In this study we will examine the efficacy and cost-effectiveness of a newly developed web-based intervention ( GET.ON Mood Enhancer Diabetes ) for people with diabetes and comorbid depressive symptoms .


A two-arm randomised controlled trial will be conducted .


Adults with diabetes ( type @ or type @ ) with increased depression scores ( > @ on the German version of the Center for Epidemiological Studies Depression Scale ( CES-D ) ) will be included .


Eligible participants will be recruited through advertisement in diabetes patient journals and via a large-scale German health insurance company .


The participants will be randomly assigned to either a @-week minimally guided web-based self-help program or an online psychoeducation program on depression .


The study will include @ participants , which will enable us to detect a statistically significant difference with a group effect size of d = @ at a power of @ % and a significance level of p = @ .


The primary outcome measure will be the level of depression as assessed by the CES-D .


The secondary outcome measures will be : diabetes-specific emotional distress , glycaemic control , self-management behaviour and the participants ' satisfaction with the intervention .


Online self-assessments will be collected at baseline and after a @ months period , with additional follow-up measurements @ and @ months after randomisation .


The data will be analysed on an intention-to-treat basis and per protocol .


In addition , we will conduct an economic evaluation from a societal perspective .


If this intervention is shown to be cost-effective , it has considerable potential for implementing psychological care for large numbers of people with diabetes and comorbid depression in routine practice and improve health outcomes .


Determine efficacy and safety of acetaminophen extended release ( ER ) @mg given three times daily compared to placebo for relieving signs and symptoms of hip or knee osteoarthritis .


Sixty investigators at @ private , ambulatory , primary care sites in the US enrolled @ outpatient adults @ years old with moderate to severe idiopathic osteoarthritis pain into a randomized , placebo-controlled , double-blind @ week clinical trial .


Patients were randomly assigned to treatment given three times daily of acetaminophen @mg ( n = @ ) or placebo ( n = @ ) .


The three primary endpoints measured through week @ favored acetaminophen ER as follows : least squares ( LS ) mean change from baseline for WOMAC physical function subscale score was significantly greater for acetaminophen ER than for placebo ( P = @ ) ; LS mean patient 's global assessment of response to therapy was significantly greater for acetaminophen ER than for placebo ( P = @ ) ; and LS mean change from baseline for WOMAC pain subscale score was marginally greater for acetaminophen ER than for placebo ( P = @ ) .


LS mean change from baseline for secondary endpoints through week @ also favored acetaminophen ER compared with placebo : significantly for WOMAC stiffness subscale score ( P = @ ) , significantly for WOMAC total index score ( P = @ ) , and marginally for Nottingham Health Profile energy subscale score ( P = @ ) .


The percentage of patients with any adverse event was similar for both treatment groups .


Hepatic transaminases exceeded @ULN in seven acetaminophen ER patients and one placebo patient .


Elevations were attributed to health conditions in three of seven acetaminophen ER patients ; elevations in the remaining four patients returned to or toward normal .


Acetaminophen ER @mg , a nonprescription drug , given three times daily , can provide effective relief of signs and symptoms of osteoarthritis of the hip or knee and was well tolerated .


ClinicalTrials.gov registration number : NCT@ .


Hypotension is a common complication following spinal anesthesia for cesarean delivery .


Techniques to prevent hypotension include preloading intravenous fluid .


To compare the effect of two preloading regimens : @ % hydroxyethyl starch ( HES ) and @ saline solution , to prevent hypotension after spinal anesthesia in cesarean delivery .


@ patients undergoing intrathecal anesthesia for elective cesarean delivery were randomized and allocated to receive a preload of @ ml HES @/@ @ ( HES Group ) or a preload of @ ml @ saline solution ( CR group ) .


Blood pressure and heart rate were recorded at baseline and after spinal anesthesia ( every minute for the first @ min , every @ min for the next @ min , and then every @ min for the last @ min ) .


The primary outcome was to compare the incidence of hypotension ( defined as a @ % reduction in systolic arterial pressure from baseline ) between the two preloading regimens .


Vasopressor requirements ( i.v. bolus of @ mg ephedrine ) were also compared .


The incidence of hypotension was @ % in the CR group and @ % in the HES group ( p = @ ) .


Ephedrine requirement , incidence of nausea , and/or vomiting and neonatal outcome did not significantly differ between the two groups .


The incidence of hypotension was lower after preloading of @ mL of HES @/@ @ than preloading with @ mL of @ saline solution .


Osteoporosis and atherosclerosis are interconnected entities and share also some pathophysiological mechanisms .


Moreover , recent literature data have supported the hypothesis that bisphosphonates ( BPs ) may have some antiatherogenic actions .


This study aimed to evaluate the effects of one year with zoledronate or ibandronate given intravenously on lipid profile and on carotid artery intima-media thickness ( CA-IMT ) .


Sixty postmenopausal osteoporotic women ( mean age : @ years ) were randomly assigned to @-year treatment with zoledronate @mg i.v. annually or ibandronate @mg i.v. every @ months .


In all patients at baseline and after @months we measured CA-IMT , total cholesterol ( TC ) , high-density lipoprotein cholesterol ( HDL-C ) , low-density lipoprotein cholesterol ( LDL-C ) , @-hydroxyvitamin D ( @OHD ) , bone alkaline phosphatase ( B-ALP ) , type I collagen carboxy telopeptide ( CTX ) , osteocalcin ( OC ) , fibroblast growth factor @ ( FGF-@ ) and sclerostin .


The osteoporotic women treated with zoledronate showed a greater reduction in CA-IMT than those treated with ibandronate .


HDL-C and HDL-C/LDL-C ratio showed a significant ( p < @ ) increase in the @ groups , whereas , LDL-C showed a reduction in the two groups which , however , reached statistical significance ( p < @ ) only in the zoledronate group .


FGF-@ serum levels showed a similar and significant decrease in both the women treated with zoledronate and in those treated with ibandronate .


At the end of the study period sclerostin serum levels showed a higher increase in the patients treated with zoledronate than in those treated with ibandronate .


In osteoporotic women both zoledronate and ibandronate given intravenously resulted in an increase in HDL-C/LDL-C ratio and a reduction of CA-IMT which was significant only for zoledronate .


Further prospective studies are needed to clarify whether the change in FGF-@ and sclerostin levels is a marker or a potential mechanism of the action of BPs at a vascular level .


The current study was performed to report the long-term results of a trial comparing concurrent chemotherapy and radiotherapy ( CCRT ) with surgery and adjuvant radiotherapy ( RT ) in patients with stage III/IV nonmetastatic head and neck squamous cell carcinoma .


Patients with stage III/IV resectable head and neck squamous cell carcinoma were randomized to surgery followed by RT or CCRT .


The trial was halted prematurely due to poor accrual .


Human papillomavirus status was tested on archival material using polymerase chain reaction sequencing .


Of the total of @ patients , @ patients were randomized to primary surgery ( S arm ) and @ patients were randomized to CCRT ( C arm ) .


Human papillomavirus status was tested in @ patients , and only @ were found to be positive .


The median follow-up for surviving patients was @ years .


Analysis of the entire cohort demonstrated no statistically significant difference in overall survival and disease-specific survival ( DSS ) : @-year rates were @ % versus @ % for overall survival ( P = @ ) and @ % versus @ % for DSS ( P = @ ) for the S arm and C arm , respectively .


Analysis by subsites indicated that this difference favoring the S arm was mainly driven by survival data among patients with cancers of the oral cavity and maxillary sinus .


For patients with oral cavity cancer , survival was significantly better in those who underwent primary surgery compared with CCRT ; the @-year DSS rate was @ % versus @ % for the S arm and C arm , respectively ( P = @ ) .


For patients with cancers of the maxillary sinus , the @-year DSS rate was @ % for patients on the S arm and @ % for patients on the C arm ( P = @ ) .


These long-term results demonstrate a significant advantage for primary surgery in patients with cancers of the oral cavity or maxillary sinus , providing strong support for primary surgery as the main modality of treatment for these subsites .


In other subsites , CCRT and surgery with adjuvant RT were found to demonstrate similar efficacy for survival in patients with advanced resectable tumors .


Liver disease is increasingly recognized in HIV-positive individuals , even among those without viral hepatitis , partly as a result of the recent availability of noninvasive methods of liver fibrosis assessment .


The objective of this substudy is to compare the effects of early versus deferred antiretroviral therapy ( ART ) on liver fibrosis progression .


Sites in the Strategic Timing of AntiRetroviral Treatment ( START ) study with access to FibroScan were invited to participate in the Liver Fibrosis Progression Substudy .


All substudy participants underwent FibroScan at baseline , and two noninvasive serum algorithms , APRI and FIB-@ , were calculated .


Demographic and liver-related information was collected for all START participants at baseline .


A total of @ participants were enrolled in the substudy ( @ % with hepatitis B or C virus coinfection ) , of whom @ had a valid transient elastography ( TE ) result .


The median TE score was @ kPa -LSB- interquartile range ( IQR ) @-@ @ kPa -RSB- .


Seventeen patients ( @ % ) -LSB- @ % confidence interval ( CI ) @-@ @ % -RSB- had a TE score of > @ kPa , indicating significant liver fibrosis .


Baseline factors associated with higher TE scores in multivariate analysis were higher alanine aminotransferase ( ALT ) per @ U/L ( P = @ ) , higher log@ HIV RNA ( P < @ ) and Hispanic/Latino ethnicity ( P = @ ) .


TE correlated weakly with noninvasive markers .


At baseline , significant liver fibrosis was observed in approximately @ % of participants , with higher ALT and HIV RNA the only clinical factors associated with increasing TE score .


TE will be used annually to monitor fibrosis and evaluate the role of ART in further fibrosis progression .


The study aim was to determine the effect of a dietary intervention on growth , body composition and resting energy expenditure ( REE ) in children with cystic fibrosis ( CF ) and pancreatic insufficiency ( PI ) in a randomized , double blind , placebo-controlled trial .


Subjects ( @ to @ yrs ) participated in a @-month trial of the organized lipid matrix LYM-X-SORB ( LXS ) vs. placebo dietary supplements with similar calories , total fat and fatty acids .


Dietary intake was assessed using @-day weighed food records .


Height ( HAZ ) , weight ( WAZ ) , BMI ( BMIZ ) , mid-upper arm muscle ( UAMAZ ) and fat area ( UAFAZ ) Z-scores were calculated .


Fat mass ( FM ) and fat-free mass ( FFM ) were obtained by whole body DXA .


REE ( kcal/d ) was evaluated by indirect calorimetry at baseline , @ and @ months and % REE calculated using Schofield equations .


No growth or REE differences were observed between LXS and placebo groups so data were pooled for analysis .


