Women who have used Shiatsu technique were significantly more likely to have spontaneous labour than those women who did not .


Results of the study showed that shiatsu technique can be used as one of safe complementary methods for post-term pregnancy induction .


The progression of carotid intima-media thickness ( CIMT ) is closely associated with ischemic stroke recurrence .


However , the efficacy of cilostazol on preventing CIMT progression in stroke patients has never been investigated properly by a prospective trial .


This study is a part of `` Trial of Cilostazol in Symptomatic Intracranial Arterial Stenosis-@ . ''


Six centers that are available to measure CIMT according to the protocol participated in this substudy .


After @ months of randomization , the changes of CIMT were compared between cilostazol group and clopidogrel group .


CIMT was measured by a semiautomated software ( Intimascope ) and was presented as the mean of maximum ( CIMT-max ) and average ( CIMT-ave ) of both common carotid arteries .


Linear logistic regression analysis and analysis of covariance were performed to verify the independent factors associated with CIMT progression .


Among the @ patients , @ subjects were assigned to cilostazol group and @ subjects to clopidogrel group .


Follow-up CIMT significantly decreased in cilostazol group ( CIMT-max : -@ and CIMT-ave : -@ ) compared with the increase in clopidogrel group ( CIMT-max : @ and CIMT-ave : @ ; P = @ and P = @ , respectively ) .


Female , diabetes , and smoking were independently associated with the progression of CIMT , whereas the use of cilostazol was against CIMT progression from the results of linear regression analysis ( P = @ for both CIMT-max and CIMT-ave ) .


The use of cilostazol also well predicted less progression of CIMT at follow-up after adjusting for baseline CIMT values and conventional risk factors ( CIMT-max : P = @ and CIMT-ave : P = @ ) .


Cilostazol has a beneficial effect in preventing the progression of CIMT in ischemic stroke patients .


Low-dose GH ( LGH ) therapy has been reported to improve insulin sensitivity in GH-deficient adults ; however , the mechanism is unclear .


Effects of LGH therapy on insulin sensitivity are mediated through changes in cortisol metabolism and ectopic fat accumulation .


This was a double-blind , placebo-controlled , parallel , @-month study .


Seventeen GH-deficient adults were randomized to receive either daily LGH or placebo injections .


Fasting blood samples were collected at baseline , and months @ and @ , whereas hyperinsulinemic-euglycemic clamps , magnetic resonance spectroscopy scans , @-hour cortisol production rates ( CPRs ) , and sc abdominal fat biopsies were performed at baseline and month @ .


Clamp glucose infusion rate , intramyocellular , extramyocellular , and intrahepatic lipid content , @-hour CPRs , adipocyte size , and adipocyte @-hydroxysteroid dehydrogenase activity in adults with GH deficiency were evaluated .


At month @ , LGH did not alter fasting levels of glucose , insulin , C-peptide , free fatty acid , adiponectin , total IGF-@ , IGF-@ bioactivity , IGF-@ , IGF binding protein ( IGFBP ) -@ , or IGF-@ to IGFBP-@ molar ratio .


At month @ , LGH increased clamp glucose infusion rates ( P < @ ) and IGF-@ to IGFBP-@ molar ratio ( P < @ ) , but fasting glucose , insulin , C-peptide , free fatty acid , adiponectin , IGF-@ bioactivity , IGF-@ , IGFBP-@ , @-hour CPRs , adipocyte size , adipocyte @-hydroxysteroid dehydrogenase activity , intrahepatic lipid , extramyocellular , or intramyocellular were unchanged .


In the placebo group , all within-group parameters from months @ and @ compared with baseline were unchanged .


Short-term LGH therapy improves insulin sensitivity without inducing basal lipolysis and had no effect on cortisol metabolism and ectopic fat accumulation in GH-deficient adults .


This may reflect an LGH-induced increase in IGF-@ to IGFBP-@ molar ratio exerting insulin-like effects through the abundant muscle IGF-@ receptors , but this hypothesis requires confirmation with further studies .


It has been shown that serum concentrations of @,@ ( OH ) @D@ are decreased in patients with gout .


A short-term administration of allopurinol increases plasma concentrations of @,@ ( OH ) @D@ in mild to moderate renal failure , with or without hyperuricemia .


It has been reported that subjects who perform regular vigorous and / or moderate physical activities have higher plasma and serum @ ( OH ) D@ levels .


However , little is known about the influence of allopurinol and/or physical exercise on serum @ ( OH ) D@ concentrations in humans .


We investigated the effect of allopurinol administration and/or physical activity on vitamin D metabolism by measuring serum uric acid , @ ( OH ) D@ , and calcium levels in twelve professional soccer players .


The athletes supplemented with allopurinol , but not those who received placebo , exhibited a significant decrease in uric acid serum concentrations after the match .


We also found a significant increase in serum calcium and @ ( OH ) D@ concentrations in the supplemented group .


We conclude that allopurinol administration might be an effective drug to lower hyperuricemia and treat hypovitaminosis D.


To observe the improvements in constipation differentiated as intestine system syndrome and lung system syndrome treated with electroacupuncture ( EA ) and explore their correlation .


Seventy cases of severe functional constipation were randomized into an EA group and a pseudo-EA group , @ cases in each one .


In the EA group , the needles were inserted deeply at Tianshu ( ST @ ) and Fujie ( SP @ ) on bilateral sides , and directly went to parietal peritoneum .


EA was attached to the needles , dense-disperse wave , @ Hz/@ Hz , and @ to @ mA .


The perpendicular insertion was done at Shangjuxu ( ST @ ) , @ mm in depth .


After qi arrival , the needle was lifted , thrusted and rotated once every @ min , for @ times totally .


The needles were retained for @ min .


In the pseudo-EA group , the pseudo-points lateral to Tianshu ( ST @ ) , Fujie ( SP @ ) and Shangjuxu ( ST @ ) on bilateral sides were punctured shallowly .


The electric stimulation was pretended to connect but with the electric wire cutting off .


The treatment was given @ times weekly in the first two weeks and @ times weekly in the later @ weeks .


Totally , @ treatments were required .


TCM intestine and lung syndrome scale was used for evaluation .


The changes in TCM syndromes were observed before and after treatment in the patients of the two groups .


The total score of intestine and lung syndrome and the score of individual syndrome were all reduced after treatment as compared with those before treatment in the two groups ( both P < @ ) .


The improvements of the EA group in the total score of intestine system syndrome , the scores of large .


intestine syndrome and stomach syndrome , the total score of lung system syndrome and the score of lung dysfunction in dispersing and descending syndrome were superior to those of the pseudo-EA group ( P < @ , P < @ ) .


The differences in the scores of lung qi deficiency syndrome and throat syndrome were not significant between the two groups ( all P > @ ) .


Simultaneously , the very strong positive correlation ( P < @ ) and positive linear correlation ( P < @ ) were presented in the total score of intestine and lung syndrome of the two groups .


EA obviously improves in intestine system syndrome ( including large intestine syndrome and stomach syndrome ) , as well as lung system syndrome ( lung dysfunction in dispersing and descending ) in the treatment of constipation .


But the improvements are not apparent in the treatment of lung qi deficiency and throat disorder .


Additionally , the obvious correlation is displayed in the improvements in intestine and lung syndrome .


The purpose of this study was to analyze the removal of implant-supported crowns retained by three different cements using an air-accelerated crown remover and to evaluate the patients ' response to the procedure .


This controlled clinical trial was conducted with @ patients ( @ women , @ men ; mean age : @ @ years ) who had received a total of @ implants ( all placed in the posterior zone of the mandible ) .


Four months after implant surgery , the crowns were cemented on standard titanium abutments of different heights .


Three different cements ( two temporary : Harvard TEMP and Improv ; and one definitive : Durelon ) were used and randomly assigned to the patients .


Eight months later , one blinded investigator removed all crowns .


The number of activations of the instrument ( CORONAflex , KaVo ) required for crown removal was recorded .


The patients completed a questionnaire retrospectively to determine the impact of the procedure and to gauge their subjective perception .


A linear regression model and descriptive statistics were used for data analysis .


All crowns could be retrieved without any technical complications or damage .


Both abutment height ( P = @ ) and cement type ( P = @ ) had a significant effect on the number of activations , but the type of cement was more important .


An increased total number of activations had no or only a weak correlation to the patients ' perception of concussion , noise , pain , and unwillingness to use the device .


Cemented implant crowns can be removed , and the application of an air-accelerated device is a practicable method .


A type of cement with appropriate retention force has to be selected .


The impact on the patients ' subjective perception should be taken into account .


Women with severe aortic valve stenosis ( AS ) have better LV systolic function and more concentric LV geometry than their male counterparts .


However , sex differences in cardiovascular ( CV ) outcome during progression of AS have not been reported from a longitudinal prospective study .


Doppler echocardiography and CV events were recorded during a median of @ years in @ men and @ women aged @-@ ( mean @ ) years in the Simvastatin Ezetimibe in Aortic Stenosis ( SEAS ) study .


LV systolic function was assessed by EF and midwall shortening ( MWS ) .


Study outcomes were AS-related events , ischaemic CV events and total mortality .


The annular cumulative incidence of AS events , ischaemic CV events and death was @ % , @ % and @ % in women , and @ % , @ % and @ % in men , respectively .


Women and men had similar AS progression rate whether measured by peak jet velocity , mean gradient or valve area .


In multivariate analyses , female sex independently predicted less reduction in LV MWS and EF during follow-up ( both p < @ ) .


In time-varying Cox analyses , women had a @ % lower rate of ischaemic CV events ( @ % CI @ % to @ % ) , in particular , more than @ % lower rate of stroke and coronary artery bypass grafting , and a @ % lower all-cause mortality ( @ % CI @ % to @ % ) , independent of active study treatment , age and hypertension , as well as time-varying valve area , low systolic function and abnormal LV geometry .


AS event rate did not differ by sex .


In the SEAS study , women and men had similar rates of AS progression and AS-related events .


However , women had lower total mortality and ischaemic CV event rate than men independent of confounders .


The purpose of the present study was to compare the effect of oral bromelain ( @ @ mg ) versus oral diclofenac sodium ( @ @ mg ) on pain , swelling , trismus , and quality of life ( QOL ) after surgical removal of impacted lower third molars .


A randomized , double-blind , placebo-controlled study was planned .


The sample included patients requiring extraction under local anesthesia of a single partial bony impacted mandibular third molar .


The patients were randomly distributed into @ of @ groups : bromelain , diclofenac , and placebo .


Treatment started @ day before surgery and continued for @ days .


The predictor variable was the type of the drug given to the patients .


The outcome variables were pain , swelling , and trismus , which were measured at @ , @ , and @ days postoperatively .


The other study variables included QOL measures to assess the patients ' perception regarding the effect of surgery on their well-being and daily activities .


