Healthy men acutely exposed during @ days to hypoxemia at @,@ m and @,@ m reveal a considerable amount of periodic breathing and sleep disturbances .


However , no significant effects on psychomotor reaction speed or cognitive performance were observed .


Low-volume bowel preparations have been shown to provide an equivalent cleansing effect as that of a standard @ L polyethylene glycol .


However , studies comparing the efficacy of low-volume bowel preparations are few , and the results have been controversial .


This study aimed to compare the bowel cleansing quality and tolerability between sodium picosulfate/magnesium citrate and polyethylene glycol with ascorbic acid .


A randomized study was performed with two hundred outpatients who were prospectively enrolled .


The Boston Bowel Preparation Scale and the Aronchick scale were used to evaluate the bowel cleansing quality , and bubble scoring was also performed to back up both results .


To investigate patients ' preferences and tolerability , a questionnaire was administered .


Sodium picosulfate/magnesium citrate was not inferior to polyethylene glycol with ascorbic acid in terms of successful bowel preparation ( @ Boston scale score : @ % vs. @ % ; p = @ , adequate Aronchick grade : @ % vs. @ % ; p = @ ) .


In addition , sodium picosulfate/magnesium citrate caused fewer gastrointestinal symptoms , and tasted better than polyethylene glycol with ascorbic acid .


Sodium picosulfate/magnesium citrate was not inferior to polyethylene glycol with ascorbic acid in cleansing efficacy , and was found to have higher tolerability .


Multimorbidity and declining performance in elderly cancer patients may result in less treatment benefit .


We investigated whether age is a predictor for pain response and quality of life ( QoL ) after radiotherapy in patients with painful bone metastases .


The database of the Dutch Bone Metastasis Study was used ( @-@ ) .


@ patients , irradiated for painful bone metastases , rated their pain , QoL-domains and overall health at baseline and during follow-up .


Response was calculated taking into account changes in pain score and medication .


Patients were grouped into three age cohorts : A : < @ ( n = @ ) , B : @-@ ( n = @ ) and C : @years ( n = @ ) .


No significant difference existed in pain response between cohorts : @ % in cohort A , @ % in B and @ % in C.


When assessing baseline QoL , a significant difference in activity level was noticed , with more impairment in elderly compared to younger patients ( C versus B ( p = @ ) , C versus A ( p < @ ) ) .


Other QoL-domains were similar at baseline and during follow-up among cohorts .


A pain response was significantly associated with improvement of health-related QoL ( OR @ , @ % CI @-@ @ ) .


The majority of elderly patients with painful bone metastases responded to radiotherapy and showed comparable overall QoL compared to their younger counterparts .


Age is not a predictor for pain response or QoL .


to investigate the efficacy of zinc supplementation in chronic prostatitis treatment .


present randomized clinical trial was conducted on @ patients with diagnosis of chronic prostatitis ( IIIA NIH ) after preliminary evaluation and ruling out other conditions .


The study group received oral zinc sulfate @ mg daily as capsule without any other supplements .


The control group received placebo .


Subjects were examined for NIH-CPSI scores every @ weeks for @ weeks .


@ subjects completed the study .


There were no statistically significant differences in scores and sub-scores of NIH-CPSI between groups before intervention .


Decline in the score and sub-scores were more prominent in case group after beginning of the study ; though the differences were not statistically significant .


Furthermore , the differences in total score and pain score at @ weeks follow was statistically significant ( p = @ and p = @ , respectively ) .


zinc supplements may benefit in management of patients with chronic prostatitis NIH-IIIA .


It can be attributable to anti-bacterial and immuno-modulatory functions of organic zinc in the body .


This study sought to examine the effect of statin therapy hospitalizations for heart failure ( HFH ) in patients in the CORONA ( Controlled Rosuvastatin Multinational Trial in Heart Failure ) trial .


HFH is an important , frequently recurrent event .


Conventional time-to-first event analyses do not take account repeat events .


We used a number of statistical approaches to examine the effect of treatment on first and repeat HFH in the CORONA trial .


In the CORONA trial , @,@ patients @ years of age with chronic New York Heart Association functional classes II to IV systolic heart failure resulting from ischemia were randomized to receive rosuvastatin or placebo .


Poisson , Andersen-Gill , and negative binomial methods ( NB ) were used to analyze the effect of rosuvastatin on HFH , and the NB and a parametric joint frailty model ( JF ) were used to examine this effect while accounting for the competing risk of cardiovascular ( CV ) death .


Rosuvastatin/placebo rate ratios were calculated , both unadjusted and adjusted .


A total of @,@ patients had @ or more HFH ( @ of these had a single HFH only ) , and there were a total of @,@ HFHs .


The hazard ratio for the conventional time-to-first event analysis for HFH was @ ( @ % confidence interval -LSB- CI -RSB- : @ to @ , p = @ ) .


In contrast , the NB on repeat hospitalizations gave an unadjusted RR ( RR ) for HFH of @ ( @ % CI : @ to @ , p = @ ) , adjusted @ ( @ % CI : @ to @ , p = @ ) , and after including CV death as the last event , adjusted RR of @ ( @ % CI : @ to @ , p = @ ) .


The JF gave an adjusted RR of @ ( @ % CI : @ to @ , p = @ ) .


Similar results were found in analyses of all CV hospitalizations and all-cause hospitalizations .


When repeat events were included , rosuvastatin was shown to reduce the risk of HFH by approximately @ % to @ % , equating to approximately @ fewer admissions per @,@ patients treated over a median @ months of follow-up .


Including repeat events could increase the ability to detect treatment effects in heart failure trials .


To determine agreement between spectral-domain ( SD ) and time-domain ( TD ) optical coherence tomography ( OCT ) image assessments by certified readers in eyes treated for neovascular age-related macular degeneration ( AMD ) .


Cross-sectional study within the Comparison of AMD Treatments Trials ( CATT ) .


During year @ of CATT , @ pairs of SD OCT and TD OCT scans were compared from a subset of @ eyes .


Masked readers independently graded OCT scans for presence of intraretinal fluid ( IRF ) , subretinal fluid ( SRF ) , and sub-retinal pigment epithelium ( RPE ) fluid and performed manual measurements of retinal , SRF , and subretinal tissue complex thicknesses at the foveal center .


Presence of fluid was evaluated with percent agreement , coefficients with @ % confidence intervals ( CIs ) , and McNemar tests .


Thickness measurements were evaluated with mean difference ( ) @ % limits of agreement and intraclass correlation coefficients ( ICCs ) with @ % CIs .


Between SD OCT and TD OCT , agreement on presence of any fluid was @ % ( = @ ; @ % CI , @-@ @ ) , with @ % more SD OCT scans demonstrating fluid ( P < @ ) .


Agreement on presence of SRF was @ % and sub-RPE fluid was @ % , with more SD OCT scans demonstrating fluid ( both P < @ ) .


Agreement on IRF was @ % ( = @ ; @ % CI , @-@ @ ) , with @ % more TD OCT scans demonstrating fluid ( P < @ ) .


Between SD OCT and TD OCT , mean thickness of the retina was = @ m , SRF was = @ m , and subretinal tissue complex was = @ m. Thickness measurements were reproducible for retina ( ICC = @ ; @ % CI , @-@ @ ) , SRF ( ICC = @ ; @ % CI , @-@ @ ) , and subretinal tissue complex ( ICC = @ ; @ % CI , @-@ @ ) , with @-m difference in these measurements in @ % , @ % , and @ % of paired scans , respectively .


