FES on the paretic lower limbs early after stroke improved the mobility and ability in ADL .


The role of bleomycin and dacarbazine in the ABVD regimen ( ie , doxorubicin , bleomycin , vinblastine , and dacarbazine ) has been questioned , especially for treatment of early-stage favourable Hodgkin 's lymphoma , because of the drugs ' toxicity .


We aimed to investigate whether omission of either bleomycin or dacarbazine , or both , from ABVD reduced the efficacy of this regimen in treatment of Hodgkin 's lymphoma .


In this open-label , randomised , multicentre trial ( HD@ ) we compared two cycles of ABVD with two cycles of the reduced-intensity regimen variants ABV ( doxorubicin , bleomycin , and vinblastine ) , AVD ( doxorubicin , vinblastine , and dacarbazine ) , and AV ( doxorubicin and vinblastine ) , in patients with newly diagnosed , histologically proven , classic or nodular , lymphocyte predominant Hodgkin 's lymphoma .


In each treatment group , @ Gy involved-field radiotherapy ( IFRT ) was given after both cycles of chemotherapy were completed .


From Jan @ , @ , patients were centrally randomly assigned ( @:@:@:@ ) with a minimisation method to the four groups .


Because of high event rates , assignment to the AV and ABV groups stopped early , on Sept @ , @ , and Feb @ , @ ; assignment to ABVD and AVD continued ( @:@ ) until Sept @ , @ .


Our primary objective was to show non-inferiority of the experimental variants compared with ABVD in terms of freedom from treatment failure ( FFTF ) , by excluding a difference of @ % after @ years corresponding to a hazard ratio ( HR ) of @ , via a @ % CI .


Analyses reported here include qualified patients only , and between-group comparisons include only patients recruited during the same period .


The trial was registered , number ISRCTN@ .


Of @ qualified patients , @ , @ , @ , and @ were randomly assigned to receive ABVD , ABV , AVD , or AV , respectively .


@ year FFTF was @ % , @ % , @ % , and @ % with ABVD , ABV , AVD , and AV , respectively .


Compared with ABVD , inferiority of the dacarbazine-deleted variants was detected with @ year differences of -@ % ( @ % CI -@ to -@ ; HR @ -LSB- @ to @ -RSB- ) for ABV and -@ % ( -@ to -@ ; HR @ -LSB- @ to @ -RSB- ) for AV .


Non-inferiority of AVD compared with ABVD could also not be detected ( @ year difference -@ % , -@ to -@ ; HR @ , @ to @ ) .


@ ( @ % ) of @ patients given ABVD had WHO grade III or IV toxicity , compared with @ ( @ % ) of @ given ABV , @ ( @ % ) of @ given AVD , and @ ( @ % ) of @ given AV .


Leucopenia was the most common event , and highest in the groups given bleomycin .


Dacarbazine can not be omitted from ABVD without a substantial loss of efficacy .


With respect to our predefined non-inferiority margin , bleomycin can not be safely omitted either , and the standard of care for patients with early-stage favourable Hodgkin 's lymphoma should remain ABVD followed by IFRT .


To assess the potential of a stabilised stannous ( Sn ) - containing NaF dentifrice ( Oral B/blend-a-Med ( ) Pro-Expert ) , in addition to a number of other marketed European dentifrices formulated with various fluoride actives and two control dentifrices , to protect enamel against erosive acid damage .


Cores of human enamel ( four per group ) were soaked in pooled human saliva , and then treated with a @:@ slurry ( dentifrice : saliva ) using a standardised in vitro erosion model ( @-day cycling ) that includes @-minute challenges with @ % citric acid applied @ minutes after each dentifrice treatment .


Enamel surface loss was measured using transverse microradiography ( TMR ) .


Specimens treated with the Sn-containing NaF dentifrice showed @ m of surface loss @ ( SEM ) , which was not significantly different ( P < @ , Fisher LSD ) from that of a clinically proven , stabilised SnF@ positive control -LSB- Crest ( ) Pro-Health , @,@ ppm F as SnF@ : @ m of surface loss @ ( SEM ) -RSB- .


The Sn-containing NaF dentifrice and the clinically proven positive control both provided significantly greater protection ( P < @ , Fisher LSD ) compared with all of the other products tested .


Enamel loss ( SEM ) values for other European products and the reference control ( active agents ) were : Meridol ( ) : ( @,@ ppm F as AmF + SnF@ ) @ m ( @ ) ; Colgate ( ) Cavity Protection : ( @,@ ppm F as SMFP + NaF ) @ m ( @ ) ; Odol med @ ( ) ( @,@ ppm F as NaF ) @ m ( @ ) ; Elmex ( ) ( @,@ ppm F as AmF ) @ m ( @ ) ; Colgate ( ) Enamel Protect : ( @,@ ppm F as NaF + KNO@ ) @ m ( @ ) ; Lacalut ( ) aktiv : ( @,@ ppm F as AlF@ ) @ m ( @ ) ; Sensodyne ( ) ProNamel ( ) : ( @,@ ppm F as NaF + KNO@ ) @ m ( @ ) ; Crest Cavity Protection ( @,@ ppm F as NaF , reference control ) @ m ( @ ) ; and Mentadent ( ) : ( @,@ ppm F as NaF + Zn citrate ) @ m ( @ ) .


These results support the potential for the stabilised , Sn-containing NaF dentifrice to provide erosion protection benefits that are not significantly different from the positive control benchmark for erosion protection ( stabilised SnF@ ) , and are significantly better than a broad range of dentifrice formulations available on the European market .


To verify the efficacy to obtain mydriasis and cardiovascular safety of Mydriasert ( ophthalmic insert containing tropicamide and phenylephrine ) in diabetic and nondiabetic patients undergoing retinal angiography by comparing it with usually administered eyedrops ( tropicamide @ % and phenylephrine @ % ) .


This was a prospective randomized study .


A total of @ eyes of @ patients were randomly divided into @ groups : group @ consisted of @ eyes , group @ consisted of @ eyes , and the patients were monitored for pupillary dilation , blood pressure , heart rate , and possible adverse effects at @ , @ , @ , @ , and @ minutes .


No severe adverse effects were observed in either group .


In the entire sample studied , the mean pupillary diameter was greater in the eyedrops group after @ and @ minutes , while mydriasis was similar in the @ groups after @ minutes .


The diabetic patients treated with Mydriasert had less mydriasis than those treated with eyedrops after @ and @ minutes , and diabetic patients showed less mydriasis than the nondiabetic patients after @ and @ minutes .


There was no significant between-group difference in mean heart rate or systolic and diastolic blood pressure at any of the time points .


Mydriasert assures an adequate degree of mydriasis for retinal angiography in both diabetic and nondiabetic patients .


There are no differences in efficacy or safety between the insert and the usually administered eyedrops , but the low total drug dose administered with the insert reduces the risk of cardiovascular side effects .


The purpose of this study was to assess the impact of a mental illness self-management intervention , called Wellness Recovery Action Planning ( WRAP ) , on the use of and need for mental health services over time compared with nutrition and wellness education .


Participants were recruited from outpatient community mental health settings in Chicago , Illinois .


Using a single-blind , randomized controlled trial design , @ individuals were assigned to WRAP or to a nutrition education course and assessed at baseline and at @-month and @-month follow-up .


The WRAP intervention was delivered by peers in recovery from serious mental illness who were certified WRAP educators over nine weekly sessions lasting @ hrs .


The nutrition education curriculum was taught by trained non-peer educators using the same schedule .


Mixed-effects random regression analysis tested for differences between the two interventions in ( a ) self-reported use of @ clinical , rehabilitation , peer , emergent , and ancillary services ; and ( b ) self-reported need for these services .


Results of mixed-effects random regression analysis indicated that , compared with controls , WRAP participants reported significantly greater reduction over time in service utilization ( total , individual , and group ) , and service need ( total and group services ) .


Participants in both interventions improved significantly over time in symptoms and recovery outcomes .


Training in mental illness self-management reduced the self-reported need for and use of formal mental health services over time .


This confirms the importance of WRAP in an era of dwindling behavioral health service availability and access .


Virologic failure following treatment of hepatitis C virus ( HCV ) genotype @ with direct-acting antiviral agents is often accompanied by the emergence of resistant variants .


MK-@ is an investigational once-daily protease inhibitor .


We analyzed variants in treatment-naive noncirrhotic patients with virologic failure on MK-@ ( @-@ mg/day ) plus pegylated interferon alfa/ribavirin ( peg-IFN/RBV ) during a phase @ trial .


Population and selective clonal sequencing were performed at baseline and at virologic failure in the @ MK-@ dosing arms .


MK-@ activity was determined using a mutant replicon assay .


Six of @ ( @ % ) MK-@ recipients satisfied prespecified criteria for virologic failure , all with genotype @a infection .


Five patients with virologic failure were in the MK-@ @-mg arm , including @ patients with low plasma MK-@ levels documented during triple therapy .


Variants associated with > @-fold loss of potency were detected in @ of the @ patients with genotype @a breakthrough while on MK-@ .


The fifth patient had undetectable HCV-RNA levels at the end of triple therapy but subsequently broke through during the peg-IFN/RBV tail @ weeks after completion of MK-@ .


Three patients had D@ variants at virologic failure , including @ with the D@A variant associated with a @-fold loss of potency .


The sole apparent relapse was actually a genotype @a reinfection in the MK-@ @-mg group .


Virologic failure occurred uncommonly ( @/@ -LSB- @ % -RSB- ) in MK-@ / peg-IFN/RBV recipients .


The most prevalent treatment-emergent variants were detected at the D@ locus .


D@A variants conferring approximately @-log reduction in MK-@ susceptibility emerged in @ of the @ evaluable patients with genotype @a breakthrough .


Clinical Trials Registration.NCT@ .


This study aimed to determine the effect of cumin powder on body composition and lipid profile in overweight and obese women .


In this randomized clinical trial , @ overweight/obese women were randomly assigned into two groups .


The experimental group was asked to have @g/d cumin powder with yogurt at two meals for @ months .


The same amount of yogurt minus cumin powder was prescribed for the control group .


All patients received nutrition counseling for weight loss in a similar manner .


Anthropometric and biochemical parameters were determined before and after the intervention .


Cumin powder reduced serum levels of fasting cholesterol , triglyceride , and LDL and increased HDL .


Weight , BMI , waist circumference , fat mass and its percentage significantly reduced .


It has no effect on FBS and fat-free mass .


Cumin powder in a weight reduction diet showed improvement in anthropometric and biochemical parameters in overweight/obese women .


Premature infants are at risk of developing encephalopathy of prematurity , which is associated with long-term neurodevelopmental delay .


Erythropoietin was shown to be neuroprotective in experimental and retrospective clinical studies .


To determine if there is an association between early high-dose recombinant human erythropoietin treatment in preterm infants and biomarkers of encephalopathy of prematurity on magnetic resonance imaging ( MRI ) at term-equivalent age .


