The Stroop Color and Word Test , Trail Making Test A and B , Controlled Oral Word Association , Hopkins Verbal Learning , Mini-Mental State Exam , and Digit Symbol were administered at baseline and @ and @ months follow-up to assess cognitive functioning .


Cytokines and growth factors were measured at baseline and @ months to assess inflammation and immune functioning .


Data were analyzed with linear mixed modeling .


No serious adverse events were noted in this study .


According to time on the Trail Making Test-B , the Ginkgo Synergy ( ) plus Choline arm showed improvement from baseline to @ months follow-up ( mean difference = @ ; SE = @ ; @ % CI : @ , @ ; p = @ ) .


On the Controlled Oral Word Association Trial-S , the scores significantly increased for the Ginkgo Synergy ( ) plus Choline arm from baseline to @ months follow-up ( mean difference = @ ; SE = @ ; @ % CI : @ , @ ; p < @ ) and for the OPC Synergy ( ) plus Catalyn ( ) arm from baseline to @ months follow-up ( mean difference = @ ; SE = @ ; @ % CI : @ , @ ; p < @ ) .


Epidermal growth factor significantly decreased from baseline to @ months follow-up for the Ginkgo Synergy ( ) plus Choline arm ( mean difference = @ ; SE = @ ; @ % CI : @ , @ ; p < @ ) .


Our study showed isolated and modest effects of a Ginkgo biloba plus choline-based formula on cognitive and immune functioning among healthy older adults with no history of significant cognitive deficits .


Our trial was registered with clinicaltrials.gov ( ID : NCT@ ) .


This study was supported by a grant from Standard Process , Inc. .


This study concerns the influence of an improvement of body contact on regulatory disorders in infancy .


Two interventions were examined : @ .


parent counseling on the subject of body contact ; @ .


practical training of body contact in connection with exposure .


Both methods were supplemented by a video-based parent training .


@ infants with regulatory disorder were assigned to each treatment .


Body and eye contact were examined by means of video ratings before and after treatment .


In addition , we measured the daily amount of crying , sleeping , feeding , being fussy , and quiet play by means of an infant behavior diary .


Both interventions resulted in an improvement of body contact , though only in the group with practical training was this improvement stable after @ months .


Taking all @ participating infants together , we found significant improvements for `` fussiness , '' `` sleep duration , '' `` awake , quiet or playing , '' and a marginal significant intervention effect for the duration of crying .


Both interventions showed that children who had markedly improved in body contact also improved with regard to the regulation problem .


Finally , the practical training of body contact was superior to pure counseling respective to the fussiness of the infants and to their gaze contact .


Body contact can be improved through specific therapeutic interventions .


Video-based parent training in combination with interventions aiming at an improvement of body contact have a positive effect on the regulation problem .


To evaluate the eradication rates , side effects and the patient compliance of a dual therapy with rabeprazole and amoxicillin as the first-line therapy in patients with Helicobacter pylori ( H. pylori ) infection .


A total of @ patients diagnosed endoscopically with non-ulcer dyspepsia with H. pylori infection were randomly assigned into two groups , one treated with amoxicillin @ g thrice daily plus rabeprazole @ mg twice daily ( R@A group ) or @ mg twice daily ( R@A group ) for @ days .


H. pylori eradication was evaluated by ( @ ) C-urea breath test ( UBT ) at @-@ weeks after the completion of treatment .


H. pylori eradication rate was analyzed by per-protocol ( PP ) and intention-to-treat ( ITT ) analyses together with @ % confidence interval ( CI ) .


Side effects and patients ' compliance were also recorded .


Overall , @ patients ( @ in the R@A group and @ in the R@A group ) completed the study , among whom five did not undertake the UBT .


H. pylori eradication was achieved in @ % of patients in the R@A group by ITT analysis and @ % by PP analysis , which was significantly higher than those in the R@A group ( @ % and @ % , respectively , P < @ ) .


Side effects , including skin rash , abdominal discomfort , headache , insomnia and nausea , were all mild and were treated symptomatically without the need to discontinue the treatment .


The modified dual therapy with high doses of rabeprazole and amoxicillin is considered an effective and safe primary therapy for H. pylori eradication and could be recommended as the first-line eradication regimen for certain patients .


Advanced cancer patients experience considerable symptoms , problems , and needs .


Early referral of these patients to specialized palliative care ( SPC ) could offer improvements .


The Danish Palliative Care Trial ( DanPaCT ) investigates whether patients with metastatic cancer will benefit from being referred to ` early SPC ' .


DanPaCT is a multicenter , parallel-group , superiority clinical trial with @:@ randomization .


The planned sample size was @ patients .


The primary data collection for DanPaCT is finished .


To prevent outcome reporting bias , selective reporting , and data-driven results , we present a detailed statistical analysis plan ( SAP ) for DanPaCT here .


This SAP provides detailed descriptions of the statistical analyses of the primary and secondary outcomes in DanPaCT .


The primary outcome is the change in the patient 's ` primary need ' .


The ` primary need ' is a patient-individualised outcome representing the score of the symptom or problem that had the highest intensity out of seven at baseline assessed with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire ( EORTC QLQ-C@ ) .


Secondary outcomes are the seven scales that are represented in the primary outcome , but each scale evaluated individually for all patients , and survival .


The detailed description includes chosen significance levels , models for multiple imputations , sensitivity analyses and blinding .


In addition , we discuss the patient-individualized primary outcome , blinding , missing data , multiplicity and the risk of bias .


Only few trials have investigated the effects of SPC. To our knowledge DanPaCT is the first trial to investigate screening based ` early SPC ' for patients with metastatic cancer from a broad spectrum of cancer diagnosis .


Chronic obstructive pulmonary disease ( COPD ) is a costly long-term condition associated with frequent Accident and Emergency ( A&E ) and hospital admissions .


Psychological difficulties and inadequate self-management can amplify this picture .


To compare a cognitive-behavioural manual versus information booklets ( IB ) on health service use , mood and health status .


Two hundred and twenty-two COPD patients were randomly allocated to receive either the COPD breathlessness manual ( CM ) or IB .


They were instructed to work through their programme at home , over @ weeks .


Guidance from a facilitator was provided at an initial home visit plus two telephone call follow-ups .


After @ months , total A&E visits had reduced by @ % in the CM group , compared with a @ % rise in the IB group .


The odds of people in the IB group attending A&E @ months post-intervention was @ times higher than for the CM group ( CI @-@ @ ) .


Reduction in hospital admissions and bed days were greatest in the CM group .


At @ months , there were significantly greater improvements in anxiety ( F ( @,@ ) = @ , P = @ ) , depression ( F ( @,@ ) = @ , P@ @ ) and dyspnoea ( F ( @,@ ) = @ , P@ @ ) in the CM group .


Estimated savings at @ months were greatest in the CM group , amounting to @k or @ per participant .


The COPD manual , which addresses physical and mental health , is a straightforward cost-effective intervention that is worth offering to COPD patients within primary or secondary care .


To describe baseline and emergent HIV-@ resistance to elvitegravir / cobicistat/emtricitabine/tenofovir DF ( EVG/COBI/FTC / TDF ) and ritonavir-boosted atazanavir/emtricitabine/tenofovir DF ( ATV+RTV+FTC / TDF ) in HIV-@-infected , treatment-nave subjects through @ weeks .


This was a randomized , double-blind , phase @ study .


HIV-@ protease ( PR ) and reverse transcriptase ( RT ) were sequenced at screening .


Genotypic and phenotypic analyses were performed at virologic failure confirmation and retrospectively at baseline for PR , RT , and integrase ( IN ) for patients with virologic failure through week @ .


In the EVG / COBI/FTC/TDF group through week @ , HIV-@ from @ patients ( @ % ; @/@ treated patients ) developed primary IN strand transfer inhibitor ( INSTI ) ( n = @ ) and/or nucleoside RT inhibitor ( NRTI ) resistance substitutions ( n = @ ) .


The emergence of resistance decreased after the first year , with @ patients developing HIV-@ resistance through week @ , @ from weeks @-@ , and @ from weeks @-@ .


Emergent substitutions were E@Q , N@H , or Q@R ( n = @ each ) and T@I or T@A ( n = @ each ) in IN and M@V/I ( n = @ ) and K@R ( n = @ ) in RT. .


All @ isolates had reduced susceptibility to EVG , FTC , or TDF .


Virus with EVG phenotypic resistance showed cross-resistance to raltegravir .


In the ATV+RTV+FTC / TDF group , HIV-@ from @ patients ( @ % ; @/@ treated patients ; both at week @ ) developed the resistance substitution M@V/I in RT. .


Resistance development to EVG/COBI/FTC / TDF was infrequent ( @ % ) through @ weeks of therapy and decreased over time , consistent with durable efficacy .


Deep brain stimulation ( DBS ) is an effective and approved therapy for advanced Parkinson 's disease ( PD ) , and a recent study suggests efficacy in mid-stage disease .


This manuscript reports the results of a pilot trial investigating preliminary safety and tolerability of DBS in early PD .


Thirty subjects with idiopathic PD ( Hoehn & Yahr Stage II off medication ) , age @-@ , on medication @ months but @ years , and without motor fluctuations or dyskinesias were randomized to optimal drug therapy ( ODT ) ( n = @ ) or DBS + ODT ( n = @ ) .


Co-primary endpoints were the time to reach a @-point worsening from baseline in the UPDRS-III off therapy and the change in levodopa equivalent daily dose from baseline to @ months .


As hypothesized , the mean UPDRS total and part III scores were not significantly different on or off therapy at @ months .


Medication requirements in the DBS + ODT group were lower at all time points with a maximal difference at @ months .


With a few exceptions , differences in neuropsychological functioning were not significant .


Two subjects in the DBS + ODT group suffered serious adverse events ; remaining adverse events were mild or transient .


This study demonstrates that subjects with early stage PD will enroll in and complete trials testing invasive therapies and provides preliminary evidence that DBS is well tolerated in early PD .


The results of this trial provide the data necessary to design a large , phase III , double-blind , multicenter trial investigating the safety and efficacy of DBS in early PD .


The Grip on Challenging Behavior care program for managing challenging behavior was implemented in the dementia special care units of @ Dutch nursing homes .


A process evaluation of the implementation of the care program was performed to determine the quality of the implementation and the lessons to be learned for future implementation .


The care program was implemented according to a stepped wedge design .


First-order data ( data on recruitment , reach , relevance and feasibility ) were used to determine the validity of the study , and second-order data ( intervention quality and the barriers and facilitators for implementing the care program ) were used to describe the implementation process .


Two structured questionnaires were administered to care staff and key stakeholders and semi-structured interviews were held in the units .


University affiliated and non-affiliated nursing homes from different parts of the Netherlands participated .


The resident participation rate was over @ % and the participation rate for the training sessions was @ % .


Respondents considered the care program relevant and feasible .


The degree of implementation was not optimal .


The barriers and facilitators in implementing the care program could be divided into three categories : organizational aspects , culture on the unit and aspects of the care program itself .