Agreement on fluid presence and manual thickness measurements between paired scans from each OCT modality was moderate , providing a reasonable basis to compare CATT results with future SD OCT-based trials .


Fluid was detected @ % more frequently with SD OCT , which may increase frequency of fluid-based treatment .


Lower-resolution and artifactual interpretation of dark areas as cystoid edema may explain the greater frequency of IRF detected with TD OCT. .


To evaluate the cost-effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared to general practitioners ' care .


A multicentre randomised trial with @ community dwelling patients newly diagnosed with mild to moderate dementia , and their informal caregivers , with twelve months ' follow-up .


Cost-effectiveness was evaluated from a societal point of view and presented as incremental cost per quality adjusted life year .


To establish cost-effectiveness , a cost-utility analysis was conducted using utilities based on the EQ-@D .


Uncertainty surrounding the incremental cost-effectiveness ratio ( difference in costs divided by difference in effects ) was calculated by bootstrapping from the original data .


Compared to general practitioners ' care , treatment by the memory clinics was on average @ ( @ % CI : -@ to @ ) cheaper , and showed a non-significant decrease of @ ( @ % CI : -@ to @ ) quality adjusted life years .


The incremental cost-effectiveness point estimate from the bootstrap simulation was @ @ per QALY lost if one would use memory clinic care instead of general practitioner care .


No evidence was found that memory clinics were more cost-effective compared to general practitioners with regard to post-diagnosis treatment and coordination of care of patients with dementia in the first year after diagnosis .


Methotrexate ( MTX ) is recognised as the cornerstone of treatment for rheumatoid arthritis .


For some patients , oral MTX demonstrates variable bioavailability , especially at higher doses .


Such concerns may be mitigated by subcutaneous ( SC ) MTX administration .


This study investigated the relative bioavailability , safety , and tolerability of MTX administered either by SC injection with a prefilled autoinjector pen ( MTX pen ) or orally .


This single-centre , open-label , randomised , @-period , @-sequence , single-dose , crossover study enrolled healthy subjects aged @ to @ years into @ of @ dose groups ( @ mg , @ mg , @ mg , and @ mg ) , where they received a single dose of SC MTX and of the oral MTX tablets .


Blood samples were collected from subjects predose and at prespecified time points postdose for pharmacokinetic analyses .


Adverse events ( AEs ) were recorded to assess differences in safety and tolerability .


Bioavailability , as measured by maximum plasma concentrations ( Cmax ) and area under the plasma-concentration curves ( AUC@-t ) , was generally higher with the SC MTX pen compared with oral administration for all dose groups .


AUC@-t ratios increased with ascending doses ; Cmax ratios did not increase .


A total of @ AEs were reported in @/@ subjects ; none were severe .


Differences in the safety profiles were related to the route of administration .


Single administrations with the MTX pen were well tolerated at the injection site .


Single-dose administration with the SC MTX pen resulted in a higher relative bioavailability compared with oral administration .


SC MTX pen administration was associated with fewer gastrointestinal AEs than oral MTX .


Degenerative spondylolisthesis is a well-recognized source of low back pain mainly induced by facet joint pain .


Pulsed radiofrequency ( PRF ) allows heat dissipation , thus producing a temporary injury that affects only type C fibers responsible for pain conduction .


We attempted to test whether PRF is a better choice for facet pain due to spondylolisthesis compared to routine steroid injection .


Patients were randomly assigned to one of two groups : group one received pulsed RF , and group @ received injection by steroids ( triamcinolone ) and bupivacaine .


Multiple outcome measures were utilized which included the numeric rating scale ( NRS ) , the Oswestry Disability Index ( ODI ) , satisfaction status , and analgesic intake with assessment at @ , @ , and @ months post-treatment .


Significant pain relief was defined as @ % or more , whereas significant improvement in disability score was defined as reduction of @ % or more .


Eighty patients were enrolled in the study and were divided into the two groups of study .


PRF significantly reduced NRS at @-month follow-up compared to steroid + bupivacaine .


@ @ % at pre-treatment and @ @ % at @ months ( p = @ ) in PRF group .


The mean ODI is depicted in two groups of study ( Fig. @ ) .


Interestingly , ODI % was significantly lower in PRF group at @ weeks and @ months compare to steroid + bupivacaine group ( p = @ and @ , respectively ) , but it was not significantly different at @ weeks ( p = @ ) .


Proportion of patients who did not require analgesics were significantly higher in PRF group compared to other group ( p = @ ) in Log-rank ( Mantel-Cox ) test .


Our results demonstrated that the application of PRF might be more effective than steroid and bupivacaine injection in decreasing back pain due to degenerative facet pain and improvement in function of patients .


To evaluate if ibuprofen @mg reduces pain with intrauterine device ( IUD ) insertion among U.S. women .


We conducted a randomized , double-blind , placebo-controlled trial of women undergoing IUD insertion approximately @-@weeks following first-trimester uterine aspiration .


Subjects were randomized to receive ibuprofen @mg or placebo @-@min prior to IUD insertion .


A @-mm visual analog scale ( VAS ) was administered to measure pain after speculum insertion ( baseline ) and immediately following IUD insertion .


A total of @ women were enrolled , with @ randomized to each group ( ibuprofen or placebo ) .


Sociodemographic characteristics and baseline VAS scores were similar between groups .


The median pain score with IUD insertion was @ mm in the placebo group and @ mm in the ibuprofen group ( p = @ ) .


Mean and median pain scores did not differ between placebo and ibuprofen when nulliparous and parous women were analyzed independently .


Overall , median pain scores were @ mm higher in nulliparous women than parous women ( p = @ ) .


Median pain scores did not differ by age , IUD-type , history of dysmenorrhea or time since aspiration .


Administration of ibuprofen @mg prior to IUD insertion does not reduce pain associated with the procedure for U.S. women .


Overall , nulliparous women report more pain with IUD insertion than multiparous women .


This prospective randomized controlled trial was conducted to compare the safety , tolerability and outcome of early oral feeding vs. traditional feeding in patients undergoing elective open bowel surgery .


A total of @ consecutive patients who underwent elective open bowel surgeries were randomized into either early feeding ( n = @ ) or traditional feeding group ( n = @ ) .


Patients in the early feeding group were started on oral fluids on post-operative day @ , while those in the traditional feeding group were started orals after the resolution of ileus .


Patient characteristics , surgical procedures , co-morbidity , first flatus , first defecation , time of starting solid diet , complications and length of hospitalization were assessed between the two groups .


The two groups were similar in demographic and baseline data .


The number of days to first flatus ( p < @ ) , first defecation ( p < @ ) , length of post-operative stay ( p = @ ) and time of starting solid diet ( p < @ ) were significantly earlier in the early feeding group .


Anastomotic leak , wound infection , fever , vomiting , abdominal distention and other complications were similar .


Multivariate analysis showed that patients in the early oral feeding group were discharged @ days earlier ( p = @ ) .


In patients undergoing elective open bowel surgeries , early post-operative feeding is safe , is well tolerated and reduces the length of hospitalization .


