Five ( @ % ) of @ participants had dyspepsia in the placebo group .


Headache was noted in @ ( @ % ) patients in the treatment group versus @ ( @ % ) in the placebo group , but was mild in all patients .


Two ( @ % ) patients in the treatment group had facial flushing , which resulted in one withdrawal .


Other withdrawals within the tadalafil group happened after a transient ischaemic attack and two deaths ( ruptured abdominal aortic aneurysm and pneumonia ) .


Tadalafil does not improve exercise capacity or quality of life despite exerting pulmonary vasodilation .


Dysregulated immune responses may contribute to the clinical complications that occur in some patients with dengue .


In Vietnamese pediatric dengue cases randomized to early prednisolone therapy , @ gene-transcripts ( @ % of the @,@ evaluated ) were differentially abundant in whole-blood between high-dose ( @ mg/kg ) prednisolone and placebo-treated patients two days after commencing therapy .


Prominent among the @ transcripts were those associated with T and NK cell cytolytic functions .


Additionally , prednisolone therapy was not associated with changes in plasma cytokine levels .


The inability of prednisolone treatment to markedly attenuate the host immune response is instructive for planning future therapeutic strategies for dengue .


Recent clinical trials suggested that abdominal drainage is not needed in all cases and should be restricted in patients with chronic liver disease or patients who underwent minor liver resection .


In this study we conducted a randomized study to determine whether abdominal drainage is beneficial or rather hazardous after hepatic resection .


Two hundred consecutive patients undergoing elective hepatectomy were entered for this prospective , randomized , case-controlled study .


Liver resection was performed under intermittent Pringle maneuver .


Clinical data such as postoperative complications and mortality rates were evaluated as well as intraoperative parameters .


There were no significant differences in postoperative morbidity between with and without abdominal drainage groups @ vs. @ % ) .


However , complications directly related no drainage such as drain site bleeding and infection , abdominal abscess , bile fistula , and ascites ( CDRD ) tended to be higher in the drainage group than the no-drainage group ( @ vs. @ % , p = @ ) .


Particularly , there was high incidence of CDRD in the drainage group compared with the no drainage group in patients with chronic liver diseases ( @ vs. @ % , p = @ ) .


We do not recommend systematic drainage after elective hepatectomy , irrespective of the extent of resection and of the underlying liver diseases when the surgical procedure has been satisfactory .


Adding nitroglycerin to the combination of vinorelbine plus cisplatin has been reported to improve the overall survival ( OS ) of Asian patients with stage IIIB/IV non-small cell lung cancer ( NSCLC ) probably due to better drug delivery based on changed vascular tonus .


The main objective of our study was to evaluate the effect of adding nitroglycerin to vinorelbine and cisplatin in a Caucasian population .


@ chemonave patients with stage IIIB/IV NSCLC received oral vinorelbine ( first cycle @ mg/m ( @ ) , subsequent cycles : @ mg/m ( @ ) in the absence of any hematological toxicity grade @ in cycle @ ) once daily on days @ and @ of each cycle and cisplatin ( @ mg/m ( @ ) i.v. ) on day @ of each cycle ( q@w ) .


Nitroglycerin ( arm A , n = @ ) or placebo patches ( arm B , n = @ ) were administered once daily from day -@ to day @ of each cycle and were removed about @h after administration .


One nitroglycerin patch contained @mg nitroglycerin .


Median age was @ ( @-@ ) years .


In the overall population ( n = @ ) , the objective response rate ( ORR ) was @ % ( all PR ; @ % CI : @-@ @ ) , with a disease control rate ( DCR ) of @ % ( @ % CI : @-@ @ ) , a median time to progression ( TTP ) of @ months ( n = @ ; @ % CI : @-@ @ ) and a median overall survival ( OS ) of @ months ( @ % CI : @-@ @ ) .


ORR and DCR were numerically higher in arm A than in arm B ( @ % vs. @ % and @ % vs. @ % , respectively ) , whereas TTP and OS were comparable .


The main hematological and non-hematological toxicities grade @ were moderate with no significant differences between the two treatment arms .


Overall , oral vinorelbine plus cisplatin showed a high level of efficacy and adequate tolerability in first line treatment of NSCLC .


Despite the low sample size per group the results seem to confirm the previous results reported in Asian patients .


An inability to show consistent relationships between gene variants and blood pressure ( BP ) may be confounded by the use of office BP measurement .


Whether the difference between office BP and day BP ( office-day ) is genetically predetermined is unknown .


We therefore aimed to determine the intrafamilial aggregation and heritability of office-day BP .


Nurse-derived office BP ( mean of @ measurements according to guidelines ) and @-h ambulatory BP were determined for @ participants from @ families ( @ spouse pairs , @ parent-child pairs , and @ sibling-sibling pairs ) , with @ families having three generations , from an urban developing community of black Africans .


Heritability estimates were determined using SAGE software .


With adjustments for confounders , office systolic BP ( SBP ) ( h = @ , P < @ ) showed comparable heritability estimates to @-h SBP ( h = @ , P < @ ) .


Similarly , with adjustments for confounders , office diastolic BP ( DBP ) ( h = @ , P < @ ) showed comparable heritability estimates as @-h DBP ( h = @ , P < @ ) .


However , multivariate adjusted heritability estimates of day SBP ( h = @ , P < @ ) and DBP ( h = @ , P < @ ) were not diminished by further adjustments for office SBP ( h = @ , P < @ ) or DBP ( h = @ , P < @ ) .


Further , independent of confounders , office-day BP showed significant intrafamilial aggregation and heritability ( SBP : h = @ , P < @ ; DBP : h = @ , P < @ ) , effects that persisted with further adjustments for office , day , or day-night BP ( P < @ for SBP and DBP ) .


Although office and ambulatory BP may show similar heritability estimates , genetic associations with carefully determined office BP measurements may be confounded by the heritability of office-day BP differences .


To establish if women obtain any measurable short term psychological benefit or perceived benefit from having a test to determine the probability of their pregnancy being on-going when this is uncertain on ultrasound examination .


This was a prospective randomised controlled study conducted January @-June @ at the EPU of King 's College Hospital .


The study population was women who conceived spontaneously and had a single intrauterine gestational sac of < @mm mean diameter , with no visible embryo on their first ultrasound scan .


Eligible women were randomised to have a test to calculate the probability of viability ( cases ) or not ( controls ) .


Depression and anxiety levels were calculated using the Hospital Anxiety and Depression Score ( HADS ) and were performed prior to randomisation and seven days later .


A repeat scan for pregnancy outcome was performed after one to two weeks as clinically indicated .


A sample size of @ in each group was calculated to have @ % power to detect a probability of @ that an observation in the cases was less than an observation in controls using a Wilcoxon Mann-Whitney rank-sum test with a @ two-sided significance .


At recruitment there was no significant difference in anxiety levels between cases and controls .


After seven days anxiety levels were significantly lower in cases than controls ( p = @ ) .


Of those who received the probability score , @/@ ( @ % @ % CI @-@ @ % ) found it useful and @/@ ( @ % @ % CI @-@ @ ) would choose to have the test in a future pregnancy if indicated .


This study has demonstrated that there is evidence of psychological benefit from a simple blood test that gives women the likelihood that their pregnancy will be on-going at the next scan .


The addition of a DDP@-inhibitor to existing insulin therapy reduces HbA@c .


However , no data exist about the addition of these agents at the beginning of insulin treatment in type @ diabetes while this could especially be interesting because it is during this period that considerable residual beta cell function is still present .


The benefit of such a strategy could be a lower insulin dose required for glycemic control .


The hypothesis of our study was that adding a DPP@-inhibitor at the beginning of insulin treatment could lead to less exogenous insulin requirement , a reduction of hyperinsulinemia and side effects ( hypoglycemia and weight gain ) , less glucose variability and improvement of insulin and glucagon dynamics during a mixed meal test .


In this small clinical trial ( trial registration NTR@ ) @ patients were randomized to receive vildagliptin and @ to receive placebo in addition to start of once daily insulin treatment .


Unfortunately , due to a difficult inclusion , the preset sample size of @ patients could not be met .


Median units of insulin at the end of the study was @ U in the placebo group and @ U in the vildagliptin group .


Median glycemic variability ( SD ) at the end of study was @ in the placebo group and @ in the vildagliptin group .


Median weight gain at the end of study was @ kg in the placebo and @ kg in the vildagliptin group .


Occurrence of hypoglycemia was low in both groups .


Insulin , C-peptide , glucose and glucagon levels were comparable during mixed meal tests .


This small randomized study did not have sufficient power to detect effects of the addition of vildagliptin to the start of once daily long-acting insulin .


However in our opinion adding a DPP@-inhibitor , especially in this group remains a very interesting approach .


This study could be used as a guidance for larger studies that are required to investigate the effects of this intervention on insulin requirements , glycemic variability , hypoglycemia and weight gain .


It has been reported that adequate calcium intake decreases body fat and appropriate intakes of magnesium suppress the development of the metabolic syndrome .


Furthermore , lactulose increases the absorption of calcium and magnesium .


An optimal combination of calcium , magnesium and lactulose may therefore reduce body fat mass .


An open-label randomized controlled trial was conducted to investigate the body fat-reducing effects of a test food containing @ mg calcium , @ mg magnesium , and @ g lactulose .


Body composition parameters and blood hormone and urine mineral concentrations were measured at baseline and at @ and @ months thereafter .


Whole-body fat mass was measured with dual-energy x-ray absorptiometry .


Seventy-six middle-aged Japanese women ( @ years ) were randomized to the intake group ( n = @ ) or the non-intake control group ( n = @ ) .


At @ months the difference in body fat mass change between the two groups ( intake group - control group ) was -@ kg ( @ % CI : -@ - @ kg , p = @ ) , although there were no differences in anthropometric data between the two groups .


Body fat percentage at @ months tended to be lower in the intake group , but the difference was not significant ( p = @ ) .


These findings may suggest that calcium in combination with magnesium and lactulose can reduce body fat mass in middle-aged Japanese women .


However , the contribution of magnesium and lactulose are unclear in this study .


Further studies are needed to clarify these contributions .


The present study investigated the effects of severe-intensity interval training at a frequency of once a week on cardiorespiratory function at rest and during exercise .


Fourteen young healthy males were randomly assigned to either an interval training group or control group .


Cardiorespiratory function was investigated by incremental maximal exercise test and constant work rate submaximal exercise test before and after the intervention period in all subjects .


Submaximal exercise test was conducted at two work rates ( @ % ventilatory threshold ( VT ) level and @ % VT level plus @ % of the difference between VT and peak oxygen consumption ( VO@ ) ) for @ min ; the same work rates and duration were used before and after training .


Left ventricular adaptations were assessed by echocardiography under supine resting conditions before and after training .


In the interval training group , seven subjects performed cycle ergometer training once per week for @ months .