@ children ( @ % males , age @ @ yr , @ % receiving LXS ) completed REE measurements .


Caloric intake increased from a median of @ -LSB- @ , @ -RSB- to @ -LSB- @ , @ -RSB- kcal/d at @ months .


HAZ , WAZ and UAMAZ increased ( p < @ ) over @ months .


Mean REE was @ @ % predicted at baseline and @ @ % at @ months ( p < @ ) .


REE ( kcal/d ) adjusted for FFM and FM decreased over @ months ( -LSB- mean SE -RSB- -@ @ kcals , p < @ ) , significant only in males ( -@ @ kcals , p < @ ) .


Over a @ month nutrition intervention with either LXS or placebo , the growth status , muscle stores and REE improved .


Sustained increased energy intake improved energy metabolism , growth and nutritional status in school age children with CF , PI and mild lung disease .


In a randomized clinical trial , short - and long-term psychodynamic group psychotherapy ( STG and LTG , respectively ) schedules were equally effective for the ` typical ' patient during a @-year study period .


Although several studies have reported good effects for patients with personality disorders ( PD ) in diverse forms of psychotherapy , the significance of treatment duration is unclear .


Therefore , we tested the hypothesis that PD patients would improve more during and after LTG than STG .


A randomized , longitudinal , prospective study contrasting the outcomes during and after short - and long-term dynamic group psychotherapies .


One hundred and sixty-seven outpatients with mood disorders , anxiety disorders , or PD were randomized to STG or LTG ( respectively , @ or @ weekly sessions of @ min each ) .


Outcome measures are as follows : symptoms ( SCL-@-R ) , interpersonal problems ( IIP-C ) , and psychosocial functioning ( GAF split version : GAF-Symptom and GAF-Function ) .


PD pathology ( number of PD criteria items ) was selected a priori as a putative moderator of treatment effects .


Change during the @-year study period was assessed using linear mixed models .


The study was registered at ClinicalTrials.gov as NCT @ .


Our hypothesis was supported , as patients with PD improved significantly more regarding all outcome variables in LTG than STG .


For patients without PD , the rate of change was similar across @ years ; however , the rate of change in symptoms and interpersonal problems was higher in STG during the first @ months .


The effectiveness of LTG is higher for patients with co-morbid PD .


Patients without PD do not appear to experience additional gain from LTG .


Clinical implications : LTG demonstrates better effectiveness than STG for patients with personality disorder co-morbidity ( PD ) .


Patients without PD do not appear to experience additional gain from attending LTG .


Correct initial allocation to treatment duration may prevent disruptive breaks in relationships and lead to both human and economic cost savings .


Limitations : Trials on mixed diagnostic samples may limit the ability to fully assess change for specific diagnostic groups .


Therapists were unable to select patients and compose their own groups .


Although this condition might increase the generalizability of the results , it may also have restricted the therapists and the clinical situation inadvertently .


Because data on contrast-induced acute kidney injury ( CI-AKI ) in patients undergoing cardiac resynchronization therapy ( CRT-D ) are scarce , we aimed to assess the incidence , natural course and prognostic importance of this syndrome in CRT recipients .


Study population consisted of @ consecutive patients enrolled into the Triple Site Versus Standard Cardiac Resynchronization ( TRUST CRT ) trial , who were treated with CRT-D .


Two patients were excluded up to @ months after randomization and not analysed further .


CI-AKI was defined as a rise in serum creatinine of at least @ mol/L ( @ mg/dL ) within @ h after contrast exposure , or at least @ % increase from the baseline value during index hospital stay with CRT-D implantation according to KDIGO Clinical Practice Guideline for Acute Kidney Injury .


Among @ subjects of TRUST CRT trial , @ patients ( @ % ) developed CI-AKI after CRT-D implantation .


In patients with glomerular filtration rate ( GFR ) < @ mL/min/@ @ m ( @ ) on admission , the incidence of CI-AKI was almost twofold ( @ % ) higher than in subjects with GFR @ ( @ % ) .


CRT-D recipients with CI-AKI had significantly higher mortality rate ( @ % ) compared to those without CI-AKI ( @ % ) during @ months of follow-up ( logrank p = @ ) .


Multivariate Cox regression analysis showed CI-AKI as significant and independent risk factor for death in CRT-D recipients ( hazard ratio @ ; @ % CI @-@ @ ; p = @ ) .


Contrast-induced acute kidney injury is a serious and frequent procedural complication of CRT-D implantation with a significant negative influence on long-term survival .


The results suggest that clinical evaluation regarding renal function should be considered in CRT-D recipients , both before and after device implantation .


Previous analyses showed that a telephone-based intervention to increase physical activity in individuals with multiple sclerosis ( MS ) and depression resulted in significantly improved depressive symptoms compared to a wait-list control group .


The aim of this study was to test positive affect and negative affect as mediators of the effect of the physical activity counseling on depressive symptoms .


Ninety-two adults with MS , who met diagnostic criteria for either major depression or dysthymia and who reported low levels of physical activity , were randomized @:@ to a @-week telephone-based motivational interviewing ( MI ) intervention to improve physical activity ( n = @ ) or to a @-week wait-list control group ( n = @ ) .


Self-reported positive and negative affect , physical activity , and depressive symptoms were gathered at baseline and postintervention .


Path-analysis was used to test whether positive affect and negative affect mediated the positive effects of the intervention on depressive symptoms .


Both positive and negative affect were significant mediators of the effects of the intervention on depressive symptoms ; however , only positive affect mediated the association between changes in physical activity and improved depressive symptoms .


Findings support physical activity and positive affect as key mediators of the MI treatment effect on improved mood .


Decreases in negative affect were also evident in the treatment group , but were not related to improved physical activity .


Findings may suggest the use of exercise-based interventions in conjunction with treatments that specifically target negative affective mechanisms for depression .


Treatment with folic acid and vitamin B@ appears capable of reducing total plasma homocysteine levels ( tHcy ) , but it is unknown whether vitamin B@ alone reduces tHcy values .


In this study we investigate the effects of alternate vitamins supplementation on homocysteine levels in patients treated by diffusive and convective dialysis techniques .


@ patients were randomized blindly into two groups of @ subjects each .


The first group was treated initially with vitamin B@ for @ months and with folic acid for the following @ months .


The second group was treated initially with folic acid .


A wash out period of @ months followed the treatment in both groups .


Total homocysteine levels decreased in both groups following the alternate vitamins therapy and dialysis , without significant difference between diffusive and convective techniques .


Surprisingly , after the wash-out period , tHcy increased remarkably , regardless of the dialysis procedure used .


At the end of the study , folate levels showed a higher reduction with haemodialysis compared to haemodiafiltration .


In contrast , vitamin B@ levels showed a significant increase using diffusive haemodialysis , confirming a decisive role of membrane performance .


In conclusion we show for the first time that , even if total homocysteine levels decreased in both dialysis procedures , the convective techniques demonstrate a superior capacity on the reduction of tHcy levels compared to the diffusive method .


Moreover , the lower depletion of vitamin B@ by diffusive techniques could determine a higher reduction of folate levels , demonstrating the decisive role of the membrane performance in the treatment of this patients .


Turning is a common activity for older people , and is one of the activities commonly associated with falls during walking .


Falls that occur while walking and turning have also been associated with an increased risk of hip fracture in older people .


Despite the importance of stability during turning , there has been little focus on identifying this impairment in at risk older people , or in evaluating interventions aiming to improve this outcome .


This study will evaluate the effectiveness of a @ week tailored home based exercise program in older adults aged ( @ years and above ) who were identified as having unsteadiness during turning .


A single blind randomized controlled trial will be conducted , with assessors blind to group allocation .


Study participants will be aged @ years and above , living in the community and have been identified as having impaired turning ability -LSB- outside of age and gender normal limits on the Step Quick Turn ( @ degree turn ) task on the Neurocom Balance Master with long plate -RSB- .


After a comprehensive baseline assessment , those classified as having balance impairment while turning will be randomized to intervention or control group .


The intervention group will receive a @ week individualized balance and strength home exercise program , based on the Otago Exercise Program with additional exercises focused on improving turning ability .


Intervention group will attend four visit to the assessment centre over @ weeks period , for provision , monitoring , modification of the exercise and encourage ongoing participation .


Participants in the control group will continue with their usual activities .


All participants will be re-assessed on completion of the @ week program .


Primary outcome measures will be the Step Quick Turn Test and Timed-Up and Go test .


Secondary outcomes will include other clinical measures of balance , psychological aspects of falls , incidence of falls and falls risk factors .


Results of this study will provide useful information for clinicians on the types of exercises to improve turning ability in older people with increased falls risk and the effectiveness of these exercises in improving outcomes .


Trauma such as hip fracture initiates a neurohumoral stress response that changes the balance between anabolism and catabolism resulting in muscle breakdown and reduced mobilisation .


Various studies have demonstrated a reduction in catabolism with pre-operative carbohydrate loading but only in an elective setting .


This is a two-centre , randomised double-blinded trial in the United Kingdom .


Sample size will be @ patients ( approximately @ from each centre ) .


Randomisation will be web based using computer-generated concealed tables .


Both participants and investigators will be blinded to group allocation .


Participants will be > @ years of age , cognitively intact ( Abbreviated Mental Score @ ) , able to give informed consent , and admitted directly through the emergency department with fractured neck of femur requiring hemiarthroplasty .


Intervention will consist of two carbohydrate drinks ( Nutricia pre-Op ) given the night before , and the morning of the surgery .


The control will receive two placebo drinks of equal volume .


All participants will receive standard hospital care at the discretion of the clinical team .


The primary outcome is the difference between groups in insulin resistance calculated by a glucose tolerance test administered pre-operatively and @ hours postoperatively .


Secondary endpoints will be changes in muscle carbohydrate metabolism ( biopsy ) , mobility ( Cumulative Ambulation Score ) and subjective measures of tolerability .


This is a small-scale pilot study , investigating the benefits and tolerability of carbohydrate loading in an emergency setting in a frail elderly group with known high morbidity and mortality .


Positive findings will provide the basis for a larger scale study .


This study examined the effects of a cardiac rehabilitation ( CR ) program on functional capacity and health status ( HS ) in patients with newly implanted left ventricular assist devices ( LVADs ) .


Reduced functional capacity and HS are independent predictors of mortality in patients with heart failure .


CR improves both , and is related to improved outcomes in patients with heart failure ; however , there is a paucity of data that describe the effects of CR in patients with LVADs .