The aim of the present study was to determine the effectiveness of parent manipulation on newborns with postural clubfoot , as compared to newborns that receive no treatment in a randomized controlled trial .


Ninety-two healthy newborns , including @ boys and @ girls , ( @ postural clubfeet , including @ with bilaterally involvement ) were included and categorized into two groups by simple randomization using the sealed opaque envelope technique .


In Group A , the parent manipulation group , there were @ boys and @ girls in @ postural clubfeet with @ bilateral involvements .


Manipulations were performed at least @ times per day and the stimulation of the newborn 's foot / feet byparent finger was performed at least @ times per day .


In Group B , the group of newborns receiving no treatment , there were @ boys and @ girls in @ postural clubfeet with @ bilateral involvements .


The follow-up periods for both groups were one , three , and four months after starting the manipulation .


The success of the manipulation was measured by the foot appearance , which was normally performed by physical examination .


A comparison of the characteristics of newborns and parents in both groups showed no statistical differences , except the sex of the newborn .


All newborns in both groups were one to six days old .


The success rate after @ months of manipulation in Group A was @ % , but it was @ % in Group B with no manipulation ; results indicate no statistically significant difference ( p = @ ) .


The severity of the postural clubfeet indicated no statistical difference in the results of either group ( p = @ ) .


All cases were followed up at one year with @ % of the studyparticipants dropping out in Group A and @ % dropping out of the study in Group B. All postural clubfeet disappeared in every case within one year of birth except one case in Group A that required casting and one case in Group B that required a prescription for orthopaedic shoes .


No clinical or statistical differences were found between newborns who received parent manipulation for the treatment of postural clubfoot and newborns who received no treatment .


Spontaneous recovery occurred in most of the cases within four months of birth or not more than one year after birth .


The aim of this trial was to investigate the effect of therapeutic microwave diathermy ( MD ) on pain , disability , trunk muscle strength , walking performance , mobility , quality of life ( QOL ) , and depression in the patients with chronic low back pain ( CLBP ) .


A total of @ patients were included in this study .


The patients were randomized into two groups .


Group @ ( n = @ ) received MD treatment and exercises .


Group @ ( n = @ ) was given only exercises .


The pain ( visual analog scale ) , disability ( Oswestry Disability Questionnaire and pain disability index ) , walking performance ( @ minute walking test , @MWT ) , depression and QOL ( Short Form @ ) of all participants were evaluated .


Patients were assessed before treatment ( BT ) , after treatment ( AT ) , and at a @-month follow-up ( F ) .


The patients with CLBP in each group had significant improvements in pain , disability , muscle strength , endurance , @MWT , mobility , QOL , and depression AT and F when compared with their initial status .


There was no statistically significant difference between the groups regarding the change scores between AT-BT test and F-BT test .


Since a @,@-MHz MD showed no beneficial effects on clinical parameters , exercise program could be preferable for the treatment of patients with CLBP alone .


Exercise intolerance is a common development in patients with chronic obstructive pulmonary disease ( COPD ) .


There is little data on the use of an isolated program using vibration platform training on functional capacity in these patients , which is an area that deserves investigation .


To investigate the effect of training on a vibrating platform ( whole-body vibration -LSB- WBV -RSB- ) on functional performance and quality of life of subjects with COPD .


A randomized controlled crossover pilot study with eleven subjects with COPD ( forced expiratory volume in @ second -LSB- FEV@ -RSB- % predicted = @ ; forced vital capacity -LSB- FVC -RSB- % predicted = @ ; FEV@/FVC = @ ) underwent a @-week WBV training program .


Participants were randomized into the intervention group ( IG ) undergoing three sessions per week for a total of @ weeks and control group ( CG ) without intervention .


We evaluated the @-minute walk test ( @MWT ) , distance walked ( DW ) , duration of the walk ( TW ) , and index of perceived exertion ( IPE ) , quality of life using St George 's Respiratory Questionnaire ( SGRQ ) and developed a @-week program of training on a vibrating platform .


The mean age was @ years old ( @ % male ) .


The DW increased at the end of training with a difference between groups of @ m ; all domains of the SGRQ improved at the end of training .


The effect size Cohen 's d ranged from small to large for all the measured results .


These preliminary results suggest that WBV may potentially be a safe and feasible way to improve functional capacity in the @MWT of patients with COPD undergoing a training program on the vibrating platform as well as in all domains of the SGRQ quality of life .


However , further studies with a larger number of patients are needed to establish the long-term effect on functional capacity and quality of life in these patients .


Insomnia is prevalent among patients with knee osteoarthritis ( OA ) .


Research indicates that sleep disruption may amplify clinical pain by altering central pain modulation , suggesting that treatment of insomnia may improve pain .


The aims of this study were to evaluate the efficacy of cognitive-behavioral therapy for insomnia ( CBT-I ) in patients with knee OA , to determine whether improvements in sleep predict reduced pain , and to determine whether alterations in pain modulation mediate improvements in clinical pain .


We conducted a randomized , double-blind , active placebo-controlled clinical trial of CBT-I in @ patients with knee OA and insomnia ( meanSD age @ years ) .


Patients were randomized ( @:@ ) to receive either @ sessions of CBT-I or behavioral desensitization ( placebo ) .


We conducted in-home polysomnography ( PSG ) , diary assessment , and sensory tests of pain modulation at baseline , posttreatment , @ months , and @ months .


Intent-to-treat analyses demonstrated substantial improvement in sleep in both groups of patients .


Patients in the CBT-I group had significantly greater reductions in wake after sleep onset ( WASO ) , as measured by patient diary and PSG .


Patients in both groups reported significant and comparable reductions in pain over @ months , with one-third reporting a @ % reduction in pain severity .


Baseline-to-posttreatment reductions in WASO as measured by diary and PSG predicted subsequent decreases in clinical pain .


This effect was significantly greater for CBT-I compared with behavioral desensitization .


No significant changes in laboratory measures of pain modulation were observed .


Compared with active placebo , CBT-I was efficacious in reducing sleep maintenance insomnia .


CBT-I decreased clinical pain , but not pain modulation , suggesting that it has the potential to augment pain management in knee OA .


Future work is needed to identify the mechanisms by which improved sleep reduces clinical pain .


The aim of our study was to characterize the neurophysiologic outcomes in a randomized clinical trial comparing local corticosteroid injection and decompressive surgery in idiopathic carpal tunnel syndrome .


Clinical and neurophysiologic assessments were done at baseline and @ months after treatment .


Four parameters were evaluated in the nerve conduction study ( NCS ) : distal motor latency , motor amplitude , sensory conduction velocity and sensory amplitude .


Statistic signification was established by the Student 's t test , independent and paired samples , and Mann-Whitney test .


Repeated measures analysis of variance was used by the three domains of symptoms .


Correlations between the changes showed in clinical parameters and those evidenced by electromyography were calculated by the Pearson 's test .


Both groups of therapy were comparable at baseline .


In @ wrists , a second NCS was done @ months post-treatment .


Although clinical outcome improved in a similar way in both groups , we found statistically significant improvement in three ( distal motor latency , sensory conduction velocity and sensory amplitude ) of four neurophysiologic parameters only in the surgery group , when compared to baseline values .