A total of @ infants were included in a randomized , double-blind , placebo-controlled study conducted in Switzerland between @ and @ .


In a nonrandomized subset of @ infants ( n = @ erythropoietin ; n = @ placebo ) , brain abnormalities were evaluated on MRI acquired at term-equivalent age .


Participants were randomly assigned to receive recombinant human erythropoietin ( @ IU/kg ; n = @ ) or placebo ( n = @ ) intravenously before @ hours , at @ to @ hours , and at @ to @ hours after birth .


The primary outcome of the trial , neurodevelopment at @ months , has not yet been assessed .


The secondary outcome , white matter disease of the preterm infant , was semiquantitatively assessed from MRI at term-equivalent age based on an established scoring method .


The resulting white matter injury and gray matter injury scores were categorized as normal or abnormal according to thresholds established in the literature by correlation with neurodevelopmental outcome .


At term-equivalent age , compared with untreated controls , fewer infants treated with recombinant human erythropoietin had abnormal scores for white matter injury ( @ % -LSB- @/@ -RSB- vs @ % -LSB- @/@ -RSB- ; adjusted risk ratio -LSB- RR -RSB- , @ ; @ % CI , @-@ @ ) , white matter signal intensity ( @ % -LSB- @/@ -RSB- vs @ % -LSB- @/@ -RSB- ; adjusted RR , @ ; @ % CI , @-@ @ ) , periventricular white matter loss ( @ % -LSB- @/@ -RSB- vs @ % -LSB- @/@ -RSB- ; adjusted RR , @ ; @ % CI , @-@ @ ) , and gray matter injury ( @ % -LSB- @/@ -RSB- vs @ % -LSB- @/@ -RSB- ; adjusted RR , @ ; @ % CI , @-@ @ ) .


In an analysis of secondary outcomes of a randomized clinical trial of preterm infants , high-dose erythropoietin treatment within @ hours after birth was associated with a reduced risk of brain injury on MRI .


These findings require assessment in a randomized trial designed primarily to assess this outcome as well as investigation of the association with neurodevelopmental outcomes .


This study compared the effect of superior and inferior joint space injections of hyaluronic acid ( HA ) and evaluated osteoarthritic changes in patients diagnosed with temporomandibular joint ( TMJ ) anterior disc displacement without reduction ( ADDw/oR ) in association with osteoarthritis ( OA ) by cone-beam computed tomography ( CBCT ) .


One hundred forty-one patients with research diagnostic criteria for ADDw/oR in association with TMJ OA were randomly assigned to @ of @ study groups that received superior or inferior joint space injection of HA .


CBCT and clinical examination were performed before treatment and at @ and @ months after treatment .


One hundred twenty-six patients returned for the @-month evaluations , and @ returned for the @-month evaluations .


Condylar remodeling and TMJ function showed improvement in most patients after treatment .


At @ months , remodeling scores in the superior and inferior groups were @ @ and @ @ , respectively , and scores were @ @ and @ @ at @ months .


There were significant differences between the superior and inferior groups at @ and @ months after treatment ( @-month , P = @ ; @-month , P = @ ) .


The Helkimo index of the inferior group was significantly lower than that of superior group at @ and @ months ( @-month , P = @ ; @-month , P = @ ) .


There were no significant differences in maximal mouth opening between the @ groups at @ and @ months ( @-month , P = @ ; @-month , P = @ ) .


Superior and inferior joint space injections of HA are effective methods for the treatment of ADDw/oR in association with TMJ OA .


The injection of HA within the inferior joint space appears to result in better condylar reparative remodeling and improvement in jaw function .


To examine whether an Internet-based learning module and small-group debriefing can improve medical trainees ' attitudes and communication skills toward patients with substance use disorders ( SUDs ) .


In @-@ , @ internal and family medicine residents and @ medical students at two medical schools participated in a cluster randomized controlled trial , which assessed the effect of adding a two-part intervention to the SUDs curricula .


The intervention included a self-directed , media-rich Internet-based learning module and a small-group , faculty-led debriefing .


Primary study outcomes were changes in self-assessed attitudes in the intervention group ( I-group ) compared with those in the control group ( C-group ) ( i.e. , a difference of differences ) .


For residents , the authors used real-time , Web-based interviews of standardized patients to assess changes in communication skills .


Statistical analyses , conducted separately for residents and students , included hierarchical linear modeling , adjusted for site , participant type , cluster , and individual scores at baseline .


The authors found no significant differences between the I - and C-groups in attitudes for residents or students at baseline .


Compared with those in the C-group , residents , but not students , in the I-group had more positive attitudes toward treatment efficacy and self-efficacy at follow-up ( P < @ ) .


Likewise , compared with residents in the C-group , residents in the I-group received higher scores on screening and counseling skills during the standardized patient interview at follow-up ( P = @ ) .


This intervention produced improved attitudes and communication skills toward patients with SUDs among residents .


Enhanced attitudes and skills may result in improved care for these patients .


Malaria remains a major public health problem in developing countries .


Then in these countries prompt access to effective antimalarial treatment such as Artemisinin based-Combination Therapies ( ACT ) proves to be an essential tool for controlling the disease .


In Senegal , since @ a nationwide scaling up program of ACT is being implemented .


In this context it has become relevant to monitor ACT efficacy and provide recommendations for the Senegalese national malaria control program .


An open randomized trial was conducted during two malaria transmission seasons ( @ and @ ) to assess the efficacy and safety of three combinations : dihydro-artemisinin-piperaquine ( DHAPQ ) , artemether-lumefantrine ( AL ) and artesunate-amodiaquine ( ASAQ ) .


The primary end point of the study was represented by a PCR adjusted adequate clinical and parasitological response ( ACPR ) at day @ .


Secondary end points included : ( i ) a ACPR at days @ and @ , ( ii ) a parasite and fever clearance time , ( iii ) ACTs safety and tolerability .


The @ WHO 's protocol for antimalarial drug evaluation was used to assess each outcome .


Overall , @ patients were randomized selected to receive , either ASAQ ( n = @ ) , AL ( n = @ ) or DHAPQ ( n = @ ) .


The PCR adjusted ACPR at day @ was @ % for the group ASAQ , while that was @ % in the AL and DHAPQ groups ( p = @ ) .


The therapeutic efficacy was evaluated at @ % in the ASAQ arm versus @ % in AL and DHAPQ arm at day @ ( p = @ ) .


At day @ , the ACPR was @ % in the ASAQ group versus @ % for both AL and DHAPQ groups , ( p = @ ) .


No serious adverse event was noted during the study period .


Also a similar safety profile was noted in the @ study groups .


In the context of scaling up of ACTs in Senegal , ASAQ , AL and DHAPQ are highly effective and safe antimalarial drugs .


However , it 's remains important to continue to monitor their efficacy .


To assess the response of soft tissues around two different abutment designs in healed sites in the esthetic zone .


Twenty-six subjects received two endosseous implants in healed , bilateral implant sites in the esthetic zone in the maxilla or the mandible .


After @ to @ weeks and left/right randomization , the implants were restored with either a conventional ( control ) or curved ( experimental ) titanium abutment and a provisional crown .


Eight weeks after abutment placement , definitive crowns were cemented ( T@ ) .


Soft tissue development was assessed based on peri-implant bone loss , Pink Esthetic Score ( PES ) , and probing depths immediately after placement of the definitive crown and after @ year ( T@ ) and compared between sites .


Possible confounding variables ( abutment angle , plaque presence , gingival bleeding , width of attached mucosa ) were also documented at T@ and T@ .


The mean peri-implant marginal bone loss from T@ to T@ was @ @ mm in the experimental group and @ @ mm in the control group .


Differences were not statistically significant ( P = @ ) .


At T@ , the curved abutment scored a mean PES of @ @ and the straight abutment scored @ @ .


The difference was not significant ( P = @ ) ) .


Probing depths were also not significantly different between the two groups ( P = @ ) .


Correlation and regression analysis showed no hints of predictive behavior for the possible confounding variables .


A titanium abutment with a circumferential curved design is of no additional benefit to soft tissue development and preservation of marginal bone compared to a conventional straight abutment design for the restoration of single-tooth implants in the esthetic zone .


To investigate the effect of postoperative early oral feeding on humoral immune function and clinical outcome in colorectal cancer patients .


Seventy patients with colorectal carcinoma requiring elective colorectal resection were prospectively enrolled and randomized into two groups : early oral feeding group ( n = @ ) and conventional oral feeding group ( n = @ ) .


The patients in early oral feeding group were started on oral feeding within @ hours after operation , while patients in conventional group were started on oral feeding after the postoperative first passage of flatus .


Postoperative parameters of clinic and humeral immune function were compared between two groups .


Sixty-two patients eventually completed the study , including @ cases in early oral feeding group and @ cases in conventional oral feeding group .


The average time to first passage of flatus -LSB- ( @ ) d vs. ( @ ) d , P < @ -RSB- , the first passage of stool -LSB- ( @ ) d vs. ( @ ) d , P < @ -RSB- , resumption of regular diet -LSB- ( @ ) d vs. ( @ ) d , P < @ -RSB- and the postoperative hospital stay -LSB- ( @ ) d vs. ( @ ) d , P < @ -RSB- were significantly shorter in early oral feeding group as compared to conventional oral feeding group .


Significantly faster recovery of postoperative humoral immunity was found .


Plasma levels of globulin -LSB- ( @ ) g/L vs. ( @ ) g/L , P < @ -RSB- , immunoglobulin G -LSB- ( @ ) g/L vs. ( @ ) g/L , P < @ -RSB- and complement @ -LSB- ( @ ) g/L vs. ( @ ) g/L , P < @ -RSB- on postoperative day @ were higher in early oral feeding group as compared to conventional oral feeding group .


Application of postoperative early oral feeding in patients undergoing elective colorectal resection is safe and effective , which can lead to faster recovery of postoperative humoral immune function and bowel function , and shorter postoperative hospital stay .


It is known that static stretching is an appropriate means of increasing the range of motion , but information in the literature about the mechanical adaptation of the muscle-tendon unit is scarce .


Therefore , the purpose of this study was to investigate the influence of a six-week static stretching training program on the structural and functional parameters of the human gastrocnemius medialis muscle and the Achilles tendon .


A total of @ volunteers were randomly assigned into static stretching and control groups .


Before and following the stretching intervention , we determined the maximum dorsiflexion range of motion with the corresponding fascicle length and pennation angle .


Passive resistive torque and maximum voluntary contraction were measured with a dynamometer .


Muscle-tendon junction displacement allowed us to determine the length changes in tendon and muscle , and hence to calculate stiffness .


Fascicle length , pennation angle , and muscle tendon junction displacement were measured with ultrasound .


Mean range of motion increased significantly from @ ( @ ) to @ ( @ ) in the intervention group , but other functional ( passive resistive torque , maximum voluntary contraction ) and structural ( fascicle length , pennation angle , muscle stiffness , tendon stiffness ) parameters were unaltered .