Enrolled subjects ( n = @ ; @ women ; age @ @ years ; ejection fraction @ @ % ) completed a symptom-limited cardiopulmonary exercise test , the Kansas City Cardiomyopathy Questionnaire ( KCCQ ) , a @-min walk test ( @MW ) , and single-leg isokinetic strength test before @:@ randomization to CR versus usual care .


Subjects in the CR group underwent @ visits of aerobic exercise at @ % to @ % of heart rate reserve .


Within-group changes from baseline to follow-up were analyzed with a paired t-test , whereas an independent t-test was used to determine differences in the change between groups .


Within-group improvements were observed in the CR group for peak oxygen uptake ( @ % ) , treadmill time ( @ min ) , KCCQ score ( @ points ) , @MW distance ( @ m ) , and leg strength ( @ % ) .


Significant differences among groups were observed for KCCQ , leg strength , and total treadmill time .


Indicators of functional capacity and HS are improved in patients with continuous-flow LVADs who attend CR .


Future trials should examine the mechanisms responsible for these improvements , and if such improvements translate into improved clinical outcomes .


( Cardiac Rehabilitation in Patients With Continuous Flow Left Ventricular Assist Devices : Rehab VAD Trial -LSB- RehabVAD -RSB- ; NCT@ ) .


Postoperative pain is one of the most important problems that confront surgical patients .


The aim of this work is to compare pain control using intravenous patient controlled analgesia ( PCA ) and patient controlled epidural analgesia ( PCEA ) in cirrhotic patients undergoing elective hepatic resection .


Thirty four adult patients ASAI and II scheduled for liver resection were randomly allocated into two groups-Group ( P ) with I.V ( PCA ) with fentanyl and Group ( E ) ( PCEA ) via epidural catheter using Bubivacaine @ % plus @ microgram per ml fentanyl .


Coagulation changes were followed and pain score was compared in both groups .


@ child A cirrhotic patients , undergoing liver resection were studied .


The demographic data were comparable in both groups .


There was a significant decrease in pain score in both groups during the follow up period when compared to their initial score .


When comparing average pain score between both groups , the PCEA group had significantly lower values .


The changes in prothrombin time ( PT ) , INR , and hemoglobin ( Hb ) , were significant all over the follow up period compared to their corresponding base line values .


@ cases needed FFP to normalize the INR for epidural removal .


There was no significant difference regarding postoperative nausea and vomiting ( PONV ) in both groups , no clinical manifestation suggesting epidural hematoma , and no cases were recorded to have respiratory depression .


There were no significant differences in patient satisfaction and ICU stay .


The two modalities of pain control seems to be nearly equivalent , but considering the risk of epidural catheter insertion and removal in cirrhotic patients who are further exposed to hepatectomy with subsequent additional coagulopathy , it may be wise to consider IVPCA technique as a policy for pain management in cirrhotic patient undergoing hepatectomy .


We studied the response to high doses of egg yolk containing antisecretory factor ( B@ , Salovum ) in young children with acute diarrhoea , presenting to the Children 's Hospital , Lahore , Pakistan .


In a randomised , placebo-controlled trial , @ children aged @ to @ months with acute diarrhoea of unknown aetiology , with mild-to-moderate dehydration , were randomised to the Salovum or placebo groups .


Initially , @ grams of Salovum or ordinary egg yolk ( placebo ) mixed in oral rehydration salts was given , followed by @ g every @ h until recovery .


The number and consistency of stools were recorded .


The two groups were comparable in age , gender , duration of diarrhoea , hydration and nutritional status , although the proportion with watery stools was higher in the Salovum group ( p = @ ) .


Reduction in the frequency of stools was seen at @ versus @ h ( p < @ ) and normalising of stool consistency was @ versus @ h , p < @ ) in the Salovum and placebo groups .


The overall effect was @ versus @ h in the two groups ( p = @ ) .


No side effects were reported .


High doses of AF in the form of Salovum effectively and safely reduce childhood diarrhoea of a likely broad aetiology .


An anabolic state can be achieved upon intravenous amino acid administration during the immediate postnatal phase despite a low energy intake .


The optimal dosing of amino acid and energy intake has yet to be established .


The aim was to quantify the efficacy of early initiation of parenteral lipids and increased amounts of amino acids on metabolism and protein accretion in very low birth weight infants .


@ very low birth weight infants were randomized to receive parenteral nutrition with glucose and either @ gamino acids / ( kgd ) ( control group ) , @ gamino acids / ( kgd ) plus @-@glipid / ( kgd ) ( AA + lipid group ) , or @ gamino acids / ( kgd ) plus @-@glipid / ( kgd ) ( high AA + lipid group ) from birth onward .


On postnatal day @ , we performed a stable isotope study with -LSB- @ - ( @ ) C -RSB- phenylalanine , -LSB- ring-D@ -RSB- tyrosine , -LSB- U - ( @ ) C@ , ( @ ) N -RSB- leucine , and -LSB- methyl-D@ -RSB- - ketoisocaproic acid to quantify intermediate amino acid metabolism .


The addition of lipids only had no effect on phenylalanine metabolism , whereas the addition of both lipids and additional amino acids increased the amount of phenylalanine used for protein synthesis .


In addition , high amino acid intake significantly increased the rate of hydroxylation of phenylalanine to tyrosine , increasing the availability of tyrosine for protein synthesis .


However , it also increased urea concentrations .


Increasing energy intake from @ to @kcal / ( kgd ) did not increase protein efficiency as measured by phenylalanine kinetics .


The leucine data were difficult to interpret due to the wide range of results and inconsistency in the data between the phenylalanine and leucine models .


High amino acid and energy intakes from birth onwards result in a more anabolic state in very low birth weight infants , but at the expense of higher urea concentrations , which reflects a higher amino acid oxidation .


Long-term outcome data should reveal whether this policy deserves routine implementation .


This trial was registered at www.trialregister.nl , trial number NTR@ , name Nutritional Intervention for Preterm Infants-@ .


To characterize the postprandial nutrient profiles of exercise-conditioned dogs fed a supplemental carbohydrate and protein bar with or without astaxanthin from Haematococcus pluvialis immediately after exercise .


@ exercise-conditioned adult Husky-Pointer dogs .


The study had @ phases .


During phase @ , postprandial plasma glucose concentration was determined for dogs fed a bar containing @ % protein and @ % or @ % maltodextrin plus dextrin ( rapidly digestible carbohydrate ; RDC ) , or dry kibble ( @ % protein and @ % RDC ) immediately after exercise .


During phase @ , dogs were exercised for @ days and fed a bar ( @ % protein and @ % RDC ) with ( CPA ; n = @ ) or without ( CP ; @ ) astaxanthin or no bar ( control ; @ ) immediately after exercise .


Pre - and postexercise concentrations of plasma biochemical analytes and serum amino acids were determined on days @ and @ .


Phase @ postexercise glucose concentration was increased when dogs were provided the @ % RDC bar , but not @ % or @ % RDC .


On day @ of phase @ , the CPA group had the highest pre-exercise triglyceride concentration and significantly less decline in postexercise glucose concentration than did the CP and control groups .


Mean glucose concentration for the CP and CPA groups was significantly higher than that for the control group between @ and @ minutes after bar consumption .


Compared to immediately after exercise , branched-chain amino acid , tryptophan , leucine , and threonine concentrations @ minutes after exercise were significantly higher for the CP and CPA groups , but were lower for the control group .


Dogs fed a bar with @ % RDCs and @ % protein immediately after exercise had increased blood nutrient concentrations for glycogen and protein synthesis , compared with control dogs .


Anger and aggression among adults with intellectual disability ( ID ) are associated with a range of adverse consequences for their well-being and that of their family or staff carers .


The aims were to evaluate the effectiveness of an anger management intervention for adults with mild to moderate ID and to evaluate the costs of the intervention and its impact on health and social care resource use .


This paper is concerned with the latter aim .


A cluster-randomised controlled trial was conducted involving day services for adults with ID in Scotland , England and Wales .


Incremental costs of delivering the intervention and its impact on subsequent total health and social care package costs were calculated .


Full data comparing costs between baseline and follow-up @ months later were collected for @ participants in the intervention arm and @ participants in the control arm .


Cost differences between the groups at follow-up , adjusted for baseline levels , were calculated using non-parametric bootstrapping controlling for clustering .


The mean hourly excess cost of intervention over treatment as usual was @ .


A mean adjusted cost difference of @ per person per week in favour of the intervention group was found but this was not statistically significant .


The baseline-adjusted cost difference at follow-up would result in a fairly immediate compensation for the excess costs of intervention , provided the difference is not a statistical artefact .


Further research is needed to clarify the extent to which it might represent a real saving in service support costs .


Data on risk associated with @-hour ambulatory diastolic ( DBP@ ) versus systolic ( SBP@ ) blood pressure are scarce .


We recorded @-hour blood pressure and health outcomes in @ untreated people ( mean age , @ years ; @ % women ) randomly recruited from @ populations .


We computed hazard ratios ( HRs ) using multivariable-adjusted Cox regression .


Over @ years ( median ) , @ ( @ % ) participants died , @ ( @ % ) from cardiovascular causes , and @ ( @ % ) experienced a fatal or nonfatal cardiovascular event .


Isolated diastolic hypertension ( DBP@ mmHg ) did not increase the risk of total mortality , cardiovascular mortality , or stroke ( HRs@ @ ; P@ @ ) , but was associated with a higher risk of fatal combined with nonfatal cardiovascular , cardiac , or coronary events ( HRs@ @ ; P@ @ ) .


Isolated systolic hypertension ( SBP@ mmHg ) and mixed diastolic plus systolic hypertension were associated with increased risks of all aforementioned end points ( P@ @ ) .


Below age @ , DBP@ was the main driver of risk , reaching significance for total ( HR for @-SD increase , @ ; P = @ ) and cardiovascular mortality ( HR , @ ; P = @ ) and for all cardiovascular end points combined ( HR , @ ; P = @ ) with a nonsignificant contribution of SBP@ ( HR@ @ ; P@ @ ) ; above age @ , SBP@ predicted all end points ( HR@ @ ; P@ @ ) with a nonsignificant contribution of DBP@ ( @ HR@ @ ; P@ @ ) .


The interactions of age with SBP@ and DBP@ were significant for all cardiovascular and coronary events ( P@ @ ) .


The risks conferred by DBP@ and SBP@ are age dependent .


DBP@ and isolated diastolic hypertension drive coronary complications below age @ , whereas above age @ SBP@ and isolated systolic and mixed hypertension are the predominant risk factors .


To evaluate efficacy and safety of subcutaneous ( SC ) and intravenous ( IV ) abatacept and background methotrexate ( MTX ) in Japanese patients with rheumatoid arthritis ( RA ) and inadequate response to MTX ( MTX-IR ) .