A validated questionnaire was used to measure QOL .


The data were analyzed using analysis of variance , multiple measures analysis of variance , or Pearson 's ( @ ) test , as appropriate .


P < @ was considered significant .


A total of @ subjects requiring surgical removal of a single impacted mandibular third molar under local anesthesia were included in the present study .


The bromelain and diclofenac groups both showed a significant reduction in pain compared with the placebo group at all intervals ( P < @ ) .


Diclofenac also resulted in a significant reduction of swelling at @ and @ days , and bromelain resulted in an insignificant reduction .


A nonsignificant reduction in trismus occurred in both treatment groups compared with the placebo group .


Both treatment groups also showed a significant difference in the effect on QOL in most subscales and total scores ( P < @ ) .


The effect was comparable between the @ treatment groups for all parameters and at all intervals .


The results of our study have shown that oral bromelain is an effective therapy to improve the QOL after surgical removal of impacted lower third molars , with an effect on the postoperative sequelae comparable to that of preemptive diclofenac sodium .


Little is known about the effect of various dietary fatty acids on pro- and anti-inflammatory processes .


We investigated the effect of @ oils containing various amounts of alpha-linolenic acid ( ALA ) , linoleic acid ( LA ) , oleic acid ( OA ) and docosahexaenoic acid ( DHA ) on plasma inflammatory biomarkers and expression levels of key inflammatory genes and transcription factors in whole blood cells .


In a randomized , crossover controlled nutrition intervention , @ adult men and women with abdominal obesity and at least one other criterion for the metabolic syndrome consumed @ experimental isoenergetic diets for @ weeks each , separated by @-week washout periods .


Each diet provided @ g/@ kcal of different oils : @ ) control corn/safflower oil blend ( CornSaff ; LA-rich ) , @ ) flax/safflower oil blend ( FlaxSaff ; ALA-rich ) , @ ) conventional canola oil ( Canola ; OA-rich ) , @ ) high oleic canola oil ( CanolaOleic ; highest OA content ) , @ ) DHA-enriched high oleic canola oil ( CanolaDHA ; OA - and DHA-rich ) .


Gene expression in whole blood cells was assessed in a subset of @ subjects .


CanolaDHA increased plasma adiponectin concentrations compared with the control CornSaff oil treatment ( +@ % , P = @ ) and FlaxSaff ( +@ % , P = @ ) .


CanolaDHA also reduced relative expression levels of interleukin ( IL ) @B compared with CornSaff and Canola ( -@ % and -@ % , respectively , both P = @ ) .


High-sensitivity C-reactive protein concentrations were lower after Canola than after FlaxSaff ( -@ % , P = @ ) .


DHA-enriched canola oil exerts anti-inflammatory effects compared with polyunsaturated fatty acids from plant sources .


The present study aimed to compare the treatment outcomes of a fixed-functional appliance ( Twin-Force Bite Corrector - TFBC ) and a conventional removable functional appliance ( Activator ) in the treatment of skeletal Class II malocclusions .


The TFBC and Activator Groups each included @ young adults possessing a skeletal Class II malocclusion , and the treatment outcomes of both groups were quantified and compared , using lateral cephalometric radiographs , with an untreated skeletal Class II Control Group .


A skeletal Class I relationship and a marked reduction in overjet were achieved in both treatment groups ; however , the duration of treatment was significantly shorter in the TFBC Group ( @ years ) when compared with the Activator Group ( @ years ) ( p < @ ) .


Effective length and sagittal positioning of the mandible underwent significant changes in the TFBC and Activator Groups .


Vertical facial dimensions increased in each group ; however , these increases were significantly greater in the Activator Group when compared to the TFBC and Control Groups ( p < @ ) .


Dentoalveolar changes also contributed to the reduction in overjet .


Although both appliances succeeded in eliminating the Class II relationship and improving the overjet and overbite , the short treatment time in the TFBC Group raises questions regarding the long-term stability of the results .


NHS Health Checks is a new program for primary prevention of heart disease , stroke , diabetes , chronic kidney disease , and vascular dementia in adults aged @ to @years in England .


Individuals without existing cardiovascular disease or diabetes are invited for a Health Check every @years .


Uptake among those invited is lower than anticipated .


The project is a three-arm randomized controlled trial to test the hypothesis that enhanced invitation methods , using the Question-Behaviour Effect ( QBE ) , will increase uptake of NHS Health Checks compared with a standard invitation .


Participants comprise individuals eligible for an NHS Health Check registered in two London boroughs .


Participants are randomized into one of three arms .


Group A receives the standard NHS Health Check invitation letter , information sheet , and reminder letter at @weeks for nonattenders .


Group B receives a QBE questionnaire @week before receiving the standard invitation , information sheet , and reminder letter where appropriate .


Group C is the same as Group B , but participants are offered a @ retail voucher if they return the questionnaire .


Participants are randomized in equal proportions , stratified by general practice .


The primary outcome is uptake of NHS Health Checks @months after invitation from electronic health records .


We will estimate the incremental health service cost per additional completed Health Check for trial groups B and C versus trial arm A , as well as evaluating the impact of the QBE questionnaire , and questionnaire plus voucher , on the socioeconomic inequality in uptake of Health Checks.The trial includes a nested comparison of two methods for implementing allocation , one implemented manually at general practices and the other implemented automatically through the information systems used to generate invitations for the Health Check .


The research will provide evidence on whether asking individuals to complete a preliminary questionnaire , by using the QBE , is effective in increasing uptake of Health Checks and whether an incentive alters questionnaire return rates as well as uptake of Health Checks .


The trial interventions can be readily translated into routine service delivery if they are shown to be cost-effective .


To compare the difference in the clinical efficacy on posterior circulation ischemia between acupuncture at stellate ganglion and conventional acupuncture as well as the impacts on blood pressure .


Eighty cases of posterior circulation ischemia were randomized into an observation group ( @ cases ) and a control group ( @ cases ) .


In the observation group , acupuncture was applied to the bilateral stellate ganglions on the neck , stimulated with reinforcing technique by rotating the needles .


In the control group , the acupuncture of reducing technique was applied to Fengchi ( GB @ ) , Baihui ( GV @ ) , Neiguan ( PC @ ) and Taichong ( LR @ ) in the excess syndrome .


The even needling or reinforcing technique was applied to Fengchi ( GB @ ) , Baihui ( GV @ ) , Ganshu ( BL @ ) , Shenshu ( BL @ ) and Zusanli ( ST @ ) for the deficiency syndrome .


The treatment was given once every @ days and @ treatments were required totally in the two groups .


The changes in total syndrome score , peak Systolic blood flow velocity ( Vp ) of vertebral artery and basilar artery , systolic and diastolic blood pressures were compared before and after treatment in the two groups .


The clinical efficacy was compared between the two groups .


The total syndrome score was reduced apparently after treatment compared with that before treatment in the two groups ( P < @ ) , and the reducing was more obvious in the observation group as compared with that in the control group ( P < @ ) .


The total effective rate was @ % ( @/@ ) in the observation group , higher than @ % ( @/@ , P < @ ) in the control group .


After treatment , the reduced Vp of vertebral artery was not improved apparently as compared with that before treatment in the control group , Vp in blood velocity abnormality ( including vascular spasm , stenosis or reduced velocity ) of vertebral artery and basilar artery was all improved as compared with that before treatment in the two groups ( P < @ ) , and the improvements in the observation group were more obvious than those in the control group ( P < @ ) .


After treatment , the systolic and diastolic pressures were reduced as compared with those before treatment in the two groups , and the reduced systolic and diastolic pressures in the observation group were more apparent than those in the control group ( P < @ ) .


Acupuncture at stellate ganglion achieves the satisfactory efficacy in the treatment of posterior circulation ischemia and the significant efficacy of reducing blood pressure , more advanced than the conventional acupuncture .


To compare self-reported physical activity recorded in physical activity diaries or the Active Australia Survey with objectively measured physical activity using accelerometry in sedentary middle-aged adults completing two physical activity interventions .


Cross-sectional study .


Sedentary @-@ year olds were recruited to a non-randomized @-month community group exercise program ( G ) or a physiotherapist-led home-based physical activity program ( HB ) .


Over @-days , @ participants ( HB @ , G @ ) wore an ActiGraph GT@M accelerometer ( @s epochs ) , completed the Active Australia Survey ( AAS ) and a daily physical activity diary .


Data were analysed using descriptive statistics and Spearman rank-order correlations .


The two interventions had similar demographic and physical activity characteristics except that home-based participants were younger ( p < @ ) , more likely to be employed full time ( p @ ) and reported less moderate-to-vigorous physical activity in the physical activity diaries compared to group exercise participants ( HB @ @ min d ( -@ ) vs. G @ @ min d ( -@ ) , p @ ) .


Home-based participants had fair-to-good agreement between the physical activity diaries and AAS or ActiGraph data ( r = @-@ @ , p < @ ) .


Group exercise physical activity diary data did not correlate significantly with either the AAS or ActiGraph data .


In contrast , group exercise AAS data had good correlations with ActiGraph data ( r = @-@ @ , p @ ) .


Physical activity diaries should be interpreted cautiously unless intervention participants have an adequate understanding of physical activity intensity .


The AAS is the preferred self-report measure in middle-aged adults independent of intervention .


Human infections with avian influenza A/H@N@ have resulted in high morbidity and mortality in China .


To compare safety and immunogenicity of different doses of influenza A/Shanghai/@ / @ ( H@N@ ) vaccine mixed with or without the MF@ adjuvant .


Multicenter , randomized , double-blind , phase @ trial at @ US sites enrolled @ adults aged @ to @ years beginning in September @ ; @-month follow-up was completed in May @ .


The H@N@ inactivated virus vaccine was administered intramuscularly on days @ and @ at nominal doses of @ , @ , @ , or @ g of hemagglutinin ( actual doses approximately @ % higher ) with or without the MF@ adjuvant .


A total @ , @ , or @ participants were randomized to each group ( @ groups ; N = @ ) .


Proportions achieving day @ antibody titer of @ or greater or seroconversion ( a minimum @-fold increase to titer @ ) with the hemagglutination inhibition assay ; vaccine-related serious adverse events through month @ ; and solicited postvaccination symptoms through day @ .


Hemagglutination inhibition antibodies were minimal after participants received an unadjuvanted vaccine .


After receiving @ doses of H@N@ vaccine at a dosage of @ g plus the MF@ adjuvant , day @ seroconversion occurred in @ participants ( @ % ; @ % CI , @ % -@ % ) .


The peak seroconversion occurred at day @ in @ participants ( @ % ; @ % CI , @ % -@ % ) .


The day @ geometric mean titer was @ ( @ % CI , @-@ @ ) .


Higher antigen doses were not associated with increased response .


