-reactive protein ) were prospectively monitored .


Remission was analysed using observed cases , last observation carried forward imputation and nonresponder imputation .


A total of @ patients entered the study ; @ ( @ % ) completed @years .


Discontinuation rates were @ % , @ % , @ % , @ % , @ % , @ % and @ % ( years @-@ respectively ) .


During @ patient-years of exposure to CZP , no new safety signals were observed .


Incidence rates ( new cases/@ patient-years ) for serious infections and malignant neoplasms were @ and @ respectively .


No lymphoproliferative malignancies were reported .


Clinical remission rates were @ % at each year ( observed cases ) ; rates by last observation carried forward and nonresponder imputation were @ % and @ % at year @ , @ % and @ % at year @ and @ % and @ % at year @ respectively .


Certolizumab pegol was well tolerated in the long-term treatment of Crohn 's disease , with sustained remission in some patients continuing in the study for up to @years .


ClinicalTrials.gov identifier NCT@ .


HIV-@ plasma viral load during treatment can be highly variable .


Thus , there is the need to find a measure of cumulative viremia that can be used to assess both the short - and long-term efficacy of highly active antiretroviral therapy ( HAART ) .


Here , we validate a measure of cumulative viremia to evaluate HAART efficacy .


We accessed HAART efficacy using data from a randomized clinical trial conducted in Mexico .


We compared the proportion of individuals achieving a viral load < @ and < @ copies/mL at week @ , against the cumulative plasma viral load , estimated as the area under the plasma viral load curve ( AUVLC ) .


High AUVLC indicates high cumulative viremia .


There was a strong and significant association between the proportion of individuals achieving a viral load < @ and < @ copies/mL at week @ , with individuals suppressed having significant lower cumulative viremia .


The median area was @ ( @th-@th percentile -LSB- Q@-Q@ -RSB- @-@ ) if viral load < @ copies/mL and @ ( Q@-Q@ @-@ ) if viral load @ copies/mL ( p-value @ ) .


When the analysis was stratified by study arm , individuals on efavirenz had lower cumulative viremia than those on boosted lopinavir .


Our findings suggest that cumulative viremia should be explored further as a tool to simultaneously evaluate the individual and public health efficacy of HAART .


This is particularly relevant to the implementation and evaluation of the Treatment @ strategy recently proposed by UNAIDS and the WHO , as a means to maximize the individual and public health benefit of HAART .


To determine whether differences could be detected in mobility outcomes during community mobility and home mobility tasks according to type of mobility assistive device .


Randomized , repeated measures .


Community mobility task : traversing @ m between the rehabilitation clinic and hospital entrance ; home mobility task : traversing @m into and out of a patient training bathroom and bedroom .


Community-dwelling , cognitively intact ambulatory veterans ( N = @ ) who used a mobility device within the @ days prior to the study .


Participants tested @ types of mobility assistive devices with wheels : @-wheeled walker ( WW ) , manual wheelchair ( MWC ) , and powered wheelchair ( PWC ) .


The first and last devices used by each participant were randomly assigned as either MWC or WW .


The PWC was always the second device .


Speed ( m/s ) , collisions ( total ) , fatigue ( @-@ Likert scale ) , and pain ( @-@ Likert scale , diagram ) .


The community mobility task was performed with all @ devices by @ ( @ % ) veterans , and the home mobility task was performed with all @ devices by @ ( @ % ) participants .


In each task , @ participants used the WW and @ participants used the MWC as the final device .


In the community mobility task , statistically significant differences ( P < @ ) were seen with @ device comparison for all studied outcomes ( eg , standardized mean difference for the MWC compared with the PWC showed -@ fewer collisions for the MWC ) .


In the home mobility task , speed , collisions , and fatigue showed statistically significant ( P < @ ) device-related differences ( eg , standardized mean difference for the WW compared with the MWC showed -@ fewer collisions for the WW ) .