Double-dummy , double-blind study ( NCT@ ) ; @ adults with @ swollen joints , @ tender joints and C-reactive protein ( CRP ) @ mg/dL randomized @:@ to SC abatacept ( @ mg weekly ) with IV loading ( @ mg/kg on Day @ ) , or IV abatacept ( @ mg/kg monthly ) for @ days , both also receiving MTX ( @-@ mg/week ) .


Primary endpoint was Day @ American College of Rheumatology ( ACR ) @ response ; other efficacy endpoints , safety and immunogenicity were assessed .


Similar proportions of patients achieved ACR@ responses at Day @ with SC ( @ % -LSB- @ % CI @ , @ -RSB- ) and IV abatacept ( @ % -LSB- @ , @ -RSB- ) .


ACR@/@ responses , adjusted mean changes from baseline in Health Assessment Questionnaire-Disability Index scores and remission rates ( @-joint Disease Activity Score -LSB- CRP -RSB- < @ ) were also comparable between groups .


Serious adverse event frequencies ( @ % vs. @ % ) were similar with both formulations .


One patient per group tested seropositive for immunogenicity .


Weekly SC abatacept dosing achieved mean serum concentrations > @ g/mL ( minimum therapeutic target ) .


SC abatacept demonstrated comparable efficacy and safety to IV abatacept , with low immunogenicity rates , in MTX-IR Japanese patients with RA .


To measure the change in the minimum alveolar concentration of isoflurane ( EtISO ) associated with epidural nalbuphine and the postoperative analgesic requirements in dogs after ovariohysterectomy .


Twenty four healthy female dogs were randomly assigned to receive saline or nalbuphine at @ or @ mg/kg ( n = @ for each group ) administered via lumbosacral epidural catheter introduced cranially into the epidural canal .


Changes in heart and respiratory rates and arterial blood pressure during surgery were recorded along with the corresponding EtISO .


Immediately after tracheal extubation , analgesia , sedation , heart rate , respiratory rate , and arterial blood pressure were measured at predetermined intervals and every @ min thereafter until the first rescue analgesic .


A significant decrease in EtISO was associated with epidural nalbuphine at @ mg/kg ( @ % ) and @ mg/kg ( @ % ) but not with saline in ovariohysterectomized dogs .


In the postoperative period , VAS and Colorado analgesic scores were lower for the dogs that received the higher nalbuphine dose , which only required supplemental analgesia @ h following its administration , compared with dogs that received the lower dose .


Epidural nalbuphine significantly reduces the intra-operative isoflurane requirement and provides prolonged postoperative analgesia after ovariohysterectomy in dogs .


Parental smoking is associated with an increased risk of smoking among youth .


Epidemiological research has shown that parental smoking cessation can attenuate this risk .


This study examined whether telephone counselling for parents and subsequent parental smoking cessation affect smoking-related cognitions and smoking initiation among children of smoking parents .


Data of a two-arm randomized controlled trial were used in which @ smoking parents were recruited into cessation support through their children 's primary schools .


After the baseline assessment , smoking parents were randomly assigned to tailored telephone counselling or a standard self-help brochure .


Parental cessation was measured as @-month prolonged abstinence at the @-month follow-up .


Children 's smoking-related cognitions and smoking initiation were examined at @-month , @-month , and @-month follow-up .


No statistical evidence was found that children of parents who received telephone counselling tailored to smoking parents or children of parents who achieved prolonged abstinence differ in smoking-related cognitions ( i.e. , smoking outcome expectancies , perceived safety of smoking , self-efficacy to refrain from smoking , susceptibility to smoking ) or smoking initiation rate on any follow-up assessment .


This study is the first to examine the effects of an evidence-based smoking cessation treatment for parents and treatment-induced parental smoking cessation on cognitive and behavioural outcomes among children .


Although descriptive statistics showed lower smoking initiation rates among children of parents who achieved prolonged abstinence , there was no statistical evidence that telephone counselling tailored to parents or treatment-induced parental smoking cessation affects precursors of smoking or smoking initiation among youth .


Increasing rates of obesity and associated diseases and their consequences make the implementation of preventive and counteracting measures necessary .


The aim of this study was the examination of the long-term effects of financial incentives on weight loss in obese patients and the identification of influencing factors .


@ obese patients were randomly assigned to one of three study conditions : For reaching a pre-defined target weight within @ months they were rewarded with Euro @ , Euro @ or not at all .


The effect of the incentives on weight loss in different subgroups was compared .


After @ months , other possible influences on weight loss were analyzed by comparing responders and non-responders .


Financial rewards led to significant weight loss in all subgroups , whereupon the height of the incentive only mattered in some .


After @ months , for several subgroups , the incentive 's effect was still visible .


Furthermore , responders showed more healthy behaviour , were better informed and reported more social support .


Especially for patient groups who do not lose weight in orthodox treatments alone , financial incentives can be an effective supplement .


In addition it became clear that this kind of reward programme can be implemented area-wide .


Older adults have increased visual impairment , including refractive blur from presbyopic multifocal spectacle corrections , and are less able to extract visual information from the environment to plan and execute appropriate stepping actions ; these factors may collectively contribute to their higher risk of falls .


The aim of this study was to examine the effect of refractive blur and target visibility on the stepping accuracy and visuomotor stepping strategies of older adults during a precision stepping task .


Ten healthy , visually normal older adults ( mean age @ years ) walked up and down a @m indoor corridor stepping onto selected high and low contrast targets while viewing under three visual conditions : best-corrected vision , +@ DS and +@ DS blur ; the order of blur conditions was randomised between participants .


Stepping accuracy and gaze behaviours were recorded using an eyetracker and a secondary hand-held camera .


Older adults made significantly more stepping errors with increasing levels of blur , particularly exhibiting under-stepping ( stepping more posteriorly ) onto the targets ( p < @ ) , while visuomotor stepping strategies did not significantly alter .


Stepping errors were also significantly greater for the low compared to the high contrast targets and differences in visuomotor stepping strategies were found , including increased duration of gaze and increased interval between gaze onset and initiation of the leg swing when stepping onto the low contrast targets .


These findings highlight that stepping accuracy is reduced for low visibility targets , and for high levels of refractive blur at levels typically present in multifocal spectacle corrections , despite significant changes in some of the visuomotor stepping strategies .


These findings highlight the importance of maximising the contrast of objects in the environment , and may help explain why older adults wearing multifocal spectacle corrections exhibit an increased risk of falling .


Chemoradiotherapy has become the standard of care for head and neck squamous cell carcinoma ; however , those patients often experience multiple treatment-related symptoms or symptom clusters .


Two symptom clusters have been identified for this population .


Little is known about the risk factors of these symptom clusters .


Subjects comprised @ patients who were treated with concurrent chemoradiotherapy in a phase @ randomized clinical trial .


This trial compared standard fractionation radiotherapy to accelerated fractionation radiotherapy .


Symptom clusters were evaluated at the end of the first and the second cycle of chemotherapy , and @ months after the start of radiotherapy .


Mixed-effect modeling was used to observe risk factors for symptom clusters .


Race and education were independent predictors for the head and neck cluster , whereas sex and history of tobacco use were independent predictors for the gastrointestinal cluster .


Primary cancer site was only significant for the head and neck cluster when other factors were not controlled : patients with oropharyngeal cancer had more severe symptoms in the head and neck clusters than did patients with laryngeal cancer .


In addition , patients receiving accelerated fractionation radiotherapy experienced more symptoms of radiomucositis , pain , and nausea at @ months after the start of radiotherapy than those receiving standard fractionation radiotherapy .


Demographic characteristics were more predictive to symptom clusters , whereas clinical characteristics , such as cancer site and treatment arms , were more significant for individual symptoms .


Knowing the risk factors will enhance the capability of clinicians to evaluate patients ' risk of severe symptom clusters and to personalize management strategies .


To determine the physiological impact of exposure to weight stigma by examining alterations in salivary cortisol among lean and overweight women .


Participants were @ lean and overweight adult women ( mean body mass index = @ -LSB- @ -RSB- kg/m ( @ ) ) .


Participants ' salivary cortisol was assessed both before and after either a weight stigmatizing or a neutral video .


Participants completed self-report measures of mood and reactions to the video .


Height and weight were obtained at the conclusion of the study .


Participants in the stigmatizing condition exhibited significantly greater cortisol reactivity when compared with those in the neutral condition , irrespective of weight status ( Pillai trace = @ ; F ( @,@ ) = @ , p = @ ) .


Lean and overweight women in the stigmatizing condition were equally likely to find the video upsetting and were equally likely to report that they would rather not see obese individuals depicted in a stigmatizing manner in the media .


Exposure to weight-stigmatizing stimuli was associated with greater cortisol reactivity among lean and overweight women .


These findings highlight the potentially harmful physiological consequences of exposure to weight stigma .


This study aimed to compare the effects of rectal midazolam addition after applying bupivacaine and caudal anesthesia on postoperative analgesia time , the need for additional analgesics , postoperative recovery , and sedation and to find out its adverse effects in children having lower abdominal surgery .


@ children between @ and @ years of ASA I-II were randomized , and they received caudal anesthesia under general anesthesia .


Patients underwent the application of caudal block in addition to saline and @ mL/kg bupivacaine @ % .


In the postoperative period , Group C ( n = @ ) was given @ mL saline , and Group M ( n = @ ) was given @ mg/kg rectal midazolam diluted with @ mL saline .


Sedation scale and postoperative pain scale ( CHIPPS ) of the patients were evaluated .


The patients were observed for their analgesic need , first analgesic time , and adverse effects for @ hours .


Demographic and hemodynamic data of the two groups did not differ .


Postoperative sedation scores in both groups were significantly lower compared with the preoperative period .


There was no significant difference between the groups in terms of sedation and sufficient analgesia .


We conclude that caudal anesthesia provided sufficient analgesia in peroperative and postoperative periods , and rectal midazolam addition did not create any differences .


This trial is registered with ClinicalTrials.gov NCT@ .


Bleeding control with epinephrine hydrochloride-soaked cotton packing in the maxillary sinus after canine fossa puncture ( CFP ) during operation is a simple method for reducing complications , especially those associated with blood leakage from the maxillary sinus into the subcutaneous tissue .


Although CFP is a useful method for extensive maxillary sinus disease , complications can occur associated with nerve injuries or mucosal bleeding .


We evaluated whether maxillary sinus packing with epinephrine hydrochloride-soaked cotton pledgets would reduce complications after CFP .


Patients who met the inclusion criteria were randomly allocated to groups @ ( packing ) and @ ( no packing ) .


Patients underwent unilateral or bilateral CFP .


We compared the disease entities , complication incidence , and average symptom duration between the groups .


A total of @ patients were included .