The recruitment , reach , relevance and feasibility are sufficient to allow for analysis and generalization of the effects of the care program , but the degree of implementation should be taken into account in further analysis .


Future projects that involve implementation should consider the specific features of the organization and the cultural orientation of the unit to better adapt to specific needs .


Cooling the body before exercise ( precooling ) has been studied as an ergogenic aid for many thermal conditions ; however , airflow accompanying exercise is seldom reported .


To determine whether the physiologic and ergogenic benefits of precooling before endurance exercise may be negated with semirealistic airflow in hot conditions .


Crossover study .


Climate-controlled chamber in a research laboratory .


Ten fit , healthy cyclists .


After a familiarization trial , participants completed @ randomized , counterbalanced sessions consisting of no precooling versus precooling and no fan airflow versus airflow ( ~ @ m/s ) during exercise .


Precooling was via chest-deep immersion ( ~ @ C ) for @ hour or until core temperature dropped @ C. Participants then cycled at @ % ventilatory threshold in a hot environment ( temperature = @ C , relative humidity = @ % ) until volitional exhaustion , core temperature reached > @ C , or heart rate reached > @ % of maximum .


Thermal strain was assessed via core temperature ( esophageal and rectal thermistors ) and mean skin temperature ( thermistors at @ sites ) and cardiovascular strain via heart rate and ratings of perceived exertion .


Endurance time ( @ @ minutes without precooling or airflow ) increased by @ @ minutes with airflow ( ~ @ % ; @ % confidence interval = @ , @ minutes ; P < @ ) and by @ @ minutes with precooling ( ~ @ % ; @ % confidence interval = @ , @ minutes ; P = @ ) , but it was not further extended when the strategies were combined ( @ @ minutes longer than control ) .


During cycling without precooling or airflow , mean core and skin temperatures were higher than in all other trials .


Precooling reduced heart rate by @-@ beats/min during the first @ minutes of exercise , but this attenuation ended by @ minutes .


Most laboratory-based precooling studies have ( inadvertently ) overestimated the extent of the physiologic and ergogenic benefits for typical athlete-endurance situations .


Precooling increases work capacity effectively when airflow is restricted but may have little or no benefit when airflow is present .


Currently , a ` pedagogical gap ' exists in distributed medical education in that distance educators teach medical students but typically do not have the opportunity to assess them in large-scale examinations such as the objective structured clinical examination ( OSCE ) .


We developed a remote examiner OSCE ( reOSCE ) that was integrated into a traditional OSCE to establish whether remote examination technology may be used to bridge this gap .


The purpose of this study was to explore whether remote physician-examiners can replace on-site physician-examiners in an OSCE , and to determine the feasibility of this new examination method .


Forty Year @ medical students were randomised into six reOSCE stations that were incorporated into two tracks of a @-station traditional OSCE .


For the reOSCE stations , student performance was assessed by both a local examiner ( LE ) in the room and a remote examiner ( RE ) who viewed the OSCE encounters from a distance .


The primary endpoint was the correlation of scores between LEs and REs across all reOSCE stations .


The secondary endpoint was a post-OSCE survey of both REs and students .


Statistically significant correlations were found between LE and RE checklist scores for history taking ( r = @-r = @ ) , physical examination ( r = @-r = @ ) , and management stations ( r = @ ) .


Correlations between LE and RE global ratings were more varied ( r = @-r = @ ) .


Correlations on three of the six stations reached significance .


Qualitative analysis of feedback from REs and students showed high acceptance of the reOSCE despite technological issues .


This preliminary study demonstrated that OSCE ratings by LEs and REs were reasonably comparable when using checklists .


Remote examination may be a feasible and acceptable way of assessing students ' clinical skills , but further validity evidence will be required before it can be recommended for use in high-stakes examinations .


To evaluate the anti-ischemic and anti-anginal efficacy of meldonium ( Idrinol ) in its short-term use as part of combination therapy in patients with chronic heart failure in the early post-infarction period .


The investigation enrolled @ patients ( men and women ) aged @ to @ years at weeks @-@ after postmyocardial infarction with symptoms of Functional Class II-III heart failure .


All the patients underwent physical examination , @-hour ECG monitoring , heart rate variability ( HRV ) study , and quality of life assessment using the Seattle questionnaire .


After randomization of the patients into @ groups , Group @ ( a study group ) ( n = @ ) was given intravenous Idrinol @ mg/day in addition to the basic therapy of coronary heart disease .


The study and control ( Group @ ; n = @ ) groups were matched for age , gender , disease severity , and basic therapy pattern .


Following @-@ days of treatment , both groups showed clinical improvement and the autonomically normalizing effect of meldonium ( Idrinol ) , which were more pronounced in Group @ patients .


Meldonium ( Idrinol ) was effective when parenterally administered in a dose of @ mg/day for @-@ days as part of combination therapy in the early post-infarction period , which showed up as clinical improvement , a significant reduction in the frequency of angina attacks and in the need to use nitroglycerin , a decrease in the number of arrhythmia episodes , and its normalizing effect of HRV .


In some emergency situations resuscitation and ventilation may have to be performed by basic life support trained personnel , especially in rural areas where arrival of advanced life support teams can be delayed .


The use of advanced airway devices such as endotracheal intubation has been deemphasized for basically-trained personnel , but it is unclear whether supraglottic airway devices are advisable over traditional mask-ventilation .


In this prospective , randomized clinical single-centre trial we compared airway management and ventilation performed by nurses using facemask , laryngeal mask Supreme ( LMA-S ) and laryngeal tube suction-disposable ( LTS-D ) .


Basic life support trained nurses ( n = @ ) received one-hour practical training with each device .


ASA @-@ patients scheduled for elective surgery were included ( n = @ ) .


After induction of anaesthesia and neuromuscular block nurses had two @-second attempts to manage the airway and ventilate the patient with volume-controlled ventilation .


Ventilation failed in @ % of patients with facemask , @ % with LMA-S and @ % with LTS-D ( P < @ ) .


In patients who could be ventilated successfully mean tidal volume was @ ml with facemask , @ ml with LMA-S and @ ml with LTS-D ( P < @ ) .


Leak pressure was lower with LMA-S ( @ cm H@O , @ % CI @-@ @ ) than with LTS-D ( @ cmH@O , @ % CI @-@ @ ; P = @ ) .


After one hour of introductory training , nurses were able to use LMA-S more effectively than facemask and LTS-D .


High ventilation failure rates with facemask and LTS-D may indicate that additional training is required to perform airway management adequately with these devices .


High-level trials are needed to confirm these results in cardiac arrest patients .


Tadalafil ( TAD ) @mg coadministered with finasteride ( FIN ) @mg significantly improves lower urinary tract symptoms ( LUTS ) in men with benign prostatic hyperplasia ( BPH ) and prostatic enlargement .


However , its effects on erectile/sexual function have yet to be fully described .


Assess the effects of TAD/FIN coadministration ( compared with placebo -LSB- PBO -RSB- / FIN ) on erectile and sexual function in sexually active men with LUTS and prostatic enlargement secondary to BPH with or without baseline comorbid erectile dysfunction ( ED ) .


A randomized , double-blind , PBO-controlled study of @ men ( @ sexually active ; @ with baseline ED ; @ sexually active with baseline ED ) conducted at @ sites in @ countries .


TAD @mg or PBO once daily coadministered with FIN @mg once daily for @ weeks .


International Index of Erectile Function ( IIEF ) domain and single-item scores ; proportions of patients who demonstrated minimal clinically important differences ( MCIDs ) in IIEF-Erectile Function domain scores ( IIEF-EF ; MCID defined as @-point improvement ) ; and sexual dysfunction adverse events ( AEs ) .


Compared with PBO/FIN , TAD/FIN resulted in improvements for all IIEF domain and single-item scores assessed among patients with baseline ED ( P@ @ for all measures ) and among patients without baseline ED ( P@ @ for all measures ) .


Compared with PBO/FIN , significantly larger percentages of sexually active men with baseline ED treated with TAD/FIN achieved an IIEF-EF MCID after @ , @ , and @ weeks of therapy ( P < @ for odds ratio comparisons between TAD/FIN and PBO/FIN at all @ three postbaseline timepoints ) .


The incidence of sexual AEs was low : five TAD/FIN patients and seven PBO/FIN patients reported sexual AEs , including ED , decreased/lost libido , and ejaculation disorders .


TAD/FIN coadministration for the treatment of men with LUTS and prostatic enlargement secondary to BPH concurrently leads to statistically significant improvements in erectile/sexual function and is well-tolerated , regardless of the presence/absence of ED at treatment initiation .


Limited data exist regarding baseline characteristics and management of heart failure with reduced ejection fraction ( EF ) in tertiary care facilities .


EVITA-HF comprises web-based case report data on demography , comorbidities , diagnostic and therapy measures , quality of life , adverse events and @-year follow-up of patients hospitalized for chronic heart failure and an ejection fraction of less than @ % .


Between February @ and June @ , a total of @,@ consecutive , hospitalized patients ( pts ) were included in @ centers in Germany .


Mean age was @ years , @ % were male .


Median EF was @ % , and @ % were in NYHA III/IV .


Ischemic cardiomyopathy was present in @ % , history of hypertension in @ % , diabetes in @ % , impaired renal function in @ % , thyroid dysfunction in @ % , and malignoma in @ % .


Sixty-eight percent of pts had a non-elective admission .


Rhythm was sinus/atrial fibrillation or flutter/pacemaker in @ , @ and @ % , respectively .


Median heart rate amounted to @ bpm , median blood pressure to @/@ mmHg .


LBBB was present in @ % of non-pacemaker pts .


Eighteen percent had an ICD or CRT-D .


Medication ( admission vs. discharge ) consisted of ACEI or ARB in @ vs. @ % , - blocker in @ vs. @ % , mineral corticosteroid receptor antagonist ( MRA ) in @ vs. @ % , diuretics in @ vs. @ % ( p < @ for each ) .


Forty-two percent of pts received a specific treatment procedure beyond pharmacotherapy , of these @ % revascularization , @ % device therapy , @ % electrical cardioversion , @ % ablation procedures , @ % valvular procedures , @ % iv inotropes , @ % IABP or LVAD implantation .


At discharge , @ % of survivors had ICD - or CRT-D implants .


One-year mortality amounted to @ % , and death or rehospitalization to @ % .


NYHA class III/IV was found in @ % ( p < @ vs. index admission ) , general health status was improved in @ % and unchanged in @ % of patients .


Eighty-five percent of pts took ACEI or ARB , @ % - blockers , @ % MRA , and @ % diuretics ( p < @ vs. index discharge for all ) .


Patients with chronic heart failure and low ejection fraction represent an elderly and multimorbid population .


While hospitalized , they experience a significant optimization of prognosis-relevant medication , revascularization and device therapy .


After @ year , mortality is moderate ; drug adherence is high and NYHA status favourable .


The EVITA-HF registry is able to reflect coherently the real-world management , efforts and follow-up in heart failure pts managed in tertiary care facilities .


To explore the relationship between prenatal hemoglobin ( Hb ) concentration and infant cognitive and motor functions .