For the neutralizing antibody assays , after receiving @ g of H@N@ vaccine plus the MF@ adjuvant , day @ seroconversion occurred in @ participants ( @ % ; @ % CI , @ % -@ % ) .


There was no statistically significant difference in day @ hemagglutination inhibition seroconversion after mixing adjuvant with either the first or both @ g doses ( n = @ -LSB- @ % ; @ % CI , @ % -@ % -RSB- vs n = @ -LSB- @ % ; @ % CI , @ % -@ % -RSB- , respectively ; P = @ ) .


Recent receipt of seasonal influenza vaccination and older age were associated with attenuated response .


No vaccine-related serious adverse events occurred .


Solicited postvaccination symptoms were generally mild with more local symptoms seen in participants who received the adjuvant .


Point-of-use mixing and administration of @ doses of H@N@ vaccine at the lowest tested antigen dose with MF@ adjuvant produced seroconversion in @ % of participants .


Although these findings indicate potential value in this approach , the study is limited by the absence of antibody data beyond @ days and the absence of clinical outcomes .


Previous exercise intervention studies for smoking cessation have been challenged by a number of methodological limitations that confound the potential efficacy of aerobic exercise for smoking cessation .


The preliminary efficacy of a behavioral exercise intervention that incorporated features designed to address prior limitations was tested in a randomized controlled trial ( RCT ) .


Sixty-one smokers ( @ % female , mean age = @ years , smoked a mean of @ cigarettes/day ) were randomized to receive either a @-week exercise intervention or a @-week health education contact control .


Participants in both conditions received an @-week telephone-delivered , standard smoking cessation protocol ( with the transdermal nicotine patch ) .


Follow-ups were conducted at the end of treatment ( EOT ) , @ - and @-month timepoints .


There were no differences between conditions with respect to the number of weekly exercise or health education sessions attended ( @ vs. @ , respectively ) .


While not statistically significant , participants in the exercise condition demonstrated higher verified abstinence rates ( EOT : @ % vs. @ % , odds ratio -LSB- OR -RSB- = @ ; @ - and @-month follow-ups : @ % vs. @ % , OR = @ ) .


Irrespective of treatment condition , higher levels of moderate-to-vigorous exercise were associated with lower levels of depressive symptoms during the intervention .


The results of this small RCT point toward the benefit of a behavioral exercise intervention designed to address previous methodological limitations for smoking cessation .


Given the potential public health impact of the demonstrated efficacy of exercise for smoking cessation , the continued development and optimization of exercise interventions for smokers through larger RCTs merits pursuit .


Statins are commonly used for the management of dyslipidemia in type @ diabetes mellitus patients .


We hypothesized that atorvastatin could modulate the beta-cell function by altering the levels of proapoptotic and antiapoptotic lipoproteins and could also have an effect on insulin resistance .


The aim of the present pilot study was to assess the effect of atorvastatin @ mg on pancreatic beta-cell function and insulin resistance in patients with hyperlipidemia and type @ diabetes by using the homeostasis model assessment-@ ( HOMA@ ) index .


Fifty-one type @ diabetes patients receiving oral antidiabetes drugs , not taking statins , with baseline low-density lipoprotein cholesterol between @ mmol/L and @ mmol/L were included .


Forty-three patients ( @ in placebo group and @ in atorvastatin group ) completed the study and were taken up for final analysis .


Fasting blood samples were obtained at baseline and at @ weeks to determine levels of blood glucose , lipid profile , insulin , C-peptide and glycosylated hemoglobin ( A@C ) .


Atorvastatin nonsignificantly increased fasting serum insulin ( +@ % , p = @ ) , accompanied by marginal nonsignificant increases in fasting plasma glucose and A@C .


There was a decrease in HOMA@ percent beta-cell function ( -@ % , p = @ ) and increase in HOMA@ insulin resistance ( +@ % , p = @ ) in the atorvastatin group as compared with baseline , but the difference was not statistically significant .


Atorvastatin in the dose used failed to produce significant change in pancreatic beta-cell function and insulin resistance in type @ diabetes patients as assessed by the HOMA@ index .


The possible explanations include absence of lipotoxicity at prevailing levels of dyslipidemia at baseline or inadequacy of statin dose used in the study .


( Clinical Trials Registry-India : CTRI/@/@ / @ ) .


Critically ill patients typically receive @ % of estimated calorie requirements .


We aimed to determine whether the substitution of a @-kcal / mL enteral nutrition solution for a @-kcal / mL solution resulted in greater calorie delivery to critically ill patients and establish the feasibility of conducting a multicenter , double-blind , randomized trial to evaluate the effect of an increased calorie delivery on clinical outcomes .


A prospective , randomized , double-blind , parallel-group , multicenter study was conducted in @ Australian intensive care units .


One hundred twelve mechanically ventilated patients expected to receive enteral nutrition for @ d were randomly assigned to receive @ ( n = @ ) or @ ( n = @ ) kcal/mL enteral nutrition solution at a rate of @ mL/kg ideal body weight per hour for @ d. Protein and fiber contents in the @ solutions were equivalent .


The @ groups had similar baseline characteristics ( @ compared with @ kcal/mL ) .


The mean ( SD ) age was @ @ compared with @ @ y , @ % compared with @ % were men , and the Acute Physiology and Chronic Health Evaluation II score was @ @ compared with @ @ .


The groups received similar volumes of enteral nutrition solution -LSB- @ mL/d ( @ % CI : @ , @ mL/d ) compared with @ mL/d ( @ % CI : @ , @ mL/d ) ; P = @ -RSB- , which led to a @ % increase in daily calories in the group given the @-kcal / mL solution -LSB- @ kcal/d ( @ % CI : @ , @ kcal/d ) compared with @ kcal/d ( @ % CI : @ , @ kcal/d ) ; P < @ -RSB- .


The @-kcal / mL solution was not associated with larger gastric residual volumes or diarrhea .


In this feasibility study , there was a trend to a reduced @-d mortality in patients given @ kcal/mL -LSB- @ patients ( @ % ) compared with @ patients ( @ % ) ; P = @ -RSB- .


The substitution of a @ - with a @-kcal / mL enteral nutrition solution administered at the same rate resulted in a @ % greater calorie delivery without adverse effects .


The results support the conduct of a large-scale trial to evaluate the effect of increased calorie delivery on clinically important outcomes in the critically ill .


Ilaprazole , a proton pump inhibitor ( PPI ) currently in clinical use , may provide improved acid suppression vs. other PPIs .


To compare the pharmacodynamic and pharmacokinetic profiles of ilaprazole and esomeprazole .


A phase @ , randomised , open-label , single-centre , @-period crossover study was conducted in @ healthy volunteers .


Ilaprazole @ , @ or @mg or esomeprazole @mg was administered once daily for @days with @-day washout intervals .


Pharmacokinetic blood samples and intragastric pH measurements were collected at scheduled timepoints for @h after dosing on Days @ and @ .


Esomeprazole @mg provided significantly better pH control during the initial hours ( @-@h ) after a single dose , but ilaprazole ( particularly @ and @mg ) provided significantly better pH control for the entire @-h period and during evening and overnight hours after single and multiple doses .


Increasing ilaprazole doses resulted in dose-proportional increases in peak plasma concentration and area under the plasma concentration vs. time curve following single and multiple doses .


Ilaprazole was safe and generally well tolerated ; an unexpectedly high incidence of allergic eye and skin reactions were observed but were not specific to any dosing regimen .


Plasma gastrin concentrations did not increase proportionately with increasing ilaprazole dose .


Ilaprazole provided significantly better pH control over @h and during evening and overnight hours compared with esomeprazole in healthy volunteers , which may translate to greater relief of night-time heartburn in the clinical setting for patients with gastric acid-related disorders .


The aim of this study was to evaluate whether the remote introduction of electronic decision support tools into family practices improves risk factor control after first stroke .


This study also aimed to develop methods to implement cluster randomized trials in stroke using electronic health records .


Family practices were recruited from the UK Clinical Practice Research Datalink and allocated to intervention and control trial arms by minimization .


Remotely installed , electronic decision support tools promoted intensified secondary prevention for @ months with last measure of systolic blood pressure as the primary outcome .


Outcome data from electronic health records were analyzed using marginal models .


There were @ Clinical Practice Research Datalink family practices allocated ( intervention , @ ; control , @ ) , with @ @ ( control , @ ; intervention , @ ) participants with acute stroke ever diagnosed .


Participants at trial practices had similar characteristics as @,@ patients with stroke at nontrial practices .


During the intervention period , blood pressure values were recorded in the electronic health records for @ % and cholesterol values for @ % of participants .


After intervention , the latest mean systolic blood pressure was @ ( SD , @ ) mm Hg in the control trial arm and @ ( @ ) mm Hg in the intervention trial arm , and adjusted mean difference was -@ mm Hg ( @ % confidence interval , -@ to @ ; P = @ ) .


The financial cost of the trial was approximately US $ @ per participant , or US $ @ per family practice allocated .


Large pragmatic intervention studies may be implemented at low cost by using electronic health records .


The intervention used in this trial was not found to be effective , and further research is needed to develop more effective intervention strategies .


Introducing colonoscopy as part of colorectal cancer screening on a national level , we aimed at evaluating the efficacy of the two most common bowel cleansing agents , Moviprep ( ) and Phosphoral ( ) .


Secondly , we evaluated the benefit for the patient and society in terms of sick leave and discomfort .


In a single-blinded randomized equivalence trial , Phosphoral ( ) ( NaP ) was compared with Moviprep ( ) ( @ l polyethylene glycol + ascorbic acid ) in patients undergoing colonoscopy due to suspicion of cancer .


Patients filled out questionnaires concerning stool consistency , discomfort and number of sick days due to bowel cleansing .


Blinded colonoscopists estimated the efficiency of the cleansing using the validated Harefield Cleansing Scale .


Two hundred and sixty-six patients were included @ of whom underwent full colonoscopy .


There was no difference in the percentage of acceptable bowel cleansings in the two groups ; however , a significantly higher number of A scores were observed in the Moviprep ( ) group ( p = @ ) .


We found no correlation between stool consistency and outcome of the cleansing and no difference in subjective discomfort during cleansing .


Vomiting during cleansing occurred more often in the Phosphoral ( ) group ( p = @ ) .


There was a trend toward a smaller number of sick days in patients who used Moviprep ( ) compared with Phosphoral ( ) .


Moviprep ( ) and Phosphoral ( ) provided equally efficient bowel cleansing in @ % of patients , but Moviprep ( ) provided a higher quality of cleansings graded as successful .


The two agents were equally tolerated , and no difference was found in the related number of sick days .


Improving health-related quality of life ( HRQoL ) is an important treatment goal in the management of patients with atrial fibrillation ( AF ) .