Group @ underwent @ CFPs , and complications occurred in @ sides of @ patients .


Group @ had @ CFPs , and @ patients experienced complications in @ sides .


The total number of complications was @ and @ in groups @ and @ , respectively .


Incidence or duration of facial , dental , or gum numbness did not differ between groups .


Tingling sensation , facial pain , facial swelling , and bruising showed significantly lower occurrence rates and shorter duration in group @ .


Coffee consumption has been reported to decrease oxidative damage in peripheral white blood cells ( WBC ) .


However , effects on the level of spontaneous DNA strand breaks , a well established marker of health risk , have not been specifically reported yet .


We analyzed the impact of consuming a dark roast coffee blend on the level of spontaneous DNA strand breaks .


Healthy men ( n = @ ) were randomized to consume daily for @ weeks either @ ml of fresh coffee brew or @ ml of water , subsequent to a run in washout phase of @ weeks .


The study coffee was a blend providing high amounts of both caffeoylquinic acids ( @ @ mg/g ) and the roast product N-methylpyridinium ( @ @ mg/g ) .


Before and after the coffee/water consumption phase , spontaneous strand breaks were determined by comet assay .


At baseline , both groups exhibited a similar level of spontaneous DNA strand breaks .


In the intervention phase , spontaneous DNA strand breaks slightly increased in the control ( water only ) group whereas they significantly decreased in the coffee group , leading to a @ % difference within both arms ( p = @ ) .


Food frequency questionnaires indicated no differences in the overall diet between groups , and mean body weight during the intervention phases remained stable .


The consumption of the study coffee substantially lowered the level of spontaneous DNA strand breaks in WBC .


We conclude that regular coffee consumption contributes to DNA integrity .


Clinical trials of radiation after radical cystectomy ( RC ) and chemotherapy for bladder cancer are in development , but inclusion and stratification factors have not been clearly established .


In this study , the authors evaluated and refined a published risk stratification for locoregional failure ( LF ) by applying it to a multicenter patient cohort .


The original stratification , which was developed using a single-institution series , produced @ subgroups with significantly different LF risk based on pathologic tumor ( pT ) classification and the number of lymph nodes identified .


This model was then applied to patients in Southwest Oncology Group ( SWOG ) @ , a randomized trial of RC with or without chemotherapy .


LF was defined as any pelvic failure before or within @ months of distant failure .


Patients in the development cohort and the SWOG cohort had significantly different baseline characteristics .


The original risk model was not fully validated in the SWOG cohort , because lymph node yield was not as strongly associated with LF as in the development cohort .


Regression analysis indicated that margin status could improve the model .


A revised stratification using pT classification , margin status , and the number of lymph nodes identified produced @ subgroups with significantly different LF risk in both cohorts : low risk ( pT@ ) , intermediate risk ( pT@ with negative margins AND @ lymph nodes identified ) , and high risk ( pT@ with positive margins OR < @ lymph nodes identified ) with @-year LF rates of @ % , @ % , and @ % , respectively , in the SWOG cohort and @ % , @ % , and @ % , respectively , in the development cohort .


A model incorporating pT classification , margin status , and the number of lymph nodes identified stratified LF risk in @ different RC populations and may inform the design of future trials .


Our primary purpose was to evaluate the efficacy of the high-potency @C-adrenoceptor antagonist ORM-@ in the attenuation of a cold-induced reduction in finger blood flow and temperature in patients with RP secondary to SSc .


Secondary objectives were to assess safety and tolerability .


This was a phase IIa , randomized , double-blind , crossover , single-dose , placebo-controlled , single-centre study .


Patients attended five times : initial screening , treatment visits @-@ ( each at least @ week apart ) and @-@ weeks after the last treatment .


At each treatment visit , each subject received a single oral dose of @ mg or @ mg of ORM-@ or placebo .


Thirty minutes later the subject underwent a cold challenge .


Blood flow to the fingers was assessed by three methods -LSB- temperature by probe , laser Doppler imaging ( LDI ) and infrared thermography -RSB- performed before , during and after the cold challenge .


Twelve patients ( @ female , mean age @ years ) were included .


The area under the rewarming curve ( LDI ) of the right index finger ( arbitrary flux units time ) was lower for both @ mg ( P = @ ) and @ mg ( P = @ ) of ORM-@ compared with placebo , indicating delayed reperfusion .


The time to @ % temperature recovery ( middle finger probe ) was longer with active than placebo treatment : mean ( s.d. ) values for placebo , @ mg of ORM-@ and @ mg of ORM-@ were @ min ( @ ) , @ min ( @ ) and @ min ( @ ) , respectively .


Overall ORM-@ was well tolerated .


ORM-@ did not expedite recovery from a cold challenge in the fingers of patients with SSc .


Approximal surfaces are a challenge to caries lesions control .


Silver diamine fluoride ( SDF ) is a simple,low-cost and promisor intervention for arresting caries lesions , but it has never been tested on approximal surfaces .


Our aim is to evaluate the efficacy and cost-efficacy of SDF in arresting initial lesions compared to resin infiltration and exclusively flossing ( control group ) .


Our second aim is to assess discomfort and satisfaction regarding interventions .


This is a randomized clinical trial , double-blinded , placebo-controlled study .


Children/adolescents presenting at least one approximal initial caries lesion in primary molars/permanent premolars and molars will be included .


Surfaces with advanced dentine lesions identified by radiography and participants who refuse to participate or present negative behaviors will be excluded .


A minimum sample size of @ surfaces will be required for each subgroup .


Individuals will be randomly allocated in three groups of interventions : SDF , resin infiltration , and control group .


Depending on the allocation , the patients will receive the active treatment and respective placebo therapies .


All patients will be oriented to daily flossing the included surfaces .


Our primary outcome will be caries progression by clinical and radiographic examinations .


Appointments will be timed and costs of materials will be considered to calculate cost-efficacy .


Patient discomfort will be assessed after interventions .


Parent and patient satisfaction with the treatment will be collected after treatment and in the last follow-up visit .


Individuals will be assessed at @ and @ months after treatment to evaluate dental biofilm and at @ , @ , and @ months to assess caries progression by visual examination and/or radiography .


Multilevel analyses will be used to verify if the type of treatment influenced on the tested outcomes .


Costs will be compared and analyses of cost-efficacy will be performed .


Poisson analysis will test the association between intervention and reported discomfort and satisfaction .


Our hypothesis is that SDF is the most cost-efficacious option from all tested interventions .


If our hypothesis is confirmed , the use of SDF in private and public contexts could represent an easier and effective option in the treatment of enamel approximal caries in children/adolescents .


There is insufficient evidence to support use of occupational therapy interventions for patients with Parkinson 's disease .


We aimed to assess the efficacy of occupational therapy in improving daily activities of patients with Parkinson 's disease .


We did a multicentre , assessor-masked , randomised controlled clinical trial in ten hospitals in nine Dutch regional networks of specialised health-care professionals ( ParkinsonNet ) , with assessment at @ months and @ months .


Patients with Parkinson 's disease with self-reported difficulties in daily activities were included , along with their primary caregivers .


Patients were randomly assigned ( @:@ ) to the intervention or control group by a computer-generated minimisation algorithm .


The intervention consisted of @ weeks of home-based occupational therapy according to national practice guidelines ; control individuals received usual care with no occupational therapy .


The primary outcome was self-perceived performance in daily activities at @ months , assessed with the Canadian Occupational Performance Measure ( score @-@ ) .


Data were analysed using linear mixed models for repeated measures ( intention-to-treat principle ) .


Assessors monitored safety by asking patients about any unusual health events during the preceding @ months .


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


Between April @ , @ , and Nov @ , @ , @ patients were randomly assigned to the intervention group ( n = @ ) or the control group ( n = @ ) .


@ ( @ % ) of @ patients in the intervention group and @ ( @ % ) of @ in the control group had a participating caregiver .


At baseline , the median score on the Canadian Occupational Performance Measure was @ ( IQR @-@ ) in the intervention group and @ ( @-@ ) in the control group .


At @ months , these scores were @ ( @-@ ) and @ ( @-@ ) , respectively .


The adjusted mean difference in score between groups at @ months was in favour of the intervention group ( @ ; @ % CI @-@ ; p < @ ) .


There were no adverse events associated with the study .


Home-based , individualised occupational therapy led to an improvement in self-perceived performance in daily activities in patients with Parkinson 's disease .


Further work should identify which factors related to the patient , environmental context , or therapist might predict which patients are most likely to benefit from occupational therapy .


The UKW@ trial compared biopsy/pre-operative chemotherapy versus immediate nephrectomy and afforded the opportunity to examine the influence of percutaneous retroperitoneal biopsy and other factors on local and distant relapse of Wilms tumour ( WT ) .


Patients with unilateral WT ( stages I-IV ) excluding metachronous relapse or early progressive disease were eligible .


Metastatic and ` inoperable ' tumours were biopsied electively .


` Local ' was defined as relapse within the abdomen , except for liver metastases considered as ` distant ' relapse , together with other haematogenous routes .


Uni - and multivariable analyses estimated the risk factors for relapse .


Overall , @/@ ( @ % ) patients had a biopsy .


With a median follow-up of @ years , @ ( @ % ) patients experienced a ` local ' , @ a combined ( @ % ) and @ ( @ % ) a ` distant ' relapse .


On univariate analysis , biopsy , anaplasia and tumour size were associated with an increased risk of local relapse .


On multivariable analysis , anaplasia and tumour size remained significant for local relapse whereas the elevated risk of biopsy ( hazards ratio ( HR ) = @ : @ % confidence interval ( CI ) @-@ @ , p = @ ) was marginal .


Age , anaplasia , tumour size , lymph nodes metastases and stage , but not biopsy , were individually associated with increased risk of distant relapse but only age and anaplasia remained significant following multivariable analysis .


The UKW@ trial provides some reassurance that biopsy should not automatically lead to ` upstaging ' of WT .


Further assessment of this controversial area is required .


Comparison of local relapse rates in a multinational trial in which the United Kingdom ( UK ) continued the practice of routinely biopsying all patients in contrast to the standard European approach will afford this opportunity and is planned .


To evaluate the usefulness and safety of bronchoscopy by the laryngeal mask airway ( LMA ) compared with by nose and by mouth .


Between April @ and Dec @ , we prospectively studied @ analgesia brochoscopy in the operating theater of the our hospital .


All the patients were randomly assigned by computer to LMA group , non-LMA by nose group ( NLBN ) and non-LMA by mouth group ( NLBM ) according the way of bronchoscopy .


Each group had @ cases .


We recorded the time of bronchoscopy just through subglottic , total operation time , the times of blood oxygen less than @ % so as to suspend procedure and so on .