The training consisted of three bouts of exercises to volitional fatigue at @ % maximum work rate .


Increased VO@max ( +@ % , P = @ ) , VT ( +@ % , P = @ ) , and left ventricular posterior wall thickness ( +@ % , P = @ ) and reduced minute ventilation ( -@ % , P = @ ) and blood lactate concentration ( -@ % , P = @ ) during high-intensity exercise were observed after the training program compared with baseline .


Although not significant , VO@ and cycling economy ( VO@ per work rate ) during high-intensity exercise decreased slightly after training .


The present results indicate that severe-intensity interval training , even when performed at a low frequency , markedly improves cardiorespiratory function as well as induces cardiac morphological adaptations involving left ventricular hypertrophy and cardiorespiratory metabolic response during submaximal exercise .


The present findings may provide new insights for low-frequency , severe-intensity interval training in the field of sports science .


Communication , impulse control and motivation can all be affected by Bipolar Disorder ( BD ) making consistent parenting more difficult than for parents without mental health problems .


Children of parents with BD ( CPB ) are at significantly increased risk of a range of mental health issues including Attention Deficit Hyperactivity Disorder ( ADHD ) , anxiety , depression , substance use , and sleep disorders .


Furthermore , CPB are also at elevated risk for BD compared to the general population .


This paper describes the rationale and protocol for a pilot randomised controlled trial ( RCT ) designed to assess the feasibility and acceptability of a new online intervention providing interactive psychoeducational information and parenting support for parents with BD .


This article describes a single-blind randomised controlled trial comparing an Integrated Bipolar Parenting Intervention ( IBPI ) in addition to treatment as usual ( TAU ) with TAU alone .


Participants will be recruited from across the UK from mental health services and through self-referral .


The primary outcome of the study is the feasibility and acceptability of IBPI as indicated by recruitment to target , use of the intervention site , and retention to follow-up .


Parents with BD allocated to the IBPI condition will have access to the intervention for @ weeks .


Effect size estimates will be obtained with respect to child behaviour , parenting skills and measures of parental mental health using measures taken at baseline ( @ ) , and at @ , @ , @ , and @ weeks post randomization .


This is the first randomised controlled trial of an integrated bipolar disorder parenting intervention .


The benefits and challenges of delivering this online intervention , and evaluation using online RCT methodology are discussed .


To ( @ ) investigate effects of aerobic walking on motor function , cognition , and quality of life in Parkinson disease ( PD ) , and ( @ ) compare safety , tolerability , and fitness benefits of different forms of exercise intervention : continuous/moderate intensity vs interval/alternating between low and vigorous intensity , and individual/neighborhood vs group/facility setting .


Initial design was a @-month , @ @ randomized trial of different exercise regimens in independently ambulatory patients with PD .


All arms were required to exercise @ times per week , @ minutes per session .


Randomization to group/facility setting was not feasible because of logistical factors .


Over the first @ years , we randomized @ participants to continuous or interval training .


Because preliminary analyses suggested higher musculoskeletal adverse events in the interval group and lack of difference between training methods in improving fitness , the next @ participants were allocated only to continuous training .


Eighty-one percent of @ participants completed the study with a mean attendance of @ % ( @ % confidence interval : @ % -@ % ) , exercising at @ % ( @ % -@ % ) of their heart rate reserve .


There were no serious adverse events .


Across all completers , we observed improvements in maximum oxygen consumption , gait speed , Unified Parkinson 's Disease Rating Scale sections I and III scores ( particularly axial functions and rigidity ) , fatigue , depression , quality of life ( e.g. , psychological outlook ) , and flanker task scores ( p < @ to p < @ ) .


Increase in maximum oxygen consumption correlated with improvements on the flanker task and quality of life ( p < @ ) .


Our preliminary study suggests that aerobic walking in a community setting is safe , well tolerated , and improves aerobic fitness , motor function , fatigue , mood , executive control , and quality of life in mild to moderate PD .


This study provides Class IV evidence that in patients with PD , an aerobic exercise program improves aerobic fitness , motor function , fatigue , mood , and cognition .


Irritable bowel syndrome ( IBS ) is characterized by heterogeneous pathophysiology and low response to treatment .


Up to @ % of IBS patients suffers from visceral hypersensitivity , which is associated with symptom severity and underlying pathophysiological mechanisms .


Recently , positive effects of probiotics in IBS have been reported , but overall the response was modest .


We performed a study in IBS patients , characterized by visceral hypersensitivity measured with the rectal barostat , aiming to assess the effect of @weeks of multispecies probiotic mix on visceral pain perception .


We conducted a randomized , placebo-controlled , double-blind trial in forty Rome III IBS patients with visceral hypersensitivity .


Prior to intake , patients kept a @-week symptom diary and underwent a rectal barostat measurement .


When hypersensitivity was confirmed , participation was allowed and patients received a multispecies probiotic with in vitro proven potential beneficial effects on mechanisms contributing to visceral hypersensitivity ( six different probiotic strains ; @ ( @ ) cfu/g ) , or a placebo product of one sachet ( @g ) per day for @weeks .


At the end of the intervention period , visceroperception and symptoms were reassessed .


Thirty-five patients completed the trial .


The percentage of patients with visceral hypersensitivity decreased significantly in the probiotic and placebo group ( @ % and @ % , respectively ; N.S. between groups ) .


Improvement in pain scores and mean symptom score did not differ between the probiotic and placebo group .


In this placebo-controlled trial in IBS patients with visceral hypersensitivity , no significant effect of a multispecies probiotic on viscerperception was observed .


The study has been registered in the US National Library of Medicine ( http://www.clinicaltrials.gov , NCT@ ) .


The aim of this study was to determine the efficacy of real-time continuous glucose monitoring in T@D patients treated with insulin pump therapy or multiple daily insulin therapy .


Twenty adult patients ( ten insulin pump therapy and ten multiple daily insulin ) with poor glycaemic control ( HbA@c > @ % ) were randomized into two groups for @ months : the continuous glucose monitoring arm ( using real-time continuous glucose monitoring ) and the SMBG arm .


After @ months of wash-out , the participants crossed over .


The primary outcome was HbA@c reduction .


The secondary outcomes were hypoglycaemia and hyperglycaemia risk assessment ( area under the curve < @ mg/dL/day and AUC > @ mg/dL/day , respectively ) and glucose variability .


Fourteen patients ( eight multiple daily insulin , six insulin pump therapy ) used continuous glucose monitoring appropriately ( at least @ % of the time ) .


In these patients , the improvement in glycaemic control was more evident during the real-time continuous glucose monitoring period ( @ % @ vs @ % @ , p < @ ) than during the self-monitoring of blood glucose period ( @ % @ vs @ % @ , p = @ ) .


Better results with continuous glucose monitoring were observed in patients using multiple daily insulin with greater improvement in both glycaemic control ( @ % @ vs @ % @ , p < @ ) and glucose variability and with a marked reduction in the risk of both hypoglycaemia and hyperglycaemia .


Appropriate use of real-time continuous glucose monitoring improved glycometabolic control in T@D patients .


The effects of continuous glucose monitoring were more evident in patients under multiple daily insulin treatment , compared with insulin pump therapy .


Glucose variability , in addition to glycaemic control , was improved in compliant diabetic patients .


Acute heart failure is a common reason for admission , and outcome is often poor .


Improved prognostic risk stratification may assist in the design of future trials and in patient management .


Using data from a large randomized trial , we explored the prognostic value of clinical variables , measured at hospital admission for acute heart failure , to determine whether a few selected variables were inferior to an extended data set .


The prognostic model included @ clinical characteristics collected at baseline in PROTECT , a study comparing rolofylline and placebo in @ patients admitted with acute heart failure .


Prespecified outcomes at @ days were death or rehospitalization for any reason ; death or rehospitalization for cardiovascular or renal reasons ; and , at both @ and @ days , all-cause mortality .


No variable had a c-index > @ , and few had values > @ ; c-indices were lower for composite outcomes than for mortality .


Blood urea was generally the strongest single predictor .


Eighteen variables contributed independent prognostic information , but a reduced model using only @ items ( age , previous heart failure hospitalization , peripheral edema , systolic blood pressure , serum sodium , urea , creatinine , and albumin ) performed similarly .


For prediction of all-cause mortality at @ days , the model c-index using all variables was @ and for the simplified model , also @ .


A few simple clinical variables measured on admission in patients with acute heart failure predict a variety of adverse outcomes with accuracy similar to more complex models .


However , predictive models were of only moderate accuracy , especially for outcomes that included nonfatal events .


Better methods of risk stratification are required .


Exogenous glucagon-like peptide-@ ( GLP-@ ) inhibits eating in healthy , overweight , and diabetic subjects .


The GLP-@ receptor antagonist exendin ( @-@ ) NH@ ( ex@-@ ) was used to further explore the role of GLP-@ as an endogenous satiation signal .


Two double-blind , @-way crossover studies were performed , each of which included @ healthy men .


In study A , subjects received an intravenous infusion of ex@-@ or saline plus an oral glucose preload and an intraduodenal infusion of saline or glucose for @ min .


In study B , intravenous infusions were identical , but an oral mixed-liquid meal preload and a @-min intraduodenal infusion of saline or oleic acid were administered .


Thirty minutes after oral preloads , subjects ate and drank ad libitum , and amounts ingested and the time to meal completion were quantified .


In addition , appetite and plasma GLP-@ , peptide YY ( PYY ) , insulin , glucagon , and blood glucose concentrations were measured .


In both studies , GLP-@ , PYY , and glucagon were substantially higher with intravenous ex@-@ than with intravenous saline ( P @ ) .


Insulin was lower with intravenous ex@-@ during intraduodenal glucose ( P @ ) .


The decrease in prospective food consumption and desire to eat during ad libitum eating after glucose ingestion was slightly attenuated ( P @ and P @ , respectively ) with ex@-@ .


However , with intravenous ex@-@ , food and fluid intakes and eating duration were not changed in either study .


GLP-@ receptor antagonism slightly modulates appetite during ad libitum eating , but food and fluid intakes and meal duration remain unchanged , suggesting that endogenous GLP-@ is a weak satiation signal .


However , concomitant substantial increases in plasma PYY and glucagon may counteract a desatiating effect of ex@-@ .


The effect of ex@-@ on PYY secretion supports an autoinhibitory feedback mechanism that controls L cell secretion ; the effect on insulin and glucagon confirms the role of GLP-@ in glycemic control through its action on pancreatic and cells .


Drug dependence is a major problem in our country and in international level .


Reality therapy is an internal control system that determines why and how to choose the options that are set for our lives .


This study aimed to investigate the effect of reality therapy on metacognition , stress and decline in hope in drug addicts .


This study is quasi-experimental study .


Samples were chosen convenient among @ drug addicts in Jahrom in @ .