The increased range of motion could not be explained by the structural changes in the muscle-tendon unit , and was likely due to increased stretch tolerance possibly due to adaptations of nociceptive nerve endings .


Melasma is a dermatosis with significant repercussions on patients ' quality of life , and there is currently no standard treatment .


Hydroquinone is deemed the treatment of choice , but its safety has been questioned in certain cases .


To determine the efficacy and safety of a new combination of retinoids in the improvement of melasma .


Prospective , double-blind , vehicle-controlled , and randomized study in @ patients with melasma .


The product was applied on one side of the face and the vehicle on the other , twice daily during @months .


Standardized photographs were taken using RBX technology on the three visits ( basal , at one and a half months and at @months ) .


The main variable to determine the efficacy was the improvement of the hemifacial Melasma Area Severity Index ( MASI ) .


Other variables were determined such as improvement perceived by the investigator , improvement perceived by the patient , impact on quality of life or side effects .


The MASI improvement at @months of treatment was significant on the treated side vs. the vehicle side , reaching an improvement of @ % , which is comparable to the percentage of improvement described with hydroquinone .


No notable side effects were detected , in spite of a significant percentage of patients included in the study citing a history that could be compatible with sensitive skin .


This new combination of retinoids and depigmenting agents proved to be effective and safe in the treatment of melasma .


A common variant rs@ in the PCSK@ gene has the strongest association with iron homeostasis and is related to insulin resistance .


Dietary carbohydrate ( CHO ) modulates the genetic effect on insulin resistance .


We examined whether @-year weight-loss diets modify the effect of PCSK@ genetic variants on changes in fasting insulin levels and insulin resistance in a randomized , controlled trial .


Data were analyzed in the Preventing Overweight Using Novel Dietary Strategies ( POUNDS LOST ) trial , which is a randomized , controlled @-year weight-loss trial using diets that differed in macronutrient proportions .


PCSK@ rs@ was genotyped in @ overweight or obese adults ( @ % whites ) in this trial .


We assessed the progression in fasting insulin and glucose levels , and insulin resistance by genotypes .


During the @-month weight-loss phase , the PCSK@ rs@ G allele was significantly associated with greater decreases in fasting insulin levels in the high-dietary CHO group ( P for interaction = @ ) , while the interaction for changes in HOMA-insulin resistance ( HOMA-IR ) ( P for interaction = @ ) did not reach significant levels in white subjects .


The G allele was significantly associated with a greater decrease in fasting insulin levels and HOMA-IR in response to high dietary CHO levels ( P = @ and P = @ , respectively ) .


From @ months to @ years ( weight-regain phase ) , the interactions became attenuated due to the regaining of weight ( P for interactions = @ and @ , respectively ) .


In addition , we observed similar and even stronger results in the whole-study samples from the trial .


Our data suggest that PCSK@ genotypes may interact with dietary CHO intake on changes in insulin sensitivity in the white Americans .


To assess the use of a hydrogel ocular bandage ( HOB ) on clear corneal incisions in phacoemulsification cataract surgery and determine whether HOB reduces ocular surface contaminants ingress after routine surgery .


In this prospective randomized controlled study , thirty eyes of patients undergoing uneventful phacoemulsification were recruited consecutively and randomly assigned to have a HOB applied to the corneal incision at the end of the surgery or not .


At the end of the surgery , trypan blue ( TRB ) was instilled on the ocular surface , aqueous fluid was aspirated from the anterior chamber ( AC ) and its optical density was measured using ultraviolet spectrophotometry .


The corneal incisions were examined postoperatively using anterior segment optical coherence tomography .


Main outcome measures were concentration of TRB in the AC , corneal incision architecture , intraocular pressure ( IOP ) and Seidel test .


All incisions were Seidel negative .


The mean IOP in the immediate postoperative period was @ @ mmHg for the intervention group and @ @ mmHg for the control group ( p > @ ) .


No architectural differences of the incisions between the two groups were noted .


The total mean length of the three-step corneal incisions in the two groups was @ @ m and @ @ m , respectively ( p > @ ) .


No trace of TRB was detected in any of the samples .


Proper surgical wound construction without the use of a HOB is efficient in preventing the ingress of fluid through the main corneal incision postoperatively .


Concurrent administration of dopamine and serotonin reuptake inhibitors reduces cocaine self-administration in monkeys .


Consonant with this , clinical trials assessing modafinil and selective serotonin reuptake inhibitors alone show some efficacy as potential pharmacotherapies for cocaine dependence .


We hypothesized that combining modafinil with escitalopram would attenuate the euphoric effects of cocaine to a greater degree than modafinil alone .


In a randomized , double blind , parallel groups design participants received either placebo ( @mg/day ; n = @ ) , modafinil ( @mg/day ; n = @ ) , escitalopram ( @mg/day ; n = @ ) , or modafinil + escitalopram ( @ +@ mg/day ; n = @ ) for @ days .


On day @ , during separate sessions participants received an intravenous sample of cocaine ( @ or @mg ; randomized ) and five $ @ bills .


Participants rated the subjective effects of the infusions and subsequently made choices to either return $ @ and receive another infusion or keep $ @ and receive no infusion .


Compared to saline , cocaine ( @mg ) significantly ( p@ @ ) increased most ratings , including `` good effects '' , `` stimulated '' , and `` high '' .


Relative to placebo , modafinil significantly ( p@ @ ) attenuated subject-rated increases of `` any drug effect '' , `` high '' , `` good effects '' , and `` stimulated '' produced by cocaine .


Compared to saline , participants chose cocaine infusions significantly more ; however , no treatment significantly reduced choices for cocaine infusions .


Escitalopram did not enhance the efficacy of modafinil to reduce any measure .


Modafinil attenuated many positive subjective effects produced by cocaine ; however , escitalopram combined with modafinil did not enhance the efficacy of modafinil to reduce cocaine effects .


To compare polypropylene suture and skin staples for securing mesh in Lichtenstein inguinal hernioplasty in terms of mean operating time and postoperative pain .


Randomized clinical trial .


Surgical Ward , Combined Military Hospital , Kharian , from August @ to February @ .


All individuals fulfilling inclusion criteria underwent elective Lichtenstein inguinal hernioplasty as admitted patients , under spinal anaesthesia and with aseptic measures .


In group @ , during the operation , mesh fixation was done with @/@ polypropylene suture and skin was closed with subcuticular @/@ polypropylene suture whereas in group @ , the anchorage of mesh was done with skin staples and skin was closed with staples from the same stapler .


Mean operative time and postoperative pain , assessed on a visual analog score , were compared between the groups .


The overall postoperative pain was lower ( p = @ ) when staples were used to anchor mesh .


Moreover , operative time was also lower ( @ @ minutes ) in staple group versus ( @ @ minutes in polypropylene group ) .


Mean operating time and postoperative pain is less in securing mesh with skin staples as compared to polypropylene suture in Lichtenstein inguinal hernioplasty .


Endoscopic sphincterotomy ( ES ) is one of the most important advances in the treatment of common bile duct ( CBD ) stones .


However , the use of ES to remove CBD stones in high-risk patients without cholecystectomy is still debatable .


The aim of this study was to compare the efficacy of a wait-and-see policy versus cholecystectomy after ES for CBD stones in high-risk patients with co-existing cholelithiasis .


A total of @ patients after undergoing ES with the clearance of CBD stones were randomised after informed consent to cholecystectomy or conservative management of their gallbladder stones .


The results indicated that cholecystectomy after ES for CBD stones significantly reduced the biliary complications in high-risk patients .


Every patient who has both CBD stones and gallstones with significant co-morbid illnesses , after clearance of CBD stones by ES , should undergo early cholecystectomy .


Parenterally administered ascorbic acid modulates sepsis-induced inflammation and coagulation in experimental animal models .


The objective of this randomized , double-blind , placebo-controlled , phase I trial was to determine the safety of intravenously infused ascorbic acid in patients with severe sepsis .


Twenty-four patients with severe sepsis in the medical intensive care unit were randomized @:@:@ to receive intravenous infusions every six hours for four days of ascorbic acid : Lo-AscA ( @ mg/kg/@ h , n = @ ) , or Hi-AscA ( @ mg/kg/@ h , n = @ ) , or Placebo ( @ % dextrose/water , n = @ ) .


The primary end points were ascorbic acid safety and tolerability , assessed as treatment-related adverse-event frequency and severity .


Patients were monitored for worsened arterial hypotension , tachycardia , hypernatremia , and nausea or vomiting .


In addition Sequential Organ Failure Assessment ( SOFA ) scores and plasma levels of ascorbic acid , C-reactive protein , procalcitonin , and thrombomodulin were monitored .


Mean plasma ascorbic acid levels at entry for the entire cohort were @ @ M ( normal range @-@ M ) .


Ascorbic acid infusion rapidly and significantly increased plasma ascorbic acid levels .


No adverse safety events were observed in ascorbic acid-infused patients .


Patients receiving ascorbic acid exhibited prompt reductions in SOFA scores while placebo patients exhibited no such reduction .


Ascorbic acid significantly reduced the proinflammatory biomarkers C-reactive protein and procalcitonin .


Unlike placebo patients , thrombomodulin in ascorbic acid infused patients exhibited no significant rise , suggesting attenuation of vascular endothelial injury .


Intravenous ascorbic acid infusion was safe and well tolerated in this study and may positively impact the extent of multiple organ failure and biomarkers of inflammation and endothelial injury .


We sought to test the hypothesis that plasma galectin @ ( Gal-@ ) is positively associated with the risk of heart failure ( HF ) in male subjects .


While Gal-@ has been reported as prognostic factor in HF patients , limited data are available on the role of Gal-@ in the development of HF .


We used a prospective nested-case control study ( n = @ cases and @ controls ) within the Physicians ' Health Study for current analyses .


For each case of HF , we randomly selected one control among subjects that were alive and free of HF at the time of index case occurrence and matched on age , race , and time of blood collection .


Gal-@ was measured using ELISA and we used conditional logistic regression to compute adjusted odds ratios .


Mean age at baseline was @ y and median log-Gal-@ was @ ( IQR : @-@ @ ) ng/ml .


Cubic splines suggested a non-linear relation between Gal-@ and HF .


Odds ratios ( @ % CI ) for HF were @ ( ref ) , @ ( @-@ @ ) , @ ( @-@ @ ) , and @ ( @-@ @ ) across consecutive quartiles of Gal-@ after adjustment for body mass index , diabetes , atrial fibrillation , hypertension , C-reactive protein , alcohol , smoking , and exercise .


The Gal-@-HF relation was seen for HF with and without antecedent coronary heart disease .


Our data are consistent with a positive non-linear association between Gal-@ and HF risk in male subjects .


Acetaminophen administration for more than @ days causes aminotransferase elevation in some subjects .


The objective of this randomized , placebo-controlled trial is to describe the course of alanine aminotransferase ( ALT ) elevation in subjects administered @ g/day of acetaminophen for at least @ days .


A randomized , placebo controlled trial of acetaminophen ( @ g/day ) vs placebo .