Uncertainty exists as to whether patients ' HRQoL differ when treated with medical rhythm control or rate control .


We compared HRQoL between patients treated with rhythm control or rate control in a large observational registry of patients with recent-onset AF .


In the Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation ( RECORD-AF ) , @ patients with recent onset ( < @ year ) AF completed an AF-specific HRQoL questionnaire , the University of Toronto Atrial Fibrillation Severity Scale .


HRQoL was assessed by the AF symptom severity score ( @-@ , with higher scores reflecting more severe AF-related symptoms ) at baseline and @ year .


The minimal clinically important difference was defined as a change of @ points .


The primary analysis was based on a propensity score-adjusted longitudinal regression analysis which compared the change in AF symptom severity scores between the @ groups .


Over an average follow-up of @ year , the AF symptom severity scores improved in both groups ( rhythm control : -@ point -LSB- @ % confidence interval , -@ to -@ -RSB- ; rate control : -@ point -LSB- @ % confidence interval , -@ to -@ -RSB- ; P < @ for both groups ) .


The magnitude of improvement was higher in the rhythm control group than the rate control group ( unadjusted difference : -@ point ; @ % confidence interval , -@ to -@ ; P = @ ; propensity score-adjusted difference : -@ point ; @ % confidence interval , -@ to -@ ; P = @ ) .


In this observational cohort of recent-onset AF patients , treatment with medical rhythm - or rate control over @ year was associated with an improvement in HRQoL .


The magnitude of HRQoL improvement was minimally higher in patients treated with rhythm control than rate control .


However , the overall degree of improvement was not large , and its clinical significance was uncertain .


To compare outcomes after @-month maintenance treatment of adults diagnosed with obsessive-compulsive disorder ( OCD ) based on DSM-IV criteria who responded to acute treatment with serotonin reuptake inhibitors ( SRIs ) augmented by exposure and response prevention ( EX/RP ) or risperidone .


A randomized trial was conducted at @ academic sites from January @ through December @ .


In the acute phase , @ patients on therapeutic SRI dose with at least moderate OCD severity were randomized to @ weeks of EX/RP , risperidone , or pill placebo .


Responders entered the @-month maintenance phase , continuing the augmentation strategy they received acutely ( n = @ EX/RP , n = @ risperidone ) .


Independent evaluations were conducted every month .


The main outcome was the Yale-Brown Obsessive Compulsive Scale ( Y-BOCS ) .


Intent-to-treat analyses indicated that , after @-month maintenance treatment , EX/RP yielded OCD outcomes that were superior to risperidone ( Y-BOCS = @ vs @ ; t@ = @ , P = @ ) ; more patients randomized to EX/RP met response criteria ( Y-BOCS decrease @ % : @ % vs @ % ; P < @ ) and achieved minimal symptoms ( Y-BOCS @ : @ % vs @ % ; P < @ ) .


During maintenance , OCD severity decreased slightly in both conditions ( Y-BOCS decrease = @ points , P = @ ) .


Lower Y-BOCS at entry to maintenance was associated with more improvement in both conditions ( r@ = @ , P < @ ) .


OCD patients taking SRIs who responded to acute EX/RP or risperidone maintained their gains over @-month maintenance .


Because EX/RP patients improved more during acute treatment than risperidone-treated patients , and both maintained their gains during maintenance , EX/RP yielded superior outcomes @ months later .


The findings that @ % of patients randomized to EX/RP had minimal symptoms at @-month maintenance , a rate double that of prior studies , suggests that EX/RP maintenance helps maximize long-term outcome .


Examine women 's perceptions of what is ` normal ' and ` desirable ' in female genital appearance .


Experiment with random allocation across three conditions .


Community .


A total of @ women aged @-@years .


Women were randomly assigned to view a series of images of ( @ ) surgically modified vulvas or ( @ ) nonmodified vulvas , or ( @ ) no images .


They then viewed and rated ten target images of surgically modified vulvas and ten of unmodified vulvas .


Women used a four-point Likert scale ( ` strongly agree ' to ` strongly disagree ' ) , to rate each target image for ` looks normal ' and ` represents society 's ideal ' .


For each woman , we created two summary scores that represented the extent to which she rated the unmodified vulvas as more ` normal ' and more ` society 's ideal ' than the modified vulvas .


For ratings of ` normality , ' there was a significant effect for condition ( F@ ,@ = @ P = @ , radj@ = @ ) : women who had first viewed the modified images rated the modified target vulvas as more normal than the nonmodified vulvas , significantly different from the control group , who rated them as less normal .


For ratings of ` society 's ideal ' , there was again a significant effect for condition ( F@ ,@ = @ , P < @ , radj@ = @ ) ; all three groups rated modified target vulvas as more like society 's ideal than the nonmodified target vulvas , with the effect significantly strongest for the women who had viewed the modified images .


Exposure to images of modified vulvas may change women 's perceptions of what is normal and desirable .


This may explain why some healthy women seek labiaplasty .


Chronic musculoskeletal pain is among the most prevalent , costly , and disabling medical disorders .


However , few clinical trials have examined interventions to improve chronic pain in primary care .


To determine the effectiveness of a telecare intervention for chronic pain .


The Stepped Care to Optimize Pain Care Effectiveness ( SCOPE ) study was a randomized trial comparing a telephone-delivered collaborative care management intervention vs usual care in @ patients with chronic ( @ months ) musculoskeletal pain of at least moderate intensity ( Brief Pain Inventory -LSB- BPI -RSB- score @ ) .


Patients were enrolled from @ primary care clinics in a single Veterans Affairs medical center from June @ through May @ , with @-month follow-up completed by June @ .


Patients were randomized either to an intervention group ( n = @ ) or to a usual care group whose members received all pain care as usual from their primary care physicians ( n = @ ) .


The intervention group received @ months of telecare management that coupled automated symptom monitoring with an algorithm-guided stepped care approach to optimizing analgesics .


Primary outcome was the BPI total score , which ranges from @ ( `` no pain '' ) to @ ( `` pain as bad as you can imagine '' ) and for which a @-point change is considered clinically important .


Secondary pain outcomes included BPI interference and severity , global pain improvement , treatment satisfaction , and use of opioids and other analgesics .


Overall , mean ( SD ) baseline BPI scores in the intervention and control groups were @ ( @ ) and @ ( @ ) , respectively .


Compared with usual care , the intervention group had a @-point lower ( @ % CI , -@ to -@ ) BPI score at @ months ( @ vs @ ) .


Patients in the intervention group were nearly twice as likely to report at least a @ % improvement in their pain score by @ months ( @ % vs @ % ; relative risk , @ -LSB- @ % CI , @ to @ -RSB- ) , with a number needed to treat of @ ( @ % CI , @ to @ ) for a @ % improvement .


Secondary pain outcomes also improved .


Few patients in either group required opioid initiation or dose escalation .


Telecare collaborative management increased the proportion of primary care patients with improved chronic musculoskeletal pain .


This was accomplished by optimizing nonopioid analgesic medications using a stepped care algorithm and monitoring .


Regional anesthesia is a commonly used technique in orthopedic procedures .


Sedation should reduce the patient 's anxiety and fear while increasing regional anesthesia quality .


This study evaluated the hemodynamic changes , level of sedation , both patients ' and surgeons ' levels of satisfaction and potential side effects in patient-controlled sedation using propofol .


This randomized clinical trial studied sixty ASA physical class I-III patients scheduled for total knee replacement surgery under combined spinal-epidural anesthesia .


Patients in Group P ( n = @ ) received propofol via a patient-controlled analgesia device with the following settings : intravenous propofol bolus dose @ g.kg ( -@ ) , @-minute lockout interval and no basal infusion .


In Group S , we infused saline @ using the same settings .


To determine the level of sedation , we used BIS and Observer 's Assessment of Alertness / Sedation Scale .


For all patients , we recorded the number of requests .


As the fi nal evaluation , we scored surgeons ' and patients ' satisfaction on @-point scales .


Both BIS values and OAA/S scores were lower in Group P than in Group S. Patients ' satisfaction was higher in Group P , although there was no significant difference with respect to surgeons ' satisfaction between the groups .


The number of requests for sedation was significantly higher in Group S. However , most requests were considered unsuccessful .


This study suggests that patient-controlled sedation with propofol can be used efficiently in orthopedic procedures .


The high number of adult males engaging in low levels of physical activity and poor dietary practices , and the health risks posed by these behaviors , necessitate broad-reaching intervention strategies .


Information technology ( IT ) - based ( Web and mobile phone ) interventions can be accessed by large numbers of people , yet there are few reported IT-based interventions targeting males ' physical activity and dietary practices .


This study examines the effectiveness of a @-month IT-based intervention ( ManUp ) to improve the physical activity , dietary behaviors , and health literacy in middle-aged males compared to a print-based intervention .


Participants , recruited offline ( eg , newspaper ads ) , were randomized into either an IT-based or print-based intervention arm on a @:@ basis in favor of the fully automated IT-based arm .


Participants were adult males aged @-@ years living in @ regional cities in Queensland , Australia , who could access the Internet , owned a mobile phone , and were able to increase their activity level .


The intervention , ManUp , was based on social cognitive and self-regulation theories and specifically designed to target males .


Educational materials were provided and self-monitoring of physical activity and nutrition behaviors was promoted .


Intervention content was the same in both intervention arms ; only the delivery mode differed .


Content could be accessed throughout the @-month study period .


Participants ' physical activity , dietary behaviors , and health literacy were measured using online surveys at baseline , @ months , and @ months .


A total of @ participants completed baseline assessments , @ in the IT-based arm and @ in the print-based arm .


A total of @ participants completed all @ assessments .


There were no significant between-group differences in physical activity and dietary behaviors ( P. @ ) .


Participants reported an increased number of minutes and sessions of physical activity at @ months ( exp ( ) = @ , @ % CI @-@ @ ; exp ( ) = @ , @ % CI @-@ @ ) and @ months ( exp ( ) = @ , @ % CI @-@ @ ; exp ( ) = @ , @ % CI @-@ @ ) .


Overall dietary behaviors improved at @ months ( exp ( ) = @ , @ % CI @-@ @ ) and @ months ( exp ( ) = @ , @ % CI @-@ @ ) .


The proportion of participants in both groups eating higher-fiber bread and low-fat milk increased at @ months ( exp ( ) = @ , @ % CI @-@ @ ; exp ( ) = @ , @ % CI @-@ @ ) .


Participants in the IT-based arm were less likely to report that @ minutes of physical activity per day improves health ( exp ( ) = @ , @ % CI @-@ @ ) and more likely to report that vigorous intensity physical activity @ times per week is essential ( exp ( ) = @ , @ % CI @-@ @ ) .