Our prospective cohort study included @-year-old children born to women enrolled at their first antenatal care ( ANC ) visit in Allada , Benin , before @ weeks of pregnancy , within a trial comparing the efficacy of sulfadoxine-pyrimethamine and mefloquine .


Hb concentrations of pregnant women were determined from venous blood samples collected at first and second ANC visits of at least @-month interval and at delivery .


Women were prescribed oral iron , folic acid , and anthelminthics after the first ANC visit .


A total of @ children ( @ % of eligible children ) were assessed by trained research nurses for cognitive and motor functions by using the Mullen Scales of Early Learning .


Prevalence of anemia ( Hb < @ g/L ) decreased from @ % at first ANC visit ( mean gestational age -LSB- SD -RSB- , @ -LSB- @ -RSB- weeks ) to @ % at delivery .


Mean ( SD ) Hb concentrations increased from @ ( @ ) at first ANC visit to @ ( @ ) at delivery .


We observed a significant negative quadratic relationship between infant gross motor ( GM ) function and Hb concentration at first and second ANC visits .


Thus , infant GM scores increased sharply with increasing maternal Hb concentration until @ g/L where increasing GM was mild , and began to decline after @ g/L .


There appears to be an Hb concentration range that may be optimal for GM function of @-year-old children .


This may reflect the importance of physiologic hemodilution , which occurs after the second trimester until @ weeks of gestation .


Hypertension is one of the main cardiovascular risk factors in the elderly .


The aims of this work were to evaluate if a one-year intervention with two Mediterranean diets ( Med-diet ) could decrease blood pressure ( BP ) due to a high polyphenol consumption , and if the decrease in BP was mediated by plasma nitric oxide ( NO ) production .


An intervention substudy of @ participants at high cardiovascular risk was carried out within the PREDIMED trial .


They were randomly assigned to a low-fat control diet or to two Med-diets , one supplemented with extra virgin olive oil ( Med-EVOO ) and the other with nuts ( Med-nuts ) .


Anthropometrics and clinical parameters were measured at baseline and after one year of intervention , as well as BP , plasma NO and total polyphenol excretion ( TPE ) in urine samples .


Systolic and diastolic BP decreased significantly after a one-year dietary intervention with Med-EVOO and Med-nuts .


These changes were associated with a significant increase in TPE and plasma NO .


Additionally , a significant positive correlation was observed between changes in urinary TPE , a biomarker of TP intake , and in plasma NO ( Beta = @ ; @ % CI : @-@ @ ) .


TPE in spot urine sample was positively correlated with plasma NO in Med-diets supplemented with either EVOO or nuts .


The statistically significant increases in plasma NO were associated with a reduction in systolic and diastolic BP levels , adding to the growing evidence that polyphenols might protect the cardiovascular system by improving the endothelial function and enhancing endothelial synthesis of NO .


The enzyme dipeptidyl peptidase-@ ( DPP-@ ) is a key player in the degradation of incretin hormones that are involved in glucose metabolism .


DPP-@ is also expressed on immune cells and is associated with several immunological functions .


Some studies have reported increased rates of infections in patients treated with DPP-@ inhibitors .


We therefore assessed whether treatment with the DPP-@ inhibitor vildagliptin affected cytokine production and T-cell differentiation .


Patients with type @ diabetes were treated with vildagliptin or an active comparator , acarbose , for four weeks , in a randomized cross-over trial .


Blood was sampled at the end of each treatment period and peripheral blood mononuclear cells were isolated and stimulated with a broad spectrum of pattern recognition receptor agonists .


Serum cytokine concentrations and ex vivo cytokine production ( both monocyte and T-cell derived ) did not differ during treatment with vildagliptin compared to acarbose .


Similarly , ex vivo relative upregulation of mRNA transcription of T-cell lineage specific transcription factors was unaffected by vildagliptin treatment .


These data show that a four-week treatment with vildagliptin in patients with type @ diabetes mellitus does not result in a significant modulation of cytokine responses .


This observation suggests that inhibition of DDP-@ does not lead to an increased risk of infection by diminishing cytokine production .


Minimal hepatic encephalopathy ( MHE ) impairs patients ' cognitive and neurophysiological functions .


In this study , we investigated the effect of treatment-related improvement in cognitive and neurophysiological functions .


We measured psychometric performance by number connection tests part A ( NCT-A ) , digit symbol test ( DST ) , mini-mental state examination ( MMSE ) and event related potential P@ wave of @ patients with cirrhosis who have minimal hepatic encephalopathy on inclusion into the study and @ days later .


They were randomly assigned in a @:@:@:@ ratio to four groups , to receive treatment of Chinese herbal medicine formula ( HMG ) or lactulose ( LG ) or Chinese herbal medicine formula combined with lactulose ( HMCLG ) for @ days ( n = @ ) or no treatment ( CG ) ( n = @ ) .


This study was not blind .


The mean number of NCT-A and MMSE scores improved significantly in patients in the HMG ( @ day , @ for NCT-A , @ for MMSE ; @ days , @ for NCT-A , @ for MMSE ) compared with patients in the CG after @ days of follow-up ( @ day , @ for NCT-A , @ for MMSE ; @ days , @ for NCT-A , @ for MMSE ) , P < @ ; the mean number of P@ latency ( ms ) and wave amplitude ( V ) improved significantly among patients in the HMG after @ days of treatment ( @ day , @ for latency , @ for wave amplitude ; @ days , @ for latency , @ for wave amplitude ) compared with patients in the CG after @ days of follow-up ( @ day , @ for latency , @ for wave amplitude ; @ days , @ for latency , @ for wave amplitude ) , P < @ .


Similar improvement were also found among patients in the LG and HMCLG ; improvements among patients in the HMG were significantly greater than they were in the LG ( P < @ ) .


Synergistic action were shown among patients in the HMCLG ( P < @ ) .


Treatment with Chinese herbal medicine formula Jieduhuayu granules and lactulose may improve cognitive and neurophysiological functions in patients with cirrhosis who have MHE .


Compared with lactulose alone , Chinese herbal medicine formula Jieduhuayu granules has higher efficacy of improving cognitive and neurophysiological functions in patients with cirrhosis who have MHE , and the two of them together show synergistic action .


Renal stone disease is a significant and worldwide health problem .


Recent advances in stone management have allowed kidney stones to be treated using extracorporeal shock wave lithotripsy ( ESWL ) , uretero-renoscopy ( URS ) , and percutaneous nephrostolithotomy ( PCNL ) .


Recently , medical expulsion therapy ( MET ) has been investigated as a supplement to observation in an effort to improve spontaneous stone passage rates .


This study was a randomized , controlled , prospective study to determine whether the administration of Alpha-@-adrenergic receptor antagonists as an adjunctive medical therapy , increases the efficacy of ESWL to treat renal stones .


Sixty patients with renal stones of @-@ @ Cm in size ( average size @ Cm ) were included in this study underwent ESWL followed by administration of Alpha-@-adrenergic receptor antagonists at department of Urology Liaquat National Hospital Karachi from Feb @ to Sept @ .


This was a comparative study and patients were divided into two groups .


In group A patients received conventional treatment Diclofenac sodium , Anti Spasmodic ( Drotverine HCl ) as required and Proton Pump inhibitor ( Omeprazole @ mg ) once daily after shock wave lithotripsy .


In group B patients received alpha-@ blocker , Alfuzosin HCI @ mg twice daily in addition to conventional treatment .


All patients were instructed to drink a minimum of @ litres water daily .


Ultrasound guided Dornier Alpha Impact Lithotripter was utilised for shock wave lithotripsy .


Of the @ patients , @ % of those receiving Alfuzosin and @ % of controls had achieved clinical success at @ month ( p = @ ) .


The mean cumulative diclofenac dose was @ mg per patient in the Alfuzosin group and @ mg per patient in the control group ( p = @ ) .


This difference was statistically significant .


Alfuzosin therapy as an adjunctive medical therapy after ESWL is more effective than lithotripsy alone for the treatment of patients with large renal stones and is equally safe .


It increases the expulsion rates of stones , decreases time to expulsion , and decreases need for analgesia during stone passage .


Previous studies have demonstrated the psychosocial effect of heart failure in patients with reduced ejection fraction .


However , the effects on patients with preserved ejection fraction have not yet been elucidated .


This study aimed to determine the baseline characteristics of participants with heart failure with preserved ejection fraction as it relates to impaired quality of life ( QOL ) and depression , identify predictors of poor QOL and depression , and determine the correlation between QOL and depression .


Among patients enrolled in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial ( TOPCAT ) , @ patients completed the Kansas City Cardiomyopathy Questionnaire , @ patients completed European QOL @D Visual Analog Scale , and @ patients in United States and Canada completed the Patient Health Questionnaire-@ .


The mean summary score on the Kansas City Cardiomyopathy Questionnaire was @ , and on European QOL @D Visual Analog Scale , it was @ ; @ % of patients had moderate to severe depression .


Factors associated with better Kansas City Cardiomyopathy Questionnaire and European QOL @D Visual Analog Scale via multiple logistic regression analysis were American region , older age , no history of angina pectoris or asthma , no use of hypoglycemic agent , more activity level , and lower New York Heart Association class .


Factors associated with depression via multiple logistic regression analysis included younger age , female sex , comorbid angina , chronic obstructive pulmonary disease , use of a hypoglycemic agent , lower activity level , higher New York Heart Association class , and selective serotonin reuptake inhibitor use .


There were significant correlations between each of the QOL scores and depression .


Patients with heart failure with preserved ejection fraction , who were younger had higher New York Heart Association class or comorbid angina pectoris , had lower activity levels , lived in Eastern Europe or were taking hypoglycemic agents , were more likely to have impaired QOL and depression .


To compare the efficiency of surgical procedures using three phaco tip designs in torsional phacoemulsification using the bevel-down technique .


In this prospective , comparative , masked study , patients were randomly assigned to have torsional coaxial microincision cataract surgery using the mini-flared @-degree Kelman tip , reversed mini-flared @-degree Kelman tip , or Sidewinder @-degree Kelman tip .


Clinical measurements included preoperative and @-month postoperative corrected distance visual acuity ( CDVA ) , endothelial cell counts ( ECC ) , and preoperative and @-day postoperative central corneal thickness ( CCT ) .


Intraoperative measurements included phaco time , torsional time , aspiration time , case time , cumulative dissipated energy ( CDE ) , and balanced salt solution volume ( BSS ) .


The study evaluated @ eyes of @ patients .


Intraoperatively , there was no statistically significant difference in cumulative dissipated energy , case time , torsional time , and aspiration time between the three tip configurations .


However , less phaco time was used with the mini-flared @-degree Kelman tip ( p = @ ) than that with the Sidewinder @-degree Kelman tip or reversed mini-flared @-degree Kelman tip .


The mini-flared @-degree Kelman tip and the reversed mini-flared @-degree Kelman tip required significantly less balanced salt solution volume than that required by the Sidewinder @-degree Kelman tip ( p = @ ) .


There was no statistically significant difference in corrected distance visual acuity and endothelial cell counts between tips @ months postoperatively ( p > @ ) .