Subjects were healthy volunteers with normal liver enzymes .


The primary outcome was the course of ALT during acetaminophen administration .


All subjects were treated for a minimum of @ days .


Subjects with ALT elevation at day @ were continued on treatment until these elevations resolved up to a maximum of @ days .


Subjects were also evaluated for elevation of INR or serum bilirubin as evidence of hepatic dysfunction .


@/@ ( @ % ) completed acetaminophen subjects had no ALT elevation or transient elevations that resolved by day @ .


Of the @ subjects who had ALT elevations at study day @ , @ continued on acetaminophen and had resolution by study day @ .


One acetaminophen subject did not have resolution by study day @ , and the course of aminotransferase elevation suggests an alternative cause .


One placebo subject had an ALT elevation at day @ that resolved by day @ .


The highest observed ALT among all acetaminophen subjects was @ IU/L .


The mean ALT at day @ was @ IU/L higher for the acetaminophen than for the placebo group .


No subject developed liver dysfunction .


A minority of subjects treated with @ g/day of acetaminophen for @ days will have low-grade aminotransferase elevations that are not accompanied by liver dysfunction and resolve if administration is continued .


The aim of the present study was to evaluate the effect of oral caffeine ingestion during repeated sets of resistance .


Fourteen moderately resistance-trained men ( @ @ years and @ @ kg of body weight ) ingested a dose of caffeine ( @ mg.kg-@ ) or placebo prior to @ sets of bench press and @ sets of leg press exercises , respectively .


The study used a double-blind , counterbalanced , crossover design .


Repetitions completed and total weight lifted were recorded in each set .


Readiness to invest in both physical ( RTIPE ) and mental ( RTIME ) effort were assessed prior each set , and rating of perceived exertion ( RPE ) was recorded after each set .


Rest and peak heart rates were determined via telemetry .


Caffeine ingestion result in increased number of repetitions to failure in bench press ( F -LSB- @,@ -RSB- = @ , P = @ ) and leg press ( F -LSB- @,@ -RSB- = @ , P = @ ) compared to placebo .


The sum of repetitions performed in the @ sets was @ % higher in bench press ( @ @ ; caffeine : @ @ ; P = @ ) and @ % in leg press ( placebo : @ @ ; caffeine : @ @ ; P = @ ) .


Also , RTIME was increased in the caffeine condition both in bench press ( F -LSB- @,@ -RSB- = @ , P = @ ) and in leg press ( F -LSB- @,@ -RSB- = @ , P = @ ) .


There were no differences in RPE , RTIPE and HR ( P > @ ) across conditions .


Acute caffeine ingestion can improve performance in repeated sets to failure and increase RTIME in resistance-trained men .


Little evidence is available for the effect of nebulised magnesium sulphate ( MgSO ( @ ) ) in acute asthma in children .


We assessed the effect of MgSO ( @ ) treatment in children with severe acute asthma .


In this randomised placebo-controlled , multi-centre , parallel trial , we enrolled children ( aged @-@ years ) with severe acute asthma who did not respond to standard inhaled treatment from @ hospitals in the UK .


Children were randomly allocated ( @:@ ) to receive nebulised salbutamol and ipratropium bromide with either @ mL of isotonic MgSO ( @ ) ( @ mmol/L ; @ mg per dose ; MgSO ( @ ) group ) or @ mL of isotonic saline ( placebo group ) on three occasions at @-min intervals .


Randomisation was done with a computer-generated randomisation sequence , with random block sizes of two to four .


Both patients and researchers were masked to treatment allocation .


The primary outcome measure was the Yung Asthma Severity Score ( ASS ) at @ min post-randomisation .


We used a statistical significance level of p < @ for a between-group difference , but regarded a between-group difference in ASS of @ as the minimal clinically significant treatment effect .


Analysis was done by intention to treat .


This trial is registered with controlled-trials .


com , number ISRCTN@ .


Between Jan @ , @ , and March @ , @ , we recruited and randomly assigned @ children to treatment : @ to MgSO ( @ ) and @ to placebo .


Mean ASS at @ min was lower in the MgSO ( @ ) group ( @ -LSB- SD @ -RSB- ) than it was in the placebo group ( @ -LSB- SD @ -RSB- ; adjusted difference -@ , @ % CI -@ to -@ ; p = @ ) .


This difference , however , was not clinically significant .


The clinical effect was larger in children with more severe asthma exacerbation ( p = @ ) and those with symptoms present for less than @ h ( p = @ ) .


We detected no difference in the occurrence of adverse events between groups .


Overall , nebulised isotonic MgSO ( @ ) , given as an adjuvant to standard treatment , did not show a clinically significant improvement in mean ASS in children with acute severe asthma .


However , the greatest clinical response was seen in children with more severe attacks ( SaO ( @ ) < @ % ) at presentation and those with preceding symptoms lasting less than @ h.


To compare the efficacy and patient comfort of a new mode of minute ventilation-targeted adaptive servoventilation ( ASVAuto ) with auto-titrating expiratory positive airway pressure ( EPAP ) versus bilevel with back-up respiratory rate ( bilevel-ST ) in patients with central sleep apnea ( CSA ) associated with chronic use of opioid medications .


Prospective , randomized , crossover polysomnography ( PSG ) study .


Eighteen consecutive patients ( age @ years ) who had been receiving opioid therapy ( @ months ) , and had sleep disordered breathing with CSA ( central apnea index -LSB- CAI -RSB- @ ) diagnosed during an overnight sleep study or positive airway pressure ( PAP ) titration were enrolled to undergo @ PSG studies-one with ASVAuto and one with bilevel-ST .


Patients completed @ questionnaires after each PSG ; Morning After Patient Satisfaction Questionnaire and PAP Comfort Questionnaire .


Patients had a mean age of @ @ years .


PSG prior to randomization showed an apnea hypopnea index ( AHI ) of @ @ and CAI of @ @ .


Titration with ASVAuto versus bilevel-ST showed that there were significant differences with respect to AHI and CAI .


The AHI and CAI were significantly lower on ASVAuto than bilevel-ST ( @ @ versus @ @ -LSB- p = @ -RSB- , and @ @ versus @ @ -LSB- p = @ -RSB- , respectively ) .


Respiratory parameters were normalized in @ % of patients on ASVAuto versus @ % on bilevel-ST .


Patients felt more awake and alert on ASVAuto than bilevel-ST based on scores from Morning After Patient Satisfaction Questionnaire ( p = @ ) .


The ASVAuto was significantly more effective than bilevel-ST for the treatment of CSA associated with chronic opioid use .


Dementia affects over @ million people in the US and is frequently unrecognized and underdiagnosed in primary care .


Routine dementia screening in primary care is not recommended by the US Preventive Services Task Force due to lack of empirical data on the benefits and harms of screening .


This trial seeks to fill this gap and contribute information about the benefits , harms , and costs of routine screening for dementia in primary care .


Single-blinded , parallel , randomized controlled clinical trial with @:@ allocation .


A total of @,@ individuals aged @ years without a diagnosis of dementia , cognitive impairment , or serious mental illness receiving care at primary care practices within two cities in Indiana .


Subjects will be randomized to either i ) screening for dementia using the Memory Impairment Screen Telephone version or ii ) no screening for dementia .


Subjects who screen positive for dementia will be referred to the local Aging Brain Care program that delivers an evidence-based collaborative care model for dementia and depression .


Research assistants will administer the @-item Health Utility Index , Patient Health Questionnaire , Generalized Anxiety Disorder Scale , and Medical Outcomes Study at baseline , @ , @ , and @ months .


Information about advanced care planning will be collected at baseline and @ months .


All enrollees ' medical records will be reviewed to collect data on health care utilization and costs .


We have two primary hypotheses ; first , in comparison to non-screened subjects , those who are screened and referred to a dementia collaborative care program will have a higher health-related quality of life as measured by the Health Utility Index at @ months post-screening .


Second , in comparison to non-screened subjects , those who are screened and referred to a dementia collaborative care program will not have higher depression or anxiety at one month post-screening as measured by the Patient Health Questionnaire and Generalized Anxiety Disorder Scale scales .


Our secondary hypothesis is that screened subjects will have an Incremental Cost-Effectiveness Ratio below the maximum acceptable threshold of $ @,@ per quality adjusted life year saved at @ months .


To evaluate the differences in extubation times in a group of cardiac surgical patients who were anesthetized and sedated with either IV propofol or inhaled volatile anesthetic agents .


This was a prospective randomized controlled trial performed between September @ and August @ .


Cardiovascular ICU within a tertiary referral university-affiliated teaching hospital .


One hundred forty-one patients undergoing coronary artery bypass graft surgery with normal or mildly reduced left ventricular systolic function .


Participants were randomly assigned to receive anesthesia and postoperative sedation using IV propofol ( n = @ ) or inhaled volatile ( isoflurane or sevoflurane ) anesthetic agent ( n = @ ) .


Patients sedated using inhaled volatile agent displayed faster readiness to extubation time at @ minutes ( @-@ min ) compared with those receiving IV propofol at @ minutes ( @-@ min ) ( p < @ ) .


Extubation times were faster within the volatile group at @ minutes ( @-@ min ) in comparison with propofol group at @ minutes ( @-@ min ) ( p < @ ) .


The volatile group showed a higher prevalence of vasodilatation with hypotension and higher cardiac outputs necessitating greater use of vasoconstrictors .


There was no difference in postoperative pain scores , opioid consumption , sedation score , ICU or hospital length of stay , or patient mortality .


Inhaled volatile anesthesia and sedation facilitates faster extubation times in comparison with IV propofol for patient undergoing coronary artery bypass graft surgery .


Intraoral elastics are commonly used in orthodontics and require regular changing to be effective .


Unfortunately , poor compliance with elastics is often encountered , especially in adolescents .


Intention for an action and its implementation can be improved using `` if-then '' plans that spell out when , where , and how a set goal , such as elastic wear , can be put into action .


Our aim was to determine the effect of if-then plans on compliance with elastics .


To identify common barriers to compliance with recommendations concerning elastic wear , semistructured interviews were carried out with @ adolescent orthodontic patients wearing intraoral elastics full time .


Emerging themes were used to develop if-then plans to improve compliance with elastic wear .


A prospective pilot study assessed the effectiveness of if-then planning aimed at overcoming the identified barriers on compliance with elastic wear .


Twelve participants were randomized equally into study and control groups ; the study group received information about if-then planning .


The participants were asked to collect used elastics , and counts of these were used to assess compliance .


A wide range of motivational and volitional factors were described by the interviewed participants , including the perceived benefits of elastics , cues to remember , pain , eating , social situations , sports , loss of elastics , and breakages .


Compliance with elastic wear was highly variable among patients .


The study group returned more used elastics , suggesting increased compliance , but the difference was not significant .


The use of if-then plans might improve compliance with elastic wear when compared with routine clinical instructions .


Fourteen percent ( @ million ) of the population in the United States was @ years and older in @ .