The average number of log-ins to the IT platform at @ and @ months was @ ( SE @ ) and @ ( SE @ ) , respectively .


The average number of self-monitoring entries at @ and @ months was @ ( SE @ ) and @ ( SE @ ) , respectively .


The ManUp intervention was effective in improving physical activity and dietary behaviors in middle-aged males with no significant differences between IT - and print-based delivery modes .


To determine if there was a difference between patients participating in research and those who did not regarding their satisfaction with the medical encounter and their physician .


We prospectively randomized @ patients to either complete @ minutes of questionnaires ( participate in research ) or not .


After the visit , all patients rated their satisfaction with their visit and satisfaction with the doctor on an @-point ordinal satisfaction scales , with @ being not at all satisfied and @ being completely satisfied .


Average satisfaction scores were analyzed in relation to demographics , questionnaires , and involvement in research .


There were no significant differences between patients that did and did not participate in research for satisfaction with the medical encounter or satisfaction with the treating physician .


Satisfaction was not associated with marital status , work status , or diagnosis .


There was a significant correlation between greater satisfaction and both less education and lower self-efficacy .


There was no significant correlation between patient satisfaction and magnitude of disability , pain intensity , or health anxiety .


This study demonstrated that patients ' participation in research can coexist with patient satisfaction .


A dietary regimen consisting of a clear liquid diet ( CLD ) for at least @ hours is recommended for colonoscopy preparation .


However , this requirement results in problems in patient compliance with bowel preparation .


The aim of this study was to evaluate the efficacy of a CLD compared with a regular diet ( RD ) for colonoscopy preparation using a polyethylene glycol ( PEG ) solution .


This was a multicenter , randomized , investigator-blind prospective study .


A total of @ healthy outpatients undergoing afternoon colonoscopy were randomized to either a CLD or RD in addition to a @ L PEG regimen .


The quality of bowel cleansing was not different between the CLD and RD groups in terms of the proportion with excellent or good preparation .


In addition , no significant differences were observed between the two groups for polyp and adenoma detection rates and overall adverse events .


Good compliance with bowel preparation was higher in the RD group than in the CLD group .


A CLD for a full day prior to colonoscopy should not be mandatory for PEG-based bowel preparation .


Dietary education concerning the avoidance of high-fiber foods for @ days before colonoscopy is sufficient , at least for healthy outpatients .


Impairments of memory are commonly reported by people with traumatic brain injuries ( TBI ) .


Such deficits are persistent , debilitating , and can severely impact quality of life .


Currently , many do not routinely receive follow-up appointments for residual memory problems following discharge .


This is a multi-centre , randomised controlled trial investigating the clinical and cost-effectiveness of a group-based memory rehabilitation programme .


Three hundred and twelve people with a traumatic brain injury will be randomised from four centres .


Participants will be eligible if they had a traumatic brain injury more than @ months prior to recruitment , have memory problems , are @ to @ years of age , are able to travel to one of our centres and attend group sessions , and are able to give informed consent .


Participants will be randomised in clusters of @ to @ to the group rehabilitation intervention or to usual care .


Intervention groups will receive @ weekly sessions of a manualised memory rehabilitation programme , which has been developed in previous pilot studies .


The intervention will include restitution strategies to retrain impaired memory functions and compensation strategies to enable participants to cope with their memory problems .


All participants will receive a follow-up postal questionnaire and an assessment by a research assistant at @ and @ months post-randomisation .


The primary outcome is the Everyday Memory Questionnaire at @ months .


Secondary outcomes include the Rivermead Behavioural Memory Test-@ , General Health Questionnaire-@ , health related quality of life , cost-effectiveness analysis determined by the EQ-@D and a service use questionnaire , individual goal attainment , European Brain Injury Questionnaire ( patient and relative versions ) , and the Everyday Memory Questionnaire-relative version .


The primary analysis will be based on intention to treat .


A mixed-model regression analysis of the Everyday Memory Questionnaire at @ months will be used to estimate the effect of the group memory rehabilitation programme .


The study will hopefully provide robust evidence regarding the clinical and cost-effectiveness of a group-based memory rehabilitation intervention for civilians and military personnel following TBI .


We discuss our decision-making regarding choice of outcome measures and control group , and the unique challenges to recruiting people with memory problems to trials .


Cardiovascular disease is the major cause of death in hemodialysis patients .


Regular aerobic or intradialytic exercise may play a role in reducing cardiovascular mortality in these patients .


The aim of this study was to evaluate the relationship between intradialytic exercise and echocardiographic findings .


Forty patients were enrolled in the study from Shahrekord Hemodialysis Center .


They were randomly assigned into the exercise and control groups .


In the exercise group , the patients had a @-minute exercise program per dialysis session , @ times a week , for @ months .


Electrocardiography and echocardiography were done at the beginning of the study and @ months later .


The mean age and body mass index of the patients were @ + / - @ years and @ + / - @ kg/m@ , respectively .


Left ventricular ejection fraction increased and systolic pulmonary artery pressure and right ventricular size decreased significantly after the study in the exercise group patients .


Our results showed the improvement of cardiac systolic and diastolic function in patients who had physical exercise during dialysis sessions .


Regular intradialysis exercise can be suggested for hemodialysis patients without cardiac disease .


Vaccination is an effective strategy to prevent influenza .


This observer-blind , randomized study in children @-@ years of age assessed whether the hemagglutination inhibition ( HI ) antibody responses elicited by H@N@/@ vaccines adjuvanted with AS@ ( an adjuvant system containing - tocopherol and squalene in an oil-in-water emulsion ) or without adjuvant , met the European regulatory immunogenicity criteria at Days @ and @ .


Three hundred and ten healthy children were randomized ( @:@:@:@ ) to receive one dose of @ g hemagglutinin ( HA ) AS@A-adjuvanted vaccine , one or two doses of @ g HA AS@B-adjuvanted vaccine , or one dose of @ g HA pandemic vaccine .


All children received a booster dose of the allocated vaccine at Day @ .


Serum samples were tested for HI antibody response at Days @ , @ , @ and @ .


All vaccination regimens elicited HI antibody responses that met the European regulatory criteria at Days @ and @ .


HI antibody responses fulfilling European regulatory criteria were still observed six months after the first vaccine dose in all study vaccines groups .


Two doses of @ g HA AS@B-adjuvanted vaccine elicited the strongest HI antibody response throughout the study .


The non-adjuvanted @ g HA vaccine elicited a lower HI antibody response than the AS@-adjuvanted vaccines .


At Day @ , the European regulatory criteria were met for all vaccines with baseline HI antibody titers as reference .


An anamnestic response for all vaccines was suggested at Day @ , based on the rapid increase in HI antibody geometric mean titers ( @-@ @ - fold increase ) .


Injection site reactogenicity was higher following the AS@-adjuvanted vaccines compared with the non-adjuvanted vaccine .


No safety concerns were identified for any study vaccine .


All study vaccines elicited HI antibody responses that persisted at purported protective levels through six months after vaccination and fulfilled the European regulatory criteria .


The importance of measuring blood pressure before morning micturition and in the afternoon , while working , is yet to be established in relation to the accuracy of home blood pressure monitoring ( HBPM ) .


To compare two HBPM protocols , considering @-hour ambulatory blood pressure monitoring ( wakefulness ABPM ) as gold-standard and measurements taken before morning micturition ( BM ) and in the afternoon ( AM ) , for the best diagnosis of systemic arterial hypertension ( SAH ) , and their association with prognostic markers .


After undergoing @-hour wakefulness ABPM , @ participants ( @ women ) were randomized for @ - or @-day HBPM .


Two variations of the @-day protocol were considered : with measurements taken before morning micturition and in the afternoon ( BM+AM ) ; and with post-morning-micturition and evening measurements ( PM+EM ) .


All patients underwent echocardiography ( for left ventricular hypertrophy - LVH ) and urinary albumin measurement ( for microalbuminuria - MAU ) .


Kappa statistic for the diagnosis of SAH between wakefulness-ABPM and standard @-day HBPM , @-day HBPM ( BM+AM ) and ( PM+EM ) , and @-day HBPM were @ , @ , @ and @ , respectively .


The values of sensitivity of ( BM+AM ) versus ( PM+EM ) were @ % @ % , respectively , and of specificity , @ % @ % , respectively .


The positive and negative predictive values were @ % @ % and @ % @ % , respectively .


The comparisons of intraclass correlations for the diagnosis of LVH and MAU between ( BM+AM ) and ( PM+EM ) were @ @ and @ @ , respectively .


The @ day-HBPM protocol including measurements taken before morning micturition and during work in the afternoon showed the best agreement with SAH diagnosis and the best association with prognostic markers .


Glenohumeral subluxation is the most frequent complication in post stroke hemiplegia and its reduction has been considered an important goal .


Though it has been demonstrated that cyclical electrical stimulation of posterior deltoid and supraspinatus muscles can reduce subluxation , the role of biceps has not been given due consideration .


The purpose of this study was to determine whether electrical stimulation to the long head of biceps could more effectively reduce gleno humeral subluxation .


@ patients were selected and consecutively assigned to group @ ( electrical stimulation to supraspinatus & posterior deltoid ) and group II ( electrical stimulation to supraspinatus , posterior deltoid & long head of the biceps ) along with routine physiotherapy and occupational therapy for a period of @ weeks .


All patients were assessed for shoulder subluxation , pain and shoulder active abduction range of motion at the time of recruitment to study and after @ weeks of therapy .


Both the groups showed significant improvement in parameters measured .


Tukey 's post hoc analysis showed the results were more significant in Group II .


Electrical stimulation to biceps along with the supraspinatus and posterior deltoid can more effectively reduce shoulder subluxation .


To evaluate the efficacy and safety of tamsulosin dose increase to @ mg daily in Asian patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia refractory to tamsulosin @ mg treatment .


We carried out a @-week , single-center , randomized , placebo-controlled trial in @ patients .


Patients treated with @ mg tamsulosin daily without other lower urinary tract symptoms secondary to benign prostatic hyperplasia medication for more than @months and refractory to this treatment were enrolled .


We defined `` refractory '' as an International Prostate Symptom Score of @ or greater and a maximum flow rate of @ or under despite medication .


Patients with a surgical history related to lower urinary tract symptoms secondary to benign prostatic hyperplasia or a postvoid residual of @mL or greater were excluded .


Eligible patients were randomly assigned to the @ mg group ( two tablets of @ mg tamsulosin once daily ) or the @ mg group ( one tablet of @ mg tamsulosin and one tablet of placebo once daily ) .


International Prostate Symptom Score , maximum flow rate , blood pressure , heart rate , and adverse events were compared between the two groups at @weeks and @weeks .


A total of @ patients were enrolled and analyzed .


There were no differences in baseline characteristics between the two groups .


After @weeks of medication , the International Prostate Symptom Score was not different between the two groups .