Although local corticosteroid injection and decompressive surgery are clinically effective in reducing symptoms of carpal tunnel syndrome , only surgery results in an improvement of the neurophysiologic parameters , at @-months follow-up .


Only decompressive surgery allows resolution of neurophysiologic changes .


The symptoms of the syndrome are resolved with corticosteroid injections .


To compare changes of heart rate and blood pressure in patients that underwent LMA anesthesia with VIMA or TIVA technique .


A hundred healthy patients , age @ to @ years were enrolled .


They were randomized into two groups .


Patients in group V ( VIMA ) were induced with @ % sevoflurane until loss of eyelash reflexes then controlled ventilation for five minutes before LMA insertion .


Group T ( TIVA ) patients were given propofol to reach the affected site concentration of eight mcg/mlfor the LMA insertion .


Bloodpressure and heart rate were recorded before induction , immediately before and after LMA insertion then every two minutes until surgical incision .


Decreased SBP from baseline in group T was significantly more than group V in each period of time ( D@-D@ ) .


DBP in group T decreased more than group V significantly only at eight and ten minutes after LMA insertion .


The incidence of decreasing SBP > @ % from baseline was more significant in group T than group V. No significant difference of changed HR was found .


Coughing during LMA insertion occurred in eight patients ( @ % ) in group T and in three patients ( @ % ) in group V ( p = @ ) .


Induction with propofol by effective site concentration of eight mcg/ml significantly decreased SBP more than with @ % sevoflurane .


Both techniques provided smooth LMA insertion without serious complication .


Postpartum haemorrhage can lead to iron deficiency with and without anaemia , the clinical consequences of which include physical fatigue .


Although oral iron is the standard treatment , it is often associated with gastrointestinal side effects and poor compliance .


To date , no published randomised controlled studies have compared the clinical efficacy and safety of standard medical care with intravenous administration of iron supplementation after postpartum haemorrhage.The primary objective of this study is to compare the efficacy of an intravenous high single-dose of iron isomaltoside @ with standard medical care on physical fatigue in women with postpartum haemorrhage .


In a single centre , open-labelled , randomised trial , women with postpartum haemorrhage exceeding @ mL will be allocated to either a single dose of @,@ mg of iron isomaltoside @ or standard medical care .


Healthy parturients with a singleton pregnancy will be included within @ hours after delivery.Participants will complete structured questionnaires that focus on several dimensions of fatigue and mental health ( Multidimensional Fatigue Inventory , Edinburgh Postnatal Depression Scale and the Postpartum Questionnaire ) , at inclusion and at follow-up visits after three days , one week , three weeks , eight weeks , and @ weeks postpartum .


The primary endpoint is the aggregated change in physical fatigue score within @ weeks postpartum , as measured by a subscale of the Multidimensional Fatigue Inventory .


The primary objective will be considered to have been met if an intravenous high single dose of iron isomaltoside @ is shown to be superior to standard medical care in women after postpartum haemorrhage regarding physical fatigue.For claiming superiority , we set the minimal clinically relevant difference between the mean scores at @ , and the assumed standard deviation at @ .


Hence , @ participants per treatment group are needed in order to demonstrate superiority ; to provide an extra margin for missing data and dropouts , @ women will be included .


The study will provide evidence on relevant clinical outcomes beyond biochemical parameters for intravenous iron isomaltoside @ compared to standard medical care in women after postpartum haemorrhage .


The effect of vitamin D on muscle strength in adults is not established .


Our objective was to test whether vitamin D supplementation increases muscle strength and power compared with placebo .


We conducted a randomized , double-blind , placebo-controlled trial .


The setting was immigrants ' activity centers .


Two hundred fifty-one healthy adult males and females aged @-@ years with non-Western immigrant background performed the baseline test and @ % returned to the follow-up test .


Sixteen weeks of daily supplementation with @ g ( @ IU ) vitamin D@ , @ g ( @ IU ) vitamin D@ , or placebo .


Difference in jump height between pre - and postintervention .


Secondary outcomes were differences in handgrip strength and chair-rising test .


Percentage change in jump height did not differ between those receiving vitamin D ( @ or @ g vitamin D@ ) and those receiving placebo ( mean difference -@ % , @ % confidence interval : -@ % to @ % , P = @ ) .


No significant effect was detected in the subgroup randomized to @ g vitamin D or in other preplanned subgroup analyses nor were there any significant differences in handgrip strength or the chair-rising test .


Mean serum @-hydroxyvitamin D@ concentration increased from @ to @ nmol/L and from @ to @ nmol/L in the @ and @ g supplementation groups , respectively , whereas serum @-hydroxyvitamin D@ did not change in the placebo group .


Daily supplementation with @ or @ g vitamin D@ for @ weeks did not improve muscle strength or power measured by the jump test , handgrip test , or chair-rising test in this population with low baseline vitamin D status .


To evaluate the influence of stroke volume variation ( SVV ) - based goal-directed therapy ( GDT ) on splanchnic organ functions and postoperative complications in orthopedic patients .


Eighty patients scheduled for major orthopedic surgery under general anesthesia were randomly allocated to one of two equal groups to receive either intraoperative volume therapy guided by SVV ( GDT ) or standard fluid management ( control ) .


In the SVV group , patients received colloid boluses of @ ml/kg to maintain an SVV < @ % when in the supine position or an SVV < @ % if prone .


In the control group , fluids were given to maintain a mean arterial pressure > @ mm Hg , a heart rate < @ bpm , a central venous pressure of @-@ mm Hg , and a urine output > @ ml/kg/h .


Intraoperative organ perfusion , hemodynamic data , hospitalization , postoperative complications , and mortality were recorded .


The heart rate at the end of surgery was significantly lower ( p < @ ) , there were fewer hypotensive episodes ( p < @ ) , the arterial and gastric intramucosal pH were higher ( p < @ for both ) , the gastric intramucosal PCO@ was lower ( p < @ ) , the intraoperative infused colloids and the total infused volume were lower ( p < @ for both ) , and the postoperative time to flatus was shorter ( p < @ ) in the GDT group than in the control group .


No differences in the length of hospital stay , complications , or mortality were found between the groups .


SVV-based GDT during major orthopedic surgery reduced the volume of the required intraoperative infused fluids , maintained intraoperative hemodynamic stability , and improved the perioperative gastrointestinal function .


To estimate the effectiveness of office-based bipolar radiofrequency ablation compared with thermal balloon ablation of the endometrium for the treatment of heavy menstrual bleeding at @-year follow-up .


A single blind randomized controlled trial was conducted in an office hysteroscopy clinic in a university teaching hospital .


A total of @ women were randomly allocated to either bipolar radiofrequency ablation or thermal balloon ablation in an office setting avoiding use of general anesthesia or conscious sedation .


The primary outcome for the trial was amenorrhea at @ months follow-up .


In this planned secondary analysis , the main outcome measures were amenorrhea rates , patient satisfaction , health-related quality of life , and incidence of further uterine surgery at @-year follow-up .


At @-year follow-up , @ ( @ % ) women responded to postal questionnaires .


Amenorrhea was reported in @ % of thermal balloon ablation and @ % of bipolar radiofrequency ablation ( odds ratio -LSB- OR -RSB- @ -LSB- @-@ @ -RSB- ) and satisfaction with treatment outcome in @ % of thermal balloon ablation and @ % of bipolar radiofrequency ablation ( OR @ -LSB- @-@ @ -RSB- ) .