All three tips were effective with no intraoperative complications .


When using torsional phacoemulsification through microincisions and the prefracture technique with the bevel-down technique , the mini-flared @-degree Kelman tip required a lower mean phaco time than the reversed mini-flared @-degree Kelman tip and the Sidewinder @-degree Kelman tip .


To examine the metabolic , gluco-regulatory-hormonal and inflammatory cytokine responses to large reductions in rapid-acting insulin dose administered prandially before and after intensive running exercise in male type @ diabetes patients .


This was a single centre , randomised , controlled open label study .


Following preliminary testing , @ male patients ( @ years , HbA@c @ % / @ mmol.l-@ ) treated with insulin 's glargine and aspart , or lispro attended the laboratory on two mornings at @:@ h and consumed a standardised breakfast carbohydrate bolus ( @ g carbohydrate.kg-@BM ; @ kcal ) and self-administered a @ % reduced rapid-acting insulin dose @ minutes before @ minutes of intensive treadmill running at @ % VO@peak .


At @ minutes post-exercise , patients ingested a meal ( @ g carbohydrate.kg-@BM ; @ kcal ) and administered either a Full or @ % reduced rapid-acting insulin dose .


Blood glucose and lactate , serum insulin , cortisol , non-esterified-fatty-acids , - Hydroxybutyrate , and plasma glucagon , adrenaline , noradrenaline , IL-@ , and TNF - concentrations were measured for @ minutes post-meal .


All participants were analysed .


All glycaemic , metabolic , hormonal , and cytokine responses were similar between conditions up to @ minutes following exercise .


Following the post-exercise meal , serum insulin concentrations were lower under @ % ( p < @ ) resulting in @ % of patients experiencing hyperglycaemia ( blood glucose @ mmol.l-@ ; @ % n = @ , Full n = @ ) .


- Hydroxybutyrate concentrations decreased similarly , such that at @ minutes post-meal concentrations were lower than rest under Full and @ % .


IL-@ and TNF - concentrations remained similar to fasting levels under @ % but declined under Full .


Under @ % IL-@ concentrations were inversely related with serum insulin concentrations ( r = -@ , p = @ ) .


Heavily reducing rapid-acting insulin dose with a carbohydrate bolus before , and a meal after intensive running exercise may cause hyperglycaemia , but does not augment ketonaemia , raise inflammatory cytokines TNF - and IL-@ above fasting levels , or cause other adverse metabolic or hormonal disturbances .


To assess the impact of hexaminolevulinate ( HAL ) on the long-term recurrence rate of NMIBC .


A total of @ patients with bladder tumour were randomized into two groups .


The patients in one group had a HAL instillation before surgery , and they first had a white-light and after that a blue-light cystoscopy ( BL group ) and resection .


The second group had only white-light cystoscopy ( WL group ) and resection .


They have been followed up with cystoscopy every @ months for a period of up to @ months .


The recurrence-free period was not significantly different between the two groups ( BL and WL groups ) ( long-rank test p = @ ) .


The use of HAL helped detect four flat lesions and @ papillary lesions with cancer that would have been missed under WL only , on @ out of the @ patients ( @ % CI @ % @-@ @ ) .


The use of HAL changed the proposed postoperative treatment and follow-up for one out of the five patients .


Although the use of HAL cystoscopy identified at least one cancer lesion more than WL cystoscopy on one out of the three patients , the recurrence-free period was not significantly different .


Selective serotonin reuptake inhibitors ( SSRIs ) are often prescribed in patients with postural tachycardia syndrome ( POTS ) , and act at synaptic terminals to increase monoamine neurotransmitters .


We hypothesized that they act to increase blood pressure and attenuate reflex tachycardia , thereby improving symptoms .


Acute hemodynamic profiles after SSRI administration in POTS patients have not previously been reported .


Patients with POTS ( n = @ ; F = @ , @ @ years ) underwent a randomized crossover trial with sertraline @mg and placebo .


Heart rate , systolic , diastolic , and mean blood pressure were measured with the patient seated and standing for @ min prior to drug or placebo administration , and then hourly for @ h.


The primary endpoint was standing heart rate at @ h.


At @ h , standing heart rate and systolic blood pressure were not significantly different between sertraline and placebo .


Seated systolic ( @ mmHg vs. @ mmHg ; p = @ ) , diastolic ( @ mmHg vs. @ mmHg ; p = @ ) , and mean blood pressure ( @ mmHg vs. @ mmHg ; p = @ ) were significantly higher after sertraline administration than placebo .


At @ h , symptoms were worse with sertraline than placebo .


Sertraline had a modest pressor effect in POTS patients , but this did not translate into a reduced heart rate or improved symptoms .


To determine whether nalmefene combined with psychosocial support is cost-effective compared with psychosocial support alone for reducing alcohol consumption in alcohol-dependent patients with high/very high drinking risk levels ( DRLs ) as defined by the WHO , and to evaluate the public health benefit of reducing harmful alcohol-attributable diseases , injuries and deaths .


Decision modelling using Markov chains compared costs and effects over @ years .


The analysis was from the perspective of the National Health Service ( NHS ) in England and Wales .


The model considered the licensed population for nalmefene , specifically adults with both alcohol dependence and high/very high DRLs , who do not require immediate detoxification and who continue to have high/very high DRLs after initial assessment .


We modelled treatment effect using data from three clinical trials for nalmefene ( ESENSE @ ( NCT@ ) , ESENSE @ ( NCT@ ) and SENSE ( NCT@ ) ) .


Baseline characteristics of the model population , treatment resource utilisation and utilities were from these trials .


We estimated the number of alcohol-attributable events occurring at different levels of alcohol consumption based on published epidemiological risk-relation studies .


Health-related costs were from UK sources .


We measured incremental cost per quality-adjusted life year ( QALY ) gained and number of alcohol-attributable harmful events avoided .


Nalmefene in combination with psychosocial support had an incremental cost-effectiveness ratio ( ICER ) of @ per QALY gained , and was therefore cost-effective at the @,@ per QALY gained decision threshold .


Sensitivity analyses showed that the conclusion was robust .


Nalmefene plus psychosocial support led to the avoidance of @ alcohol-attributable diseases/injuries and @ deaths per @,@ patients compared to psychosocial support alone over the course of @ years .


Nalmefene can be seen as a cost-effective treatment for alcohol dependence , with substantial public health benefits .


Timed Up and Go ( TUG ) performance is reduced following stroke .


Gait training improves gait-related activities in hemiparetic patients .


However , no study has compared the impact of a single overground training session with a treadmill training session on gait-related activities ( assessed by TUG ) .


To compare the immediate effect of a single overground training session versus a single treadmill training session on TUG performance in hemiparetic patients .


In this randomized controlled clinical trial , @ hemiparetic patients were randomized to @ or @ distinct groups : a single gait training session overground ( O group ) or on a treadmill ( T group ) .


Time taken to perform the TUG ( in seconds ) was assessed before and immediately after the completion of each session .


Time taken to perform the TUG decreased significantly , and to a similar extent , in both groups following the training session ( O group , @ % ; T group , @ % ) .


An overground training session and a treadmill training session were equally effective in improving TUG performance in hemiparetic patients .


Hemiparetic patients should be encouraged to walk regularly overground including turns for @ minutes without stopping .


This is an easy and inexpensive self-rehabilitation method to improve functional gait-related activities involved in the TUG test .


The World Cancer Research Fund ( WCRF ) and the American Institute for Cancer Research ( AICR ) published eight recommendations for cancer prevention , but they are not targeted at prostate cancer prevention .


We investigated whether adherence to the WCRF/AICR recommendations and a prostate cancer dietary index is associated with prostate cancer risk .


We conducted a nested case-control study of @,@ prostate-specific antigen ( PSA ) - detected prostate cancer cases and @,@ controls in the ProtecT trial .


We developed a prostate cancer dietary index by incorporating three dietary factors most strongly associated with prostate cancer .


Scores were computed to quantify adherence to the WCRF/AICR recommendations and the prostate cancer dietary index separately .


The prostate cancer dietary index score was associated with decreased risk of prostate cancer -LSB- OR per @ score increment : @ ; @ % confidence interval ( CI ) : @-@ @ ; Ptrend = @ -RSB- but the WCRF/AICR index score was not ( OR : @ ; @ % CI : @-@ @ ; Ptrend = @ ) .


There was no heterogeneity in association by prostate cancer stage ( P = @ ) or grade ( P = @ ) .


Greater adherence to recommendations to increase plant foods ( OR per @ index score increment : @ ; @ % CI : @-@ @ ; Ptrend = @ ) and tomato products ( OR adherence vs. nonadherence : @ ; @ % CI : @-@ @ ; P = @ ) was inversely associated with overall prostate cancer risk .


Adherence to the prostate cancer-specific dietary recommendations was associated with decreased risk of prostate cancer .


High intake of plant foods and tomato products in particular may help protect against prostate cancer .


Meeting the WCRF/AICR recommendations alone is insufficient for prostate cancer prevention .


Additional dietary recommendations should be developed .


We assessed whether wheat bran extract ( WBE ) containing arabinoxylan-oligosaccharides ( AXOS ) elicited a prebiotic effect and modulated gastrointestinal ( GI ) parameters in healthy preadolescent children upon consumption in a beverage .


This double-blind randomized placebo-controlled crossover trial evaluated the effects of consuming WBE at @ ( control ) or @ g/day for @ weeks in @ healthy children ( @-@ years ) .


Fecal levels of microbiota , short-chain fatty acids , branched-chain fatty acids , ammonia , moisture , and fecal pH were assessed at the end of each treatment and at the end of a @-week run-in ( RI ) period .


In addition , the subjects completed questionnaires scoring distress severity of @ surveyed GI symptoms .


Finally , subjects recorded defecation frequency and stool consistency .


Nominal fecal bifidobacteria levels tended to increase after @ g/day WBE consumption ( P = @ ) , whereas bifidobacteria expressed as percentage of total fecal microbiota was significantly higher upon @ g/day WBE intake ( P = @ ) .


Additionally , @ g/day WBE intake induced a significant decrease in fecal content of isobutyric acid and isovaleric acid ( P < @ ) , markers of protein fermentation .


WBE intake did not cause a change in distress severity of the @ surveyed GI symptoms ( flatulence , abdominal pain/cramps , and urge to vomit ) ( P > @ ) .


WBE is well tolerated at doses up to @ g/day in healthy preadolescent children .


In addition , the intake of @ g/day exerts beneficial effects on gut parameters , in particular an increase in fecal bifidobacteria levels relative to total fecal microbiota , and reduction of colonic protein fermentation .


D-dimer concentrations have not been evaluated extensively as a predictor of increased venous thromboembolism ( VTE ) risk in acutely ill , hospitalized medical patients .


To analyze the relationships between D-dimer concentration , VTE and bleeding in the MAGELLAN trial ( NCT@ ) .


This was a multicenter , randomized , controlled trial .


Patients aged @years , hospitalized for acute medical illnesses with risk factors for VTE received subcutaneous enoxaparin @mg once daily for @days then placebo up to day @ , or oral rivaroxaban @mg once daily for @days .