Samples were randomly divided into two groups ( each group = @ ) of intervention and control groups .


Control group received usual care and experimental group received reality therapy .


Results revealed that there was significant difference between the mean scores of metacognition and hope before and after the intervention of experimental group ( p < @ ) .


Also , there was statistically significant difference between the two groups from these two variables ( p < @ ) .


but , Stress level was n't statistically different in two groups .


Reality therapy is a method that emphasizes the accountability and the current behavior of individuals .


Setting negative emotions , reality therapy promotes metacognition and , through increasing accountability to self-behavior improves hope .


We sought to test the efficacy of a sexual risk intervention for male clients of female sex workers ( FSWs ) and examine whether efficacy was moderated by syndemic risk .


From @ to @ , we conducted a @-arm randomized controlled trial ( @-minute , theory-based , safer sex intervention versus a didactic time-equivalent attention control ) that included @ male clients of FSWs on the US-Mexico border with follow-up at @ , @ , and @ months .


We measured @ syndemic risk factors , including substance use and depression .


Primary outcomes were sexually transmitted infections incidence and total unprotected sex with FSWs .


Although participants in both groups became safer , there was no significant difference in behavior change between groups .


However , baseline syndemic risk moderated intervention efficacy .


At baseline , there was a positive association between syndemic risk and unprotected sex .


Then at @ months , longitudinal analyses showed the association depended on intervention participation ( B = -@ ; @ % confidence interval -LSB- CI -RSB- = -@ , -@ ; P = @ ) .


Among control participants there still existed this modest association ( B = @ ; @ % CI = -@ , @ ; P = @ ) ; among intervention participants there was a significant negative association ( B = -@ ; @ % CI = -@ , -@ ; P = @ ) .


A brief intervention might attenuate syndemic risks among clients of FSWs .


Other populations experiencing syndemic problems may also benefit from such programs .


Despite preoperative anaemia treatment , a risk of postoperative anaemia remains .


This randomized , controlled study evaluated the efficacy of i.v. ferric carboxymaltose ( FCM ) as postoperative anaemia treatment after total knee arthroplasty ( TKA ) .


TKA patients with postoperative anaemia -LSB- haemoglobin ( Hb ) @-@ @ g dl ( -@ ) -RSB- without prior transfusions were randomly assigned to FCM -LSB- @-@ mg iron ( according to calculate iron deficit on postoperative day @ ) -RSB- or ferrous glycine sulphate ( FS ; @ mg iron daily from day @ onwards ) and followed for Hb , iron status , quality-of-life ( EQ-@D ) , and performance ( @ min walk test ) until day @ .


Of @ preoperatively non-anaemic patients , @ ( @ % ) developed anaemia after operation ( within @ h ) and were enrolled in this study ( @ FCM , @ FS ) .


Hb substantially decreased until day @ in both groups , and partly recovered by day @ .


FCM-treated patients achieved Hb @ g dl ( -@ ) more frequently ( @ % vs @ % ; P = @ ) and showed a trend towards higher Hb increase from day @ to day @ -LSB- +@ ( @ ) vs +@ ( @ ) ; P = @ -RSB- compared with FS-treated patients .


Patients with postoperative Hb < @ g dl ( -@ ) experienced better Hb increase with FCM -LSB- +@ ( @ ) g dl ( -@ ) -RSB- than FS -LSB- +@ ( @ ) g dl ( -@ ) ; P = @ -RSB- .


Patients being iron-deficient at enrolment ( @ % ) had a higher Hb increase with FCM -LSB- +@ ( @ ) g dl ( -@ ) -RSB- than FS -LSB- +@ ( @ ) g dl ( -@ ) ; P = @ -RSB- .


Total EQ-@D and performance outcomes were comparable between the groups , but FCM was associated with better scores for ` usual activities ' .


No i.v. iron-related adverse events were reported .


Preoperatively non-anaemic TKA patients are at high risk of postoperative anaemia .


Postoperative i.v. FCM provided significant benefit over oral FS , particularly in patients with preoperative iron deficiency , severe postoperative anaemia , or both .


To compare the efficacy of gradient and swim-up semen preparation techniques on pregnancy rates in couples undergoing intrauterine insemination ( IUI ) cycles with low dose gonadotropin stimulation with the diagnosis of unexplained or mild male subfertility .


Two hundred and twenty three couples were randomized into swim up or gradient technique groups for sperm preperation .


The clinical and on going pregnancy rates per cycle and per patient were evaluated .


Both clinical and ongoing pregnancy rates per cycle were significantly higher in the `` gradient '' group ( @ % and @ % ) in comparision with the `` swim up '' group ( @ % and @ % ) ( p < @ ) .


Clinical pregnancy and on-going pregnancy rates per patient were higher in the `` gradient '' group ( @ % and @ % ) when compared to the `` swim up '' group ( @ % and @ % ) , ( p < @ ) .


In the subgroup of @ unexplained subfertile couples with @ cycles ; the `` gradient '' group also revealed significantly higher clinical and ongoing pregnancy rates per cycle ( @ % and @ % ) when compared with the `` swim up '' group ( @ % and @ % ) ( p < @ ) .


In total of @ treatment cycles upon @ couples with mild male factor subfertility no significant difference were found between the two sperm preparation techniques in terms of clinical ( % @ vs % @ , p > @ ) and ongoing ( % @ vs % @ , p > @ ) pregnancy rates per cycle .


The gradient technique significantly improves clinical outcome in IUI cycles of unexplained subfertile couples when compared to swim up technique .


In male subfertile patients , both techniques yield similar clinical outcomes .


The factors influencing the decision making of operative treatment for fractures of the proximal humerus are debated .


We hypothesized that there is no difference in treatment recommendations between surgeons shown radiographs alone and those shown radiographs and patient information .


Secondarily , we addressed ( @ ) factors associated with a recommendation for operative treatment , ( @ ) factors associated with recommendation for arthroplasty , ( @ ) concordance with the recommendations of the treating surgeons , and ( @ ) factors affecting the inter-rater reliability of treatment recommendations .


A total of @ surgeons of the Science of Variation Group rated @ radiographs of patients with proximal humerus fractures .


Participants were randomized to receive information about the patient and mechanism of injury .


The response variables included the choice of treatment ( operative vs nonoperative ) and the percentage of matches with the actual treatment .


Participants who received patient information recommended operative treatment less than those who received no information .


The patient information that had the greatest influence on treatment recommendations included age ( @ % ) and fracture mechanism ( @ % ) .


The only other factor associated with a recommendation for operative treatment was region of practice .


There was no significant difference between participants who were and were not provided with information regarding agreement with the actual treatment ( operative vs nonoperative ) provided by the treating surgeon .


Patient information-older age in particular-is associated with a higher likelihood of recommending nonoperative treatment than radiographs alone .


Clinical information did not improve agreement of the Science of Variation Group with the actual treatment or the generally poor interobserver agreement on treatment recommendations .


Cobicistat ( COBI ) is a pharmacoenhancer with no antiretroviral activity .


International , randomized double-blind active-controlled trial to evaluate the efficacy and safety of COBI vs ritonavir ( RTV ) as a pharmacoenhancer of atazanavir in combination with emtricitabine/tenofovir disoproxil fumarate in HIV treatment-naive patients followed through week @ .


At Week @ , virologic suppression was achieved in @ % ( COBI ) and @ % ( RTV ) of patients .


Adverse events leading to study drug discontinuation occurred in @ % of patients in each group .


Median changes in serum creatinine ( mg/dL ) were +@ ( COBI ) and +@ ( RTV ) and were unchanged from week @ .


Once-daily COBI is a safe and effective pharmacoenhancer of the protease inhibitor atazanavir .


To evaluate the efficacy of intermittent percutaneous needle sacral nerve stimulation ( IPN-SNS ) in women with idiopathic overactive bladder ( IOAB ) treated with tolterodine .


A total of @ female patients diagnosed with IOAB were randomized to receive tolterodine only treatment ( group @ , n = @ ) or tolterodine combined with IPN-SNS ( group @ , n = @ ) .


Each group included @ participants , who were divided into subgroups depending on whether they had dry OAB ( urinary frequency and urgency ) or wet OAB ( urinary frequency and urgency with urgency incontinence ) .


In the treatment group , patients received percutaneous IPN-SNS plus tolterodine ( @ mg once daily ) , while in the control group , only tolterodine ( @ mg once daily ) was administered for @ months .


The voiding diary and urodynamic parameters were monitored , and patients ' psychological depression and anxiety scores were recorded before and after treatment .


There were significantly greater improvements in the conditions of first desire to void ( FDV ) , maximum cystometric capacity ( MCC ) , and daily average volumes , as well as the daily single maximum voided volumes in group @ ( P = @ ) than in group @ .


In addition , there were significantly greater decreases in self-rating depression scale ( SDS ) and self-rating anxiety scale ( SAS ) scores in group @ compared with group @ ( P < @ ) .


Combined treatment with tolterodine plus IPN-SNS can not only improve the symptoms of voiding dysfunction but can also reduce the concomitant depression and anxiety in women with IOAB , thereby improving patients ' quality of life .


To determine if high-intensity , task-oriented , visual feedback training with a video game balance board ( Nintendo Wii ) induces significant changes in diffusion-tensor imaging ( DTI diffusion-tensor imaging ) parameters of cerebellar connections and other supratentorial associative bundles and if these changes are related to clinical improvement in patients with multiple sclerosis .


The protocol was approved by local ethical committee ; each participant provided written informed consent .


In this @-week , randomized , two-period crossover pilot study , @ patients underwent static posturography and brain magnetic resonance ( MR ) imaging at study entry , after the first @-week period , and at study termination .


Thirteen patients started a @-week training program followed by a @-week period without any intervention , while @ patients received the intervention in reverse order .


Fifteen healthy subjects also underwent MR imaging once and underwent static posturography .


Virtual dissection of white matter tracts was performed with streamline tractography ; values of DTI diffusion-tensor imaging parameters were then obtained for each dissected tract .


Repeated measures analyses of variance were performed to evaluate whether DTI diffusion-tensor imaging parameters significantly changed after intervention , with false discovery rate correction for multiple hypothesis testing .


There were relevant differences between patients and healthy control subjects in postural sway and DTI diffusion-tensor imaging parameters ( P < @ ) .


Significant main effects of time by group interaction for fractional anisotropy and radial diffusivity of the left and right superior cerebellar peduncles were found ( F@ ,@ range , @-@ @ ; P = @ -@ after false discovery rate correction ) .


These changes correlated with objective measures of balance improvement detected at static posturography ( r = -@ to @ , P < @ ) .


However , both clinical and DTI diffusion-tensor imaging changes did not persist beyond @ weeks after training .


Despite the low statistical power ( @ % ) due to the small sample size , the results showed that training with the balance board system modified the microstructure of superior cerebellar peduncles .