However , the improvement in maximum flow rate was greater in the @ mg group than the @ mg group ( @ mL/s vs -@ mL/s , P < @ ) .


The proportion of patients who showed an increase in maximum flow rate of more than @mL/s was @ % in the @ mg group versus @ % in the @ mg group ( P = @ ) .


There were no significant differences in bother score or postvoid residual between the two groups .


Systolic and diastolic blood pressure , and heart rate were also not different between the two groups .


The incidence of adverse events was @ % in the @ mg group ( dizziness @ % ; abnormal ejaculation @ % ; palpitation @ % ; and headache @ % ) and @ % in the @ mg group ( dizziness @ % ; abnormal ejaculation @ % ; palpitations @ % ; and headache @ % ) .


Tamsulosin @ mg appears to be a safe treatment regimen for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia in Asian patients who do not respond to @ mg treatment .


Increasing the dose of tamsulosin results in a significant improvement in maximum flow rate without any increase in cardiovascular complications .


Mechanisms for cancer related fatigue suggest that exercise but `` not too much and not too little '' could be effective .


This study aimed to investigate feasibility and estimate the potential effects of a walking exercise program in people with advanced cancer and fatigue .


A pilot randomized trial .


McGill University Health Centre ( MUHC ) , Montreal , Canada .


People with advanced cancer undergoing interdisciplinary assessment and rehabilitation with a fatigue level of @ to @ on a visual analogue scale .


An @-week fatigue-adapted , walking intervention , facilitated using a pedometer ( STEPS ) , and offered at the same time as or after rehabilitation .


Measures of fatigue , physical function and well-being were administered at entry , and @ , @ and @ weeks .


Generalized estimating equations ( GEE ) estimated the odds of response for people receiving the STEPS program in comparison to the odds of response in the controls ( odds ratio , OR ) .


Twenty-six persons were randomized to three groups : during rehabilitation , after rehabilitation , and usual care .


For the fatigue measures the OR for STEPS offered at any time using an intention-to-treat approach was @ ( @ % CI : @-@ @ ) ; for the physical function measures , the OR was @ ( @ % CI : @ - @ ) and @ ( @ % CI : @-@ @ ) for the well-being measures .


Fifty percent of eligible people were able to participate .


This small trial suggests that a personalized exercise program reduces fatigue and that @ people are needed in a full strength trial .


Tuberculosis ( TB ) remains a global health problem , with vaccination likely to be a necessary part of a successful control strategy .


Results of the first Phase @b efficacy trial of a candidate vaccine , MVA@A , evaluated in BCG-vaccinated infants were published last year .


Although no improvement in efficacy above BCG alone was seen , cryopreserved samples from this trial provide an opportunity to study the immune response to vaccination in this population .


We investigated blood samples taken before vaccination ( baseline ) and one and @ days post-vaccination with MVA@A or placebo ( Candin ) .


The IFN - ELISpot assay was performed at baseline and on day @ to quantify the adaptive response to Ag@A peptides .


Gene expression analysis was performed at all three timepoints to identify early gene signatures predictive of the magnitude of the subsequent adaptive T cell response using the significance analysis of microarrays ( SAM ) statistical package and gene set enrichment analysis .


One day post-MVA@A , there is an induction of inflammatory pathways compared to placebo samples .


Modules associated with myeloid cells and inflammation pre - and one day post-MVA@A correlate with a higher IFN - ELISpot response post-vaccination .


By contrast , previous work done in UK adults shows early inflammation in this population is not associated with a strong T cell response but that induction of regulatory pathways inversely correlates with the magnitude of the T cell response .


This may be indicative of important mechanistic differences in how T cell responses develop in these two populations following vaccination with MVA@A .


The results suggest the capacity of MVA@A to induce a strong innate response is key to the initiation of an adaptive immune response in South African infants but induction of regulatory pathways may be more important in UK adults .


Understanding differences in immune response to vaccination between populations is likely to be an important aspect of developing successful vaccines and vaccination strategies .


To evaluate and analyze the mechanism of Pizhen for the treatment of patients with scapular muscle fasciitis .


One hundred and sixteen patients were divided into two groups according to random number table method , @ cases in the treatment group and @ cases in the control group .


After treatment , @ patients were followed up , and @ patients lost follow-up ( @ cases in the treatment group and @ patients in the control group ) .


In the treatment group , there were @ males and @ females , with a mean age of ( @ + / - @ ) years ; the course of disease ranged from @ to @ years ; and the patients were treated by Pizhen once a week , and @ weeks were one treatment course .


In the control group , there were @ males and @ females , with a mean age of ( @ + / - @ ) years old ; the course of disease ranged from @ to @ year ; and the patients were treated by acupuncture massage instrument , @ minutes at a time , once a day for @ weeks .


Soft tissue displacement and banana area were tested by a soft tissue tension tester , pressure value was measured by pressure measuring instrument , and VAS was recorded by pain visual analog scale record .


There were significant differences in tissue displacement , banana area , pressure value and VAS between two groups before and after treatment .


The tissue displacement and pressure value in the treatment group were higher than those in the control group , while banana area and VAS were lower than those in the control group .


In the treatment group , @ patients healed , @ patients got marked improvement , @ good and @ poor ; while @ patients healed , @ patients got marked improvement ,@ good and @ poor in the control group .


The therapeutic effects in the treatment group was better than that in the control group .


Pizhen is an effective method to treat pain in patients with scapular muscle fasciitis by relaxing tendon of soft tissue around pain point of scapular and relaxing compress and stimulation of nerves .


Peer support involves people in recovery from mental illness supporting their peers .


This mixed-methods pilot randomized control trial with qualitative interviews aimed to ( a ) compare peer support worker ( PSW ) and mental health worker ( MHW ) client outcomes and ( b ) provide estimates to inform the design of a larger study .


Fifteen adults living with a mental illness and receiving services at a community health team were randomly assigned to a PSW or a MHW group .


The Quality of Life Interview-Brief Version was administered at baseline and after @ months of intervention .


Participants completed a semi-structured exit interview .


While both groups improved from baseline to @ months , the PSW group did not improve more than the MHW group .


Interviews highlighted therapeutic alliance and boundaries .


This research adds to existing literature that PSWs produce outcomes similar to nonpeer staff and struggle with boundaries related to their unique role .


Adaptive support ventilation can speed weaning after coronary artery surgery compared with protocolized weaning using other modes .


There are no data to support this mode of weaning after cardiac valvular surgery .


Furthermore , control group weaning times have been long , suggesting that the results may reflect control group protocols that delay weaning rather than a real advantage of adaptive support ventilation .


Randomized ( computer-generated sequence and sealed opaque envelopes ) , parallel-arm , unblinded trial of adaptive support ventilation versus physician-directed weaning after adult fast-track cardiac valvular surgery .


The primary outcome was duration of mechanical ventilation .


Patients aged @ to @ yr without significant renal , liver , or lung disease or severe impairment of left ventricular function undergoing uncomplicated elective valve surgery were eligible .


Care was standardized , except postoperative ventilation .


In the adaptive support ventilation group , target minute ventilation and inspired oxygen concentration were adjusted according to blood gases .


A spontaneous breathing trial was carried out when the total inspiratory pressure of @ cm H@O or less with positive end-expiratory pressure of @ cm H@O .


In the control group , the duty physician made all ventilatory decisions .


Median duration of ventilation was statistically significantly shorter ( P = @ ) in the adaptive support ventilation group ( @ -LSB- @ to @ -RSB- min , n = @ ) than that in controls ( @ -LSB- @ to @ -RSB- min , n = @ ) .


Manual ventilator changes and alarms were less common in the adaptive support ventilation group , and arterial blood gas estimations were more common .


Adaptive support ventilation reduces ventilation time by more than @ h in patients who have undergone fast-track cardiac valvular surgery while reducing the number of manual ventilator changes and alarms .


Benign anorectal conditions are fairly common .


Physicians of various specialties usually see patients with these conditions before being referred to colorectal specialists , frequently with an incorrect diagnosis.We sought to evaluate the effect of attending an outpatient colorectal clinic by medical students on the diagnostic accuracy of these conditions .


Over a @-year period , medical students were randomized into a group that attended the clinic , and one that did not .


Both groups were shown images of six common benign anorectal conditions .


The overall diagnostic accuracy as well as the diagnostic accuracy for each one of these conditions was prospectively evaluated for both groups .


Nineteen students attended clinic and @ did not .


Overall diagnostic accuracy was @ % for students attending clinic and @ % for non-attending students .


( p < @ ) In the attending group , diagnostic accuracy was significantly greater for prolapsed internal hemorrhoids ( @ % versus @ % , p < @ ) , thrombosed external hemorrhoid , ( @ % versus @ % , p < @ ) fissure ( @ % versus @ % , p < @ ) , and anal tags ( @ % versus @ % , p < @ % ) .


Exposure to these conditions during surgical clerkships in medical school may help future specialists provide better care for patients with benign anorectal disorders .


The AMANDYSK trial was designed to assess long-term efficacy of chronic treatment with amantadine in patients with Parkinson disease ( PD ) and levodopa-induced dyskinesia ( LID ) .


This was a @-month , multicenter , randomized , double-blind , placebo-controlled , parallel-group , wash-out study conducted in @ amantadine-treated ( @ mg/d for @ months ) dyskinetic patients with PD .


The primary outcome measure was the change from baseline in a Unified Parkinson 's Disease Rating Scale ( UPDRS ) dyskinesia subscore ( items @ -LSB- duration -RSB- + @ -LSB- severity -RSB- ) .


Secondary outcomes included other LID measurements ( `` responders '' analysis , premature dropout for LID , Abnormal Involuntary Movement Scale ) .


Exploratory outcomes included time with troublesome dyskinesia as measured by diaries , UPDRS Motor Examination ( part III ) for motor symptoms of PD , and fatigue and apathy scores for nonmotor symptoms .


UPDRS items @ + @ deteriorated more in patients switched to placebo ( `` discontinuing '' group ) ( +@ @ units ; @ % confidence interval @ , @ ) as compared with those maintained on amantadine ( `` continuing '' group ) ( +@ @ units ; @ % confidence interval -@ , @ ; p = @ ) .


Secondary outcomes confirmed this difference because there were significantly more responders , more dropouts for LID , greater increase in `` ON '' time with troublesome dyskinesia , and greater worsening of Abnormal Involuntary Movement Scale score in the discontinuing group .


There were no between-group differences in the UPDRS Motor Examination , whereas apathy ( as measured by caregivers ) and fatigue scores tended to worsen more in patients randomized to placebo .


Wash-out of amantadine in dyskinetic patients with PD significantly worsened LID .


No significant effect was observed on motor parkinsonian symptoms , while exploratory outcomes suggested that amantadine might improve apathy and fatigue in such patients .