Patients ( n = @ ) were grouped by baseline D-dimer @or > @the upper limit of normal .


VTE and major plus non-major clinically relevant bleeding were recorded at day @ , day @ , and between days @ and @ .


The frequency of VTE was @-fold greater in patients with high D-dimer concentrations .


Multivariate analysis showed that D-dimer was an independent predictor of the risk of VTE ( odds ratio @ -LSB- @ % confidence interval @-@ @ -RSB- ) , and had a similar association to established risk factors for VTE , for example cancer and advanced age .


In the high D-dimer group , rivaroxaban was non-inferior to enoxaparin at day@ and , unlike the low D-dimer group , superior to placebo at day @ ( P < @ ) and days @-@ ( P < @ ) .


In both groups , bleeding outcomes favored enoxaparin/placebo .


Elevated baseline D-dimer concentrations may identify acutely ill , hospitalized medical patients at high risk of VTE for whom extended anticoagulant prophylaxis may provide greater benefit than for those with low D-dimer concentrations .


Sacral nerve stimulation ( SNS ) is a potential treatment for constipation refractory to standard therapies .


However , there have been no randomized controlled studies examining its efficacy .


In patients with slow transit constipation , we evaluated the efficacy of suprasensory and subsensory SNS compared with sham , in a prospective , @-week randomized , double-blind , placebo-controlled , two-phase crossover study .


The primary outcome measure was the proportion of patients who , on more than @ days/week for at least @ of @ weeks , reported a bowel movement associated with a feeling of complete evacuation .


After @ weeks of temporary peripheral nerve evaluation ( PNE ) , all patients had permanent implantation and were randomized to subsensory/sham ( @ weeks each ) and then re-randomized to suprasensory/sham ( @ weeks each ) with a @-week washout period between each arm .


Daily stool dairies were kept , and quality of life ( QoL ; SF@ ) was measured at the end of each arm .


Between November @ and March @ , @ constipated patients were assessed , of whom @ were willing and deemed eligible to participate ( @ male ; median age @ years ) .


Of the @ patients , @ ( @ % ) responded to PNE .


Fifty-five patients went on to permanent SNS implantation .


The proportion of patients satisfying the primary outcome measure did not differ between suprasensory ( @ % ) and sham ( @ % ) stimulations , nor between subsensory ( @ % ) and sham ( @ % ) stimulations .


There were no significant changes in QoL scores .


In patients with refractory slow transit constipation , SNS did not improve the frequency of complete bowel movements over the @-week active period .


To investigate the long-term effects of home-based constraint induced therapy ( CIT ) on motor control underlying functional change in children with unilateral cerebral palsy ( CP ) .


Randomized controlled trial .


Home based .


Children with unilateral CP ( N = @ ; aged @-@ y ) were randomly assigned to receive home-based CIT ( n = @ ) or traditional rehabilitation ( TR ) ( n = @ ) .


Both groups received a @-week therapist-based intervention at home .


The home-based CIT involved intensive functional training of the more affected upper extremity during which the less affected one was restrained .


The TR involved functional unimanual and bimanual training .


All children underwent kinematic and clinical assessments at baseline , @ weeks ( posttreatment ) , and @ and @ months ( follow-up ) .


The reach-to-grasp kinematics were reaction time ( RT ) , normalized movement time , normalized movement unit , peak velocity ( PV ) , maximum grip aperture ( MGA ) , and percentage of movement where MGA occurs .


The clinical measures were the Peabody Developmental Motor Scales , Second Edition ( PDMS-@ ) , Bruininks-Oseretsky Test of Motor Proficiency ( BOTMP ) , and Functional Independence Measure for children ( WeeFIM ) .


The home-based CIT group showed a shorter RT ( P < @ ) and normalized movement time ( P < @ ) , smaller MGA ( P = @ ) , and fewer normalized movement units ( P = @ ) in the reach-to-grasp movements at posttreatment and follow-up than the TR group .


The home-based CIT group improved more on the PDMS-@ ( P < @ ) and WeeFIM ( P < @ ) in all posttreatment tests and on the BOTMP ( P < @ ) at follow-up than the TR group .


The home-based CIT induced better spatial and temporal efficiency ( smoother movement , more efficient grasping , better movement preplanning and execution ) for functional improvement up to @ months after treatment than TR .


Chronic ankle instability is characterized by repetitive lateral ankle sprains .


Prophylactic ankle taping is a common intervention used to reduce the risk of ankle sprains .


However , little research has been conducted to evaluate the effect ankle taping has on gait kinematics .


To investigate the effect of taping on ankle and knee kinematics during walking and jogging in participants with chronic ankle instability .


Controlled laboratory study .


Motion analysis laboratory .


A total of @ individuals ( @ men , @ women ; age = @ @ years , height = @ @ cm , mass = @ @ kg ) with self-reported chronic ankle instability volunteered .


They had an average of @ @ incidences of ankle sprain .


Participants walked and jogged in shoes on a treadmill while untaped and taped .


The tape technique was a traditional preventive taping procedure .


Conditions were randomized .


Frontal-plane and sagittal-plane ankle and sagittal-plane knee kinematics were recorded throughout the entire gait cycle .


Group means and @ % confidence intervals were calculated , plotted , and inspected for percentages of the gait cycle in which the confidence intervals did not overlap .


During walking , participants were less plantar flexed from @ % to @ % of the gait cycle ( mean difference = @ @ ) and less inverted from @ % to @ % ( mean difference = @ @ ) and @ % to @ % ( mean difference = @ @ ) of the gait cycle when taped .


During jogging , participants were less dorsiflexed from @ % to @ % ( mean difference = @ @ ) and less inverted from @ % to @ % ( mean difference = @ @ ) of the gait cycle when taped .


No sagittal-plane knee kinematic differences were found .


In those with chronic ankle instability , taping resulted in a more neutral ankle position during walking and jogging in shoes on a treadmill .


This change in foot positioning and the mechanical properties of the tape may explain the protective aspect of taping in preventing lateral ankle sprains .


Dysregulation of CD@ + T cell subsets participates in the pathogenesis of immunoglobulin A nephropathy ( IgAN ) .


Vitamin D has immunomodulatory functions .


This study aims to investigate the regulatory effect of vitamin D@ on T helper - regulatory T ( Th@-Treg ) cells balance in rats with IgAN .


Sprague-Dawley rats were randomly assigned to a normal group ( n = @ ) , an IgAN model group ( n = @ ) , a prednisone treatment IgAN group ( n = @ ) , a @,@-dihydroxyvitamin D@ IgAN group ( n = @ ) , and prednisone plus @,@-dihydroxyvitamin D@ treatment group ( n = @ ) .


At week @ , the @-hour urine protein excretion and erythrocyte count and renal pathological changes were determined , and serum interleukin-@ and Treg cell levels were measured in blood .


The urine protein content and the number of erythrocytes were lower in the vitamin D group than in the model group ( P < @ ) , but higher than in the prednisone groups ( P < @ ) .


The pathological impairments in the glomerular mesangium , renal tubule , and renal interstitium decreased in response to treatment with prednisone with and without @,@-dihydroxyvitamin D@ .


Serum interleukin-@ level in the vitamin D and prednisone plus vitamin D groups was lower than in the prednisone group ( P < @ ) .


The Treg cells in the vitamin D and prednisone plus vitamin D groups showed higher levels than in the prednisone group ( P < @ ) .


Vitamin D@ can regulate the Th@/Treg balance and reduce the level of protein and blood in the urine of rats with IgAN .


Patients undergoing catheter ablation for atrial fibrillation ( AF ) often experience recurrent arrhythmias within the first few months post-ablation .


We aimed to investigate whether short-term use of amiodarone to prevent early arrhythmias following radiofrequency ablation for AF could reduce later recurrence .


In a two-centre , randomized , double-blind , placebo-controlled study , we randomized a total of @ patients undergoing AF ablation .


Patients were stratified according to type of AF ( paroxysmal/persistent ) and history of previous AF ablation and randomly assigned to @ weeks of oral amiodarone therapy or matched placebo following catheter ablation .


Patients were followed for @ months .


Analyses were performed according to the intention-to-treat principle .


Of @ enrolled patients -LSB- median age @ ( inter-quartile range @-@ ) , @ % male , @ % paroxysmal , @ % with history of previous ablation -RSB- , @ patients were available for analysis of the primary end-point which was any documented atrial tachyarrhythmia lasting > @ s following a blanking period of @ months .


This was observed in @/@ ( @ % ) in the amiodarone group vs. @/@ ( @ % ) in the placebo group ( P = @ ) .


Among the secondary end-points , the amiodarone group showed significantly lower rate of atrial tachyarrhythmia-related hospitalizations -LSB- rate ratio = @ ; @ % confidence interval ( CI ) = @-@ @ , P = @ -RSB- and cardioversions ( rate ratio = @ ; @ % CI = @-@ @ , P = @ ) within the blanking period .


Short-term oral amiodarone treatment following ablation for paroxysmal or persistent AF did not significantly reduce recurrence of atrial tachyarrhythmias at the @-month follow-up , but it more than halved atrial arrhythmia related hospitalization and cardioversion rates during the blanking period .


This study aimed to observe the effects of a concurrent physical training program ( CPTP ) on aerobic power and body composition in adults .


The final sample was composed of @ non-athletic men , randomized into @ groups : experimental group ( EG , N. = @ , @ years ) and control group ( CG , N. = @ , @ years ) .


Body composition was assessed by Dual Energy X-ray Absorptiometry ( DEXA ) and aerobic power by maximal oxygen uptake ( VO@max ) , obtained in the Cooper @-minute run test .


CPTP consisted of running training in the Fatmax intensity zone and strength training ( squats and bench presses ) ; three @-minute sessions a week for @ weeks .


Descriptive and inferential analysis ( intra-group : t-test and inter-group : @x@ ANOVA and Sheffe post-hoc ) was applied , and the Shapiro-Wilk test was used to test sample normality .


The significance level was set at @ % for all tests .


A significant alteration was found in intra-group comparison for the EG , with respect to fat percentage ( D = -@ kg ; P < @ ) , lean mass ( D = @ kg ; P = @ ) and VO@max ( D = @ mL/kg/min ; P < @ ) .


It can be inferred that CPTP caused an increase in aerobic power , evidenced in VO@max and enhanced body composition , with an increase in LM and reduction in F % .


The aim of this study was to compare the technical success between left spermatic vein ( LSV ) scleroembolisation achieved with the injection of sclerosant through a diagnostic catheter and through an occluding balloon ( OB ) , in the treatment of male varicocele .


From January @ to September @ , we prospectively enrolled @ patients with left varicocele and an indication for LSV scleroembolisation related to symptoms or spermiogram anomalies ; patients were randomised to two groups ( we wrote a list of @ lines assigned casually with A or B and each patient was consecutively allocated to group A or B on the basis of this list ) .


Patients in group A underwent injection of the sclerosing agent through an angiographic diagnostic catheter ( free catheter technique ) and patients in group B through an OB catheter ( OB technique ) .