The clinical improvement observed after training might be mediated by enhanced myelination-related processes , suggesting that high-intensity , task-oriented exercises could induce favorable microstructural changes in the brains of patients with multiple sclerosis .


To explore the effectiveness of the color Doppler ultrasound-guided botulinum toxin type A ( BTX-A ) injection combined with an ankle foot brace ( AFO ) for treating lower limb spasticity after a stroke .


A total of @ post-stroke patients with lower limb spasticity were divided into three groups : the control group treated with conventional therapy and rehabilitation training , the observation group treated with conventional therapy , rehabilitation training and botulinum toxin type A injection , the treatment group treated with AFO plus the same treatment received by the observation group .


The muscle spasms were evaluated using the Clinic Spasticity Influx ( CSI ) , movement with the Fugl-Meyer Assessment ( FMA ) , dynamic and static balance with the Berg Balance Scale ( BBS ) , and daily life activities with the Functional Independence Measure ( FIM ) , respectively .


Compared the first month after treatment with the prior treatment , there were significant differences in CSI , FMA and FIM scores in both control group and the observation group ( p < @ ) .


However , no differences were noticed in the control group ( p > @ ) .


Compared the third and sixth month after treatment with prior treatment , there were significant differences in these three groups ( p < @ ) .


In terms of treatment time , the BBS scores were always higher in all three groups after one month , three months and six months treatment than prior treatment ( p < @ ) , and there were significant differences in third month and sixth month after treatment compared with the first month treatment ( p < @ ) .


Compared the third month after treatment with the sixth month , there were significant differences in all three groups ( p < @ ) .


The color Doppler ultrasound-guided BTX-A injection combined with AFO can effectively promote patients with post-stroke lower limb spasticity in lower limb muscle spasm , movement , balance and daily life activities .


Previous efforts to preserve cell function in individuals with type @ diabetes ( T@D ) have focused largely on the use of single immunomodulatory agents administered within @ days of diagnosis .


Based on human and preclinical studies , we hypothesized that a combination of low-dose anti-thymocyte globulin ( ATG ) and pegylated granulocyte CSF ( G-CSF ) would preserve cell function in patients with established T@D ( duration of T@D > @ months and < @ years ) .


A randomized , single-blinded , placebo-controlled trial was performed on @ subjects : @ subjects received ATG ( @ mg/kg intravenously ) followed by pegylated G-CSF ( @ mg subcutaneously every @ weeks for @ doses ) and @ subjects received placebo .


The primary outcome was the @-year change in AUC C-peptide following a @-hour mixed-meal tolerance test ( MMTT ) .


At baseline , the age ( mean SD ) was @ @ years ; mean BMI was @ @ kg/m ; mean A@c was @ % @ % ; insulin use was @ @ units/kg/d ; and length of diagnosis was @ @ years .


Combination ATG/G-CSF treatment tended to preserve cell function in patients with established T@D .


The mean difference in MMTT-stimulated AUC C-peptide between treated and placebo subjects was @ nmol/l/min ( @ % CI @-@ @ , P = @ ) .


A@c was lower in ATG/G-CSF-treated subjects at the @-month study visit .


ATG/G-CSF therapy was associated with relative preservation of Tregs .


Patients with established T@D may benefit from combination immunotherapy approaches to preserve cell function .


Further studies are needed to determine whether such approaches may prevent or delay the onset of the disease .


To test the hypothesis that colchicine use during early disease decreases immunosuppressive use in Behet syndrome ( BS ) in the long term .


Patients with BS who participated in a double-blind , placebo-controlled trial of colchicine @ years ago were evaluated for immunosuppressive use during the posttrial period .


We could contact @/@ patients ; @ ( @ % ) received immunosuppressives during the posttrial period , @ being from the colchicine arm .


Posttrial colchicine use and cumulative duration were similar between patients who received immunosuppressives and those who did not .


Continuous use of colchicine , even when initiated at an early disease stage , does not seem to decrease the use of immunosuppressives in the long term .


Feeding polyphenol-rich plant products has been shown to increase the gain : feed ratio in growing pigs .


The reason for this finding has not yet been elucidated .


In order to find the reasons for an increase of the gain : feed ratio , this study investigated the effect of two polyphenol-rich dietary supplements , grape seed and grape marc meal extract ( GSGME ) or spent hops ( SH ) , on gut morphology , apparent digestibility of nutrients , microbial composition in faeces and the expression of pro-inflammatory genes in the intestine of pigs .


Pigs fed GSGME or SH showed an improved gain : feed ratio in comparison to the control group ( P < @ for GSGME , P < @ for SH ) .


Villus height : crypt depth ratio in duodenum and jejunum as well as apparent total tract digestibility of nutrients were unchanged in the groups receiving GSGME or SH in comparison to the control group .


However , the groups receiving GSGME or SH revealed an increased faecal pH value , lower levels of volatile fatty acids and lower counts of Streptococcus spp .


and Clostridium Cluster XIVa in the faecal microbiota ( P < @ ) .


Moreover , both treatment groups had a lower expression of various pro-inflammatory genes in duodenum , ileum and colon than the control group ( P < @ ) .


The present study suggests that dietary plant products rich in polyphenols are able to improve the gain : feed ratio in growing pigs .


It is assumed that an alteration in the microbial composition and anti-inflammatory effects of the polyphenol-rich plant products in the intestine might contribute to this effect .


Accuracy of the radiologic diagnosis of gastric cancer staging after neoadjuvant chemotherapy remains unclear .


Patients enrolled in the COMPASS trial , a randomized phase II study comparing two and four courses of S-@ plus cisplatin and paclitaxel and cisplatin followed by gastrectomy , were examined .


The radiologic stage was determined by using thin-slice computed tomography ( CT ) or multidetector low CT by following Habermann 's method .


A total of @ patients registered in the COMPASS study who underwent surgical resection were examined in this study .


The radiologic T and pathologic T stages were not significantly correlated ( p = @ ) .


The radiologic accuracy and rates of underdiagnosis and overdiagnosis were @ , @ , and @ % , respectively .


When patients were stratified according to the pathologic response of the primary tumor , the correlation was not significant in either the responders ( n = @ , p = @ ) or the nonresponders ( n = @ , p = @ ) .


The radiologic accuracy was @ % in the responders and @ % in the nonresponders .


The radiologic N and pathologic N stages were significantly correlated ( p = @ ) .


When stratifying the patients with measurable lymph nodes according only to the radiologic response , the correlation was significant in the nonresponders ( n = @ , p = @ ) but not in the responders ( n = @ , p = @ ) .


Restaging using CT after neoadjuvant chemotherapy for gastric cancer is considered to be inaccurate and unreliable .


In particular , the radiologic T-staging determined after neoadjuvant chemotherapy should not be considered in clinical decision-making .


Most randomized trials have shown similar results with endoscopic carpal tunnel release ( ECTR ) and open carpal tunnel release ( OCTR ) ; however , there are studies suggesting less postoperative pain , faster improvement in grip and pinch strength , and earlier return to work with the endoscopic technique .


The goal of this study was to prospectively examine subjective and functional outcomes , satisfaction , and complications after both ECTR and OCTR in the opposite hands of the same patient , serving as their own control .


This was a prospective , randomized study in which patients underwent surgery for bilateral carpal tunnel syndrome .


The first carpal tunnel release was performed on the most symptomatic hand-determined by the patient .


Operative approach was randomly assigned and , approximately @ month later , the alternative technique was performed on the contralateral side .


Demographic data were obtained , and functional outcomes were recorded preoperatively and postoperatively , including pain score , @-point discrimination , Semmes-Weinstein monofilament testing , thenar strength , and overall grip strength .


The carpal tunnel syndrome-functional status score and carpal tunnel syndrome-symptom severity score were recorded before surgery and at @ , @ , @ , @ , and @ weeks postoperatively .


Overall satisfaction with each technique was recorded at the conclusion of the study .


Currently , @ subjects have completed final visit testing .


There were no differences in pain score , @-point discrimination , Semmes-Weinstein monofilament testing , thenar strength , or overall grip strength at any of the postoperative time points .


Carpal tunnel syndrome-symptom severity score and carpal tunnel syndrome-functional status score were not significantly different between groups at any of the evaluations .


Overall satisfaction , where patients recorded a number from @ to @ , was significantly greater in the ECTR group ( @ vs @ , P = @ ) .


There were no complications with either technique .


This interim analysis , using the same patient as an internal control , suggests that both OCTR and ECTR are well tolerated with no differences in functional outcomes , symptom severity and functional status questionnaires , or complications .


Although there were no differences between groups using our study metrics , patients still preferred the ECTR , demonstrated by significantly higher overall satisfaction scores at the conclusion of the study .


To evaluate the @-month efficacy and safety of intravitreal ranibizumab @ mg and @ mg administered monthly or as needed ( pro re nata -LSB- PRN -RSB- ) in patients with neovascular age-related macular degeneration ( wet AMD ) .


Twenty-four-month , multicenter , randomized , double-masked , active treatment-controlled phase @ trial .


Patients ( n = @ ) @ years of age with treatment-nave subfoveal wet AMD .


Patients were randomized to receive intravitreal injections of ranibizumab @ mg or @ mg monthly or PRN after @ monthly loading doses .


The primary efficacy end point was the mean change in best-corrected visual acuity ( BCVA ) from baseline at month @ .


Key secondary end points included mean change in BCVA from baseline at month @ , proportion of patients who gained @ letters in BCVA , mean number of ranibizumab injections , and mean change in central foveal thickness from baseline over time by spectral-domain optical coherence tomography .


Ocular and systemic safety events also were evaluated through month @ .


At month @ , the mean change from baseline in BCVA was ( letters ) +@ ( @ mg monthly ) , +@ ( @ mg PRN ) , +@ ( @ mg monthly ) , and +@ ( @ mg PRN ) .


The change in mean BCVA from month @ to @ was ( letters ) -@ , -@ , -@ , and -@ , respectively .


The proportion of patients who gained @ letters from baseline in BCVA at month @ was @ % , @ % , @ % , and @ % , respectively .


The mean number of ranibizumab injections through month @ was @ , @ , @ , and @ , respectively ; @ and @ mean injections were required in year @ in the @ mg and @ mg PRN groups , respectively .


The average treatment interval in the @ mg PRN group was @ weeks after @ monthly loading doses , and @ % of these patients did not require monthly dosing .


Ocular and systemic safety profiles over @ years were similar among all @ treatment groups and were consistent with previous ranibizumab trials in AMD .


At month @ , mean BCVA improvements were clinically meaningful and similar among all @ ranibizumab treatment groups .


The @ mg PRN group achieved a mean gain of @ letters at month @ with an average of @ injections ( @ injections in year @ ) .


No new safety events were identified over @ months .