Further surgical intervention was needed in three of @ ( @ % ) women treated with bipolar radiofrequency ablation compared with four of @ ( @ % ) of women treated with thermal balloon ablation ( P = @ ) .


There was no significant difference in either condition-specific or generic health-related quality-of-life measures .


There was no difference in the effectiveness of bipolar radiofrequency ablation and thermal balloon ablation performed in an office setting at @-year follow-up .


Evidence supports a role of @ receptors in Alzheimer 's disease ( AD ) .


This Korean , multicenter , double-blind , two-period ( @ weeks each ) , crossover study randomized participants to the order in which they received varenicline ( @ mg twice daily ) and placebo .


Assessments included AD Assessment Scale-Cognitive Subscale ( ADAS-Cog ) @ , Neuropsychiatric Inventory ( NPI ) , adverse events ( AEs ) and Columbia-Suicide Severity Rating Scale ( C-SSRS ) .


For varenicline versus placebo ( n = @ randomized ) , there was no significant difference in the week @ least square ( LS ) mean ADAS-Cog @ total score ( primary endpoint ; @ vs. @ ; p = @ ) and a slight worsening in the week @ LS mean NPI ( @ vs. @ ; p = @ ) , primarily driven by decreased appetite/eating .


Common treatment-related AEs were nausea ( @ ; @ % ) , vomiting ( @ % ; @ ) and decreased appetite ( @ ; @ % ) .


Varenicline did not improve cognition , behavior or global change in this population .


The most frequent varenicline-associated AEs were gastrointestinal ; psychiatric AEs were rare and similar between the groups .


Socioeconomic disadvantage is associated with shorter adult stature .


Few studies have examined socioeconomic differences in stature from birth to childhood and the mechanisms involved , particularly in middle-income former Soviet settings .


The sample included @,@ Belarusian children ( @ % of the original cohort ) born in @-@ , with up to @ stature measurements from birth to @ years .


Linear spline multi-level models with @ knots at @ , @ and @ months were used to analyse birth length and growth velocity during four age-periods by parental educational achievement ( up to secondary school , advanced secondary/partial university , completed university ) and occupation ( manual , non-manual ) .


Girls born to the most ( versus least ) educated mothers were @ cm ( @ % confidence interval ( CI ) : @ , @ ) longer at birth ; for boys , the corresponding difference was @ cm ( @ % CI : @ , @ ) .


Similarly , children of the most educated mothers grew faster from birth-@ months and @-@ months ( p-values for trend @ ) , such that , by age @ years , girls with the most ( versus least ) educated mothers were @ cm ( @ % CI : @ , @ ) taller ; after controlling for urban/rural and East/West area of residence , this difference remained at @ cm ( @ % CI : @ , @ ) , but after additionally controlling for mid-parental height , attenuated to @ cm ( @ % CI : @ , @ ) .


Among boys , these differences were @ cm ( @ % CI : @ , @ ) , @ cm ( @ % CI : @ , @ ) and @ cm ( @ % CI : @ , @ ) , respectively .


Additionally controlling for breastfeeding , maternal smoking and older siblings did not substantively alter these findings .


There was no evidence that the association of maternal educational attainment with growth differed in girls compared to boys ( p for interaction = @ ) .


Results were similar for those born to the most ( versus least ) educated fathers , or who had a parent with a non-manual ( versus manual ) occupation .


In Belarus , a middle-income former Soviet country , socioeconomic differences in offspring growth commence in the pre-natal period and generate up to approximately @ cm difference in height at age @ years .


These associations are partly explained by genetic or other factors influencing parental stature .


To determine whether severe intraoperative floppy iris syndrome ( IFIS ) is more or equally likely with tamsulosin or alfuzosin .


Prospective , masked , multicenter , cross-sectional study .


Consecutive patients taking systemic tamsulosin or alfuzosin and scheduled for routine cataract surgery ( case group ) and patients with no history of systemic @-antagonists scheduled for routine cataract surgery ( control group ) .


Phacoemulsification with intraocular lens implantation was performed and recorded on video .


Intracameral phenylephrine or epinephrine , either by direct injection or placement in the irrigation bottle , was not permitted .


Every surgical video subsequently was reviewed remotely by @ masked investigators who diagnosed the presence or absence of IFIS and graded the severity of IFIS as follows : none , mild ( billowing only ) , moderate ( billowing and either iris prolapse or @ mm of pupil constriction ) , or severe ( billowing accompanied by iris prolapse and @ mm of pupil constriction ) .


Rate and severity of IFIS and surgical complication rate .


A total of @ eyes ( @ in the tamsulosin group , @ in the alfuzosin group , and @ in the control group ) were enrolled .


Severe IFIS was noted in @ % ( @/@ ) of the tamsulosin eyes and in @ % ( @/@ ) of the alfuzosin eyes compared with @ % ( @/@ ) of the control eyes .


The differences between each of the @ groups were statistically significant .


In the absence of epinephrine in the irrigation bottle , @ % of control eyes had moderate to severe IFIS .


There were no instances of posterior capsular rupture or significant surgical complications in either the case or control groups .


Moderate to severe IFIS can occur in low-risk eyes when epinephrine is omitted from the irrigation bottle .


Although both tamsulosin and alfuzosin significantly increase the risk of IFIS compared with patients without prior @-antagonist intake , severe IFIS statistically was more likely with tamsulosin than with alfuzosin ( P = @ ) .


Patients with symptomatic benign prostatic hyperplasia and cataracts requiring a uroselective @-antagonist may consider trying alfuzosin first .


Jet injectors allow needle-free insulin delivery .


The study objective was to compare the tolerability and device preference of subcutaneous insulin aspart delivery by jet injector ( InsuJet ; European Pharma Group , Schiphol-Rijk , The Netherlands ) with pen injection in an open-label , randomized , crossover pilot study .


Ten participants with type @ diabetes underwent two meal tolerance tests @ week apart .


Plasma glucose and serum insulin levels were sampled from @ min preceding to @ min after insulin aspart administration by InsuJet or FlexPen ( ) ( Novo Nordisk Pharmaceuticals Pty. Ltd. , Baulkham Hills , NSW , Australia ) .


Insulin dose was calculated using participants ' insulin-to-carbohydrate ratios .


Immediately after insulin administration , participants drank @ mL of Ensure ( ) ( Abbott Australasia Pty. Ltd. , Botany , NSW , Australia ) ( providing @,@ kJ of energy , @ g of protein , @ g of carbohydrate , and @ g of fat ) .


In this small pilot study , the devices were similar in glucose excursion ( median -LSB- quartile @ , quartile @ -RSB- , InsuJet vs. FlexPen , @ -LSB- @ , @ -RSB- vs. @ -LSB- @ , @ -RSB- mmol/L ; P = @ ) , in the area under the glucose concentration-time curve for @-@ min corrected for baseline glucose level ( InsuJet vs. FlexPen , @,@ -LSB- @ , @,@ -RSB- vs. @,@ -LSB- @ , @,@ -RSB- mmol min/L ; P = @ ) , and in insulin absorption over the @-min period .


Devices were similar for participant preference and relative injection pain .


Subcutaneous jet injection of aspart insulin was well tolerated .