In cases of incomplete occlusion of the LSV , the procedure was completed with coils .


Total occlusion of the LSV at post-treatment phlebography during a Valsalva manoeuvre before any coil embolisation was considered a technical success .


The rate of complications was also evaluated .


The Fischer 's test was used for statistical analysis .


We evaluated a total of @ patients because five patients for each group were not included in the statistical analysis owing to technical problems or complications .


In group A we had a technical success of @ versus @ % in group B , and the difference was statistically significant ( P = @ ) ; in particular , we had to complete the embolisation with insertion of coils in @ cases ( @ % ) in group A , and in three cases in group B ( @ % ) .


In group A , LSV rupture occurred in four cases ( @ % ) so the procedure was completed by sclerosant injection through the OB located distally to the lesion .


These patients were not considered for evaluation .


In another case , a high flow shunt towards the inferior vena cava was detected , so the patient underwent OB injection to stop the flow to the shunt , and was not included for statistical evaluation .


In group B , vein rupture with contrast leakage was noted in six cases ( @ % ) ; nonetheless , all the procedures were completed because the OB was positioned distally to the vessel tear , obviating any retrograde leakage of sclerosant .


In group B , in five cases ( @ % ) , we were unable to advance the OB though the LSV ostium so the procedures were completed with the diagnostic catheter and not considered for statistical evaluation .


On the basis of our data , the embolisation of the LSV obtained by injecting the sclerosant through an OB rather than through a diagnostic catheter seems to be more effective in achieving total vein embolisation , as well as allowing a controlled injection of sclerosant even in cases of vein rupture .


This randomized , controlled , double-blind study was designed to determine the optimal dose of remifentanil for preventing complications associated with the removal of a laryngeal mask airway ( LMA ) without delaying emergence .


This study randomly assigned @ patients to remifentanil effect-site concentrations ( Ce ) of @ ng/mL ( group R@ ) , @ ng/mL ( group R@ @ ) , @ ng/mL ( group R@ @ ) , and @ ng/mL ( group R@ @ ) during emergence .


The emergence and recovery profiles were recorded .


Adverse events such as coughing , airway obstruction , breath-holding , agitation , desaturation , nausea , and vomiting were also evaluated .


The number of patients with respiratory complications such as coughing and breath-holding was significantly lower in the R@ @ and R@ @ groups than in the R@ group ( p < @ ) .


Emergence agitation also decreased in the R@ @ and R@ @ groups ( p < @ ) .


The time to LMA removal was significantly longer in the R@ @ group than in the other groups ( p < @ ) .


Maintaining a remifentanil Ce of @ ng/mL during emergence may suppress adverse events such as coughing , breath-holding , and agitation following the removal of LMA without delayed awakening .


The standard of care for increasing keratinized tissue ( KT ) and vestibular area is an autogenous free gingival graft ( FGG ) and vestibuloplasty ; however , there is morbidity associated with the harvest of autogenous tissue , and supply is limited .


The purpose of this study is to determine if a xenogeneic collagen matrix ( CM ) might be as effective as FGG .


This study is a single-masked , randomized , controlled , split-mouth study of @ patients with insufficient zones of KT ( < @ mm ) .


It uses a within-patient treatment-comparison design to establish non-inferiority of the test ( CM ) versus control ( FGG ) therapy .


The primary efficacy endpoint was change in KT width ( KT ) from surgery to @ months post-surgery .


Secondary endpoints included traditional periodontal measures , such as clinical attachment level , recession , and bleeding on probing .


Patient-reported pain , discomfort , and esthetic satisfaction were also recorded .


Biopsies were obtained at @ months .


Surgery and postoperative sequelae were uneventful , with normal healing observed at both test and control sites .


The primary outcome , KT width at @ months , did not establish non-inferiority of CM compared to FGG ( P = @ ) , with the FGG sites averaging @ mm more KT width than CM sites .


However , the amount of new KT generated for both therapies averaged @ mm .


Secondary outcomes were not significantly different between test and control sites .


All site biopsies appeared as normal mucoperiosteum with keratinized epithelium .


CM sites achieved better texture and color matches , and more than two-thirds of patients preferred the appearance of their CM sites .


With the proviso of sufficient KT ( @ mm in width ) and study goals of lower morbidity , unlimited supply , and patient satisfaction , CM appears to be a suitable substitute for FGG in vestibuloplasty procedures designed to increase KT around teeth .


Olive oil polyphenols have shown beneficial properties against cardiovascular risk factors .


Their consumption has been associated with higher cholesterol content in high-density lipoproteins ( HDL ) .


However , data on polyphenol effects on HDL quality are scarce .


We , therefore , assessed whether polyphenol-rich olive oil consumption could enhance the HDL main function , its cholesterol efflux capacity , and some of its quality-related properties , such HDL polyphenol content , size , and composition .


A randomized , crossover , controlled trial with @ healthy European male volunteers was performed .


Participants ingested @ mL/d of polyphenol-poor ( @ mg/kg ) or polyphenol-rich ( @ mg/kg ) raw olive oil in @-week intervention periods , preceded by @-week washout periods .


HDL cholesterol efflux capacity significantly improved after polyphenol-rich intervention versus the polyphenol-poor one ( +@ % and -@ % , respectively ; P = @ ) .


Incorporation of olive oil polyphenol biological metabolites to HDL , as well as large HDL ( HDL@ ) levels , was higher after the polyphenol-rich olive oil intervention , compared with the polyphenol-poor one .


Small HDL ( HDL@ ) levels decreased , the HDL core became triglyceride-poor , and HDL fluidity increased after the polyphenol-rich intervention .


Olive oil polyphenols promote the main HDL antiatherogenic function , its cholesterol efflux capacity .


These polyphenols increased HDL size , promoted a greater HDL stability reflected as a triglyceride-poor core , and enhanced the HDL oxidative status , through an increase in the olive oil polyphenol metabolites content in the lipoprotein .


Our results provide for the first time a first-level evidence of an enhancement in HDL function by polyphenol-rich olive oil .


Repetitive Transcranial Magnetic Stimulation ( rTMS ) is an effective treatment for Major Depressive Disorder ( MDD ) , and is based upon delivery of focal high-energy pulses of electromagnetic stimulation .


We postulated that delivery of rTMS at the subject 's individual alpha frequency ( synchronized TMS , or sTMS ) would achieve efficacy with lower energy of stimulation .


We developed a device that rotates neodymium cylindrical magnets at three locations along the midline above the subject 's scalp to impart low-energy , sinusoidal-waveform magnetic brain stimulation over a broad area , and performed this efficacy study .


Fifty-two subjects with MDD were enrolled in a randomized , sham controlled , double-blind treatment study ( Trial Registration : NCT@ ) .


Forty-six subjects were included in the final analysis .


Most subjects received concurrent antidepressant medications that remained unchanged during the study .


Subjects were randomized to three treatment groups : @ ) active sTMS with a fixed frequency at the subject 's alpha frequency ; @ ) active sTMS with a random stimulus frequency that varied between @ Hz and @ Hz ; and , @ ) sham sTMS .


@ half-hour sTMS sessions were administered @ days per week for @ weeks .


Subjects with either fixed or random frequency active sTMS had statistically significantly greater percentage reduction in depression severity compared to sham ( @ % vs. @ % , respectively ; p = @ ) .


No significant difference was found between fixed and random groups ( p = @ ) .


No significant side effects were reported .


These results suggest that sTMS may be an effective treatment for MDD .


Although emotional stress is associated with ischemic heart disease ( IHD ) and related clinical events , sex-specific differences in the psychobiological response to mental stress have not been clearly identified .


We aimed to study the differential psychological and cardiovascular responses to mental stress between male and female patients with stable IHD .


Patients with stable IHD enrolled in the REMIT ( Responses of Mental Stress-Induced Myocardial Ischemia to Escitalopram ) study underwent psychometric assessments , transthoracic echocardiography , and platelet aggregation studies at baseline and after @ mental stress tasks .


Mental stress-induced myocardial ischemia ( MSIMI ) was defined as the development or worsening of regional wall motion abnormality , reduction of left ventricular ejection fraction ( LVEF ) @ % by transthoracic echocardiography , and/or ischemic ST-segment change on electrocardiogram during @ or more of the @ mental stress tasks .


In the @ participants with known IHD ( @ % women , @ % men ) , most baseline characteristics were similar between women and men ( including heart rate , blood pressure , and LVEF ) , although women were more likely to be nonwhite , living alone ( p < @ ) , and unmarried ( p < @ ) ; they also had higher baseline depression and anxiety ( p < @ ) .


At rest , women had heightened platelet aggregation responses to serotonin ( p = @ ) and epinephrine ( p = @ ) compared with men .


Following mental stress , women had more MSIMI ( @ % vs. @ % ; p < @ ) , expressed more negative ( p = @ ) and less positive emotion ( p < @ ) , and demonstrated higher collagen-stimulated platelet aggregation responses ( p = @ ) than men .


Men were more likely than women to show changes in traditional physiological measures , such as blood pressure ( p < @ ) and double product .


In this exploratory analysis , we identified clear , measurable , and differential responses to mental stress in women and men .


Further studies should test the association of sex differences in cardiovascular and platelet reactivity in response to mental stress and long-term outcomes .


( Responses of Myocardial Ischemia to Escitalopram Treatment -LSB- REMIT -RSB- ; NCT@ ) .


Combination long-acting bronchodilator treatment might be more effective than long-acting bronchodilator monotherapy for the treatment of chronic obstructive pulmonary disease ( COPD ) .


We aimed to compare the efficacy and safety of umeclidinium ( UMEC ) plus vilanterol ( VI ) with tiotropium ( TIO ) monotherapy , UMEC monotherapy , or VI monotherapy in patients with moderate to very severe COPD .


In two multicentre , randomised , blinded , double-dummy , parallel-group , active-controlled trials , eligible patients ( current or former smokers aged @ years or older with an established clinical history of COPD ) were randomly assigned in @:@:@:@ ratio to UMEC @ g plus VI @ g , UMEC @ g plus VI @ g , TIO @ g , and either VI @ g ( study @ ) or UMEC @ g ( study @ ) .


All study drugs were used once daily for @ weeks .


TIO was delivered via the HandiHaler inhaler and all other active treatments were delivered via the ELLIPTA dry powder inhaler .


Random assignment ( by a validated computer-based system ) was done by centre and was not stratified .


All patients and physicians were masked to assigned treatment during the studies .


The primary efficacy endpoint of both studies was trough forced expiratory volume in @ s ( FEV@ ) on day @ , which was analysed in the intention-to-treat population .


Both studies are registered with ClinicalTrials.gov , numbers NCT@ ( study @ ) and NCT@ ( study @ ) .


@ participants were recruited in study @ , and @ in study @ .


For study @ , after exclusions , @ , @ , @ , and @ patients were included in the intention-to-treat analyses for TIO monotherapy , VI monotherapy , UMEC @ g plus VI @ g , and UMEC @ g plus VI @ g , respectively .