We found statistically significant and substantively different effects from @ commonly used mobility assistive devices with wheels on diverse mobility outcomes when used in typical community mobility and home mobility tasks , providing proof of concept support for a research methodology applicable to comparative outcome studies of diverse mobility aids .


Ramadan fasting is a special model of hunger and particularly affects metabolic processes , including carbohydrate and lipid levels .


Endocrine changes induced by Ramadan fasting are not well known .


The aim of this article was to evaluate the changes in hormone levels in women before and after the special Muslim fasting period of Ramadan .


This study was performed in @ healthy women in Obstetrics and Gynecology department during the Ramadan month of@ .


Patients during and after the first menstrual period had menstrual cycles fasting blood samples taken on the same days .


Luteinizing hormone ( LH ) , follicle stimulating hormone ( FSH ) , estradiol ( E@ ) , testosterone , and prolactin ( PRL ) levels were determined .


Before and during fasting LH , FSH , E@ , testosterone and PRL levels were not statistically different .


Despite the limited available studies on these subjects in women , effect of Ramadan fasting on hormone levels were found to be within the normal limits .


This work intended to observe the effect of injecting botolinum toxin type A ( BTX-A ) for relieving spastic iliopsoas of cerebral palsy on children , and to investigate the improvement of this method for the motor function in these children .


From July @ to August @ , @ children with spastic iliopsoas cerebral palsy were received rehabilitation therapy .


The age ranged from @ to @ years .


The control group were treated by conventional physical therapy ( PY ) .


The experimental group were treated not only by the conventional physical therapy , but also BTX-A injection .


The dose of BTX-A injection was according to the weight of the child and the Modified Ashworth Scale ( MAS ) .


The dose of the injection ranged from @ IU to @ IU with the average dose @ IU .


There was no significant difference between two the groups on ages , weight and MAS , GMFM ( Gross Motor Function Measure ) and extension angle of hip joints before treatment .


In both groups , the Modified Ashworth Scale decreased , GMFM and extension angle of hip joints increased after eight weeks .


In the control group , the GMFM improved significantly .


In the experimental group , MAS , GMFM and extension angle of hip joints changed significantly after therapy .


There was significant difference between two groups in MAS , GMFM and extension angle of hip joints after two months .


The BTX-A injection can relieve iliopsoas spasticity of cerebral palsy on children efficiently .


This therapy can help children to correct abnormal gait and to improve their motor function .


This study sought to assess radiation exposure and operator discomfort when using left radial approach ( LRA ) versus right radial approach ( RRA ) for coronary diagnostic and percutaneous interventions .


The transradial approach is increasingly being adopted as the preferred vascular access for coronary interventions .


Currently , most are performed using an RRA .


This is in part due to the perceived increased operator physical discomforts as well increased radiation exposure with an LRA .


One hundred patients were randomized to an LRA or RRA .


Each operator ( n = @ ) had an independent randomization process , and patients were stratified according to obesity status .


Operator radiation was measured using separate sets of radiation dosimeter badges placed externally on the head and thyroid and internally on the sternum .


Operator physical discomfort was surveyed at @ time points : during vascular access and at the end of the procedure .


Moderate to severe physical discomfort was defined as a score of > @ .


There were no significant differences in baseline and procedural variables between groups .


There was a significant increase in external radiation exposure using the RRA versus LRA ( head : median : @ -LSB- interquartile range ( IQR ) : @ to @ -RSB- mRems vs. median : @ -LSB- IQR : @ to @ -RSB- mRems , p = @ ; thyroid : median : @ -LSB- IQR : @ to @ -RSB- mRems vs. median : @ -LSB- IQR : @ to @ -RSB- mRems , p = @ ) .


More discomfort was reported with the LRA during access ( LRA : @ % vs. RRA : @ % ; p = @ ) , but not during the procedure ( LRA : @ % vs. RRA : @ % , p = @ ) .


This difference was almost entirely noted inobese patients ( LRA : @ % vs. RRA : @ % , p = @ ) .