Intergroup comparisons showed no difference in gender , age , and the successful rate of biopsy ( P > @ ) .


The time of bronchoscopy just through subglottic in LMA group was lower than that in NLBN group and in NLBM group significantly ( P < @ ) , and no difference between two latter groups ( P > @ ) .


Also , total operation time of LMA group was higher than that of others ( P < @ ) , but no difference between the latter two groups .


There were @ cases in NLBN group and @ cases in NLBM group respectively , which were suspended procedure during operation due to low oxygen , and the difference did not reach statistical sense ( P > @ ) .


There were @ patients presented with nasal discomfort after operations in NLBN Group .


The patients in all the three groups had no bad memory or fear , and the acceptance rate of reoperation was all @ % .


In general , as to the cases of the patients who presented with pharyngeal discomfort and abnormal pronunciation , there was significance difference between LMA Group and NLBN Group and also between LMA Group and NLBM Group , while the difference between NLBN Group and NLBM Group was not statistically significan .


The use of the LMA during FFB is safe , provides excellent patient comfort , reduces the time of bronchoscopy just through subglottic so as to decrease the total operation time , and is better to control the situation of patient in operation .


We investigated whether thymidylate synthase ( TS ) expression is a predictive marker for the clinical outcome of pemetrexed/cisplatin in patients with nonsquamous non-small-cell lung cancer .


Eligible patients were tested for TS expression by immunohistochemistry and stratified into either a TS-negative or a TS-positive group .


After stratification , patients in each group were randomly assigned ( @:@ ratio ) to receive either pemetrexed/cisplatin or gemcitabine/cisplatin for a maximum of six cycles until disease progression .


The primary end point was evaluation of the interaction between TS groups and treatment allocation for objective response rate .


Of @ enrolled patients with nonsquamous non-small-cell lung cancer , @ received at least one dose of study chemotherapy and were analyzed .


By investigator assessment , response rates were @ % for the pemetrexed/cisplatin arm and @ % for the gemcitabine/cisplatin arm in the TS-negative group and @ % and @ % , respectively , for the TS-positive group ( interaction P = @ ) .


By independent reviewers , response rates of pemetrexed/cisplatin and gemcitabine/cisplatin were @ % and @ % , respectively , in the TS-negative group and @ % and @ % in the TS-positive group ( interaction P = @ ) .


The median progression-free survival times for the pemetrexed/cisplatin and the gemcitabine/cisplatin arms were @ and @ months , respectively , in the TS-negative group and @ and @ months in the TS-positive group ( interaction P = @ ) .


With regard to response rate and progression-free survival , pemetrexed/cisplatin was superior to gemcitabine/cisplatin in the TS-negative group but not in the TS-positive group , indicative of TS expression as a potential predictive marker .


Additional prospective studies involving larger cohorts are warranted to confirm the predictive role of TS expression .


It is difficult to foster research utilization among allied health professionals ( AHPs ) .


Tailored , multifaceted knowledge translation ( KT ) strategies are now recommended but are resource intensive to implement .


Employers need effective KT solutions but little is known about ; the impact and viability of multifaceted KT strategies using an online KT tool , their effectiveness with AHPs and their effect on evidence-based practice ( EBP ) decision-making behavior .


The study aim was to measure the effectiveness of a multifaceted KT intervention including a customized KT tool , to change EBP behavior , knowledge , and attitudes of AHPs .


This is an evaluator-blinded , cluster randomized controlled trial conducted in an Australian community-based cerebral palsy service .


@ AHPs ( physiotherapists , occupational therapists , speech pathologists , psychologists and social workers ) from four regions were cluster randomized ( n = @ ) , to either the KT intervention group ( n = @ AHPs ) or the control group ( n = @ AHPs ) , using computer-generated random numbers , concealed in opaque envelopes , by an independent officer .


The KT intervention included three-day skills training workshop and multifaceted workplace supports to redress barriers ( paid EBP time , mentoring , system changes and access to an online research synthesis tool ) .


Primary outcome ( self - and peer-rated EBP behavior ) was measured using the Goal Attainment Scale ( individual level ) .


Secondary outcomes ( knowledge and attitudes ) were measured using exams and the Evidence Based Practice Attitude Scale .


The intervention group 's primary outcome scores improved relative to the control group , however when clustering was taken into account , the findings were non-significant : self-rated EBP behavior -LSB- effect size @ ( @ % CI -@ , @ ) ( p = @ ) -RSB- ; peer-rated EBP behavior -LSB- effect size @ ( @ % CI -@ , @ ) ( p = @ ) -RSB- .


Statistically significant improvements in EBP knowledge were detected -LSB- effect size @ ( @ % CI @ , @ ( p < @ ) -RSB- .


Change in EBP attitudes was not statistically significant .


Improvement in EBP behavior was not statistically significant after adjusting for cluster effect , however similar improvements from peer-ratings suggest behaviorally meaningful gains .


The large variability in behavior observed between clusters suggests barrier assessments and subsequent KT interventions may need to target subgroups within an organization .


Functional dysphonias are commonly associated with reduced treatment attendance leading to variable treatment outcomes .


Preliminary research has proposed that intensive treatment may improve client adherence and outcomes ; however , further research into the application of intensive models in functional dysphonia in comparison with standard intensity models is warranted .


The present study evaluated the impact of intensive and standard treatments on functional , well-being , and service outcome measures in clients with functional dysphonia .


Participants with a functional dysphonia were randomly allocated to one of two treatment groups : ( @ ) intensive treatment ( n = @ ) or ( @ ) standard treatment ( n = @ ) .


Participants completed the voice handicap index ( VHI ) and the Australian therapy outcome measures voice assessment ( conducted by a blinded assessor ) before and after treatment and @weeks after treatment .


Satisfaction questionnaires were completed after treatment and data pertaining to attendance and duration of intervention were collected throughout treatment .


In addition to a vocal hygiene education session , all participants received a total of @hours of treatment ; intensive treatment consisted of four @-hour treatment sessions per week over @weeks , whereas the standard group received one @-hour treatment session per week over @weeks .


High satisfaction and statistically significant improvements on the VHI ratings were found after treatment in the intensive group .


Significantly greater attendance rates were found in the intensive group .


Intensive treatment is a potentially viable service delivery option for functional dysphonia and warrants further larger scale investigation .


Previous studies show a prolongation of activated partial thromboplastin time and prothrombin time in healthy volunteers after treatment with sugammadex .


The authors investigated the effect of sugammadex on postsurgical bleeding and coagulation variables .


This randomized , double-blind trial enrolled patients receiving thromboprophylaxis and undergoing hip or knee joint replacement or hip fracture surgery .


Patients received sugammadex @ mg/kg or usual care ( neostigmine or spontaneous recovery ) for reversal of rocuronium - or vecuronium-induced neuromuscular blockade .


The Cochran-Mantel-Haenszel method , stratified by thromboprophylaxis and renal status , was used to estimate relative risk and @ % confidence interval ( CI ) of bleeding events with sugammadex versus usual care .


Safety was further evaluated by prespecified endpoints and adverse event reporting .


Of @,@ patients randomized , @,@ were treated ( sugammadex n = @ , usual care n = @ ) .


Bleeding events within @ h ( classified by an independent , blinded Adjudication Committee ) were reported in @ ( @ % ) sugammadex and @ ( @ % ) usual care patients ( relative risk -LSB- @ % CI -RSB- , @ -LSB- @ to @ -RSB- ) .


Compared with usual care , increases of @ % in activated partial thromboplastin time ( P < @ ) and @ % in prothrombin time ( P < @ ) from baseline with sugammadex occurred @ min after administration and resolved within @ min .


There were no significant differences between sugammadex and usual care for other blood loss measures ( transfusion , @-h drain volume , drop in hemoglobin , and anemia ) , or risk of venous thromboembolism , and no cases of anaphylaxis .


Sugammadex produced limited , transient ( < @ h ) increases in activated partial thromboplastin time and prothrombin time but was not associated with increased risk of bleeding versus usual care .


To compare the therapeutic effect of traditional and modified apocrine gland removal surgery with the combination of high radiofrequency knife for axillary osmidrosis .


@ cases ( @ sides ) were randomly divided into traditional group A ( @ cases , @ sides ) and modified group B ( @ cases , @ sides ) .


The wound healing and complications were recorded .


The clinical effect was followed up for @-@ months after operation .


No flap necrosis happened in both groups .


The cure rate was @ % ( @/@ ) ) and @ % ( @/@ ) in group A and B , respectively , which was significantly different ( P < @ ) .


The effective rate of hair removal in group A and B was @ % , @ % ( P < @ ) .


There is no markedly difference between the two groups in postoperative hematoma ( P > @ ) .


The recurrence rate in group A and B was @ % and @ % respectively , with a statistically difference between them ( P < @ ) .


Modified apocrine gland removal surgery with the combination of high radiofrequency knife can expose the apocrine gland better and the gland , as well as hair , can be removed in the most .


The residue hair and recurrency of osmidrosis are very lower .


Minimal information exists regarding the long-term comparative effectiveness of telemedicine to provide diabetic retinopathy screening examinations .


To compare telemedicine to traditional eye examinations in their ability to provide diabetic retinopathy screening examinations .


From August @ , @ , through September @ , @ , @ participants with diabetes were randomized and followed up to @ years of follow-up ( last date of patient follow-up occurred on August @ , @ ) as part of a multicenter randomized clinical trial with an intent to treat analysis .


We assigned participants to telemedicine with a nonmydriatic camera in a primary care medical clinic ( n = @ ) or traditional surveillance with an eye care professional ( n = @ ) .


Two years after enrollment , we offered telemedicine to all participants .


Percentage of participants receiving annual diabetic retinopathy screening examinations , percentage of eyes with worsening diabetic retinopathy during the follow-up period using a validated scale from stage @ ( none ) to stage @ ( proliferative diabetic retinopathy ) , and percentage of telemedicine participants who would require referral to an eye care professional for follow-up care using a cutoff of moderate diabetic retinopathy or worse , the presence of macular edema , or an unable-to-determine result for retinopathy or macular edema .


The telemedicine group was more likely to receive a diabetic retinopathy screening examination when compared with the traditional surveillance group during the @-month or less ( @ % -LSB- @/@ -RSB- vs @ % -LSB- @/@ -RSB- ; @ % CI , @ % -@ % ; P < @ ) and greater than @-month through @-month ( @ % -LSB- @/@ -RSB- vs @ % -LSB- @/@ -RSB- ; @ % CI , @ % -@ % ; P < @ ) time bins .


After we offered telemedicine to both groups , we could not identify a difference between the groups in the percentage of diabetic retinopathy screening examinations .