Malnutrition in head and neck cancer ( HNC ) patients decreases survival , quality of life ( QOL ) and oncological outcomes .


The aim of the prospective three-year study was to compare QOL , clinical symptoms and variables ( complications , survival and mortality rates in HNC patients ) .


A total of @ patients aged @ to @ years with treatable HNC were included from January @ to December @ ; these patients were randomized to either group with PEG and enteral nutrition and nonPEG group with nutritional counselling according to nutritional care .


We used EORTC questionnaires QOL C-@ and Head and neck module ( HN-@ ) for measuring of QOL .


The following variables due to expectable influence on QOL ( demographic data , oncological data , nutritional screening , Clinical symptom score , Karnofsky performance status score , Charlson comorbidity index ) were included .


Monitoring was done five times in three years .


In the first six months , we found decrease of weight and body mass index ( BMI ) .


After this critical time point and finish of oncological treatment , a marked difference in the development of patients treated with PEG .


Negative factors influencing patients survival , QOL , clinical status were males aged > @ years , hypopharyngeal cancer ( stage III-IV ) , smoking , weight loss > @ % , BMI < @ and disallowance of PEG .


QOL is an essential factor for cancer patients .


Our study showed that nutritional intervention with early enteral nutrition may improve QOL and survival in HNC patients .


The PEG group better tolerated oncological treatment , had lower incidence of complications , shorter time to re-entry of permanent increase in weight , lower rate of rehospitalization and its shorter length .


We found QOL questionnaires to be very important for better understanding and communication and a key instrument for improving solution of patients difficulties during their therapy in multidisciplinary approach .


Oxidative stress and vascular impairment are believed to partly mediate age-related cognitive decline , a strong risk factor for development of dementia .


Epidemiologic studies suggest that a Mediterranean diet , an antioxidant-rich cardioprotective dietary pattern , delays cognitive decline , but clinical trial evidence is lacking .


To investigate whether a Mediterranean diet supplemented with antioxidant-rich foods influences cognitive function compared with a control diet .


Parallel-group randomized clinical trial of @ cognitively healthy volunteers from Barcelona , Spain ( @ women -LSB- @ % -RSB- ; mean age , @ years ) , at high cardiovascular risk were enrolled into the Prevencin con Dieta Mediterrnea nutrition intervention trial from October @ , @ , through December @ , @ .


All patients underwent neuropsychological assessment at inclusion and were offered retesting at the end of the study .


Participants were randomly assigned to a Mediterranean diet supplemented with extravirgin olive oil ( @ L/wk ) , a Mediterranean diet supplemented with mixed nuts ( @ g/d ) , or a control diet ( advice to reduce dietary fat ) .


Rates of cognitive change over time based on a neuropsychological test battery : Mini-Mental State Examination , Rey Auditory Verbal Learning Test ( RAVLT ) , Animals Semantic Fluency , Digit Span subtest from the Wechsler Adult Intelligence Scale , Verbal Paired Associates from the Wechsler Memory Scale , and the Color Trail Test .


We used mean z scores of change in each test to construct @ cognitive composites : memory , frontal ( attention and executive function ) , and global .


Follow-up cognitive tests were available in @ participants after intervention ( median , @ years ) .


In multivariate analyses adjusted for confounders , participants allocated to a Mediterranean dietplus olive oil scored better on the RAVLT ( P = @ ) and Color Trail Test part @ ( P = @ ) compared with controls ; no between-group differences were observed for the other cognitive tests .


Similarly adjusted cognitive composites ( mean z scores with @ % CIs ) for changes above baseline of the memory composite were @ ( -@ to @ ) for the Mediterranean diet plus olive oil , @ ( -@ to @ ; P = @ vs controls ) for the Mediterranean diet plus nuts , and -@ ( -@ to -@ ) for the control diet .


Respective changes from baseline of the frontal cognition composite were @ ( @ to @ ; P = @ vs controls ) , @ ( -@ to @ ) , and -@ ( -@ to -@ ) .


Changes from baseline of the global cognition composite were @ ( -@ to @ ; P = @ vs controls ) for the Mediterranean diet plus olive oil , -@ ( -@ to @ ) for the Mediterranean diet plus nuts , and -@ ( -@ to -@ ) for the control diet .


All cognitive composites significantly ( P < @ ) decreased from baseline in controls .


In an older population , a Mediterranean diet supplemented with olive oil or nuts is associated with improved cognitive function .


To evaluate the effect of transcutaneous electrical acupuncture point stimulation ( TEAS ) on endometrial HOXA@ protein expression and three-dimensional ( @D ) power Doppler ultrasound parameters as markers of endometrial receptivity in women undergoing frozen-thawed embryo transfer ( FET ) .


A total of @ women undergoing FET were randomised to receive TEAS or mock TEAS at acupuncture points CV@ , CV@ and SP@ and Zigong bilaterally .


Both groups had six sessions per cycle for three menstrual cycles prior to the scheduled FET .


Each session lasted @min and was repeated every other day .


@D power Doppler ultrasound parameters , HOXA@ protein expression and rates of embryo implantation , clinical pregnancy and live birth were compared .


There were no significant differences between the two groups in endometrial thickness or endometrial volume .


The ultrasonographic endometrial triple-line pattern was present more often in the TEAS group ( p = @ ) .


The TEAS group had a greater endometrial and subendometrial vascularisation index ( VI ) than the mock TEAS group ( p = @ and p < @ , respectively ) on @D ultrasound and increased endometrial HOXA@ expression ( p = @ ) immediately prior to FET .


Subsequently , the rates of embryo implantation , clinical pregnancy and live birth rates were all higher in the TEAS group than in the mock TEAS group ( p = @ , p = @ and p = @ , respectively ) .


In patients undergoing FET , TEAS may have beneficial effects on endometrial HOXA@ expression and ultrasound markers of endometrial receptivity .


These findings may explain the improvement in clinical outcome of FET associated with the use of TEAS .


Malignant pleural mesothelioma is an incurable cancer caused by exposure to asbestos .


The United Kingdom has the highest death rate from mesothelioma in the world and this figure is increasing .


Median survival is @ to @ months , and most patients have symptoms at diagnosis .


The fittest patients may be offered chemotherapy with palliative intent .


For patients not fit for systemic anticancer treatment , best supportive care remains the mainstay of management .


A study from the United States examining advanced lung cancer showed that early specialist palliative care input improved patient health related quality of life and depression symptoms @ weeks after diagnosis .


While mesothelioma and advanced lung cancer share many symptoms and have a poor prognosis , oncology and palliative care services in the United Kingdom , and many other countries , vary considerably compared to the United States .


The aim of this trial is to assess whether regular early symptom control treatment provided by palliative care specialists can improve health related quality of life in patients newly diagnosed with mesothelioma .


This multicentre study is an non-blinded , randomised controlled , parallel group trial .


A total of @ patients with a new diagnosis of malignant pleural mesothelioma will be minimised with a random element in a @:@ ratio to receive either @ weekly regular early specialist symptom control care , or standard care .


The primary outcome is health related quality of life for patients at @ weeks .


Secondary outcomes include health related quality of life for patients at @ weeks , carer health related quality of life at @ and @ weeks , patient and carer mood at @ and @ weeks , overall survival and analysis of healthcare utilisation and cost .