Lifestyle modification is recommended for management of prehypertension , yet finding effective interventions to reach rural women is a public health challenge .


This community-based clinical trial compared the effectiveness of standard advice to two multi-component theory-based tailored interventions , using web-based or print-mailed delivery , in reducing blood pressure among rural women , ages @-@ , with prehypertension .


@ women with prehypertension enrolled in the Wellness for Women : DASHing towards Health trial , a @-month intervention with @-month follow-up .


Women were randomly assigned to groups using a @:@:@ ratio , comparing standard advice ( @-minute counseling session ) to two interventions ( two @-hour counseling sessions , @ phone goal-setting sessions , strength-training video , and @ tailored newsletters , web-based or print-mailed ) .


Linear mixed model methods were used to test planned pairwise comparisons of marginal mean change in blood pressure , healthy eating and activity , adjusted for age and baseline level .


General estimating equations were used to examine the proportion of women achieving normotensive status and meeting health outcome criteria for eating and activity .


Mean blood pressure reduction ranged from @ ( SD = @ ) mm Hg to @ ( SD = @ ) mm Hg .


The @-month estimated marginal proportions of women achieving normotensive status were @ % for web-based , and @ % for both print-mailed and standard advice groups , with no group differences ( p = @ and p = @ , respectively ) .


Web-based and print-mailed groups improved more than standard advice group for waist circumference ( p = @ and p = @ , respectively ) ; % daily calories from fat ( p = @ and p = @ ) and saturated fat ( p = @ and p = @ ) ; daily servings of fruit and vegetables ( p = @ and p < @ ) ; and low fat dairy ( p < @ and p = @ ) .


Greater improvements were observed in web-based versus standard advice groups in systolic blood pressure ( p = @ ) and estimated VO@max ( p = @ ) .


Dropout rates were @ % by @-months , @ % by @ months , with no differences across groups .


Rural women with prehypertension receiving distance-delivery theory-based lifestyle modifications can achieve a reduction of blood pressure and attainment of normotensive status .


To investigate the safety and efficacy of trastuzumab administered concurrently with anthracycline-containing adjuvant regimen for breast cancer .


It is a prospective , randomized and controlled trial .


Participants were randomized to receive trastuzumab administered concurrently or sequentially with anthracycline-containing adjuvant regimen .


The primary endpoint was cardiac safety .


The second endpoints were disease-free survival ( DFS ) and overall survival ( OS ) .


One hundred and nine breast cancer patients were enrolled and randomized in this trial .


Fifty-five participants received trastuzumab administered concurrently with anthracycline-containing adjuvant regimen and @ patients received trastuzumab administered sequentially with anthracycline .


The primary cardiac event was asymptomatic decrease in the left ventricular ejection fraction ( LVEF ) .


There was no significant difference between concurrent and sequential groups in cardiac event rates ( @ % vs@ @ % , P = @ ) , neither of LVEF values at basline or at @ , @ , @ and @ months during trastuzumab treatment ( P > @ ) .


Four patients ( @ % ) in the concurrent group suffered local recurrences or distant metastases , and @ participants ( @ % ) in the sequential group had distant metastases .


There was no significant difference between the two groups in DFS ( P = @ ) .


There was no death in both groups .


Trastuzumab administered concurrently with anthracycline is a safe adjuvant regimen for breast cancer and does not increase cardiac events .


Further research is needed to determine the efficacy of this treatment regimen .


Anthroponotic cutaneous leishmaniasis ( CL ) due to Leishmania ( L. ) tropica infection is a chronic , frequently disfiguring skin disease with limited therapeutic options .


In endemic countries healing of ulcerative lesions is often delayed by bacterial and/or fungal infections .


Here , we studied a novel therapeutic concept to prevent superinfections , accelerate wound closure , and improve the cosmetic outcome of ACL .


From @ to @ we performed a two-armed , randomized , double-blinded , phase IIa trial in Kabul , Afghanistan , with patients suffering from L. tropica CL .


The skin lesions were treated with bipolar high-frequency electrocauterization ( EC ) followed by daily moist-wound-treatment ( MWT ) with polyacrylate hydrogel with ( group I ) or without ( group II ) pharmaceutical sodium chlorite ( DAC N-@ ) .


Patients below age @ , with facial lesions , pregnancy , or serious comorbidities were excluded .


The primary , photodocumented outcome was the time needed for complete lesion epithelialization .


Biopsies for parasitological and ( immuno ) histopathological analyses were taken prior to EC ( @ ( st ) ) , after wound closure ( @ ( nd ) ) and after @ months ( @ ( rd ) ) .


The mean duration for complete wound closure was short and indifferent in group I ( @ patients , @ d ) and II ( @ patients , @ d ; p = @ ) .


In patients with Leishmania-positive @ ( nd ) biopsies DAC N-@ caused a more rapid wound epithelialization ( @ d vs. @ d ; p = @ ) .


Superinfections occurred in both groups at the same rate ( @ % ) .


Except for one patient , reulcerations ( @ % in group I , @ % in group II ; p = @ ) were confined to cases with persistent high parasite loads after healing .


In vitro , DAC N-@ showed a leishmanicidal effect on pro- and amastigotes .


Compared to previous results with intralesional antimony injections , the EC plus MWT protocol led to more rapid wound closure .


The tentatively lower rate of relapses and the acceleration of wound closure in a subgroup of patients with parasite persistence warrant future studies on the activity of DAC N-@ .


To evaluate the effects of energy restriction with or without aerobic exercise on thigh muscle mass and quality in adults with visceral adiposity .


@ males and females were randomly assigned to the groups ` diet only ' ( DO ; n = @ ) or ` diet plus aerobic exercise ' ( D/Ex ; n = @ ) for @ weeks .


The target energy intake in both groups was @ kcal/kg of ideal body weight .


Subjects in the D/Ex group were instructed to exercise for @ min/week at lactate threshold .


Computed tomography was used to measure thigh muscle cross-sectional area ( CSA ) , normal-density muscle area ( NDMA ) , and visceral fat area .


Total body weight ( DO : -@ @ % ; D/Ex : -@ @ % ) and visceral fat ( DO : -@ @ % ; D/Ex : -@ @ % ) decreased significantly in both groups ; however , the changes were not significantly different between the two groups .


The decrease in muscle CSA was significantly greater in the DO group ( -@ @ % ) compared with the D/Ex group ( -@ @ % ) .


NDMA decreased significantly in the DO ( -@ @ % ) but not in the D/Ex group ( -@ @ % ) .


Aerobic exercise attenuated the loss of skeletal muscle during energy restriction in adults with visceral adiposity .


Splanchnic hypoperfusion is a physiological phenomenon during strenuous exercise .


It has been associated with gastrointestinal symptoms and intestinal injury and may hamper athletic performance .


We hypothesized that L-citrulline supplementation improves splanchnic perfusion and decreases intestinal injury by enhancing arginine availability .


The aim of this study was to determine the effect of L-citrulline intake on splanchnic perfusion , intestinal injury , and barrier function during exercise .


In this randomized , double-blind crossover study , @ men cycled for @ min at @ % of their maximum workload after L-citrulline ( @ g ) or placebo ( L-alanine ) intake .


Splanchnic perfusion was assessed using gastric air tonometry .


Sublingual microcirculation was evaluated by sidestream dark field imaging .


Plasma amino acid levels and intestinal fatty acid binding protein concentrations , reflecting enterocyte damage , were assessed every @ min .


Urinary excretion of sugar probes was measured to evaluate intestinal permeability changes .


Oral L-citrulline supplementation enhanced plasma citrulline ( @ @ M ) and arginine levels ( @ @ M ) compared with that in placebo ( @ @ M and @ @ M , respectively , P < @ ) , resulting in increased arginine availability .


Splanchnic hypoperfusion was prevented during exercise after L-citrulline ingestion ( reflected by unaltered gapg-apCO@ levels ) , whereas gapg-apCO@ increased with placebo treatment ( P < @ ) .


Accordingly , L-citrulline intake resulted in an increased number of perfused small sublingual vessels compared with that in placebo ( @ @ vs -@ @ , P = @ ) .


Furthermore , plasma intestinal fatty acid binding protein levels were attenuated during exercise after L-citrulline supplementation compared with that in placebo ( AUC@-@ min , -@ % @ % vs @ % @ % , P < @ ) .


No significant differences were observed for intestinal permeability .


Pre-exercise L-citrulline intake preserves splanchnic perfusion and attenuates intestinal injury during exercise in athletes compared with placebo , probably by enhancing arginine availability .


These results suggest that oral L-citrulline supplementation is a promising intervention to combat splanchnic hypoperfusion-induced intestinal compromise .


Vitamin D supplementation is recommended for breastfed infants .


Maternal supplementation beginning in gestation is a potential alternative , but its efficacy in maintaining infant @-hydroxyvitamin D -LSB- @ ( OH ) D -RSB- concentration after birth is unknown .


We determined the effect of @ doses of maternal vitamin D supplementation beginning in gestation and continued in lactation on infant serum @ ( OH ) D and compared the prevalence of infant serum @ ( OH ) D cutoffs ( > @ , > @ , > @ , and > @ nmol/L ) by dose at @ wk of age .


Pregnant women ( n = @ ) were randomly allocated to receive @ , @ , or @ g vitamin D/d from @ to @ wk of gestation until @ wk postpartum , with no infant supplementation .


Mother and infant blood was collected at @ wk postpartum .


At @ wk postpartum , mean -LSB- nmol/L ( @ % CI ) -RSB- infant @ ( OH ) D at @ wk was higher in the @-g/d -LSB- @ ( @ , @ ) -RSB- than in the @-g/d -LSB- @ ( @ , @ ) -RSB- or @-g/d -LSB- @ ( @ , @ ) -RSB- vitamin D groups ( P < @ ) .


Fewer infants born to mothers in the @-g/d group had a @ ( OH ) D concentration < @ nmol/L ( indicative of deficiency ) than infants in the @ - and @-g/d groups , respectively ( @ % compared with @ % and @ % ; P < @ ) .


Fewer than @ % of infants in the @ - or @-g/d groups achieved a @ ( OH ) D concentration > @ nmol/L compared with @ % in the @-g/d group ( P < @ ) .


Almost all infants ( @ % , n = @ ) born to mothers in the @-g/d group achieved a @ ( OH ) D concentration > @ nmol/L .


At @ wk postpartum , mean maternal @ ( OH ) D concentration was higher in the @-g/d -LSB- @ ( @ , @ ) -RSB- than in the @-g/d -LSB- @ ( @ , @ ) -RSB- or @-g/d -LSB- @ ( @ , @ ) -RSB- groups ( P < @ ) .


Maternal supplementation beginning in gestation with @ g vitamin D/d protects @ % of unsupplemented breastfed infants against @ ( OH ) D deficiency ( < @ nmol/L ) to at least @ wk , whereas @ or @ g vitamin D/d protects only @ % and @ % of infants , respectively .