This article provides Class II evidence that in patients with PD , withdrawing amantadine significantly aggravates LID in a median time of @ days .


The U.S. Food and Drug Administration has requested post-market surveillance data , including data on metal ion levels , regarding metal-on-metal total hip arthroplasty .


We performed a prospective , randomized study of metal ion levels in erythrocytes , serum , and whole blood at five years after @ and @-mm metal-on-metal and @-mm metal-on-polyethylene total hip arthroplasty .


One hundred and five enrolled patients were randomized equally to the three bearing surface options and were blinded with regard to their treatment group .


Metal ion measurements and clinical evaluations were performed at regular intervals .


Cobalt and chromium ion levels in all blood sample types at the five-year time point were significantly lower in the metal-on-polyethylene group than in each of the two metal-on-metal groups ( p < @ ) with the exception of chromium in erythrocytes ( p = @ ) .


Cobalt in serum ( p = @ ) and erythrocytes ( p = @ ) showed significant increases from two to five years in the @-mm metal-on-metal group ; similar increases were not seen in the @-mm metal-on-metal group .


At five years , five patients in the @-mm metal-on-metal group and none in the @-mm metal-on-metal group had cobalt or chromium levels of > @ ppb .


Correlations among levels in serum , erythrocyte , and whole blood were stronger for cobalt than for chromium .


One patient in the @-mm metal-on-metal group underwent revision because of an adverse local tissue reaction .


The @-mm metal-on-metal bearing underperformed the @-mm metal-on-metal bearing with respect to metal ion levels .


The authors are closely following all patients treated with metal-on-metal total hip arthroplasty .


The aim of this study was to assess the safety and tolerability , pharmacokinetics and pharmacodynamics of LY@ when administered as single escalating doses to healthy volunteers .


This was a phase @ , placebo-controlled , dose escalation study with LY@ in @ healthy male volunteers .


Subjects were administered escalating LY@ doses up to @mg with food in this single dose study .


Blood samples were collected at set times post-dose for the assessment of LY@ pharmacokinetics and the measurement of cathepsin S ( CatS ) activity , CatS mass and calculated CatS specific activity .


All doses of LY@ were well tolerated , with linear pharmacokinetics up to the @mg dose .


The pharmacodynamic activity of LY@ was measured ex vivo showing a biphasic response to LY@ , where CatS activity declines , then returns to baseline , and then increases to a level above baseline .


CatS mass was also assessed post-dose which increased in a dose-dependent manner , and continued to increase after LY@ had been cleared from the body .


CatS specific activity was additionally calculated to normalize CatS activity for changes in CatS mass .


This demonstrated the increase in CatS activity was attributable to the increase in CatS mass detected in plasma .


A specific inhibitor of CatS which is cleared quickly from plasma may produce a transient decrease in plasma CatS activity which is followed by a more prolonged increase in plasma CatS mass which may have implications for the future clinical development of inhibitors of CatS .


The clinical value of ischemic preconditioning ( IP ) on patients undergoing hepatectomy under portal triad clamping ( PTC ) is uncertain , especially for patients with liver cirrhosis .


Hence , we conducted a prospective randomized controlled trial to test whether IP could protect liver against ischemic reperfusion ( IR ) injury after hepatectomy under PTC .


One hundred patients , including @ with cirrhosis , undergoing hepatectomy with PTC were randomly divided into IP and control groups .


Liver function tests at postoperative days @ , @ , and @ as well as postoperative morbidity , mortality , and duration of hospitalization were compared between the two groups .


The general clinical characteristics between both groups were comparable .


The duration of the operation , the amount of intraoperative blood loss , and the need and amount of perioperative blood transfusion were similar in both groups .


The postoperative levels of serum alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) , total bilirubin , and albumin were not statistically different between the two groups .


In addition , the morbidity and mortality rates and the duration of hospitalization were similar in both groups .


IP did not improve liver tolerance to IR injury after hepatectomy under PTC .


Therefore , the clinical use of IP can not be recommended as a standard procedure before PTC .


To assess the effects of renal impairment ( RI ) on the efficacy and safety of ipragliflozin in patients with type @ diabetes mellitus ( T@DM ) .


A cohort of Japanese patients with T@DM and mild to moderate RI and poor glycaemic control , despite diet/exercise therapy alone or diet/exercise therapy in combination with an oral hypoglycaemic agent ( an - glucosidase inhibitor , a sulfonylurea , or pioglitazone ) , were randomized in a double-blind manner to @mg ipragliflozin or placebo once daily for @weeks .


The patients continued open-label ipragliflozin for a @-week extension period ( total treatment duration : @weeks ) .


Ipragliflozin significantly decreased glycated haemoglobin ( HbA@c ) and fasting plasma glucose ( FPG ) levels and body weight from baseline to week @ ( last observation carried forward ) compared with placebo in all patients with RI .


The decreases in HbA@c and FPG levels were statistically significant in patients with mild RI , but not in patients with moderate RI .


Ipragliflozin significantly reduced body weight in both RI groups .


The improvements in glycaemic control were maintained in the @-week extension period .


Ipragliflozin was associated with no clinically significant safety concerns , and its safety profiles were not influenced by the severity of RI .


Ipragliflozin significantly improved glycaemic control and body weight in patients with T@DM with mild RI , but did not improve glycaemic control in patients with moderate RI .


Ipragliflozin is a valid treatment option for patients with mild RI but not those with moderate RI .


Use of granulocyte colony-stimulating factor ( G-CSF ) to treat damaged myocardium is a relatively new concept .


Clinical beneficial and safety outcomes are still controversial .


The aim of this study was to evaluate recruitment of hematopoietic stem cells and therapeutic efficacy of G-CSF in the treatment of myxomatous mitral valve disease ( MMVD ) of dogs .


Thirty client-owned MMVD dogs with clinical signs of heart failure were enrolled in a prospective double-blind , randomized , placebo-controlled study to compare the short-term effect of G-CSF ( n = @ ) with control group ( n = @ ) for identical periods .


Clinical , hematological , and cardiovascular assessments were performed on days @ , @ , @ , and @ .


Follow-up examination was conducted four weeks after the study .


Dogs treated with G-CSF had a significantly elevated white blood cell ( WBC ) ( @ ( @ ) / L ) count at day @ compared with baseline ( from @ @ to @ @ ; P = @ ) .


The WBC population was also changed ( elevated neutrophils and decreased lymphocytes ) and the numbers of CD@ + cells in the peripheral blood were also increased at day @ .


However , the results of clinical , laboratory , and echocardiographic assessments did not differ significantly between the G-CSF treatment and control groups after four weeks .


G-CSF administration elevated the peripheral WBC count , especially neutrophils , and recruited hematopoietic stem cells .


However , positive effects of G-CSF on cardiac function were not detected during short-term monitoring .


Metabolic syndrome ( MetS ) is a clustering of metabolic risk factors for cardiovascular diseases and type @ diabetes .


The study aimed to estimate the prevalence of MetS , its components , and their associations among rural middle-aged population in Vietnam .


A cross-sectional study with a representative sample ( n = @ ) was conducted to collect data on demographic , socioeconomic , anthropometric , lifestyles , plasma glucose , and lipid profile .


The age - and sex-adjusted prevalences of MetS and its components were calculated using the direct standardization .


Associations of risk factors with MetS were evaluated using logistic regression , taken into account the confounding factors .


The total age - and sex-adjusted prevalence ( @ % CI ) of MetS was @ % ( @-@ @ ) .


The most frequent component of MetS was high triglycerides ( @ % ) , followed by low HDL-C ( @ % ) , elevated blood pressure ( @ % ) , high plasma glucose ( @ % ) , and central obesity ( @ % ) .


Of the total population , only @ % did not have any component of MetS and more than @ % had at least two MetS components .


The association of MetS with residence , age , body mass index , marital status , and siesta time per day was statistically significant in univariate analysis and replicated in multivariate analysis .


The MetS prevalence and its components are common and major public health burden in the middle-aged adults in Vietnam .


Habitants living in urban , being never-married , having an increase in age , BMI , and siesta time per day are significantly associated with MetS , and they should be paid much more attention for screening and implementing preventive activities .


Among infants born prematurely , competence at oral feeding is necessary for growth and hospital discharge .


Extremely preterm ( EP ) infants ( @ weeks of gestational age -LSB- GA -RSB- ) are at risk for a variety of medical complications , which can limit the infant 's capacity to develop oral feeding competence .


This study examined feeding progression by assessing timing of acquisition of five early feeding milestones among EP infants and the impact of immaturity and medical complications .


A chart review was conducted for @ EP infants who participated in a larger longitudinal randomized study .


Feeding progression was defined as infants ' postmenstrual age ( PMA ) at five milestones : first enteral feeding , full enteral feeding , first oral feeding , half oral feeding , and full oral feeding .


GA at birth and five medical complications ( neurological risk , bronchopulmonary dysplasia , necrotizing enterocolitis , patent ductus arteriosus , and gastroesophageal reflux disease ) were used as potential factors influencing the feeding progression .


Linear mixed models were used to examine feeding progression across the milestones and contributions of GA at birth and five medical complications on the progression , after controlling for milk type as a covariate .


EP infants gradually achieved feeding milestones ; however , the attainment of the feeding milestones slowed significantly for infants with younger GA at birth and the presence of medical complications , including neurological risk , bronchopulmonary dysplasia , necrotizing enterocolitis , and patent ductus arteriosus but not gastroesophageal reflux disease .


Milk type was a significant covariate for all analyses , suggesting that infants fed with breast milk achieved each of five milestones earlier than formula-fed infants .


Improved understanding of the timing of essential feeding milestones among EP infants and the contribution of specific medical conditions to the acquisition of these milestones may allow for more targeted care to support feeding skill development .


Gastrointestinal bleeding ( GIB ) is a common and often serious complication after stroke .


Although several risk factors for post-stroke GIB have been identified , no reliable or validated scoring system is currently available to predict GIB after acute stroke in routine clinical practice or clinical trials .


In the present study , we aimed to develop and validate a risk model ( acute ischemic stroke associated gastrointestinal bleeding score , the AIS-GIB score ) to predict in-hospital GIB after acute ischemic stroke .


The AIS-GIB score was developed from data in the China National Stroke Registry ( CNSR ) .


Eligible patients in the CNSR were randomly divided into derivation ( @ % ) and internal validation ( @ % ) cohorts .


External validation was performed using data from the prospective Chinese Intracranial Atherosclerosis Study ( CICAS ) .


Independent predictors of in-hospital GIB were obtained using multivariable logistic regression in the derivation cohort , and - coefficients were used to generate point scoring system for the AIS-GIB .