For study @ , @ , @ , @ , and @ patients were included in the intention-to-treat analyses for TIO monotherapy , UMEC monotherapy , UMEC @ g plus VI @ g , and UMEC @ g plus VI @ g , respectively .


In both studies , we noted improvements in trough FEV@ on day @ for both doses of UMEC plus VI compared with TIO monotherapy ( study @ , UMEC @ g plus VI @ g : @ L -LSB- @ % CI @ to @ ; p = @ -RSB- ; study @ , UMEC @ g plus VI @ g : @ L -LSB- @ to @ ; p = @ -RSB- ; study @ , UMEC @ g plus VI @ g : @ L -LSB- @ to @ ; p = @ -RSB- ; study @ , UMEC @ g plus VI @ g : @ L -LSB- @ to @ ; nominal p = @ -RSB- ) .


Both doses of UMEC plus VI also improved trough FEV@ compared with VI monotherapy ( UMEC @ g plus VI @ g : @ L -LSB- @ to @ ; p = @ -RSB- ; UMEC @ g plus VI @ g : @ L -LSB- @ to @ ; p = @ -RSB- , but not compared with UMEC @ g monotherapy ( UMEC @ g plus VI @ g : @ L -LSB- -@ to @ ; p = @ -RSB- ; UMEC @ g plus VI @ g : @ L -LSB- -@ to @ ; p = @ -RSB- ) .


All treatments produced improvements in dyspnoea and health-related quality of life ; we noted no significant differences in symptoms , health status , or risk of exacerbation between UMEC plus VI and TIO .


The most common on-treatment , severe-intensity adverse event in both studies was acute exacerbation of COPD ( @-@ -LSB- < @-@ % -RSB- patients across treatment groups in study @ and @-@ -LSB- < @-@ % -RSB- patients in study @ ) .


We recorded five to @ ( @-@ % ) on-treatment serious adverse events across treatment groups in study @ , and nine to @ ( @-@ % ) in study @ .


We noted no substantial changes from baseline in vital signs , clinical laboratory findings , or electrocardiography findings in any of the treatment groups .


Combination treatment with once-daily UMEC plus VI improved lung function compared with VI monotherapy and TIO monotherapy in patients with COPD .


Overall our results suggest that the combination of UMEC plus VI could be beneficial for the treatment of moderate to very severe COPD .


Definitive chemoradiotherapy is a curative treatment option for oesophageal carcinoma , especially in patients unsuitable for surgery .


The PRODIGE@/ACCORD@ trial aimed to assess the efficacy and safety of the FOLFOX treatment regimen ( fluorouracil plus leucovorin and oxaliplatin ) versus fluorouracil and cisplatin as part of chemoradiotherapy in patients with localised oesophageal cancer .


We did a multicentre , randomised , open-label , parallel-group , phase @/@ trial of patients aged @ years or older enrolled from @ centres in France between Oct @ , @ , and Aug @ , @ .


Eligible participants had confirmed stage I-IVA oesophageal carcinoma ( adenocarcinoma , squamous-cell , or adenosquamous ) , Eastern Cooperative Oncology Group ( ECOG ) status @-@ , sufficient caloric intake , adequate haematological , renal , and hepatic function , and had been selected to receive definitive chemoradiotherapy .


Patients were randomly assigned ( @:@ ) to receive either six cycles ( three concomitant to radiotherapy ) of oxaliplatin @ mg/m ( @ ) , leucovorin @ mg/m ( @ ) , bolus fluorouracil @ mg/m ( @ ) , and infusional fluorouracil @ mg/m ( @ ) ( FOLFOX ) over @ h , or four cycles ( two concomitant to radiotherapy ) of fluorouracil @ mg/m ( @ ) per day for @ days and cisplatin @ mg/m ( @ ) on day @ .


Both groups also received @ Gy radiotherapy in @ fractions ( five fractions per week ) .


Random allocation to treatment groups was done by a central computerised randomisation procedure by minimisation , stratified by centre , histology , weight loss , and ECOG status , and was achieved independently from the study investigators .


The primary endpoint was progression-free survival .


Data analysis was primarily done by intention to treat .


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


@ participants were randomly allocated to the FOLFOX group and @ to the fluorouracil and cisplatin group ( intention-to-treat population ) , and @ patients in the FOLFOX group and @ in the fluorouracil and cisplatin group actually received the study drugs ( safety population ) .


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


Median progression-free survival was @ months ( @ % CI @-@ ) in the FOLFOX group and @ months ( @-@ ) in the fluorouracil and cisplatin group ( HR @ , @ % CI @-@ ; p = @ ) .


One toxic death occurred in the FOLFOX group and six in the fluorouracil-cisplatin group ( p = @ ) .


No significant differences were recorded in the rates of most frequent grade @ or @ adverse events between the treatment groups .


Of all-grade adverse events that occurred in @ % or more of patients , paraesthesia ( @ -LSB- @ % -RSB- events in @ patients in the FOLFOX group vs three -LSB- @ % -RSB- in @ patients in the cisplatin-fluorouracil group , p < @ ) , sensory neuropathy ( @ -LSB- @ % -RSB- vs one -LSB- @ % -RSB- , p < @ ) , increases in aspartate aminotransferase concentrations ( @ -LSB- @ % -RSB- vs two -LSB- @ % -RSB- , p = @ ) , and increases in alanine aminotransferase concentrations ( @ -LSB- @ % -RSB- vs two -LSB- @ % -RSB- , p = @ ) were more common in the FOLFOX group , whereas serum creatinine increases ( four -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- , p = @ ) , mucositis ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- , p = @ ) , and alopecia ( two -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- , p = @ ) were more common in the fluorouracil and cisplatin group .


Although chemoradiotherapy with FOLFOX did not increase progression-free survival compared with chemoradiotherapy with fluorouracil and cisplatin , FOLFOX might be a more convenient option for patients with localised oesophageal cancer unsuitable for surgery .


High definition endoscopy is the accepted standard in colonoscopy .


However , an important problem is missed polyps .


Our objective was to assess the additional adenoma detection rate between high definition colonoscopy with tone enhancement ( digital chromoendoscopy ) vs. white light high definition colonoscopy .


In this prospective randomized trial patients were included to undergo a tandem colonoscopy .


The first exam was a white light colonoscopy with removal of all visualized polyps .


The second examination was randomly assigned in a @:@ ratio as either again white light colonoscopy ( Group A ) or colonoscopy with tone enhancement ( Group B ) .


Primary endpoint was the adenoma detection rate during the second withdrawal ( sample size calculation - @ per group ) .


@ lesions ( Group A : n = @ vs. Group B : n = @ ) in @ patients ( mean age @ years , male @ % ) were identified on the first colonoscopy .


The second colonoscopy detected @ additional lesions : n = @ with tone enhancement vs. n = @ with white light endoscopy ( p < @ ) .


Tone enhancement found more additional adenomas ( A n = @ vs. B n = @ , p = @ ) and identified significantly more missed adenomas per subject ( @ vs. @ , p = @ ) .


High definition plus colonoscopy with tone enhancement detected more adenomas missed by white light colonoscopy .


Home-based diagnosis of obstructive sleep apnea ( OSA ) with portable monitoring ( PM ) is increasingly utilized , but remains understudied in underserved and minority populations .


We tested the feasibility of home PM in an urban population at risk for OSA compared to in-laboratory polysomnography ( PSG ) and examined patient preference with respect to home PM versus PSG .


Randomized crossover study of home PM ( WatchPAT@ ) and in-laboratory simultaneous PSG and PM in @ urban African Americans with high pre-test probability of OSA , identified with the Berlin questionnaire .


Fifty-seven of @ participants were women , average age @ @ years ( mean SD ) , @ % with high school education , and @ % with annual household income < $ @,@ .


Technical failure rates were @ % for home vs. @ % for in-laboratory PM .


There was good agreement between apnea hypopnea index on PSG ; AHIPSG and AHI on home PM ( mean @ SD of the differences = @ @ and intraclass correlation coefficient ; ICC = @ ) .


The areas under the curve for the receiver-operator characteristic curves for home PM were @ for AHIPSG @ , @ for AHIPSG @ , and @ for AHIPSG @ / @ ( @ % ) participants preferred home over in-laboratory testing .


Home PM for diagnosis of OSA in a high risk urban population is feasible , accurate , and preferred by patients .


As home PM may improve access to care , the cost-effectiveness of this diagnostic strategy for OSA should be examined in underserved urban and rural populations .


To evaluate the effect of health education path on advanced schistosomiasis patients with splenomegaly in perioperative period .


A total of @ advanced schistosomiasis patients with splenomegaly in perioperative period were randomly divided into an observation group and a control group ( @ cases each group ) .


The patients in the observation group were intervened by the nursing and health education from admission to discharge according to the standardized process of health education path , while those in the control group were implemented with the conventional health education .


Then the satisfaction of nursing work , hospital stays , hospitalization expenses and mastery of health knowledge of the patients in the two groups were investigated and the results were compared .


The satisfaction rates of nursing work of patients in the observation group and the control group were @ % and @ % , respectively , the difference between them was statistically significant ( @ = @ , P < @ ) .


The average hospitals stays of the above two groups were @ @ d and @ @ d ( t = @ , P < @ ) , respectively , and the average hospitalization expenses were ( @ @ ) thousand Yuan and ( @ @ ) thousand Yuan ( t = @ , P < @ ) , respectively , both of the differences were statistically significant .


On the @th day after surgery , the mastery rates of the health knowledge of the two groups were @ % and @ % , respectively , the difference was statistically significant ( @ = @ , P < @ ) .


The implementation of the health education path can promote the rehabilitation of advanced schistosomiasis patients with splenomegaly , and increase the satisfaction as well as improve the mastery of the health knowledge of the patients .


Meanwhile , it also can cut down the hospital stays and save the hospitalization expenses .


Cardiovascular dysfunction is common after out-of-hospital cardiac arrest as part of the postcardiac arrest syndrome , and hypothermia may pose additional impact on hemodynamics .


The aim was to investigate systemic vascular resistance index ( SVRI ) , cardiac index , and myocardial performance at a targeted temperature management of @C ( TTM@ ) versus @C ( TTM@ ) .


Single-center substudy of @ patients included in the Target Temperature Management Trial ( TTM Trial ) randomly assigned to TTM@ or TTM@ for @ hours after out-of-hospital cardiac arrest .


Mean arterial pressure @ mm Hg and central venous pressure of @ to @ mm Hg were hemodynamic treatment goals .


Hemodynamic evaluation was performed by serial right heart catheterization and transthoracic echocardiography .


Primary end point was SVRI after @ hours of cooling and secondary end points included mean SVRI , cardiac index , systolic function , and lactate levels .


The TTM@ group had a significant increase in SVRI compared with TTM@ ( @ ; @ % confidence interval , @-@ ) versus @ ( @ % confidence interval , @-@ ) dynes m ( @ ) / s per cm ( @ ) ; P < @ , respectively ) after @ hours of cooling with an overall difference of @ dynes m ( @ ) / s per cm ( @ ) ( P ( group ) < @ ) .