This population is projected to reach @ % ( @ million ) by @ .


Older adults accounted for @ % of all traffic fatalities and @ % of all vehicle occupant injuries in @ .


We explored the effectiveness of three interventions to help older adults assess their current driving behaviors at a Level @ trauma center .


During @ to @ , @,@ inpatients @ years and older admitted for surgical and medical services were screened for eligibility , and @ were enrolled .


Participants completed a driving assessment and preintervention questionnaires and were subsequently randomized to one of the following interventions : ( @ ) brief negotiated interview plus an educational kit by the American Automobile Association about older driving plus an accompanying list of Web-based resources for older adult drivers ; ( @ ) American Automobile Association document and a list of Web-based resources ; ( @ ) online referral sheet of the list of Web-based resources only .


A @-month postintervention follow-up questionnaire was administered over the telephone to measure changes in ( @ ) driving-related knowledge , attitudes , and beliefs as well as ( @ ) driving-related behaviors and intended behaviors .


A total of @ randomized patients were included in the analysis .


The mean ( SD ) age was @ ( @ ) years ; majority of patients were white ( @ % ) , followed by black African American ( @ % ) ; and @ % were males and @ % were females .


Multivariate analysis showed that older adults ' driving knowledge , attitudes , and beliefs ( p < @ , R = @ ) as well as behaviors and intentions ( p < @ , R = @ ) toward driving were positively correlated , controlling for other predictors in the model .


Intervention assignment did not affect changes in outcomes , although outcomes improved across experimental conditions .


Our pilot study suggests that older adults are likely to make changes in their driving behavior on the basis of minimal hospital-based intervention .


Extending palliative care to those with advanced non-malignant disease is advocated , but the implications in specific conditions are poorly understood .


We piloted a novel nurse-led intervention , HELPing older people with very severe chronic obstructive pulmonary disease ( HELP-COPD ) , undertaken @ weeks after discharge from hospital , which sought to identify and address the holistic care needs of people with severe COPD .


This @-month mixed-method feasibility pilot trial randomised ( ratio @:@ ) patients to HELP-COPD or usual care .


We assessed the feasibility of using validated questionnaires as outcome measures and analysed the needs/actions recorded in the HELP-COPD records .


Semi-structured interviews with a purposive sample of patients , carers and professionals explored the perceptions of HELP-COPD .


Verbatim transcriptions and field notes were analysed using Normalisation Process Theory as a framework .


We randomised @ patients ( @ to HELP-COPD ) ; @ completed the study ( death = @ , ill-health = @ , declined = @ ) .


The HELP-COPD record noted a mean of @ actions/assessment , mostly provision of information or self-help actions : only five referrals were made .


Most patients were positive about HELP-COPD , discussing their concerns and coping strategies in all domains , but the questionnaires were burdensome for some patients .


Adaptation to their slowly progressive disability and a strong preference to rely on family support was reflected in limited acceptance of formal services .


Professionals perceived HELP-COPD as addressing an important aspect of care , although timing overlapped with discharge planning .


The HELP-COPD intervention was well received by patients and the concept resonated with professionals , although delivery post discharge overlapped with existing services .


Integration of brief holistic care assessments in the routine primary care management of COPD may be more appropriate .


The increasing prevalence of resistant bacteria such as fluoroquinolone-resistant or extended-spectrum - lactamase-producing strains in pathogens causing acute uncomplicated cystitis has been of concern in Japan .


Faropenem sodium is a penem antimicrobial that demonstrates a wide antimicrobial spectrum against both aerobic and anaerobic bacteria .


It is stable against a number of - lactamases .


We compared @ and @ day administration regimens of faropenem in a multicentre , randomized , open-label , controlled study .


In total , @ female patients with cystitis were enrolled and randomized into @ day ( N = @ ) or @ day ( N = @ ) treatment groups .


At the first visit , @ bacterial strains were isolated from @ participants , and Escherichia coli accounted for @ % ( @/@ ) of bacterial strains .


At @-@ days after the completion of treatment , @ and @ patients from the @ day and @ day groups , respectively , were evaluated by intention-to-treat analysis ; the microbiological efficacies were @ % eradication ( @/@ ) , @ % persistence ( @/@ ) and @ % replaced ( @/@ ) , and @ % eradication ( @/@ ) , @ % persistence ( @/@ ) and @ % replaced ( @/@ ) , respectively ( P = @ ) .


The clinical efficacies were @ % ( @/@ ) and @ % ( @/@ ) , respectively ( P = @ ) .


Adverse events due to faropenem were reported in @ % of participants ( @/@ ) , and the most common adverse event was diarrhoea .


The @ day regimen showed a superior rate of microbiological response .


E. coli strains were in general susceptible to faropenem , including fluoroquinolone - and cephalosporin-resistant strains .


Teaching people with epilepsy to identify and manage seizure triggers , implement strategies to remember to take antiepileptic drugs , implement precautions to minimize risks during seizures , tell others what to do during a seizure and learn what to do during recovery may lead to better self-management .


No teaching programme exists for adults with epilepsy in the United Kingdom although a number of surveys have shown patients want more information .


This is a multicentre , pragmatic , parallel group randomised controlled trial to evaluate the effectiveness and cost-effectiveness of a two-day Self-Management education for epILEpsy ( SMILE ( UK ) ) , which was originally developed in Germany ( MOSES ) .


Four hundred and twenty eight adult patients who attended specialist epilepsy outpatient clinics at @ NHS participating sites in the previous @ months , and who fulfil other eligibility criteria will be randomised to receive the intervention ( SMILE ( UK ) course with treatment as usual - TAU ) or to have TAU only ( control ) .


The primary outcome is the effect on patient reported quality of life ( QoL ) .


Secondary outcomes are seizure frequency and psychological distress ( anxiety and depression ) , perceived impact of epilepsy , adherence to medication , management of adverse effects from medication , and improved self-efficacy in management ( mastery/control ) of epilepsy.Within the trial there will be a nested qualitative study to explore users ' views of the intervention , including barriers to participation and the perceived benefits of the intervention .


The cost-effectiveness of the intervention will also be assessed .


This study will provide quantitative and qualitative evidence of the impact of a structured self management programme on quality of life and other aspects of clinical and cost effectiveness in adults with poorly controlled epilepsy .


Depression related to interferon-alpha ( IFN - ) is common , may reduce adherence , and can be treatment limiting .


HIV-HCV coinfected persons experience lower sustained virologic response rates and commonly have psychiatric comorbidities , thus they may benefit from prevention of depression .


The aim of the study was to determine whether prophylactic citalopram can increase HCV treatment adherence and reduce the incidence of moderate depression in HIV-HCV coinfected patients initiating PEG-IFN - / ribavirin therapy .


This was an investigator-initiated Canadian multicenter randomized , double-blind placebo-controlled trial .


HIV-HCV coinfected patients were randomized in a @:@ ratio to receive citalopram or placebo @ weeks prior to starting PEG-IFN-@b / ribavirin , stratified by study center and HCV genotype .


The protocol design permitted the comparison of prophylaxis with the treatment of emergent depression .


The primary outcomes were adherence ( assessed through questionnaire and returned medication ) and time to moderate depression measured by Beck Depression Inventory-II ( BDI - II ) score greater than @ , confirmed @ weeks apart .


Seventy-six patients ( @ citalopram/@ placebo ) were randomized .


Overall adherence was high , ranging from @ % ( week @ ) to @ % ( week @ ) .


There was no difference between arms with respect to mean or median adherence at any study time point .


Cumulative incidence of moderate depression did not differ significantly by group ( log rank P = @ ) .


The hazard ratio for moderate depression was @ ( @ % CI , @ to @ ) for citalopram compared with placebo when adjusted for baseline BDI-II score .


A strategy of prophylactic citalopram compared to treatment of emergent depression was not associated with higher adherence or a reduction in treatment-limiting depression nor did it significantly reduce depressive symptoms among HIV-HCV coinfected persons during treatment for HCV .


To investigate the impact of continuous blood purification ( CBP ) on T-cell subsets and prognosis in children with severe sepsis .


A total of @ children with severe sepsis were randomly divided into a control group ( n = @ ) and a CBP group ( n = @ ) .


The patients in the control group received conventional treatment , while those in the CBP group underwent continuous veno-venous hemofiltration daily @-@ hours for @ days besides conventional treatment .


Changes in clinical variables and in peripheral blood regulatory T cell subsets were assessed @ and @ days after treatment .


The pediatric intensive care unit length of stay and duration of mechanical ventilation were significantly shortened and the @-day mortality rate was significantly lower in the CPB treatment group as compared with the control group ( P < @ ) .


In the CBP treatment group , the percentage of CD@ ( + ) , CD@ ( + ) , CD@ ( + ) T cell populations and PCIS scores were significantly higher at @ and @ days after treatment than before treatment ( P < @ ) .


At @ days after treatment , the percentage of CD@ ( + ) , CD@ ( + ) , CD@ ( + ) T cell populations , CD@ ( + ) / CD@ ( + ) ratio and PCIS scores were significantly higher in the CBP group than in the control group ( P < @ ) .


The CBP treatment may counteract the suppression of immune function and thus improve prognosis in children with severe sepsis .


While living with others has been associated with improved functional outcome after acute stroke , it is unclear if this affects adherence to stroke prevention measures .


We examined the relationship between living arrangements and adherence to antiplatelet therapy assignment and participation status in an international randomized trial for secondary stroke prevention .


Antiplatelet therapy adherence , trial retention outcomes , and baseline characteristics for participants enrolled in the Secondary Prevention of Small Subcortical Strokes study were compared between those who lived alone vs. with others ( n = @ ) .


Participant status at end-of-trial was categorized into ( @ ) on assigned antiplatelet , ( @ ) off assigned antiplatelet by participant request , or ( @ ) participant withdrew consent/lost to follow-up .


Multivariable multivariate logistic regression was used to identify patient features at entry predictive of participant status at trial end .


Living arrangement , alone vs. with other ( s ) , was not significantly associated with participant status .


Participants enrolled in the United States/Canada ( odds ratio @ , confidence intervals @-@ @ , vs. Latin America ) , taking more ( @ + ) prescription medications ( odds ratio @ , confidence intervals @-@ @ , vs. @-@ medications ) , and scoring lower on the Stroke Specific Quality of Life scale ( odds ratio @ , confidence intervals @-@ @ , per @ points ) were more likely to withdraw or become lost to follow-up in the study vs. completing the study on assigned antiplatelet therapy .


Participants enrolled in the United States/Canada ( odds ratio @ , confidence intervals @-@ @ , vs. Latin America ) and taking fewer ( @-@ ) medications ( odds ratio @ , confidence intervals @-@ @ vs. @-@ medications ) were more likely to request discontinuation of assigned antiplatelet medication vs. completing the study .


Living with others was not independently predictive of protocol adherence in this cohort .


Number of medications and Stroke Specific Quality of Life scale score may be more indicative of likelihood of trial participation and acceptance of long-term antiplatelet regimen .