LRA is as effective as RRA , showing a safer profile with decreased radiation exposure to the operator , at the expense of more operator discomfort only during vascular access and limited to obese patients .


To determine dose-dependent effects of T administration on cardiovascular risk markers in women with low T levels .


Seventy-one hysterectomized women with or without oophorectomy with total T < @ ng/dL and/or free T < @ pg/mL received a standardized transdermal estradiol regimen during the @-week run-in period and were then randomized to receive weekly im injections of placebo or @ - , @ - , @ - , or @-mg T enanthate for @ weeks .


Total and free T levels were measured by liquid chromatography-tandem mass spectrometry and equilibrium dialysis , respectively .


Insulin resistance and inflammatory markers were measured at baseline and @ weeks .


In a subset of women , magnetic resonance imaging of the abdomen was performed to quantify abdominal fat volume .


Fifty-nine women who completed the @-week intervention were included in the final analysis .


The five groups were similar at baseline .


Mean on-treatment nadir total T concentrations were @ , @ , @ , @ , and @ ng/dL in the placebo group and the @ - , @ - , @ - , and @-mg groups , respectively .


No significant changes in fasting glucose , fasting insulin , homeostatic model assessment of insulin resistance , high sensitivity C-reactive protein , adiponectin , blood pressure , and heart rate were observed at any T dose when compared to placebo .


Similarly , no dose - or concentration-dependent changes were observed in abdominal fat on magnetic resonance imaging .


Short-term T administration over a wide range of doses for @ weeks in women with low T levels was not associated with worsening of cardiovascular risk markers .


The phe@del CFTR mutation causes cystic fibrosis by limiting the amount of CFTR protein that reaches the epithelial cell surface .


We tested combination treatment with lumacaftor , an investigational CFTR corrector that increases trafficking of phe@del CFTR to the cell surface , and ivacaftor , a CFTR potentiator that enhances chloride transport of CFTR on the cell surface .


In this phase @ clinical trial , we assessed three successive cohorts , with the results of each cohort informing dose selection for the subsequent cohort .


We recruited patients from @ cystic fibrosis centres in Australia , Belgium , Germany , New Zealand , and the USA .


Eligibility criteria were : confirmed diagnosis of cystic fibrosis , age at least @ years , and a forced expiratory volume in @ s ( FEV@ ) of @ % or more than predicted .


Cohort @ included phe@del CFTR homozygous patients randomly assigned to either lumacaftor @ mg once per day for @ days followed by addition of ivacaftor @ mg or @ mg every @ h for @ days , or @ days of placebo .


Together , cohorts @ and @ included phe@del CFTR homozygous and heterozygous patients , randomly assigned to either @ days of lumacaftor ( cohort @ : @ mg , @ mg , or @ mg once per day , cohort @ : @ mg every @ h ) with ivacaftor @ mg every @ h added after @ days , or @ days of placebo .


The primary outcomes for all cohorts were change in sweat chloride concentration during the combination treatment period in the intention-to-treat population and safety ( laboratory measurements and adverse events ) .


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


Cohort @ included @ participants .


Cohort @ and @ combined contained @ phe@del CFTR homozygous patients and @ compound heterozygotes .


Treatment with lumacaftor @ mg once daily and ivacaftor @ mg every @ h decreased mean sweat chloride concentration by @ mmol/L ( p < @ ) during the combination treatment period in cohort @ .


In cohorts @ and @ , mean sweat chloride concentration did not decrease significantly during combination treatment in any group .


Frequency and nature of adverse events were much the same in the treatment and placebo groups during the combination treatment period ; the most commonly reported events were respiratory .


@ of @ participants had chest tightness or dyspnoea during treatment with lumacaftor alone .


In pre-planned secondary analyses , a significant decrease in sweat chloride concentration occurred in the treatment groups between day @ and day @ ( lumacaftor @ mg once per day group -@ mmol/L , p < @ ; lumacaftor @ mg once per day group -@ mmol/L , p < @ ; lumacaftor @ mg every @ h group -@ mmol/L , p = @ ) .