TTM@ was associated with decreased cardiac index ( -@ L/min per m ( @ ) ; P ( group ) < @ ) , decreased heart rate ( P ( group ) = @ ) , and stroke volume index ( P ( group ) = @ ) compared with TTM@ .


Left ventricular ejection fraction ( P = @ ) and peak systolic myocardial velocity ( P = @ ) did not differ between TTM groups .


Lactate levels were significantly higher in the TTM@ group ( P = @ ) .


Targeted temperature management at @C with target mean arterial pressure @ mm Hg is associated with increased SVRI and lower cardiac index because of lower heart rate with unaffected left ventricular systolic function compared with @C .


Locally advanced rectal cancer ( LARC ) is a heterogeneous group of tumors where a risk-adapted therapeutic strategy is needed .


Short-course radiotherapy ( SCRT ) is a more convenient option for LARC patients than preoperative long-course RT plus capecitabine .


Histone-deacetylase inhibitors ( HDACi ) have shown activity in combination with RT and chemotherapy in the treatment of solid tumors .


Valproic acid ( VPA ) is an anti-epileptic drug with HDACi and anticancer activity .


In preclinical studies , our group showed that the addition of HDACi , including VPA , to capecitabine produces synergistic antitumour effects by up-regulating thymidine phosphorylase ( TP ) , the key enzyme converting capecitabine to @-FU , and by downregulating thymidylate synthase ( TS ) , the @-FU target .


Two parallel phase-@ studies will assess the safety of preoperative SCRT ( @ fractions each of @Gy , on days @ to @ ) combined with ( a ) capecitabine alone ( increasing dose levels : @-@mg / m@/bid ) , on days @-@ , or ( b ) capecitabine as above plus VPA ( oral daily day -@ to @ , with an intra-patient titration for a target serum level of @-@ microg/ml ) followed by surgery @weeks after the end of SCRT , in low-moderate risk RC patients .


Also , a randomized phase-@ study will be performed to explore whether the addition of VPA and/or capecitabine to preoperative SCRT might increase pathologic complete tumor regression ( TRG@ ) rate .


A sample size of @ patients ( @-@ / arm ) was calculated under the hypothesis that the addition of capecitabine or VPA to SCRT can improve the TRG@ rate from @ % to @ % , with one-sided alpha = @ and @ % power.Several biomarkers will be evaluated comparing normal mucosa with tumor ( TP , TS , VEGF , RAD@ , XRCC@ , Histones/proteins acetylation , HDAC isoforms ) and on blood samples ( polymorphisms of DPD , TS , XRCC@ , GSTP@ , RAD@ and XRCC@ , circulating endothelial and progenitors cells ; PBMCs-Histones/proteins acetylation ) .


Tumor metabolism will be measured by @FDG-PET at baseline and @days after the beginning of SCRT .


This project aims to improve the efficacy of preoperative treatment of LARC and to decrease the inconvenience and the cost of standard long-course RT. .


Correlative studies could identify both prognostic and predictive biomarkers and could add new insight in the mechanism of interaction between VPA , capecitabine and RT.EudraCT Number : @-@-@ .


Chronic obstructive pulmonary disease ( COPD ) generates a high burden on health care , and hospital admissions represent a substantial proportion of the overall costs of the disease .


Integrated care ( IC ) has shown efficacy to reduce hospitalisations in COPD patients at a pilot level .


Deployment strategies for IC services require assessment of effectiveness at the health care system level .


The aim of this study was to explore the effectiveness of a community-based IC service in preventing hospitalisations and emergency department ( ED ) visits in stable frail COPD patients .


From April to December @ , @ frail community-dwelling COPD patients were randomly allocated either to IC ( n = @ , age @ ( @ ) years , forced expiratory volume during the first second , FEV@ @ ( @ ) % predicted ) or usual care ( n = @ , age @ ( @ ) years , FEV@ @ ( @ ) % predicted ) and followed up for @ months .


The IC intervention consisted of the following : ( a ) patient 's empowerment for self-management ; ( b ) an individualised care plan ; ( c ) access to a call centre ; and ( d ) coordination between the levels of care .


Thereafter , hospital admissions , ED visits and mortality were monitored for @ years .


IC enhanced self-management ( P = @ ) , reduced anxiety-depression ( P = @ ) and improved health-related quality of life ( P = @ ) .


IC reduced both ED visits ( P = @ ) and mortality ( P = @ ) but not hospital admission .


No differences between the two groups were seen after @ years .


The intervention improved clinical outcomes including survival and decreased the ED visits , but it did not reduce hospital admissions .


The study facilitated the identification of two key requirements for adoption of IC services in the community : appropriate risk stratification of patients , and preparation of the community-based work force .


The objective of this study was to assess change in sitting and physical activity behavior in response to a workplace intervention to disrupt prolonged sitting time .


Sixty office workers were randomized to either a Stand group ( n = @ ) , which received hourly prompts ( computer-based and wrist-worn ) to stand up , or a Step group ( n = @ ) , which received the same hourly prompts and an additional prompt to walk @ steps or more upon standing .


An ActivPAL monitor was used to assess sitting and physical activity behavior on the same @ consecutive workdays during baseline and intervention periods .


Mixed-effect models with random intercepts and random slopes for time were performed to assess change between groups and across time .


Both groups significantly reduced duration of average sitting bouts ( Stand group , by @ % ; Step group , by @ % ) and the number of sitting bouts of @ minutes or more ( Step group , by @ % ; Stand group , by @ % ) .


The Stand group significantly reduced total sitting time ( by @ % ) , duration of the longest sitting bout ( by @ % ) , and number of sitting bouts of @ minutes or more ( by @ % ) and increased the number of sit-to-stand transitions ( by @ % ) and standing time ( by @ % ) .


Stepping time significantly increased in the Stand ( by @ % ) and Step ( by @ % ) groups , but only the Step group significantly increased ( by @ % ) the number of steps per workday .


Differences in changes from baseline to intervention between groups were not significant for any outcome .


Interventions that focus on disrupting sitting time only in the workplace may result in less sitting .


When sitting time disruptions are paired with a physical activity prompt , people may be more likely to increase their workday physical activity , but the effect on sitting time may be attenuated .


We compared the ability of biennial fecal immunochemical testing ( FIT ) and one-time sigmoidoscopy to detect colon side-specific advanced neoplasms in a population-based , multicenter , nationwide , randomized controlled trial .


We identified asymptomatic men and women , @-@ years old , through community health registries and randomly assigned them to groups that received a single colonoscopy examination or biennial FIT .


Sigmoidoscopy yield was simulated from results obtained from the colonoscopy group , according to the criteria proposed in the UK Flexible Sigmoidoscopy Trial for colonoscopy referral .


Patients who underwent FIT and were found to have @ ng hemoglobin/mL were referred for colonoscopy .


Data were analyzed from @ subjects in the colonoscopy group and @,@ in the FIT group .


The main outcome was rate of detection of any advanced neoplasm proximal to the splenic flexure .


Advanced neoplasms were detected in @ subjects ( @ % ) in the sigmoidoscopy simulation group compared with @ ( @ % ) in the FIT group ( odds ratio for sigmoidoscopy , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


Sigmoidoscopy also detected advanced distal neoplasia in a higher percentage of patients than FIT ( odds ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


The methods did not differ significantly in identifying patients with advanced proximal neoplasms ( odds ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


This was probably due to the lower performance of both strategies in detecting patients with proximal lesions ( sigmoidoscopy detected these in @ % of patients and FIT in @ % of patients ) vs distal ones ( sigmoidoscopy detected these in @ % of patients and FIT in @ % of patients ) .


Sigmoidoscopy , but not FIT , detected proximal lesions in lower percentages of women ( especially those @-@ years old ) than men .


Sigmoidoscopy and FIT have similar limitations in detecting advanced proximal neoplasms , which depend on patients ' characteristics ; sigmoidoscopy underperforms for women @-@ years old .


Screening strategies should be designed on the basis of target population to increase effectiveness and cost-effectiveness .


ClinicalTrials.gov number : NCT@ .


The authors evaluated whether an obstetrics-gynecology clinic-based collaborative depression care intervention is differentially effective compared with usual care for socially disadvantaged women with either no health insurance or with public coverage compared with those with commercial insurance .


The study was a two-site randomized controlled trial with an @-month follow-up .


Women were recruited who screened positive ( a score of at least @ on the Patient Health Questionnaire-@ ) and met criteria for major depression or dysthymia .


The authors tested whether insurance status had a differential effect on continuous depression outcomes between the intervention and usual care over @ months .


They also assessed differences between the intervention and usual care in quality of depression care and dichotomous clinical outcomes ( a decrease of at least @ % in depressive symptom severity and patient-rated improvement on the Patient Global Improvement Scale ) .


The treatment effect was significantly associated with insurance status .


Compared with patients with commercial insurance , those with no insurance or with public coverage had greater recovery from depression symptoms with collaborative care than with usual care over the @-month follow-up period .


At the @-month follow-up , the effect size for depression improvement compared with usual care among women with no insurance or with public coverage was @ ( @ % CI = @ , @ ) , whereas it was @ ( @ % CI = -@ , @ ) for women with commercial insurance .


Collaborative depression care adapted to obstetrics-gynecology settings had a greater impact on depression outcomes for socially disadvantaged women with no insurance or with public coverage compared with women with commercial insurance .


To assess the applicability of the Peak Nasal Inspiratory Flow ( PNIF ) curves in follow-up of children in the treatment of allergic rhinitis .


Prospective study of @ patients with AR , grouped in corticosteroid spray versus physiological saline solution use .


Follow up for @ weeks through clinical score and PNIF percentages in relation to the reference curves , with was-out at week @ .


Statistical assessment of the effect of treatment on variation of PNIF and clinical score was calculated by ANOVA model and Multiple Comparison of Means Test - Least Significant Difference .


There was a statistically significant influence of the group , time and interaction between time and group on PNIF percentages .


Throughout follow up , patients from the treatment group had mean PNIF percentages significantly higher than the placebo group .


Clinical score results also demonstrated a statistically significant influence between the groups , time and interaction between time and group .


Increase in PNIF percentage values observed in children treated with intranasal corticosteroids revealed the applicability of PNIF curves in their follow up .


Regular maternal exercise may play an important role in the management of gestational diabetes mellitus ( GDM ) , yet specific exercise guidelines to achieve glycemic control have not been established .


Furthermore , many women remain sedentary during pregnancy because of perceived barriers to exercise participation .


This study examined the effectiveness of a home-based cycling program commenced upon diagnosis of GDM on daily fasting and postprandial blood glucose levels , glycosylated hemoglobin ( HbA@c ) , and the response of glucose and insulin to a @-g oral glucose load .


Forty sedentary women ( @ @ wk of gestation ) were randomized to either home-based exercise training in combination with conventional management ( EX , n = @ ) or to conventional management alone ( CON , n = @ ) until week @ of pregnancy .


Mean compliance to the supervised exercise training was @ % , and no adverse effects were reported .


Capillary glucose concentration was acutely reduced in response to each cycling session ( @ @ mM to @ @ mM , P < @ ) .