The MIRCIT trial was a randomized , double-blind , placebo-controlled study of advanced Non-small cell lung cancer ( NSCLC ) .


Patients were randomized to receive @ mg or @ mg of melatonin or placebo .


Assessment of health-related quality of life ( HRQoL ) was completed at baseline , and at @ , @ and @ months .


Survival and adverse events were collected .


DNA damage marker @-oxo-@ ,@ - dihydro-@ ' - deoxyguanosine ( @-oxodG ) was measured during the first three months of chemotherapy .


Patients in the melatonin-treated group had better adjusted HRQoL scores , with a slightly significantly better score ( @ points , @ % confidence interval ( CI ) = @-@ @ , p = @ ) being found in social well-being .


Median survival was @ months ( @ % CI = @-@ @ ) without significant difference .


A great amont of DNA damage marker was observed in the placebo-treated group , and this was associated with lower survival ( r ( @ ) = -@ , p = @ ) , implying the protective effect of melatonin in healthy cells .


Melatonin in combination with chemotherapy did not affect survival and adverse events of advanced patients with NSCLC , but there was a trend for better HRQoL .


Modifiable risk factors , including life-style habits and psychological variables , have been increasingly demonstrated to have an important role in influencing morbidity and mortality in cardiovascular patients , and to account for approximately @ % of the population risk for cardiac events.Acceptance and Commitment Therapy ( ACT ) has shown effectiveness in promoting healthy behaviors , and improving psychological well-being in patients with chronic physical conditions .


Moreover , a first application of an acceptance-based program in cardiac patients has revealed high treatment satisfaction and initial evidences of effectiveness in increasing heart-healthy behaviour .


However , no clinical trial to date has evaluated the efficacy of an acceptance-based program for the modification of cardiovascular risk factors and the improvement of psychological well-being , compared to usual secondary prevention care .


Approximately @ patients will be recruited from an outpatient cardiac rehabilitation unit and randomly assigned to receive usual care or usual care + a brief ACT-based intervention .


The ACT group will be administered five group therapy sessions integrating educational topics on heart-healthy behaviours with acceptance and mindfulness skills .


Participants will be assessed at baseline , six weeks later ( post treatment for the ACT condition ) , at six and twelve months follow-up .


A partially-nested design will be used to balance effects due to clustering of participants into small therapy groups .


Primary outcome measures will include biological indicators of cardiovascular risk and self-reported psychological well-being .


Treatment effects will be tested via multilevel modeling after which the mediational role of psychological flexibility will be evaluated .


The ACTonHEART study is the first randomized clinical trial designed to evaluate the efficacy of a brief group-administered , ACT-based program to promote health behavior change and psychological well-being among cardiac patients .


Results will address the effectiveness of a brief treatment created to simultaneously impact multiple cardiovascular risk factors .


Conducted in the context of clinical practice , this trial will potentially offer empirical support to alternative interventions to improve quality of life and reduce mortality and morbidity rates among cardiac patients .


Compensatory responses may attenuate the effectiveness of exercise training in weight management .


The aim of this study was to compare the effect of moderate - and high-intensity interval training on eating behavior compensation .


Using a crossover design , @ overweight and obese men participated in @-week moderate ( MIIT ) and high ( HIIT ) intensity interval training .


MIIT consisted of @-min cycling stages at @ % of mechanical work at @ % VO ( @ ) peak , and HIIT consisted of alternate @-s work at @ % VO ( @ ) peak and @-s rests , for @ to @ min .


Assessments included a constant-load exercise test at @ % VO ( @ ) peak for @ min followed by @-min recovery .


Appetite sensations were measured during the exercise test using a Visual Analog Scale .


Food preferences ( liking and wanting ) were assessed using a computer-based paradigm , and this paradigm uses @ photographic food stimuli varying along two dimensions , fat ( high or low ) and taste ( sweet or nonsweet ) .


An ad libitum test meal was provided after the constant-load exercise test .


Exercise-induced hunger and desire to eat decreased after HIIT , and the difference between MIIT and HIIT in desire to eat approached significance ( p = @ ) .


Exercise-induced liking for high-fat nonsweet food tended to increase after MIIT and decreased after HIIT ( p = @ ) .


Fat intake decreased by @ % after HIIT , and increased by @ % after MIIT , with the difference between MIIT and HIIT approaching significance ( p = @ ) .


This study provides evidence that energy intake compensation differs between MIIT and HIIT .


To determine if lower extremity exercise-induced muscle injury reduces vascular endothelial function of the upper extremity and if massage therapy ( MT ) improves peripheral vascular function after exertion-induced muscle injury .


Randomized , blinded trial with evaluations at @ minutes , @ hours , @ hours , and @ hours .


Clinical research center .


Sedentary young adults ( N = @ ) were randomly assigned to @ of @ groups : ( @ ) exertion-induced muscle injury and MT ( n = @ ; mean age SE , @ @ ) ; ( @ ) exertion-induced muscle injury only ( n = @ ; mean age SE , @ @ ) , and ( @ ) MT only ( n = @ ; mean age SE , @ @ ) .


Participants were assigned to exertion-induced muscle injury only ( a single bout of bilateral , eccentric leg press exercise ) , MT only ( @-min lower extremity massage using Swedish technique ) , or exertion-induced muscle injury and MT.


Brachial artery flow-mediated dilation ( FMD ) was determined by ultrasound at each time point .


Nitroglycerin ( NTG ) - induced dilation was also assessed ( @ mg ) .


Brachial FMD increased from baseline in the exertion-induced muscle injury and MT group and the MT only group ( @ % @ % to @ % @ % , P < @ and @ % @ % to @ % @ % , P < @ , respectively ) at @ minutes and remained elevated until @ hours .


In the exertion-induced muscle injury only group , FMD was reduced from baseline at @ and @ hours ( @ % @ % to @ % @ % , P < @ and @ % @ % , P < @ , respectively ) and returned to baseline after @ hours .


Dilations of NTG were similar over time .


Our results suggest that MT attenuates impairment of upper extremity endothelial function resulting from lower extremity exertion-induced muscle injury in sedentary young adults .


In research clinic settings , overweight adults undertaking HIIT ( high intensity interval training ) improve their fitness as effectively as those undertaking conventional walking programs but can do so within a shorter time spent exercising .


We undertook a randomized controlled feasibility ( pilot ) study aimed at extending HIIT into a real world setting by recruiting overweight/obese , inactive adults into a group based activity program , held in a community park .


Participants were allocated into one of three groups .


The two interventions , aerobic interval training and maximal volitional interval training , were compared with an active control group undertaking walking based exercise .


Supervised group sessions ( @ per intervention ) were held outdoors .


Cardiorespiratory fitness was measured using VO@max ( maximal oxygen uptake , results expressed in ml/min/kg ) , before and after the @ week interventions .


On ITT ( intention to treat ) analyses , baseline ( N = @ ) and exit ( N = @ ) -LSB- Formula : see text -RSB- O@ was @ and @ , respectively .


Participant allocation and baseline/exit VO@max by group was as follows : Aerobic interval training N = @ , @ / @ ; maximal volitional interval training N = @ , @ / @ ; walking N = @ , @ / @ .


The post intervention change in VO@max was +@ in the aerobic interval training , -@ in the maximal volitional interval training and -@ in the walking subgroups .


The aerobic interval training subgroup increased VO@max compared to walking ( p = @ ) .


The actual ( observed , rather than prescribed ) time spent exercising ( minutes per week , ITT analysis ) was @ for aerobic interval training , @ for maximal volitional interval training and @ for walking ( p = @ ) .


On descriptive analysis , the walking subgroup had the fewest adverse events .


In contrast to earlier studies , the improvement in cardiorespiratory fitness in a cohort of overweight/obese participants undertaking aerobic interval training in a real world setting was modest .


The most likely reason for this finding relates to reduced adherence to the exercise program , when moving beyond the research clinic setting .


In experimental animal studies , pulsing the CO@ laser beam has been shown to reduce the thermal damage zone of excised oral mucosal tissue .


However , there is still controversy over whether this is borne out under clinical conditions .


To compare the outcome following excisional biopsies of fibrous hyperplasias using a pulsed ( cf ) versus a continuous wave ( cw ) CO@ laser mode regarding the thermal damage zone , duration of surgeries , intra - and postoperative complications , postoperative pain sensation , scarring and/or relapse during the initial @ months .


One hundred Swiss-resident patients with a fibrous hyperplasia in their buccal mucosa were randomly assigned to the cw mode ( @W ) or the cf mode ( @Hz , @microseconds , @mJ , @ W ) group .


All excisions were performed by one single oral surgeon .


Postoperative pain ( @ weeks ) was recorded by visual analogue scale ( VAS ; ranging from @ to @ ) .


Intake of analgesics and postoperative complications were recorded in a standardized study form .


The maximum width of the collateral thermal damage zone was measured ( m ) in excision specimens by one pathologist .


Intraoral photographs at @-month follow-up examinations were evaluated regarding scarring ( yes/no ) .


Median duration of the excision was @seconds in the cw and @seconds in the cf group ( P = @ ) .


Intraoperative bleeding occurred in @ % of the patients in the cw and @ % of the cf group .


The median value of the thermal damage zone was @ ( @ ) m in the cw and @ ( @ ) m in the cf group ( P = @ ) .


The reported postoperative complications included swelling in @ % and minor bleeding in @ % without significant differences between the two laser modes .


When comparing each day separately or the combined mean VAS scores of both groups between Days @-@ , @-@ , and @-@ , there were no significant differences .


However , more patients of the cw group ( @ % ) took analgesics than patients of the cf group ( @ % ) resulting in a borderline significance ( P = @ ) .


Scarring at the excision site was found in @ % of @ patients after @ months , and more scars were identified in cases treated with the cf mode ( P = @ ) .


Excision of fibrous hyperplasias performed with a CO@ laser demonstrated a good clinical outcome and long-term predictability with a low risk of recurrence regardless of the laser mode ( cf or cw ) used .


Scarring after @ months was only seen in @ % of the cases and was slightly more frequent in the cf mode group .


Based on the findings of the present study , a safety border of @mm appears sufficient for both laser modes especially when performing a biopsy of a suspicious soft tissue lesion to ensure a proper histopathological examination .


Patients with chronic kidney disease ( CKD ) show an increase in bowel aerobic bacteria that produce uremic toxins and decreased anaerobic bacteria as bifidobacteria and lactobacillus .


The latter can be used as probiotics .


The probiotic with greater availability in Mexico , is the lactobacillus casei shirota ( LcS ) , currently there is no known LcS specified dose that produces a benefit to the patient with CKD .


To determine the effectiveness of two different LcS doses in achieving a decrease in urea concentrations of at least @ % in patients with KDOQI stage @ and stage @ CKD .