Diabetic retinopathy worsened by @ stages or more in @ ( @ % ) of @ participants ( @ % CI , @ % -@ % ) and improved by @ stages or more in @ ( @ % ) of @ participants ( @ % CI , @ % -@ % ) during the @-year period .


The percent of telemedicine participants requiring referral ranged from @ % ( @/@ ) to @ % ( @/@ ) .


Telemedicine increased the percentage of diabetic retinopathy screening examinations , most participants did not require referral to an eye care professional , and diabetic retinopathy levels were generally stable during the study period .


This finding suggests that primary care clinics can use telemedicine to screen for diabetic retinopathy and monitor for disease worsening over a long period .


In this randomized trial , strut coverage and neointimal proliferation of a therapy of bare metal stents ( BMSs ) postdilated with the paclitaxel drug-eluting balloon ( DEB ) was compared with everolimus drug-eluting stents ( DESs ) at @-month follow-up using optical coherence tomography .


We hypothesized sufficient stent coverage at follow-up .


A total of @ lesions in @ patients were treated with either XIENCE V DES ( n = @ ) or BMS postdilated with the SeQuent Please DEB ( n = @ ) .


At follow-up , comparable results on the primary optical coherence tomography end point ( percentage uncovered struts @ % in BMS+DEB versus @ % in DES ; P = @ ) were found .


Thus , BMS+DEB achieved the prespecified noninferiority margin of @ % uncovered struts versus DES ( difference between treatment means , @ % ; one-sided upper @ % confidence interval , @ % ; noninferiority P = @ ) .


Optical coherence tomography analysis showed significantly more global neointimal proliferation in the BMS+DEB group ( @ versus @ mm ( @ ) proliferation volume/cm stent length ; P = @ ) .


No significant focal in-stent stenosis analyzed with angiography ( percentage diameter stenosis at follow-up , @ versus @ ; P = @ ) and optical coherence tomography ( peak local area stenosis , @ % versus @ % ; P = @ ) was found .


Good stent strut coverage of > @ % was found in both therapy groups .


Despite greater suppression of global neointimal growth in DES , both DES and BMS+DEB effectively prevented clinically relevant focal restenosis at @-month follow-up .


Few studies to date have used the cancer diagnosis as a teachable moment to promote healthy behavior changes in survivors of cancer and their family members .


Given the role of obesity in the primary and tertiary prevention of breast cancer , the authors explored the feasibility of a mother-daughter weight loss intervention .


A randomized controlled trial of a mailed weight loss intervention was undertaken among @ mother-daughter dyads ( n = @ ) , each comprised of a survivor of breast cancer ( AJCC stage @-III ) and her adult biological daughter .


All women had body mass indices @ kg/m ( @ ) and underwent in-person assessments at baseline , @ months , and @ months , with accelerometry and exercise capacity performed on a subset of individuals .


All women received a personalized workbook and @ newsletters over a @-year period that promoted weight loss ; exercise ; and a nutrient-rich , low-energy density diet .


A total of @ dyads received individually tailored instruction ( individual ) , @ dyads received team-tailored instruction ( TEAM ) , and @ dyads received standardized brochures ( control ) .


The trial met its accrual target , experienced @ % retention , and caused no serious adverse events .


Significant differences in baseline to @-month changes were observed between individual versus control mothers for body mass index , weight , and waist circumference ( WC ) ; significant differences also were observed in the WC of corresponding daughters ( P < @ ) .


Significant differences were found between individual versus control and team versus control dyads for WC ( P = @ and @ , respectively ) , minutes per week of physical activity ( P = @ and @ , respectively ) , and exercise capacity ( P = @ for both ) .


Significant improvements in lifestyle behaviors and health outcomes are possible with tailored print interventions directed toward survivors of cancer and their family members .


For greater impact , more research is needed to expand this work beyond the mother-daughter dyad .


Childhood obesity is an increasing health problem globally .


Overweight and obesity may be established as early as @-@ years of age , highlighting the need for evidence-based effective prevention and treatment programs early in life .


In adults , mobile phone based interventions for weight management ( mHealth ) have demonstrated positive effects on body mass , however , their use in child populations has yet to be examined .


The aim of this paper is to report the study design and methodology of the MINSTOP ( Mobile-based Intervention Intended to Stop Obesity in Preschoolers ) trial .


A two-arm , parallel design randomized controlled trial in @ healthy Swedish @-year-olds is conducted .


After baseline measures , parents are allocated to either an intervention - or control group .


The @ - month mHealth intervention consists of a web-based application ( the MINSTOP app ) to help parents promote healthy eating and physical activity in children .


MINISTOP is based on the Social Cognitive Theory and involves the delivery of a comprehensive , personalized program of information and text messages based on existing guidelines for a healthy diet and active lifestyle in pre-school children .


Parents also register physical activity and intakes of candy , soft drinks , vegetables as well as fruits of their child and receive feedback through the application .


Primary outcomes include body fatness and energy intake , while secondary outcomes are time spent in sedentary , moderate , and vigorous physical activity , physical fitness and intakes of fruits and vegetables , snacks , soft drinks and candy .


Food and energy intake ( Tool for Energy balance in Children , TECH ) , body fatness ( pediatric option for BodPod ) , physical activity ( Actigraph wGT@x-BT ) and physical fitness ( the PREFIT battery of five fitness tests ) are measured at baseline , after the intervention ( six months after baseline ) and at follow-up ( @ months after baseline ) .


This novel study will evaluate the effectiveness of a mHealth program for mitigating gain in body fatness among @-year-old children .


If the intervention proves effective it has great potential to be implemented in child-health care to counteract childhood overweight and obesity .


Sevoflurane and propofol are both widely used in clinical anesthesia .


The aim of this study is to compare the effects of sevoflurane and propofol on right ventricular function and pulmonary circulation in patients receiving esophagectomy .


Forty adult patients undergoing an elective open-chest thoracotomy for esophagectomy were randomized to receive either propofol ( n = @ ) or sevoflurane ( n = @ ) as the main anesthetic agent .


The study was performed in Changzheng Hospital .


Hemodynamic data were recorded at specific intervals : before the surgery ( T@ ) , BIS values reaching @ after anesthesia induction ( T@ ) , two-lung ventilation ( T@ ) , ten minutes after one-lung ventilation ( T@ ) , the end of the operation ( T@ ) using PiCCO@ and Swan-Ganz catheter .


CI , RVEF , RVSWI and RVEDVI were significantly smaller in propofol group than those in sevoflurane group throughout the surgery ( P < @ ) .


However , SVRI was significantly greater in propofol group than that in sevoflurane group ( P < @ ) .


Compared with the patients in propofol group , the patients who received sevoflurane had a greater reduction in OI and increase in Os/Ot ( P < @ ) .


And , PVRI was significantly smaller in sevoflurane group than in propofol group ( P < @ ) .


Anesthesia with sevoflurane preserved better right ventricular function than propofol in patients receiving esophagectomy .


However , propofol improved oxygenation and shunt fraction during one-lung ventilation compared with sevoflurane anesthesia .


To have the best effect , anesthesiologists can choose the two anesthetics flexibly according to the monitoring results .


Chlorophyll-a is a novel photosensitizer recently tested for the treatment of acne vulgaris .


We sought to evaluate the clinical efficacy and safety of chlorophyll-a photodynamic therapy used for acne treatment .


Subjects with acne on both sides of the face were included .


Eight treatment sessions were performed over a @-week duration .


Half of the face was irradiated using a blue and red light-emitting diode after topical application of chlorophyll-lipoid complex .


The other half underwent only light-emitting diode phototherapy .


The lesion counts and acne severity were assessed by a blinded examiner .


Sebum secretion , safety , and histologic changes were also evaluated .


In total , @ subjects completed the study .


Facial acne improved on both treated sides .


On the chlorophyll-a photodynamic therapy-treated side , there were significant reductions in acne lesion counts , acne severity grades , and sebum levels compared with the side treated with light-emitting diode phototherapy alone .


The side effects were tolerable in all the cases .


All the subjects were of Asian descent with darker skin types , which may limit the generalizability of the study .


A chlorophyll-a arm alone is absent , as is a no-treatment arm .


We suggest that chlorophyll-a photodynamic therapy for the treatment of acne vulgaris can be effective and safe with minimal side effects .


To observe the effect of Kuntai Capsule ( KC ) on the number of retrieved oocytes , the quality of high-quality oocytes and embryos in in vitro fertilization of poor ovarian response ( POR ) patients .


Totally @ POR patients preparing for in vitro fertilization-embryo transfer ( IVF-ET ) were randomly assigned to the observation group and the control group , @ cases in each group .


KC was administered to patients in the observation group in the preparation cycle ( i.e. , three menstrual cycles before IVF-ET ) and during the superovulation process .


Those in the control group took placebo during this period .


Before and after medication the improvement of Shen yin deficiency syndrome ( SYDS ) was observed in the two groups .


The basal follicle-stimulating hormone ( bFSH ) , luteinizing hormone ( LH ) , estradiol ( E@ ) , anti-Mullerian hormone ( AMH ) , the ratio of FSH to LH , and antral follicle count ( AFC ) were observed .


Besides , the E@ level of a single ovum on the day of HCG injection , the number of retrieved oocytes , the high-quality oocyte rate , and the high-quality embryos were observed .


Compared with the control group , the SYDS , decreased bFSH and LH levels , increased ACF numbers , the E@ level of a single ovum on the day of HCG injection , the number of retrieved oocytes , high-quality oocytes , and high-quality embryos were superior in the observation group ( P < @ ) .


There was no statistical difference in the decreased FSH/LH level ( P > @ ) .


E@ and AMH increased after medication of KC in the observation group , while they decreased after administration of placebos in the control group .


There was statistical difference in the post-pre treatment difference of E@ and AMH between the two groups ( P < @ ) .


KC could increase the number of retrieved oocytes , and elevate the quality of occytes and embryos in the IVF-ET .


Post-visit `` booster '' sessions have been recommended to augment the impact of brief interventions delivered in the emergency department ( ED ) .


This paper , which focuses on implementation issues , presents descriptive information and interventionists ' qualitative perspectives on providing brief interventions over the phone , challenges , `` lessons learned '' , and recommendations for others attempting to implement adjunctive booster calls .


Attempts were made to complete two @-minute telephone `` booster '' calls within a week following a patient 's ED discharge with @ patients who screened positive for and had recent problematic substance use other than alcohol or nicotine .


Over half ( @ % ) of participants completed the initial call ; @ % of those who received the initial call also completed the second call .


Median number of attempts to successfully contact participants for the first and second calls were @ and @ , respectively .


Each completed call lasted an average of about @ minutes .