Short sleep duration is a contributing factor for decreased insulin sensitivity and hyperglycemia .


Sleep architecture represents a cyclical pattern of sleep that shifts between sleep Stages N@ , N@ , N@ ( slow wave sleep ) and Stage R ( rapid eye movement sleep ) .


The aim of the present study was to examine the association between sleep architecture and glucose and insulin metabolism in both normal weight and overweight/obese children and adolescents .


A total of @ subjects participated in the study .


Subjects under-went overnight polysomnography ( PSG ) when the percentage of total sleep time ( % TST ) spent at each sleep stage was recorded and an oral glucose tolerance test together was performed the next morning .


We assessed glucose tolerance , insulin sensitivity and pancreatic - cell function using @-h glucose levels , the Matsuda index ( IS ( OGTT ) ) , and insulin secretion-sensitivity index-@ ( ISSI-@ ) , respectively .


After adjustment for age , gender , body mass index z-score , pubertal status , and obstructive apnea hypopnea index , Stage N@ ( % TST ) was positively associated with IS ( OGTT ) , whereas Stage N@ ( % TST ) exerted an opposite effect on IS ( OGTT ) .


Higher sleep efficiency and longer TST were independently associated with lower @-h glucose levels , higher ISSI-@ and/or higher IS ( OGTT ) .


Stage N@ , sleep efficiency and TST were protective factors in maintaining glucose and insulin homeostasis ; however , Stage N@ functioned in the opposite direction .


Although blood donation is allowed every @ weeks in the United States , recovery of hemoglobin to the currently accepted standard ( @ g/dL ) is frequently delayed , and some donors become anemic .


To determine the effect of oral iron supplementation on hemoglobin recovery time ( days to recovery of @ % of hemoglobin removed ) and recovery of iron stores in iron-depleted ( `` low ferritin , '' @ ng/mL ) and iron-replete ( `` higher ferritin , '' > @ ng/mL ) blood donors .


Randomized , nonblinded clinical trial of blood donors stratified by ferritin level , sex , and age conducted in @ regional blood centers in the United States in @ .


Included were @ eligible participants aged @ to @ years who had not donated whole blood or red blood cells within @ months .


One tablet of ferrous gluconate ( @ mg of elemental iron ) daily or no iron for @ weeks ( @ days ) after donating a unit of whole blood ( @ mL ) .


Time to recovery of @ % of the postdonation decrease in hemoglobin and recovery of ferritin level to baseline as a measure of iron stores .


The mean baseline hemoglobin levels were comparable in the iron and no-iron groups and declined from a mean ( SD ) of @ ( @ ) g/dL to @ ( @ ) g/dL after donation in the low-ferritin group and from @ ( @ ) g/dL to @ ( @ ) g/dL in the higher-ferritin group .


Compared with participants who did not receive iron supplementation , those who received iron supplementation had shortened time to @ % hemoglobin recovery in both the low-ferritin ( mean , @ days , interquartile range -LSB- IQR -RSB- , @-@ , vs @ days , IQR , @ - > @ ) and higher-ferritin groups ( @ days , IQR , @-@ , vs @ days , IQR , @-@ ) .


Median time to recovery to baseline ferritin levels in the low-ferritin group taking iron was @ days ( IQR , @-@ ) .


For participants not taking iron , recovery to baseline was longer than @ days ( IQR , @ - > @ ) .


Median time to recovery to baseline in the higher-ferritin group taking iron was @ days ( IQR , @-@ ) , and for participants not taking iron , recovery to baseline was longer than @ days ( IQR , > @ - > @ ) .


Recovery of iron stores in all participants who received supplements took a median of @ days ( IQR , @-@ ) ; for participants not taking iron , median recovery time was longer than @ days ( IQR , @ - > @ days ; P < @ ) .


Without iron supplements , @ % of participants did not recover iron stores by @ days .


Among blood donors with normal hemoglobin levels , low-dose iron supplementation , compared with no supplementation , reduced time to @ % recovery of the postdonation decrease in hemoglobin concentration in donors with low ferritin ( @ ng/mL ) or higher ferritin ( > @ ng/mL ) .


AZD@ is a novel - aminobutyric acid A receptor modulator with higher in vitro efficacy at the @,@ subtypes as compared to the @ and @ subtypes .


This study compared the pharmacodynamic effects of single oral dose AZD@ @ mg and @ mg on the central nervous system with @ mg of lorazepam .


Sixteen healthy males were enrolled into the double-blind , randomized , @-way crossover study .


Two validated central nervous system test batteries , Neurocart and CogState , were administered to measure drug effects on cognition , neurophysiologic function , and psychomotor and subjective feelings .


Statistical analysis was performed using mixed model analysis of variance , with fixed factors of treatment , period , time and treatment by time , and random factors of subject , subject by treatment and subject by time , and the average prevalue as covariate .


Most pharmacodynamic parameters were affected by lorazepam .


AZD@ induced dose-dependent smaller-than-lorazepam effects on saccadic peak velocity ( SPV ) ( AZD@ , @ mg vs. AZD@ , @ mg vs. lorazepam -LSB- deg/s -RSB- : -@ vs. -@ vs. -@ , P < @ ) , whereas the impacts on adaptive-tracking , body-sway , smooth-pursuit , and the one-card-learning tests were significant but much smaller than lorazepam .


Thus , the slopes of regression lines for the Log ( Sway ) - SPV , Tracking-SPV , and Smooth-SPV relations were flatter with AZD@ than with lorazepam .


AZD@ caused a distinct electroencephalography signature from that of lorazepam .


The SPV responses to AZD@ suggest potential concentration-related anxiolytic effects , whereas the smaller SPV-normalized effects of AZD@ on various non-SPV pharmacodynamic parameters suggest a more favorable side effect profile compared to lorazepam .


Overall , the pharmacodynamic profile of AZD@ matches the pharmacological specificity and selectivity of this compound at the @,@ - aminobutyric acid A receptor subtypes .


Cross-sectional analysis of long-term follow-up ( LTFU ) data from @ randomized controlled trials of operative versus nonoperative treatment for chronic low back pain .


To examine the influence of spinal fusion on adjacent segment disc space height as an indicator of disc degeneration at LTFU .


There is ongoing debate as to whether adjacent segment disc degeneration results from the increased mechanical stress of fusion .


Plain standing lateral radiographs were obtained at LTFU ( mean , @ @ yr postrandomization ) in @ of @ ( @ % ) patients randomized to surgery and @ of @ ( @ % ) , to nonoperative care .


Disc space height and posteroanterior displacement were measured for each lumbar segment using a validated computer-assisted distortion compensated roentgen analysis technique .


Values were reported in units of standard deviations above or below age and sex-adjusted normal values .


Patient-rated outcomes included the Oswestry Disability Index and pain scales .


Radiographs were usable in @ of @ ( @ % ) patients ( @ fusion and @ nonoperative treatment ) .


Both treatment groups showed significantly lower values for disc space height of the adjacent segment than norm values .


There was a significant difference between treatment groups for the disc space height of the cranial adjacent segment ( in both as-treated and intention-to-treat analyses ) .


The mean treatment effect of fusion on adjacent segment disc space height was -@ SDs ( @ % CI , -@ to -@ ; P = @ ; as-treated analysis ) ; there was no group difference for posteroanterior displacement ( @ SDs , @ % confidence interval , -@ to @ , P = @ ) .


Adjacent level disc space height and posteroanterior displacement were not correlated with Oswestry Disability Index or pain scores at LTFU ( r = @-@ @ ; P > @ ) .


Fusion was associated with lower disc space height at the adjacent segment after an average of @ years of FU .


The reduced disc space height had no influence on patient self-rated outcomes ( pain or disability ) .


To demonstrate the efficacy of exenatide versus insulin glargine on endothelial functions and cardiovascular risk markers .


Thirty-four insulin and incretin-naive patients with type @ diabetes mellitus ( body mass index @-@ kg/m ( @ ) ) who received metformin for at least two months were randomized to exenatide or insulin glargine treatment arms and followed-up for @ weeks .


Measurements of endothelial functions were done by ultrasonography , cardiovascular risk markers by serum enzyme-linked immunosorbent assay , and total body fat mass by bioimpedance .


Levels of high sensitivity-C-reactive protein and endothelin-@ decreased ( @ % and @ % , respectively ) in the exenatide arm .


However , in the insulin glargine arm , fibrinogen , monocyte chemoattractant protein-@ , leptin and endothelin-@ levels ( @ , @ , @ , and @ % , respectively ) increased .


Post-treatment flow mediated dilatation and endothelium independent vascular responses were significantly higher in both arms ( p = @ , p = @ ) .


Positive correlation was observed between the changes in body weight and endothelium-independent vasodilatation , leptin , plasminogen activator inhibitor type @ and endothelin-@ in both arms ( r = @ , r = @ , r = @ , r = @ , respectively ) .


Insulin glargine improved endothelial functions , without leading to positive changes in cardiovascular risk markers .


Exenatide treatment of @ weeks resulted in reduced body weight and improvement in certain cardiovascular risk markers and endothelial functions .


Paralytic ileus after laparoscopic-assisted surgery often occurs .


We investigated whether daikenchuto ( DKT ) , a traditional Japanese herbal medicine , improves intestinal motility in patients undergoing laparoscopic-assisted colectomy for colon cancer .


Fifty-four patients who underwent colectomy at Iwate Medical University Hospital between October @ and March @ were randomized to either the DKT group ( @ g/day , p.o. ) or the control group ( lactobacillus preparation , @g/day , p.o. ) .


Primary endpoints included time to first flatus , bowel movement , and tolerance of diet after extubation .


Secondary endpoints were WBC count , C-reactive protein ( CRP ) level , length of hospital stay , and postoperative ileus .


Colonic transit time was measured using radiopaque markers and abdominal radiographs .


Fifty-one patients ( DKT , @ vs. control , @ ) were included in the per-protocol analysis .


The DKT group had significantly faster time until first flatus ( @ + / - @ h vs. @ + / - @ h , P < @ ) and bowel movement ( @ + / - @ h vs. @ + / - @ h , P < @ ) and colonic transit time ( @ + / - @ h vs. @ + / - @ h , P < @ ) .


There were no significant intergroup differences in secondary endpoints and adverse events .


DKT accelerates colonic motility in patients undergoing laparoscopic-assisted colectomy for colon cancer .


Several epidemiologic studies have suggested a role of tomato products in decreasing the risk of the development of diseases related to oxidative stress ( cancer and other chronic diseases ) .


Oxidative stress may result in periodontal tissue damage either directly or indirectly .


Lycopene , a powerful antioxidant and the main carotenoid in tomato products possesses the greatest quenching ability of singlet oxygen among the various carotenoids and is effective in protecting blood lymphocytes from NOO-radical damage .


Hence , the aim of the present study is to compare the effect of systemically administered lycopene as an adjunct to scaling and root planing in patients with gingivitis and periodontitis .