METODOLOGY : A simple randomized , controlled clinical trial .


Outpatients treated at the National Institute of Medical Sciences and Nutrition Salvador Zubirn in Mxico D.F. Patients were provided the LcS , as follows : Group A : @ x @ ( @ ) colony-forming units ( CFU ) and Group B : @ x @ ( @ ) CFU .


Patients were followed-up for eight weeks , and baseline and final samples were obtained to calculate the basal and final concentrations , respectively , of blood urea and serum creatinine ( CrS ) .


During the follow-up , both groups consumed a diet of @ kcal/kg/weight and @ g/kg/weight of protein , and a food diary was made to assess both the adherence to the diet and LcS .


Thirty patients with CKD were evaluated .


When analyzing the percentage change between the different doses , a decrease > @ % was found in the blood urea concentrations for patients treated with the @ x @ dose , which was significant with respect to the baseline measurement .


There was a > @ % decrease in the serum urea concentrations with LcS in patients with stage @ and @ CRF .


SCN@A encodes the alpha subunit of the voltage-gated sodium channel and plays a crucial role in several epilepsy syndromes .


The common SCN@A splice-site polymorphism rs@ ( IVS@N +@ G > A ) might contribute to the pathophysiology underlying genetic generalized epilepsies and is associated with electrophysiologic properties of the channel and the effect of sodium-channel blocking antiepileptic drugs .


We assessed the effects of the rs@ genotype on cortical excitability at baseline and after administration of carbamazepine in order to investigate the mechanism of this association .


Paired-pulse transcranial magnetic stimulation ( TMS ) was applied in @ healthy volunteers with the homozygous genotypes AA or GG of rs@ at baseline and after application of @mg of carbamazepine or placebo in a double-blind , randomized , crossover design .


Resting motor threshold ( RMT ) , short interval intracortical inhibition ( SICI ) , intracortical facilitation ( ICF ) , and cortical silent period ( CSP ) were determined .


At baseline there was no significant difference in any TMS parameter .


Genotype GG was associated with a higher carbamazepine-induced increase in CSP duration as compared to AA ( multivariate analysis of covariance -LSB- MANCOVA -RSB- , p = @ ) .


An expected significant increase in RMT was genotype independent .


We found that the rs@ genotype modifies the effect of carbamazepine on CSP duration ( mainly reflecting modulation of - aminobutyric acid ( GABA ) ergic inhibition ) , but not on RMT ( mainly reflecting modulation of voltage-gated sodium channels ) .


This provides evidence that rs@ affects the pharmacoresponse to carbamazepine via an effect on GABAergic cortical interneurons .


Our results also confirm that TMS is useful to investigate the effect of genetic variants on cortical excitability and pharmacoresponse .


We evaluate whether aspiration and sclerosing of hydrocele testis is an effective treatment .


Men with symptomatic hydrocele testis were included in this prospective , double-blind , randomized study with polidocanol and placebo .


Patients were randomized to active treatment or placebo at the first treatment .


Depending on hydrocele testis size ( less than @ , @ to @ and greater than @ ml ) , the patients were treated with @ , @ or @ ml polidocanol after aspiration .


Patients with recurrence at the @-week followup received active treatment .


A total of @ patients were included in the study .


In group @ ( active treatment ) there were @ patients with a median age of @ years ( range @ to @ ) .


In group @ , comprised of @ patients , the median age was @ years ( range @ to @ ) .


Median followup was @ months .


A significant difference between the groups was observed after the first and second treatments .


Recurrence after the first treatment was seen in @ ( @ % ) patients from group @ and in @ ( @ % ) from group @ ( p < @ ) .


Recurrence after re-treatment with the active drug in both groups was seen in @ ( @ % ) patients in group @ and in @ ( @ % ) in the former placebo group ( p < @ ) .


The overall success rate of treatment in the active group was @ % .


There was no difference between the @ groups in terms of volume of fluid aspirated , symptoms or complications .


This long-term efficacy randomized study with placebo showed that polidocanol is effective for the treatment of hydrocele testis with a low recurrence rate .


Although hypertension is a modifiable cardiovascular risk factor , up to one-third of ambulatory patients have uncontrolled blood pressure ( BP ) .


We evaluated the impact of a targeted provider feedback intervention on rates of BP control .


Clinic BP readings were aggregated among approximately @,@ hypertensive patients followed up in @ outpatient cardiology clinic practices at a large quaternary care academic medical center .


Physician practices received quarterly reports on BP control rates .


Provider-specific reports were benchmarked vs overall peer performance and distributed quarterly between September @ and September @ .


Rates of BP control were evaluated before and after the intervention .


Medical record reviews were performed for a subset of patients with uncontrolled BP before ( n = @ ) and after ( n = @ ) the intervention to evaluate provider responses and interventions .


At baseline , @ % of clinic patients had uncontrolled BP .


After one @ of reports , the rate of uncontrolled BP remained unchanged ( @ % , P = @ ) .


Analysis of provider performance revealed a subset of providers who consistently outperform their peers .


In the sample of patients selected for medical record reviews , at baseline ( n = @ ) and follow-up ( n = @ ) , cardiologists discussed BP in @ % of clinic notes for patients with uncontrolled BP .


Cardiologists more frequently documented repeat measurements after the intervention ( @ % vs @ % , P = @ ) .


No other changes were found in documentation of provider responses to BP .


Clinician-specific audit and feedback reports as a stand-alone intervention did not affect overall BP control rates in cardiology clinics .


Future BP control interventions should consider real-time patient-specific reminders , provider incentive programs , and patient engagement interventions .


The object of this study was to assess the effects of an inside-out vein graft as a cuff after direct suture on human lingual nerve regeneration and recovery after iatrogenic lingual nerve injury .


Ten patients with unilateral lingual nerve anesthesia as a complication of iatrogenic injury after third molar extraction underwent microneurosurgical procedures for the injured lingual nerve under general anesthesia .


The patients were randomized into @ groups .


In group A , after removing the neuromas and peripheral scars surrounding the torn nerves , the @ nerve ends were sutured without tension .


In group B , after the same procedure , including the same suturing procedure , an inside-out vein graft was placed as a cuff after the direct suture .


Each group was followed at least once every @ months for @ year after the procedure .


Postoperative outcomes were evaluated using the Pogrel criteria , the Sunderland grade , and the British Medical Research Council Scale ( MRCS ) .


There were no particular differences between groups A and B at @ and @ months after the operation .


However , based on the MRCS criteria , there was a clearly better result in group B than in group A at @ and @ months after the operation , and the recovery of gustatory sensation tended to be better in group B than in group A @ year after the operation .


This inside-out vein graft as a cuff after direct suturing may facilitate faster lingual nerve regeneration than the traditional direct suture approach .


The inside-out vein graft as a cuff may provide the advantages of preventing axonal escape at the suture lines , minimizing nerve entrapment , and preventing neuroma formation in the space between the sutured nerves .


Primary percutaneous coronary intervention has improved the outcome of acute myocardial infarction ( AMI ) patients .


Counsel-guided sex rehabilitation efficacy in acute myocardial infarction patients receiving percutaneous coronary intervention remains unknown .


The aim of the study was to study counsel-guided sex rehabilitation efficacy in AMI patients receiving percutaneous coronary intervention .


@ AMI patients who received percutaneous coronary intervention were randomly divided into a control and a counselling group .


Control group patients were given written sex rehabilitation instruction before discharge , while counselling group patients were given written instruction before discharge and monthly counselling with healthcare providers .


Before discharge , the first evaluation was performed for frequency of and satisfaction with sexual activity before AMI .


At one year of follow-up , the time of resuming , frequency of and satisfaction with sexual activity was evaluated .


The main adverse event rates were also investigated .


No significant differences in age , sex , smoking status , hypertension , diabetes , PVD ( peripheral vascular disease ) , EF ( ejection fraction ) or GRACE ( Global Registry of Acute Coronary Events ) score were found between the groups .


Both groups suffered reduced frequency of and satisfaction with sexual activity after AMI as compared with prior to presentation with AMI .


However , compared with controls , the counselling group had higher scores for frequency of and satisfaction with sexual activity after AMI .


The time to resume sexual activity after AMI in the counselling group was significantly shorter than was found for the control group.There were no significant differences between the groups for recurrent AMI , non-fatal stroke , admitting the patient for angina , all-cause death or adverse events .


Intermittent discussions between healthcare providers and AMI patients improved resumption of sexual activity .


Encouraging patients who received complete coronary revascularization to resume sexual activity shortly after AMI was safe .


To identify the effects of anti-angiogenic therapy in neovascular age-related macular degeneration ( AMD ) in respect to morphologic type and time course and to identify prognostic factors for visual outcome on the basis of standardized optical coherence tomography ( OCT ) analysis .


Subanalysis of a prospective , @-month , multicenter , phase IIIb trial ( Efficacy and Safety of Ranibizumab in Patients with Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular Degeneration -LSB- EXCITE -RSB- ) .


A total of @ treatment-nave patients with subfoveal choroidal neovascularization ( CNV ) receiving quarterly or monthly ranibizumab therapy .


Patients were randomized to receive @ mg quarterly , @ mg quarterly , or @ mg monthly doses of ranibizumab .


Treatment comprised a loading phase of @ consecutive monthly injections followed by a @-month maintenance phase of monthly or quarterly injections .


Best-corrected visual acuity ( BCVA ) was measured using the Early Treatment Diabetic Retinopathy Study protocol , and retinal morphology was assessed by Stratus OCT ( Carl Zeiss Meditec , Dublin , CA ) .


Imaging data were evaluated by certified examiners of the Vienna Reading Center using a standardized protocol .


The BCVA was measured using ETDRS charts and retinal morphology was assessed by OCT. .


During the loading phase , there was a significant correlation between a reduction in central retinal thickness and an increase in BCVA ( P < @ ) , which decreased during the maintenance phase in all treatment arms .


The proportion of patients showing retinal morphologic changes , such as intraretinal cysts ( IRCs ) , subretinal fluid ( SRF ) , and pigment epithelial detachments ( PEDs ) , decreased significantly in all groups ( P < @ ) , more intensively in the @ mg quarterly than in both @ mg groups .


Intraretinal cysts resolved most rapidly followed by SRF , whereas PED decreased at a slower rate and intensity .


Patients with IRC at baseline had lower BCVA levels that remained lower over the entire study period , whereas recurrence of IRC during follow-up showed no additional negative effect on function .


Baseline SRF had no effect on visual recovery ; however , recurrence of SRF during follow-up showed a tendency for an additional negative effect on function ( P = @ ) .


Baseline PED showed a negative influence on visual outcome only in combination with IRC and SRF .


There is a distinct response pattern and time course of morphologic parameters associated withanti-vascular endothelial growth factor therapy in neovascular AMD .