Current practice in the United Kingdom is to involve specialist palliative care towards the final weeks or months of a life-limiting illness .


This study aims to investigate whether early , regular specialist care input can result in significant health related quality of life gains for patients with mesothelioma and if this change in treatment model is cost-effective .


The results will be widely applicable to many institutions and patients both in the United Kingdom and internationally .


To compare toric intraocular lens ( IOL ) implantation and astigmatic keratotomy ( AK ) in correction of astigmatism during phacoemulsification .


Tertiary care hospital .


Prospective randomized trial .


Consecutive patients with visually significant cataract and moderate astigmatism ( @ to @ diopters -LSB- D -RSB- ) were randomized into @ groups .


Temporal clear corneal @ mm phacoemulsification with toric IOL implantation was performed in the toric IOL group and with @-degree coupled AK at the @ mm optic zone in the keratotomy group .


The uncorrected ( UDVA ) and corrected ( CDVA ) distance visual acuities , refraction , keratometry , topography , central corneal thickness , and endothelial cell density were evaluated preoperatively and @ day , @ week , and @ and @ months postoperatively .


The study enrolled @ eyes ( @ patients ) , @ in each group .


There was no difference in UDVA or CDVA between the @ groups at any follow-up visit .


The mean preoperative and postoperative refractive cylinder was @ D @ ( SD ) and @ @ D , respectively , in the toric IOL group and @ @ D and @ @ D , respectively , in the keratotomy group ( P = @ ) .


The mean residual astigmatism at @ months was @ @ @ @ in the toric IOL group and @ @ @ @ in the keratotomy group ( P = @ ) .


All eyes in the toric IOL group and @ eyes ( @ % ) in the keratotomy group achieved a residual refractive cylinder of @ D or less ( P = @ ) .


Toric IOL implantation was comparable to AK in eyes with moderate astigmatism having phacoemulsification .


Impairment in left ventricular systolic function has been described in heart failure ( HF ) with preserved ejection fraction ( HFpEF ) , but its prognostic relevance is not known .


We determined whether left ventricular longitudinal strain ( LS ) is predictive of cardiovascular outcomes in HFpEF beyond clinical and conventional echocardiographic measures .


LS was assessed by @-dimensional speckle-tracking echocardiography at baseline in @ patients with HFpEF enrolled in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist ( TOPCAT ) trial .


At a median follow-up of @ years ( interquartile range , @-@ @ years ) , @ patients experienced the primary composite outcome of cardiovascular death , HF hospitalization , or aborted cardiac arrest .


Impaired LS , defined as an absolute LS < @ % , was present in @ % of patients and was predictive of the composite outcome ( adjusted hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) , cardiovascular death alone ( adjusted hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) , and HF hospitalization alone ( adjusted hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) after adjustment for clinical and conventional echocardiographic variables .


LS was the strongest echocardiographic predictor of the composite outcome .


Exploratory analysis in a subset of @ patients with follow-up LS assessed after @ to @ months demonstrated a trend toward improvement in LS associated with spironolactone in patients enrolled in the Americas but not in Russia or Georgia .


Impaired left ventricular systolic function is a powerful predictor of HF hospitalization , cardiovascular death , or aborted cardiac arrest in HFpEF independent of clinical predictors .


Impaired LS represents a novel imaging biomarker to identify patients with HFpEF at particularly high risk for cardiovascular morbidity and mortality .


We evaluated the effect of different dose hydration protocols , with normal saline or bicarbonate , on the incidence of contrast-induced acute kidney injury ( CI-AKI ) in patients with ST-elevation myocardial infarction ( STEMI ) treated with primary percutaneous coronary intervention ( PPCI ) .


We considered @ STEMI patients treated with PPCI in @ Italian centers .


Patients were randomized to receive standard or high-dose infusions of normal saline or sodium bicarbonate started immediately before contrast medium administration and continued for the following @h .


The cumulative incidence of CI-AKI was @ % without any difference among treatment groups .


Shock , age , ejection fraction @ % or less , and basal serum creatinine were significantly associated with an increased risk of CI-AKI .


Follow-up at @ months was complete in @ patients .


Overall , @ out of @ patients died ( @ % ) .


We observed higher short-term mortality rates in patients receiving high-volume hydration .


Otherwise , only age , shock and CI-AKI were significantly associated with @-year mortality .


In patients with STEMI undergoing PPCI , high-volume hydration with normal saline or sodium bicarbonate administrated at the time of contrast media administration was not associated with any significant advantage in terms of CI-AKI prevention .


The authors examined the effectiveness of virtual reality exposure augmented with D-cycloserine or alprazolam , compared with placebo , in reducing posttraumatic stress disorder ( PTSD ) due to military trauma .


After an introductory session , five sessions of virtual reality exposure were augmented with D-cycloserine ( @ mg ) or alprazolam ( @ mg ) in a double-blind , placebo-controlled randomized clinical trial for @ Iraq and Afghanistan war veterans with PTSD .


PTSD symptoms significantly improved from pre - to posttreatment across all conditions and were maintained at @ , @ , and @ months .


There were no overall differences in symptoms between D-cycloserine and placebo at any time .


Alprazolam and placebo differed significantly on the Clinician-Administered PTSD Scale score at posttreatment and PTSD diagnosis at @ months posttreatment ; the alprazolam group showed a higher rate of PTSD ( @ % ) than the placebo group ( @ % ) .


Between-session extinction learning was a treatment-specific enhancer of outcome for the D-cycloserine group only .


At posttreatment , the D-cycloserine group had the lowest cortisol reactivity and smallest startle response during virtual reality scenes .


A six-session virtual reality treatment was associated with reduction in PTSD diagnoses and symptoms in Iraq and Afghanistan veterans , although there was no control condition for the virtual reality exposure .


There was no advantage of D-cycloserine for PTSD symptoms in primary analyses .


In secondary analyses , alprazolam impaired recovery and D-cycloserine enhanced virtual reality outcome in patients who demonstrated within-session learning .


D-cycloserine augmentation reduced cortisol and startle reactivity more than did alprazolam or placebo , findings that are consistent with those in the animal literature .


To test whether long-term multivitamin supplementation affects the incidence of cataract or age-related macular degeneration ( AMD ) in a large cohort of men .


Randomized , double-blind , placebo-controlled trial .


A total of @,@ US male physicians aged @ years .


Daily multivitamin or placebo .


Incident cataract and visually significant AMD responsible for a reduction in best-corrected visual acuity to @/@ or worse based on self-reports confirmed by medical record review .


During an average of @ years of treatment and follow-up , a total of @ cases of cataract and @ cases of visually significant AMD were confirmed .


There were @ cataracts in the multivitamin group and @ cataracts in the placebo group ( hazard ratio -LSB- HR -RSB- , @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ; P = @ ) .


For visually significant AMD , there were @ cases in the multivitamin group and @ cases in the placebo group ( HR , @ ; @ % CI , @-@ @ ; P = @ ) .


These randomized trial data from a large cohort of middle-aged and older US male physicians indicate that long-term daily multivitamin use modestly and significantly decreased the risk of cataract but had no significant effect on visually significant AMD .


Despite numerous population-based randomized intervention trials , the impact of such interventions on socioeconomic inequalities has rarely been examined .