The area under the receiver operating characteristic curve ( AUROC ) and the Hosmer-Lemeshow goodness-of-fit test were used to assess model discrimination and calibration , respectively .


A total of @,@ , @,@ , and @,@ patients were enrolled in the derivation , internal validation and external validation cohorts .


The overall in-hospital GIB after AIS was @ % , @ % , and @ % in the derivation , internal , and external validation cohort , respectively .


An @-point AIS-GIB score was developed from the set of independent predictors of GIB including age , gender , history of hypertension , hepatic cirrhosis , peptic ulcer or previous GIB , pre-stroke dependence , admission National Institutes of Health stroke scale score , Glasgow Coma Scale score and stroke subtype ( Oxfordshire ) .


The AIS-GIB score showed good discrimination in the derivation ( @ ; @ % CI , @-@ @ ) , internal ( @ ; @ % CI , @-@ @ ) and external ( @ ; @ % CI , @-@ @ ) validation cohorts .


The AIS-GIB score was well calibrated in the derivation ( P = @ ) , internal ( P = @ ) and external ( P = @ ) validation cohorts .


The AIS-GIB score is a valid clinical grading scale to predict in-hospital GIB after AIS .


Further studies on the effect of the AIS-GIB score on reducing GIB and improving outcome after AIS are warranted .


To assess the immediate effect of a suboccipital muscle inhibition ( SMI ) technique on : ( a ) neck pain , ( b ) elbow extension range of motion during the upper limb neurodynamic test of the median nerve ( ULNT-@ ) , and ( c ) grip strength in subjects with cervical whiplash ; and determine the relationships between key variables .


Randomised , single-blind , controlled clinical trial .


Faculty of Nursing , Physiotherapy and Podiatry , University of Seville , Spain .


Forty subjects -LCB- mean age @ years -LSB- standard deviation ( SD ) @ -RSB- -RCB- with Grade I or II cervical whiplash and a positive response to the ULNT-@ were recruited and distributed into two study groups : intervention group ( IG ) ( n = @ ) and control group ( CG ) ( n = @ ) .


The IG underwent the SMI technique for @minutes and the CG received a sham ( placebo ) intervention .


Measures were collected immediately after the intervention .


The primary outcome was elbow range of motion during the ULNT-@ , measured with a goniometer .


The secondary outcomes were self-perceived neck pain ( visual analogue scale ) and free-pain grip strength , measured with a digital dynamometer .


The mean baseline elbow range of motion was @ ( SD @ ) for the CG and @ ( SD @ ) for the IG .


The within-group comparison found a significant difference in elbow range of motion for the IG -LSB- mean difference -@ , @ % confidence interval ( CI ) -@ to -@ ; P = @ -RSB- , but not for the CG ( mean difference -@ , @ % CI -@ to @ ; P = @ ) .


In the between-group comparison , the difference in elbow range of motion was significant ( mean difference -@ , @ % CI -@ to -@ ; P = @ ) , but the differences in grip strength ( P = @ ) and neck pain ( P = @ ) were not significant .


The SMI technique has an immediate positive effect on elbow extension in the ULNT-@ .


No immediate effects on self-perceived cervical pain or grip strength were observed .


A growing number of elderly patients with end-stage renal disease start dialysis .


We examined elderly ( @ years ) patients ' views about their decision-making experience after starting dialysis in comparison with patients aged @-@ years , and patients @ years .


Ninety-nine patients from @ outpatient dialysis centers in North Carolina , USA completed a semi-structured interview asking them about the context of decision-making and their decision-making experience , and a @-item investigator-developed Informed Decision-Making ( IDM ) questionnaire with binary response options ( yes/no ) .


While IDM scores were low for all three groups ( < @ out of @ ) , they were significantly lower for the older group compared to the other two younger groups ( p = @ ) .


A significantly lower percentage of the older group said that the doctor explained underlying conditions that led to kidney failure ( p = @ ) , the impact of dialysis on daily life ( p = @ ) , and the life-long need for dialysis ( p < @ ) , and that the doctor tried to make sure the patient understood the information ( p = @ ) .


Also a significantly higher percentage of elderly patients felt the decision was made by the doctor rather than on their own or with their family , or collaboratively with the doctor ( p = @ ) .


Informed decision-making is significantly poorer in patients aged @ years or older than in younger patients .


Clinicians should communicate clearly about the benefits and burdens of dialysis to older adults and provide an opportunity for them to understand the significant trade-offs that dialysis may require .


The combination of oral vinorelbine plus cisplatin has been studied in numerous trials as first-line treatment of patients with non-small cell lung cancer ( NSCLC ) regardless of histologic subtype .


NAVoTrial @ is the first study that explores this combination specifically in nonsquamous ( NS ) NSCLC by assessing the feasibility of this doublet ( ratio @:@ ) in an investigational approach .


A reference arm with pemetrexed plus cisplatin was included .


Maintenance therapy with single-agent therapy after @ cycles of combination therapy was included in the study schedules because it reflected a trend in first-line treatment of NSCLC .


Stage IIIB/IV untreated/relapsed patients with NS NSCLC received a @-week cycle of pemetrexed @ mg/m ( @ ) and cisplatin @ mg/m ( @ ) on day @ ( arm A ) or oral vinorelbine @ mg/m ( @ ) on days @ and @ ( first cycle @ mg/m ( @ ) ) and cisplatin @ mg/m ( @ ) on day @ ( arm B ) .


After @ cycles , patients without disease progression received single-agent maintenance treatment with pemetrexed or oral vinorelbine .


Overall , @ patients were randomized ( arm A/arm B : @/@ ) .


Disease control rate ( % ) for arm A was @ ( @ % confidence interval -LSB- CI -RSB- , @-@ @ ) and for arm B it was @ ( @ % CI , @-@ @ ) , Response rates for arm A were @ % ( @ % CI , @-@ @ ) and for arm B were @ % ( @ % CI , @-@ @ ) .


Median progression-free survival for arm A was @ months ( @ % CI , @-@ @ ) and for arm B it was @ months ( @ % CI , @-@ @ ) .


Median survival for arm A was @ months ( @ % CI , @-@ @ ) and for arm B it was @ months ( @ % CI , @-@ @ ) .


Main grade @/@ hematologic toxicities were neutropenia @ % ( arm A ) and @ % ( arm B ) , whereas febrile neutropenia was reported in @ % of patients in each arm .


Oral vinorelbine and cisplatin had an efficacy in line with that achieved with a standard treatment such as pemetrexed and cisplatin , coupled with an acceptable safety profile .


To compare radiation exposure of nurses when performing nursing tasks associated with interventional procedures depending on whether or not the nurses called out to the operator before approaching the patient .


In a prospective study , @ interventional radiology procedures were randomly divided into a call group and a no-call group ; there were @ procedures in the call group and @ procedures in the no-call group .


Two monitoring badges were used to calculate effective dose of nurses .


In the call group , the nurse first told the operator she was going to approach the patient each time she was about to do so .


In the no-call group , the nurse did not say anything to the operator when she was about to approach the patient .


In all the nursing tasks , the equivalent dose at the umbilical level inside the lead apron was below the detectable limit .


The equivalent dose at the sternal level outside the lead apron was @ Sv @ per procedure in the call group and @ Sv @ per procedure in the no-call group .


The effective dose was @ Sv @ per procedure in the call group and @ Sv @ per procedure in the no-call group .


The call group had a significantly lower radiation dose ( P = @ ) .


Radiation doses of nurses were lower in the group in which the nurse called to the operator before she approached the patient .


To characterize preinjection intraocular pressure ( IOP ) in eyes receiving monthly ranibizumab versus sham or verteporfin photodynamic therapy ( PDT ) for age-related macular degeneration ( AMD ) .


Post hoc analysis of IOP data from @ phase @ clinical trials , the Minimally Classic/Occult Trial of the Anti-VEGF Antibody Ranibizumab in the Treatment of Neovascular AMD ( MARINA ) and the Anti-VEGF Antibody for the Treatment of Predominantly Classic Choroidal Neovascularization in AMD ( ANCHOR ) trial .


All safety-evaluable patients who received @ or more injections of sham or PDT or of ranibizumab and had @ or more postbaseline IOP measurements recorded for the study eye .


Preinjection IOP measurements for study eyes ( n = @ ) and fellow eyes in MARINA and ANCHOR at baseline and at each monthly visit through month @ were analyzed .


End points evaluated were maximum preinjection IOP during the @-month treatment period ; any occurrence of absolute preinjection IOP of @ mmHg or more , @ mmHg or more , or @ mmHg or more ; any occurrence of IOP increase of @ mmHg or more , @ mmHg or more , or @ mmHg or more from baseline ; any combination of IOP increase of @ mmHg or more or @ mmHg or more from baseline with concurrent absolute preinjection IOP of @ mmHg or more or @ mmHg or more ; glaucoma-related adverse events ; new glaucoma medications used for @ days or more ; and glaucoma filtration or laser surgeries .


Across treatment groups , @ % to @ % of study eyes had a maximum preinjection IOP of less than @ mmHg .


Comparing ranibizumab @ mg versus sham or PTD treatment , respectively : @ % versus @ % and @ % versus @ % had maximum preinjection IOPs of @ mmHg or more or @ mmHg or more , respectively ; @ % versus @ % and @ % versus @ % had IOP increases from baseline of @ mmHg or more or @ mmHg or more , respectively ; @ % versus @ % and @ % versus @ % had @ or more IOP increase from baseline of @ mmHg or more or @ mmHg or more , respectively , with a concurrent IOP of @ mmHg or more ; @ % versus @ % and @ % versus @ % had @ or more IOP increase from baseline of @ mmHg or more or @ mmHg or more , respectively , with a concurrent IOP of @ mmHg or more .


No differences were observed in fellow eyes .


Most ranibizumab-treated eyes did not experience sustained preinjection IOP of @ mmHg or more ( > @ consecutive visits ) over @ months .


When evaluating the combined IOP end point , more ranibizumab-treated eyes had @ or more IOP increase from baseline of @ mmHg or more or @ mmHg or more , with concurrent highest IOPs of @ mmHg or more and @ mmHg or more versus sham or PDT .


Intraocular pressure should be monitored in eyes receiving ranibizumab .


Depressive and anxiety disorders are highly prevalent , but only a small percentage ( approximately @ % ) of patients receive appropriate treatment .


Relevant barriers include communication and coordination gaps between different providers that result from the lack of integration between different care-giving systems .


Aftercare following inpatient treatment represents one of these gaps because systematic follow-up care does not exist .


Case management-based aftercare coordination by phone might be a promising approach to overcoming this gap and improving long-term treatment outcomes .


Case management is a patient-centered and situation-based approach comprising systematic tracking and support of patients by a case manager .


The aim of this study is to evaluate the effectiveness of aftercare coordination by phone for patients with depressive and anxiety disorders .