Twenty systemically healthy patients were involved in a randomized , double-blind , parallel study and based on their clinical signs were divided into two groups of mild to moderate periodontitis ( A ) and moderate gingivitis ( B ) .


The subjects under the groups A and B were randomly distributed between the two treatment groups : test group ( n = @ ) , @ mg lycopene/day for @ weeks with oral prophylaxis ( full mouth scaling and root planing ( SRP ) completed within @ hours ) and controls ( n = @ ) , receiving only oral prophylaxis .


Pre - and post-therapeutic periodontal parameters were evaluated .


In group A , statistically significant improvement in CAL was reported in test group as compared to control group .


In group B , the difference between pretreatment and post-treatment bleeding on probing scores was found to be statistically non-significant in both groups .


Results show that lycopene is a promising treatment modality as an adjunct to full mouth SRP of the oral cavity in patients with moderate periodontal disease .


Modulation of the free radical production seems to be essential for the inhibition of tissue destruction , and treatment with antioxidants , like lycopene , which is the most potent among them will block the production of free ROS or its effects might prove to be therapeutically valuable .


To evaluate the humoral immune response to pneumococcal and influenza vaccination in adults with rheumatoid arthritis ( RA ) receiving certolizumab pegol ( CZP ) .


In this @-week , single-blind , placebo-controlled trial with optional @-month open-label extension ( NCT@ ) , patients were stratified by concomitant methotrexate ( MTX ) use and randomized to receive CZP @ mg ( loading dose ; according to CZP label ) or placebo at weeks @ , @ , and @ .


Pneumococcal ( polysaccharide @ ) and influenza vaccines were administered at Week @ .


Satisfactory humoral immune response , defined as @-fold titer increase in @ of @ pneumococcal antigens and @-fold titer increase in @ of @ influenza antigens , were assessed independently @ weeks after vaccination .


Following pneumococcal vaccination , @ % of placebo patients and @ % of CZP patients without effective titers at baseline achieved a humoral response ( difference in proportions was -@ percentage points ; @ % CI -@ to @ % ) .


Following influenza vaccination , @ % of placebo and @ % of CZP patients without effective titers at baseline achieved a humoral response ( difference in proportions : -@ percentage points ; @ % CI -@ to @ % ) .


In all patients , including those with effective titers at baseline , @ % of placebo and @ % of CZP patients developed satisfactory pneumococcal titers , and @ % of placebo and @ % of CZP patients developed satisfactory influenza antibody titers .


Vaccine responses to pneumococcal and influenza antigens were reduced similarly in both treatment groups with concomitant MTX use .


Humoral immune responses to pneumococcal and influenza vaccination are not impaired when given during the loading phase of CZP treatment in patients with RA .


( ClinicalTrials.gov NCT@ ) .


The goal of this study was to evaluate the impact of the Active Teen Leaders Avoiding Screen-time ( ATLAS ) intervention for adolescent boys , an obesity prevention intervention using smartphone technology .


ATLAS was a cluster randomized controlled trial conducted in @ secondary schools in low-income communities in New South Wales , Australia .


Participants were @ adolescent boys ( aged @-@ years ) considered at risk of obesity .


The @-week intervention was guided by self-determination theory and social cognitive theory and involved : teacher professional development , provision of fitness equipment to schools , face-to-face physical activity sessions , lunchtime student mentoring sessions , researcher-led seminars , a smartphone application and Web site , and parental strategies for reducing screen-time .


Outcome measures included BMI and waist circumference , percent body fat , physical activity ( accelerometers ) , screen-time , sugar-sweetened beverage intake , muscular fitness , and resistance training skill competency .


Overall , there were no significant intervention effects for BMI , waist circumference , percent body fat , or physical activity .


Significant intervention effects were found for screen-time ( mean SE : -@ @ min/d ; P = @ ) , sugar-sweetened beverage consumption ( mean : -@ @ glass/d ; P = @ ) , muscular fitness ( mean : @ @ repetition ; P = @ ) , and resistance training skills ( mean : @ @ units ; P < @ ) .


This school-based intervention targeting low-income adolescent boys did not result in significant effects on body composition , perhaps due to an insufficient activity dose .


However , the intervention was successful in improving muscular fitness , movement skills , and key weight-related behaviors .


Gemigliptin is approved for the treatment of type II diabetes mellitus .


Sulfonylureas are commonly used in combination with other antidiabetic drugs to improve glycemic control .


The objective of this study was to evaluate the pharmacokinetics , safety , and tolerability of gemigliptin and glimepiride combination therapy compared with those of monotherapies .


A randomized , open-label , crossover study was performed on healthy Korean male volunteers .


Each subject received the following treatments ( A and B ) with a @-day washout period : treatment A consisted of gemigliptin @ mg once daily administered orally for @ days , followed by concomitant oral dosing of glimepiride @ mg and gemigliptin @ mg on day @ ; treatment B consisted of a single dose of glimepiride @ mg .


Blood samples were collected up to @-h postdose on day @ ( gemigliptin ) and day @ ( gemigliptin and glimepiride ) following treatment A , and on day @ ( glimepiride ) following treatment B. Concentrations of gemigliptin , glimepiride , and metabolites were determined using validated liquid chromatography-tandem mass spectrometry ( LC-MS/MS ) .


Safety assessments were performed throughout the study .


Twenty-three subjects completed the study .


The geometric mean ratios ( GMRs ) of C max , ss and AUC , ss for gemigliptin were @ -LSB- @ % confidence interval ( CI ) @-@ @ -RSB- and @ ( @ % CI @-@ @ ) , respectively .


For glimepiride , the GMRs of C max and AUClast were @ ( @ % CI @-@ @ ) and @ ( @ % CI @-@ @ ) , respectively .


Both combination and monotherapy were well tolerated , and no serious adverse events were reported .


Gemigliptin and glimepiride did not alter the pharmacokinetic properties of each other when they were co-administered in healthy volunteers , and were generally tolerated .


It is estimated that more than half of those with serious mental illness smoke tobacco regularly .


Standard courses of pharmacotherapeutic cessation aids improve short-term abstinence , but most who attain abstinence relapse rapidly after discontinuation of pharmacotherapy .


To determine whether smokers diagnosed with schizophrenia and bipolar disease have higher rates of prolonged tobacco abstinence with maintenance pharmacotherapy than with standard treatment .


Randomized , double-blind , placebo-controlled , parallel-group , relapse-prevention clinical trial conducted in @ community mental-health centers .


Of @ smokers with schizophrenia or bipolar disease recruited from March @-April @ , @ received @-weeks ' open-label varenicline and cognitive behavioral therapy and @ met abstinence criteria to enter the relapse prevention intervention .


Participants who had @ weeks or more of continuous abstinence at week @ of open treatment were randomly assigned to receive cognitive behavioral therapy and double-blind varenicline ( @ mg , @ per day ) or placebo from weeks @ to @ .


Participants then discontinued study treatment and were followed up to week @ .


Seven-day rate of continuous abstinence at study week @ , the end of the relapse-prevention phase , confirmed by exhaled carbon monoxide .


Secondary outcomes were continuous abstinence rates for weeks @ through @ based on biochemically verified abstinence and weeks @ through @ , based on self-reported smoking behavior .


Sixty-one participants completed the relapse-prevention phase ; @ discontinued participation ( @ varenicline , @ placebo ) and were considered to have relapsed for the analyses ; @ of these had relapsed prior to dropout .


At week @ , point-prevalence abstinence rates were @ % in the varenicline group ( @ of @ ) vs @ % ( @ of @ ) in the placebo group ( odds ratio -LSB- OR -RSB- , @ ; @ % CI , @-@ @ ; P < @ ) .


From weeks @ through @ , @ % ( @ of @ ) among those in the varenicline group vs @ % ( @ of @ ) in the placebo group were continuously abstinent ( OR , @ ; @ % CI , @-@ @ ; P = @ ) , and from weeks @ through @ , @ % ( @ of @ ) in the varenicline group vs @ % ( @ of @ ) in the placebo group were continuously abstinent ( OR , @ ; @ % CI , @-@ @ ; P = @ ) .


There were no significant treatment effects on psychiatric symptom ratings or psychiatric adverse events .


Among smokers with serious mental illness who attained initial abstinence with standard treatment , maintenance pharmacotherapy with varenicline and cognitive behavioral therapy improved prolonged tobacco abstinence rates compared with cognitive behavioral therapy alone after @ year of treatment and at @ months after treatment discontinuation .


Insufficient production oferythropoietin ( EPO ) is the primary cause ofanemia in patients with chronic kidney disease ( CKD ) .


The EPO treatment is an established treatment for renal anemia .


The study investigated the therapeutic outcome between lyophilized powder and liquid form of EPO alpha by intravenous ( IV ) administration in hemoglobin maintenance of anemic treatment for CKD patients receiving hemodialysis .


Forty patients were randomly assigned to either lyophilized powder of EPO alpha ( treatment , n = @ ) or liquidform of EPO alpha ( control , n = @ ) for @ weeks by lVadministration .


The hemoglobin was maintained within the target range of @ to @ g/dL by adjusting the dosage of EPO .


The clinical and biochemical profiles including transferrin saturation andferritin were measured .


Adverse events were documented .


The mean hemoglobin ofboth groups at baseline was @ g/dL .


Mean hemoglobin and mean hematocrit levels at baseline , and follow-up data of both groups were not statistically different .


The mean weekly dosage of EPO in the treatment and control groups had no statistical significance within the same group and between groups as well .


Stable hemoglobin levels were maintained without EPO dosage adjustment in the majority ofpatients in both groups ( treatment group , @ % , control group , @ % ) .


During the @-week study period , no serious side effect was detected


The present study demonstrated that the lyophilizedpowder ofEPO alpha was effective and safe as the standard liquid form of EPO alpha when it was administered by IV route in hemoglobin maintenance of anemia treatment .


The objective of this study was to assess the prognostic significance of exercise capacity in patients with ischemic left ventricular ( LV ) dysfunction eligible for coronary artery bypass graft surgery ( CABG ) .


Poor exercise capacity is associated with mortality , but it is not known how this influences the benefits and risks of CABG compared with medical therapy .


In an exploratory analysis , physical activity was assessed by questionnaire and @-min walk test in @,@ patients before randomization to CABG ( n = @ ) or medical management ( n = @ ) in the STICH ( Surgical Treatment for Ischemic Heart Failure ) trial .


Mortality ( n = @ ) was compared by treatment allocation during @ months ( interquartile range : @ to @ months ) of follow-up for subjects able ( n = @ ) and unable ( n = @ ) to walk @ m in @ min and with less ( Physical Ability Score -LSB- PAS -RSB- > @ , n = @ ) and more ( PAS @ , n = @ ) limitation by dyspnea or fatigue .


Compared with medical therapy , mortality was lower for patients randomized to CABG who walked @ m ( hazard ratio -LSB- HR -RSB- : @ ; @ % confidence interval -LSB- CI -RSB- : @ to @ ; p = @ ) and those with a PAS > @ ( HR : @ ; @ % CI : @ to @ ; p = @ ) .