Common challenges/barriers identified by booster callers included unstable housing , limited phone access , unavailability due to additional treatment , lack of compensation for booster calls , and booster calls coming from an area code different than the participants ' locale and from someone other than ED staff .


Specific recommendations are presented with respect to implementing a successful centralized adjunctive booster call system .


Future use of booster calls might be informed by research on contingency management ( e.g. , incentivizing call completions ) , smoking cessation quitlines , and phone-based continuing care for substance abuse patients .


Future research needs to evaluate the incremental benefit of adjunctive booster calls on outcomes over and above that of brief motivational interventions delivered in the ED setting .


There are conflicting data on the use of cilostazol as triple antiplatelet therapy ( TAPT ) for improving clinical outcomes after drug-eluting stent implantation .


We aimed to evaluate whether @-month use of cilostazol in addition to dual antiplatelet therapy ( DAPT ) improved clinical outcomes in patients with long or multivessel coronary artery disease ( CAD ) after biolimus-eluting stent ( BES ) implantation .


Patients ( n = @ ) who had been successfully treated with BES implantation for lesions with @ mm in stent length or @ stents for different coronary arteries were enrolled in this prospective randomized multicenter trial .


All patients were randomly assigned to receive either DAPT ( aspirin and clopidogrel for @ months , n = @ ) or TAPT ( DAPT plus @-month cilostazol use , n = @ ) .


The primary end point was a device-oriented composite consisting of cardiac death , myocardial infarction ( not clearly attributable to a nontarget vessel ) , and ischemia-driven target lesion revascularization at @-year follow-up .


A total of @ patients in DAPT and @ patients in TAPT were analyzed .


Multivessel CAD was present in @ % of patients .


Stents @ mm in length were implanted in @ % of lesions .


There were no significant differences in baseline and angiographic characteristics between the @ groups .


The primary end point was similar between the @ groups ( @ % in DAPT vs @ % in TAPT , log-rank P = @ ) .


In patients treated with BES implantation for long or multivessel CAD , @ months of cilostazol use in addition to DAPT did not improve clinical outcome at @-year follow-up .


The major side-effect of photodynamic therapy ( PDT ) on port wine stains ( PWS ) is pain during the treatment .


Although several strategies for controlling the pain during topical PDT achieve a reduction in the levels of pain , none were completely effective and convenient .


This randomized , double-blind , placebo-controlled clinical trial was designed to evaluate the efficacy and safety of an oral analgesic for the treatment of pain in PDT on PWS .


Fifty-eight patients with PWS on the face were included .


The treatment and placebo groups were selected by computer randomization .


The patients , doctor and statistician were blinded to the patients ' groups .


The analgesic contained @mg of oxycodone in combination with @ mg of acetaminophen .


The patient took the tablet orally @ min before PDT .


The patient was injected intravenously with @-@mg / kg photosensitizer PSD-@ within @ min , and then the lesion was exposed to a @ nm laser immediately for @-@ min at @ mW/cm ( @ ) .


The intensity of the pain during irradiation , the characteristic and beginning time of pain , and adverse effects were recorded .


A visual analog scale ( VAS ) was used to assess the pain .


The time of the pain beginning was @ @ min in the treatment group and @ @ min in the placebo group , which was not significantly different ( P = @ ) .


The VAS score in the treatment group was @ @ compared with @ @ in the placebo group , with no significant difference ( P = @ ) .


The subgroup of age , gender , lesion location and classification between two groups had similar VAS score ( P > @ ) .


No serious adverse events were reported .


This study found that oral oxycodone @mg/acetaminophen @ mg was completely ineffective for pain relief , and age , gender , lesion location and classification did not influence the pain perception and the analgesic effect .


The challenge of controlling pain during PDT on PWS remains .


New regimens to shorten tuberculosis treatment and manage patients with drug-resistant tuberculosis who are infected with HIV are urgently needed .


Experimental and clinical evidence suggests that the new drugs bedaquiline ( B ) and pretomanid ( Pa ) , combined with an existing drug , pyrazinamide ( Z ) , and a repurposed drug , clofazimine ( C ) , may assist treatment shortening of drug-susceptible and drug-resistant tuberculosis .


To evaluate the @-day bactericidal activity of C and Z in monotherapy and in combinations with Pa and B.


Groups of @ treatment-naive , sputum smear-positive patients with pulmonary tuberculosis were randomized to receive combinations of B with Z-C , Pa-Z , Pa-Z-C , and Pa-C , or C or Z alone , or standard combination treatment for @ days .


The primary endpoint was the mean daily fall in log@ Mycobacterium tuberculosis CFU per milliliter sputum estimated by joint nonlinear mixed-effects Bayesian regression modeling .


Estimated activities were @ ( @ % confidence interval -LSB- CI -RSB- , @-@ @ ) for B-Pa-Z , @ ( @ % CI , @-@ @ ) for standard treatment , @ ( @ % CI , @-@ @ ) for B-Z-C , @ ( @ % CI , @-@ @ ) for B-Pa-Z-C , and @ ( @ % CI , @-@ @ ) for B-Pa-C .


Z alone had modest activity ( @ ; @ % CI , -@ to @ ) .


C had no activity alone ( -@ ; @ % CI , -@ to @ ) or in combinations .


Treatments were well tolerated and safe .


B-Pa-Z , including two novel agents without resistance in prevalent M. tuberculosis strains , is a potential new tuberculosis treatment regimen .


C had no measurable activity in the first @ days of treatment .


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


To evaluate the impact of an @-month school obesity prevention intervention on the health behaviors of @th and @th grade students based on ecological principles and formative research conducted in Mexico .


A Randomized Control Trial ( RCT ) , design was used to assign @ schools to one of three conditions : basic or plus interventions and control .


School environment measures , children 's eating and physical activity behaviors , and body mass index were assessed four times over a @-year period in a sample of @ students .


In the intervention schools , the availability of healthy foods increased with a concomitant decrease in unhealthy food availability .


Food intake showed the same trend .


In the intervention schools , children did not engage in more moderate to vigorous physical activity ( MVPA ) in physical education ( PE ) class or recess but increased steps taken .


Obesity prevalence did not change .


The intervention improved the school food environment and child healthy behaviors .


To evaluate the therapeutic effect of warm acupuncture ( moxa-heated acupuncture ) needle stimulation of Waiguan ( TE @ ) acupoint in the treatment of shoulder-hand syndrome ( phase I ) in patients with stroke .


Sixty stroke patients with shoulder-hand syndrome ( phase I ) were equally randomized into control group and warm acupuncture group .


Patients of the warm acupuncture group were treated by warm acupuncture stimulation of the affected TE @ in combination with routine acupuncture stimulation of Jianyu ( LI @ ) , Jianjing ( GB @ ) , Quchi ( LI @ ) , Wangu ( SI @ ) , Yangchi ( TE @ ) and Hegu ( LI @ ) , and rehabilitation training ( passive and active upper-limb motion exercise for @ min , once daily ) , and patients of the control group treated with routine acupuncture stimulation of the same acupoints mentioned above , and rehabilitation training .


The treatment was conducted once daily , @ times per week for two weeks .


The patients ' clinical conditions were evaluated by using Visual Analogue Scale ( VAS , @-@ points , shoulder pain degree ) , edema severity score ( @ point : normal , @ points : mild , @ points : moderate , and @ points : severe ) and simplified Fugl-Meyer motor assessment scale ( @ , @ and @ points , upper-limb motor function ) before and after the treatment .


After the treatment , the scores of VAS and edema severity of the two groups were significantly decreased in comparison with pre-treatment in the same one group ( P < @ ) , and the Fugl-Meyer motor scores were considerably increased ( P < @ ) , suggesting an improvement of the shoulder-hand syndrome after two weeks ' treatment .


Of the two @ patients in the control group and warm acupuncture group , @ and @ ( @ % ) were cured , @ ( @ % ) and @ ( @ % ) experienced marked improvement , @ ( @ % ) and @ ( @ % ) were effective , @ ( @ % ) and @ ( @ % ) invalid , with the effective rates being @ % and @ % , respectively .


The effect of warm acupuncture group was superior to that of the control group ( P < @ ) .


Warm acupuncture combined with routine acupuncture and rehabilitation training is effective in improving shoulder pain , hand edema and limb motor function in stroke patients with shoulder-hand syndrome at phase I.


Intermittent preventive treatment in pregnancy ( IPTp ) with sulfadoxine-pyrimethamine ( SP ) is recommended for malaria prevention in HIV-negative pregnant women , but it is contraindicated in HIV-infected women taking daily cotrimoxazole prophylaxis ( CTXp ) because of potential added risk of adverse effects associated with taking two antifolate drugs simultaneously .


We studied the safety and efficacy of mefloquine ( MQ ) in women receiving CTXp and long-lasting insecticide treated nets ( LLITNs ) .


A total of @,@ HIV-infected women from Kenya , Mozambique , and Tanzania were randomized to receive either three doses of IPTp-MQ ( @ mg/kg ) or placebo given at least one month apart ; all received CTXp and a LLITN .


IPTp-MQ was associated with reduced rates of maternal parasitemia ( risk ratio -LSB- RR -RSB- , @ -LSB- @ % CI @-@ @ -RSB- ; p = @ ) , placental malaria ( RR , @ -LSB- @ % CI @-@ @ -RSB- ; p = @ ) , and reduced incidence of non-obstetric hospital admissions ( RR , @ -LSB- @ % CI @-@ @ -RSB- ; p = @ ) in the intention to treat ( ITT ) analysis .


There were no differences in the prevalence of adverse pregnancy outcomes between groups .


Drug tolerability was poorer in the MQ group compared to the control group ( @ % referred dizziness and @ % vomiting after the first IPTp-MQ administration ) .


HIV viral load at delivery was higher in the MQ group compared to the control group ( p = @ ) in the ATP analysis .


The frequency of perinatal mother to child transmission of HIV was increased in women who received MQ ( RR , @ -LSB- @ % CI @-@ @ -RSB- ; p = @ ) .


The main limitation of the latter finding relates to the exploratory nature of this part of the analysis .


An effective antimalarial added to CTXp and LLITNs in HIV-infected pregnant women can improve malaria prevention , as well as maternal health through reduction in hospital admissions .


However , MQ was not well tolerated , limiting its potential for IPTp and indicating the need to find alternatives with better tolerability to reduce malaria in this particularly vulnerable group .


MQ was associated with an increased risk of mother to child transmission of HIV , which warrants a better understanding of the pharmacological interactions between antimalarials and antiretroviral drugs .


To compare the efficacy difference in the treatment of functional dyspepsia between acupuncture at the acupoints selected by pattern/syndrome differentiation and domperidone .