Specific alterations , such as IRC , SRF , andPED , as baseline or follow-up features are significantly influencing the potential for visual gain .


There is ongoing controversy regarding a ` J-curve ' phenomenon such that low and high blood pressure ( BP ) levels are associated with increased risks of recurrent stroke .


We aimed to determine whether large treatment-related BP reductions are associated with increased risks of recurrent stroke .


Data are from the PROGRESS trial , where @ patients with cerebrovascular disease were randomly assigned to either active treatment ( perindopril indapamide ) or placebo ( s ) .


There were no BP criteria for entry .


BP was measured at every visit , and participant groups defined by reduction in systolic BP ( SBP ) from baseline were used for the analyses .


Outcome was recurrent stroke .


During a mean follow-up of @ years , @ recurrent strokes were observed .


There were clear associations between the magnitude of SBP reduction and the risk of recurrent stroke .


After adjustment for cardiovascular risk factors and randomised treatment , annual incidence was @ % , @ % , @ % and @ % for participant groups defined by SBP reductions of @ , @-@ , @-@ and < @ mm Hg , respectively ( p = @ for trend ) .


The present analysis provided no evidence of an increase in recurrent stroke associated with larger reductions in SBP produced by treatment among patients with cerebrovascular disease .


To evaluate and compare the effect of triphala extract mouthrinse and chlorhexidine on dental plaque and gingivitis .


In this double blind , crossover study , @ qualifying boarding-school students aged @-@ years were randomised into three groups : @ % triphala , @ % chlorhexidine and negative control .


The study was conducted in @ phases of @-month duration each and a washout period of @ days .


During the experimental period , subjects rinsed with the allocated mouthrinse once daily for @ s under supervision .


The plaque and gingival status was assessed using the Turesky modification of the Quigley and Hein plaque index ( QHI ) and the gingival index ( Le and Silness ) at baseline and at the end of each phase .


The results were tested for significance at P < @ .


Triphala and chlorhexidine yielded a significant reduction in plaque and gingival index scores as compared to negative control ( P < @ ) .


No significant difference was found between the scores obtained with triphala and chlorhexidine mouthwashes .


The antiplaque and antigingivitis activity of triphala closely parallels that of chlorhexidine .


Placental growth factor ( PlGF ) has been implicated as a contributor to resistance against anti-VEGF therapy .


The purpose of the present study was to analyze the systemic levels of PlGF , VEGF-A , and VEGF-B in patients with neovascular age-related macular degeneration ( AMD ) after treatment with aflibercept , ranibizumab , or bevacizumab .


Totals of @ patients were treated with intravitreal aflibercept , @ with ranibizumab , and @ with bevacizumab .


The cytokine levels were measured by ELISA just before the injection , and @ days and @ month thereafter .


Age - and sex-matched participants ( n = @ ) served as controls .


The median PlGF plasma concentration at baseline was < @ pg/mL in the control group as well as in all three anti-VEGF treatment cohorts .


After intravitreal aflibercept injection , a significant upregulation of systemic PlGF could be observed in all treated patients ( @ -LSB- @-@ @ -RSB- pg/mL after @ week -LSB- P < @ -RSB- and @ -LSB- @-@ @ -RSB- pg/mL -LSB- P = @ -RSB- after @ weeks ) .


No significant effects on plasma PlGF concentrations could be detected in those treated with ranibizumab and bevacizumab .


The systemic VEGF-A levels were significantly reduced @ and @ weeks after intravitreal aflibercept ( P < @ , P < @ ) and bevacizumab ( P < @ , P < @ ) injections .


No significant effects on plasma cytokine concentrations could be observed in the ranibizumab cohort .


No significant effects on systemic VEGF-B could be observed in any of the treatment groups .


In this study , we report a significant systemic upregulation of the proangiogenic cytokine PlGF after intravitreal administration of aflibercept .


This might represent a counter-regulatory response to antiangiogenic therapy .


To determine the influence of arm-crank exercise in reproductive hormone levels in adults with chronic SCI .


Further objectives were to assess the influence of arm-crank exercise on muscle strength and body composition .


Seventeen male adults with complete SCI at or below the @th thoracic level ( T@ ) volunteered for this study .


Participants were randomly allocated to the intervention ( n = @ ) or control group ( n = @ ) using a concealed method .


The participants in the intervention group performed a @-week arm-crank exercise program , @ sessions/week , consisting of warming-up ( @-@ min ) followed by a main part in arm-crank ( @-@ min -LSB- increasing @ min and @ seconds each three weeks -RSB- ) at a moderate work intensity of @-@ % of heart rate reserve ( HRR ) ( starting at @ % and increasing @ % each three weeks ) and by a cooling-down period ( @-@ min ) .


Serum follicle-stimulating hormone ( FSH ) , luteinizing hormone ( LH ) , testosterone and estradiol were determined by ELISA .


Muscle strength ( handgrip ) and body composition ( waist circumference -LSB- WC -RSB- ) were assessed .


After the completion of the training program , testosterone level was significantly increased ( p = @ ;d = @ ) .


Furthermore , maximal handgrip and WC were significantly improved .


Lastly , a significant inverse correlation was found between WC and testosterone ( r = - @ ; p = @ ) .


The arm-crank exercise improved reproductive hormone profile by increasing testosterone levels in adults with chronic SCI .


A secondary finding was that it also significantly improved muscle strength and body composition in this group .


Scleral gas-permeable lenses are rapidly gaining international popularity .


Unlike corneal gas-permeable lenses , scleral lenses are fitted to the bulbar conjunctiva and settle into the tissue after insertion .


To date , we are unaware of any studies examining the settling behavior of three varying scleral lens designs .


The purpose of this study was to quantify the mean total settling and mean rates of settling for three scleral lens designs : Onefit P&A ( Blanchard Contact Lens , Inc ) , Mini Scleral Design ( msd ) ( Blanchard Contact Lens , Inc ) , and Jupiter ( Visionary Optics ) .


A randomized , repeated-measures study of Onefit P&A , msd , and Jupiter was performed .


Subjects were fitted from a trial lens set , according to the manufacturer 's guidelines .


After insertion , lens settling was measured at @ minutes , @ minutes , @ minutes , @ minutes , @ hour , @ hours , @ hours , @ hours , and @ hours .


Statistical analyses were performed using analysis of variance and two-stage , nonlinear regression analyses of settling over time .


On average , the Onefit P&A , msd , and Jupiter lenses settled a total of @ , @ , and @ m , respectively .


Although the rates of settling were not linear , analysis of variance revealed a significant difference in the average settling rates ( p < @ ) among the groups .


Tukey analyses revealed a significant difference in the settling rates for msd and Jupiter comparison ( p < @ ) .


Nonlinear regression analyses predicted that the lenses settled to about @ % of the final estimated values for the Onefit P&A lens , @ % for msd , and @ % for the Jupiter , after @ hours .


We concluded that the amount of settling varied significantly among the three lens designs .


Settling rates were greatest shortly after insertion .


Larger lenses were estimated to be settled by @ hours .


Based on the results of this short-term study , careful consideration to the settling patterns of individual scleral lens designs should be given .


A healthy lifestyle may protect against cognitive decline .


We examined outcomes in elderly individuals after @ months of a five-group intervention program consisting of various modalities to prevent cognitive decline .


We conducted a cluster randomized controlled trial assessing @ community-dwelling individuals aged @ years and older in a geriatric community mental health center in Suwon , Republic of Korea , between @ and @ .


We developed an intervention program based on the principles of contingency management , which could be delivered by ordinary primary health workers .


Group A ( n = @ ) received standard care services .


Group B ( n = @ ) received bimonthly ( once every @ months ) telephonic care management .


Group C ( n = @ ) received monthly telephonic care management and educational materials similar to those in group B. Group D ( n = @ ) received bimonthly health worker-initiated visits and counseling .


Group E ( n = @ ) received bimonthly health worker-initiated visits , counseling , and rewards for adherence to the program .


The primary outcome was the change in Mini-Mental State Examination ( MMSE ) scores from baseline to the final follow-up visit at @ months .


Group E showed superior cognitive function to group A ( adjusted coefficient = @ , p = @ ) , with participation in cognitive activities being the most important determining factor among several health behaviors ( adjusted coefficient = @ , p < @ ) .


Engaging in cognitive activities , in combination with positive health behaviors , may be most beneficial in preserving cognitive abilities in community-dwelling older adults .


Omalizumab , an anti-IgE monoclonal antibody , is administered by injection once or twice monthly in offices and clinics .


It offers a potential alternative intervention for patients with allergic asthma that is not well controlled because of recalcitrant poor adherence to inhaled corticosteroid therapy .


To assess the effect of omalizumab therapy by measuring airway responsiveness to adenosine , a marker of allergic airway inflammation , and resource use .


Patients ( N = @ ) aged @ to @ years ( mean age , @ years ) with poorly controlled persistent allergic asthma , less than @ % adherence to inhaled corticosteroid therapy , a forced expiratory volume in @ second ( FEV@ ) of @ % predicted or higher , and adenosine provocation concentration that caused a decrease in FEV@ of @ % ( PC@ ) of @ mg/mL or less were randomized to receive @ months of omalizumab or placebo in a double-blind , crossover trial with a @ - to @-month washout between treatments .


Patients were instructed to continue taking inhaled corticosteroids throughout the study .


The PC@ was measured before and after each period .


Fifteen patients completed the study .


The mean baseline PC@ was @ mg/mL ( @ % CI , @-@ @ mg/mL ) .


The fold change PC@ was @ ( @ % CI , @-@ @ ) during placebo and @ ( @ % CI , @-@ @ ) during omalizumab treatment ; the estimated ratio was @ ( @ % CI , @-@ @ ; P = @ ) .


Six patients required one or more short courses of oral corticosteroids for asthma exacerbations during placebo , but none required this intervention during omalizumab .


During the study , the median prescription refills for inhaled corticosteroids was @ ( @ % CI , @-@ @ ) canisters per month .


Omalizumab therapy is an alternative for patients with more severe poorly controlled asthma in whom adherence does not improve with conventional interventions .


To evaluate visual acuity outcomes after cataract surgery in persons with varying degrees of severity of age-related macular degeneration ( AMD ) .


Cohort study .


A total of @ eyes of @ participants who underwent cataract surgery during the Age-Related Eye Disease Study @ , a prospective , multicenter , randomized controlled trial of nutritional supplements for treatment of AMD .


Preoperative and postoperative characteristics of participants who underwent cataract extraction during the @-year trial were analyzed .


Both clinical data and standardized red-reflex lens and fundus photographs were obtained at baseline and annually .


Photographs were graded by a centralized reading center for cortical and posterior subcapsular lens opacities and for AMD severity .


Cataract surgery was documented at annual study visits or by history during the @-month telephone calls .


Analyses were conducted using multivariate repeated-measures regression .