Patients unable to walk @ m or with a PAS @ had higher mortality during the first @ days with CABG ( HR : @ ; @ % CI : @ to @ ; p = @ ) and no significant benefit from CABG during total follow-up ( HR : @ ; @ % CI : @ to @ ; p = @ ; interaction p = @ ) .


These observations suggest that patients with ischemic left ventricular dysfunction and poor exercise capacity have increased early risk and similar @-year mortality with CABG compared with medical therapy , whereas those with better exercise capacity have improved survival with CABG .


( Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease -LSB- STICH -RSB- ; NCT@ ) .


Physical activity ( PA ) declines dramatically during adolescence , and activity levels are consistently lower among children living in low-income communities .


Competency in a range of fundamental movement skills ( FMS ) may serve as a protective factor against the decline in PA typically observed during adolescence .


The purpose of this study was to evaluate the effect of a @-month multicomponent PA and FMS intervention on children attending primary schools in low-income communities .


The Supporting Children 's Outcomes using Rewards , Exercise , and Skills intervention was evaluated using a cluster randomized controlled trial .


The sample included @ classes from eight primary schools located in low-income communities .


Participants were @ children ( @ % girls ) age @ @ yr .


Primary outcomes were objectively measured PA ( ActiGraph GT@X and GT@X + accelerometers ) , FMS competency ( Test of Gross Motor Development @ , six locomotor and six object control skills ) , and cardiorespiratory fitness ( @-m multistage fitness test ) assessed at baseline , midprogram ( @-months ) , and at posttest ( @ months ) .


Linear mixed models , adjusted for sex , age , body mass index z-score , socioeconomic status , ethnicity , and school class as a random factor , were used to assess the effect of the intervention .


At midprogram , there were no significant intervention effects for any of the outcomes .


At posttest ( study 's primary time point ) , there were intervention effects for daily moderate-to-vigorous PA ( MVPA ) ( adjusted mean difference , @ mind of MVPA ; @ % confidence interval ( CI ) , @-@ @ ) , overall FMS competency ( @ units ; @ % CI , -@ to @ ) , and cardiorespiratory fitness ( @ laps ; @ % CI , @-@ @ ) .


A school-based multicomponent PA and FMS intervention maintained daily MVPA , improved overall FMS competency , and increased cardiorespiratory fitness among children attending primary schools in low-income communities .


This study determined the effective concentration of ropivacaine required to produce the type of differential block known as sensory block with mobilization , for adequate analgesia after forearm or hand soft tissue surgery by axillary brachial plexus block .


Forty-four patients were enrolled , and ultrasound-guided axillary nerve block with nerve stimulation was achieved using @ mL of ropivacaine in total .


Postoperative analgesia and sensory/motor function , side effects , the use of rescue analgesics , and the patient satisfaction score were evaluated @ h after surgery .


The effective concentration of nerve block was calculated by probit analysis .


Eighteen patients achieved differential block and were sufficiently satisfied with the block , which was significantly better than the patient satisfaction obtained with incomplete differential block .


The maximum effective concentration of @ mL of ropivacaine needed for differential block was calculated as @ % , which meant that @ % of the patients experienced both sensory block and maintenance of motor function .


This analysis showed that @ ml of @ % ropivacaine is suitable for achieving differential block in ultrasound-guided axillary nerve block for hand and forearm surgery .


Hand osteoarthritis ( OA ) is one of the most prevalent musculoskeletal diseases in an adult population and may have a large influence on an individual 's functioning , health-related quality of life and participation in society .


Several studies have demonstrated that exercises may reduce pain and improve functioning in people with knee OA , with a similar effect suggested for hip OA .


For hand OA , available research is very limited and shows conflicting results , and high-quality randomised controlled trials are warranted.This paper outlines the protocol for a randomised controlled trial that aims to determine the effect of an exercise intervention on self-reported hand activity performance in people with hand OA .


Participants with physician-confirmed hand OA according to the ACR clinical criteria are being recruited from two Norwegian OA cohorts : the population-based `` Musculoskeletal pain in Ullensaker Study '' ( MUST ) OA cohort , and the hospital-based Oslo Hand OA cohort .


Participants are randomised into an intervention - or control group .


The control group receives `` usual care '' , whereas the intervention group receives a @-week exercise intervention .


The intervention group attends four group sessions and is instructed to perform the exercise program three times a week at home .


Adherence will be captured using self-report .


During the eight weeks with no group sessions , the intervention group receives a weekly telephone call .


The assessments and group sessions are being conducted locally in Ullensaker Municipality and at Diakonhjemmet Hospital , Oslo .


Outcomes are collected at baseline , and at @ and @ months .


The primary outcome measure is self-reported hand activity performance at @ months post-randomisation , as measured by the Functional Index for Hand Osteoarthritis ( FIHOA ) ; and a patient-generated measure of disability , the Patient-Specific Functional Scale ( PSFS ) .


Secondary outcome measures are self-reported OA symptoms ( e.g. pain , stiffness and fatigue ) , the Patient Global Assessment of disease activity , measured hand function ( e.g. grip strength , thumb web space and hand dexterity ) and health-related quality of life .


Cost-utility and cost-effectiveness analyses will be conducted .


This study will contribute to the knowledge on both the effect and resource use of an exercise programme with telephone follow-up on self-reported hand activity performance among people with hand OA .


Investigate the benefit of zinc supplement combined with standard treatment ofidiopathic sudden sensorineural hearing loss ( ISSNHL ) patients .


A prospective , randomized study was designed to evaluate the hearing outcomes in ISSNHL patients treated with zinc supplement .


The patients were randomized into two groups , the study and the control group .


The study group received oral chelated zinc with standard treatment ( oral prednisolone ) , while the control group received standard treatment alone .


Hearing improvement was assessed from pure-tone average ( PTA ) and speech discrimination scores ( SDS ) .


After treatment , significant hearing improvement was noted in both groups regarding PTA value ( p = @ , @ ) .


SDS was also improved in both groups but with no statistical significance ( p > @ ) .


Post-treatment PTA and SDS values between the zinc and control groups were not statistically different ( p > @ ) .


Hearing improvement was documented in eight of @ patients in the study group and seven of @ patients in the control group .


This was no significant difference ( p = @ ) .


Zinc supplementation does not have benefit when combined with standard treatment .


Nevertheless , more subjects and well-designed studies are needed to verify the effect of zinc .


To investigate the effectiveness of shared care combined with telecare in type @ diabetic patients in an underserved community in Asia .


In total , @ patients with type @ diabetes who had a glycosylated hemoglobin ( HbA@c ) level of > @ % were recruited from six community health centers in remote areas in Changhua County , Taiwan .


All patients were randomly divided into intervention ( shared care combined with telecare ) and usual-care groups and followed up for @ months .


The decrease in HbA@c level was significantly greater in the intervention group than in the usual-care group ( @ @ % versus @ @ % , p = @ ) .


There were no significant differences in lipid profiles and blood pressure changes between the two groups .


Shared care combined with telecare could significantly reduce HbA@c levels in type @ diabetic patients with poor glycemic control in underserved rural communities .


Further studies should be conducted to clarify the target users and to develop cost-effective interventions .


Fluticasone furoate nasal spray ( FFNS ) is a glucocorticoid developed for the treatment of allergic rhinitis ( AR ) .


This is the first randomized clinical trial to assess the efficacy and safety of FFNS in Japanese children with perennial AR ( PAR ) .


In this multicentre , randomized , double-blind , placebo-controlled , parallel-group , phase III study , @ children aged @ to < @ years were treated with FFNS @g , once daily or placebo for two weeks .


Nasal and ocular symptoms were rated by parents/guardians/patients in the patient daily diary .


The primary endpoint was the mean change from baseline in the three total nasal symptom score ( @TNSS ) .


In addition , rhinoscopic findings were rated by the investigators as an efficacy measure .


As a safety measure , adverse events and clinical chemistry and hematology were evaluated .


Mean change from baseline over the entire treatment period in @TNSS was greater in the FFNS @g group compared with placebo , and the difference was statistically significant ( p < @ ) .


Significant improvements in rhinoscopic findings of swelling of inferior turbinate mucosa and quantity of nasal discharge were also observed .


The total ocular symptom score ( TOSS ) was reduced significantly in the FFNS @g group , compared with placebo , in the second week in a subgroup of patients with baseline TOSS > @ .


The incidence of adverse events was similar between FFNS @g ( @ % ) and placebo ( @ % ) .


Two-week treatment with FFNS @g , once daily is effective and tolerable in Japanese children aged @ to < @ years with PAR .


Fostering positive school climates and student drug testing have been separately proposed as strategies to reduce student drug use in high schools .


To assess the promise of these strategies , the present research examined whether positive school climates and/or student drug testing successfully predicted changes in youth substance use over a @-year follow-up .


Two waves of panel data from a sample of @ high school students , assessed @ year apart , were analyzed .


Changes in reported initiation and escalation in frequency of alcohol , cigarette , and marijuana use as a function of perceived student drug testing and positive school climates were analyzed , while we held constant prior substance use .


Perceived student drug testing was not associated with changes in substance use , whereas perceived positive school climates were associated with a reduction in cigarette and marijuana initiation and a reduction in escalation of frequency of cigarette use at @-year follow-up .


However , perceived positive school climates were not associated with a reduction in alcohol use .


Student drug testing appears to be less associated with substance use than positive school climates .


Nevertheless , even favorable school climates may not be able to influence the use of alcohol , which appears to be quite normative in this age group .


More patient-centered programming is essential for endometrial cancer ( EC ) survivors needing to lose weight to reduce cardiovascular disease risk ( CVD ) .


The purpose of this study was to improve self-efficacy ( SE ) and quality of life ( QOL ) using a lifestyle intervention program designed for weight loss .


Overweight and obese early-stage EC survivors , n = @ , were randomized into two groups : @ ) Survivors of Uterine Cancer Empowered by Exercise and Healthy Diet ( SUCCEED ) , a six-month lifestyle intervention or @ ) a usual care group ( UC ) .


Participants completed the Weight Efficacy Lifestyle Questionnaire ( WEL ) to assess SE and the Functional Assessment of Cancer Therapy-General ( FACT-G ) to measure QOL , and their body mass index ( BMI ) was calculated at baseline , @ , @ , and @ months .


Mixed , repeated-measures ANCOVA models with baseline covariates were employed using SPSS @ .


Positive effects in every WEL domain , including the total score , were statistically significant in the SUCCEED group versus the UC group .


A linear regression model demonstrated that , if BMI decreased by @ unit , the total WEL score increased by @ points .


Significant negative correlations were found in the total WEL score and a change in BMI of R = -@ ( p = @ ) .


Between-group differences in the FACT-G were significant from baseline in the fatigue domain at three months ( p = @ ) and in the physical domain at six months ( p = @ ) .


No other significant differences were found .


Overall , this study shows promise for targeted interventions to help improve SE , thus improving BMI .