These changes were significantly greater than the change in the placebo group .


In cohort @ , the lumacaftor @ mg once per day significantly improved FEV@ from day @ to @ ( difference compared with placebo group : +@ percentage points , p = @ ) , primarily during the combination period .


In cohort @ , FEV@ did not change significantly across the entire study period compared with placebo ( difference +@ percentage points , p = @ ) , but did during the combination period ( difference +@ percentage points , p = @ ) .


Phe@del CFTR heterozygous patients did not have a significant improvement in FEV@ .


We provide evidence that combination lumacaftor and ivacaftor improves FEV@ for patients with cystic fibrosis who are homozygous for phe@del CFTR , with a modest effect on sweat chloride concentration .


These results support the further exploration of combination lumacaftor and ivacaftor as a treatment in this setting .


The aim of this study was to assess the glucose-lowering and lipid-modifying effects , and safety profile of lobeglitazone , a novel peroxisome proliferator-activated receptor - agonist , compared to placebo as a monotherapy in patients with type @ diabetes .


In this @-week , multicenter , randomized , double-blind , parallel-group , placebo controlled study , @ patients were randomly assigned ( a @ ratio ) to lobeglitazone @ mg ( n = @ ) or matching placebo ( n = @ ) orally once daily .


The primary endpoint was the change in glycated hemoglobin ( HbA@c ) from baseline to the end of treatment .


The secondary endpoints included various glycemic parameters , lipid parameters and safety profile ( ClinicalTrials.gov number NCT@ ) .


At @ weeks , a significant reduction in HbA@c was observed with lobeglitazone versus placebo ( -@ % vs @ % , mean difference -@ % , p < @ ) .


The goal of HbA@c < @ % was achieved significantly more in the lobeglitazone group compared to the placebo group ( @ % vs @ % , p < @ ) .


Markers of insulin resistance were also improved in the lobeglitazone group .


In addition , lobeglitazone treatment significantly improved triglycerides , high density lipoprotein cholesterol , small dense low density lipoprotein cholesterol , free fatty acid , and apolipoprotein-B/CIII compared to placebo ( p < @ , respectively ) .


More weight gain was observed in the lobeglitazone group than the placebo group ( @ kg vs - @ kg , mean difference @ kg , p < @ ) .


The safety profile was comparable between the two groups and lobeglitazone was well tolerated .


Lobeglitazone @ mg showed a favorable balance in the efficacy and safety profile .


The results support a potential role of lobeglitazone in treating type @ diabetes .


Pulsed electromagnetic fields have been shown to reduce postoperative pain , inflammation , and narcotic requirements after breast reduction and augmentation surgical procedures .


This study examined whether pulsed electromagnetic field therapy could produce similar results in patients undergoing unilateral transverse rectus abdominis myocutaneous ( TRAM ) flap breast reconstruction , a significantly more complex and painful surgical procedure .


In this double-blind , placebo-controlled , randomized study , @ patients undergoing unilateral TRAM flap breast reconstruction received active or sham pulsed electromagnetic field therapy .


Pain levels were measured by using a visual analogue scale ; narcotic use and wound exudate volume were recorded starting @ hour postoperatively .


Wound exudates were analyzed for interleukin-@ .


Mean visual analogue scale pain scores were @-fold higher in the sham cohort at @ hours and @-fold higher at @ hours ( p < @ ) , along with a concomitant @-fold increase in narcotic use in sham patients ( p < @ ) .


Wound exudate volume was @-fold higher in the sham cohort at @ hours ( p < @ ) , and mean interleukin-@ concentration in wound exudates of sham patients was @-fold higher at @ hours ( p < @ ) .


Pulsed electromagnetic field therapy significantly reduced postoperative pain , inflammation , and narcotic use following TRAM flap breast reconstruction , paralleling its effect in breast reduction patients .