We used data from a large cluster-randomized trial to assess the impact of a breastfeeding promotion intervention on socioeconomic inequalities in breastfeeding ( exclusivity and duration ) and in child cognitive ability at early school age .


The Promotion of Breastfeeding Intervention Trial ( PROBIT ) randomized @ Belarusian maternity hospitals and their affiliated polyclinics either to receive a breastfeeding promotion intervention modelled on the WHO/UNICEF Baby-Friendly Hospital Initiative or to continue the standard practices in effect at the time of randomization .


We estimated and compared inequalities in discontinuation of exclusive breastfeeding before @ months and of any breastfeeding before @ months and in child verbal IQ at age @ years , across maternal education strata between the two intervention arms .


Socioeconomic inequalities in discontinuing exclusive breastfeeding before @ months were negligible in the control group .


However , graded inequalities by maternal education emerged in the intervention group -LCB- relative risk -LSB- RR -RSB- = @ -LSB- @ % confidence interval ( CI ) : @ , @ -RSB- for partial university and RR = @ -LSB- @ % CI : @ , @ -RSB- for secondary education or less vs complete university ; risk difference -LSB- RD -RSB- = @ -LSB- @ % CI : @ , @ -RSB- and @ -LSB- @ % CI : @ , @ -RSB- , respectively -RCB- .


For discontinuing any breastfeeding before @ months , small socioeconomic gradients in the control group were widened in the intervention group ( RR = @ and @ , respectively , for mothers with secondary education or less ) .


Despite these differential effects on breastfeeding , however , we observed a small , nonsignificant reduction in socioeconomic inequalities in child verbal IQ at age @ years .


A population-based intervention to promote breastfeeding slightly widened socioeconomic inequalities in breastfeeding but not those in child cognitive ability .


Some trial have demonstrated a benefit of adjuvant fluoropirimidine with or without platinum compounds compared with surgery alone .


ITACA-S study was designed to evaluate whether a sequential treatment of FOLFIRI -LSB- irinotecan plus @-fluorouracil/folinic acid ( @-FU/LV ) -RSB- followed by docetaxel plus cisplatin improves disease-free survival in comparison with @-FU/LV in patients with radically resected gastric cancer .


Patients with resectable adenocarcinoma of the stomach or gastroesophageal junction were randomly assigned to either FOLFIRI ( irinotecan @ mg/m ( @ ) day @ , LV @ mg/m ( @ ) as @ h infusion and @-FU @ mg/m ( @ ) as bolus , days @ and @ followed by @ mg/m ( @ ) / day as @ h continuous infusion , q@ for four cycles ) followed by docetaxel @ mg/m ( @ ) day @ , cisplatin @ mg/m ( @ ) day @ , q@ for three cycles ( sequential arm ) or De Gramont regimen ( @-FU/LV arm ) .


From February @ to August @ , @ patients were enrolled , and @ included in the analysis : @ in the sequential arm and @ in the @-FU/LV arm .


With a median follow-up of @ months , @ patients recurred or died ( @ sequential arm and @ @-FU/LV arm ) , and @ died ( @ and @ , respectively ) .


No statistically significant difference was detected for both disease-free -LSB- hazard ratio ( HR ) @ ; @ % confidence interval ( CI ) : @-@ @ ; P = @ -RSB- and overall survival ( OS ) ( HR @ ; @ % CI : @-@ @ ; P = @ ) .


Five-year disease-free and OS rates were @ % and @ % , @ % and @ % in the sequential and @-FU/LV arm , respectively .


A more intensive regimen failed to show any benefit in disease-free and OS versus monotherapy .


Brain metastases are often accompanied by edema .


Endostatin therapy can prevent tumor tissue edema .


Therefore , we investigated the therapeutic effects of endostatin combined with radiotherapy in the treatment of brain metastases of non-small cell lung cancer ( NSCLC ) and assessed the relations between the effect and vascular endothelial growth factor receptor @ ( VEGFR@ ) expression .


Eighty patients with brain metastases of NSCLC were randomly divided into a combination therapy group and a radiotherapy-alone group , each group with @ patients .


The short-term effective rate , overall survival time , cerebral edema index , and adverse reactions were observed , and the expressions of VEGFR@ protein and KDR gene in primary lesions were detected via immunohistochemical methods and fluorescence in-situ hybridization ( FISH ) in all patients .


Compared with the radiotherapy-alone group , brain edema was significantly relieved ( P = @ ) and there were no marked adverse reactions in the combination therapy group .


Regarding the short-term effective rate , there was no statistical significance in the total population ( n = @ , @ % vs. @ % , P = @ ) , but there was statistical significance in cases of positive VEGFR@ ( @ % vs. @ % , P = @ ) or positive KDR gene ( @ % vs. @ % , P = @ ) in both groups .


For overall survival time , there was no statistical significance in total population ( n = @ , P = @ ) , positive VEGFR@ patients ( P = @ ) , and positive KDR gene patients ( P = @ ) .


Compared with radiotherapy alone , endostatin combined with radiotherapy can relieve brain edema in patients with brain metastases of NSCLC and can obtain a better short-term effective rate in patients with positive VEGFR@ or positive KDR gene , but endostatin therapy does not significantly improve overall survival time .


It has been demonstrated that protein ingestion before sleep increases muscle protein synthesis rates during overnight recovery from an exercise bout .


However , it remains to be established whether dietary protein ingestion before sleep can effectively augment the muscle adaptive response to resistance-type exercise training .


Here we assessed the impact of dietary protein supplementation before sleep on muscle mass and strength gains during resistance-type exercise training .


Forty-four young men ( @ @ y ) were randomly assigned to a progressive , @-wk resistance exercise training program .


One group consumed a protein supplement containing @ g of protein , @ g of carbohydrate , and @ g of fat every night before sleep .


The other group received a noncaloric placebo .


Muscle hypertrophy was assessed on a whole-body ( dual-energy X-ray absorptiometry ) , limb ( computed tomography scan ) , and muscle fiber ( muscle biopsy specimen ) level before and after exercise training .


Strength was assessed regularly by @-repetition maximum strength testing .


Muscle strength increased after resistance exercise training to a significantly greater extent in the protein-supplemented ( PRO ) group than in the placebo-supplemented ( PLA ) group ( +@ @ kg and +@ @ kg , respectively ; P < @ ) .


In addition , quadriceps muscle cross-sectional area increased in both groups over time ( P < @ ) , with a greater increase in the PRO group than in the PLA group ( +@ @ cm ( @ ) vs. +@ @ cm ( @ ) , respectively ; P < @ ) .


Both type I and type II muscle fiber size increased after exercise training ( P < @ ) , with a greater increase in type II muscle fiber size in the PRO group ( +@ @ m ( @ ) ) than in the PLA group ( +@ @ m ( @ ) ; P < @ ) .


Protein ingestion before sleep represents an effective dietary strategy to augment muscle mass and strength gains during resistance exercise training in young men .


This trial was registered at clinicaltrials.gov as NCT@ .


The transient receptor potential vanilloid @ ( TRPV@ ) - expressing sensory C-fibers may play a role in the development of nasal hyper-responsiveness and symptoms of non-allergic rhinitis ( NAR ) .


To evaluate the effects of a TRPV@-antagonist , SB-@ , on cold dry air ( CDA ) - induced symptoms in patients with NAR .


This randomized , double-blind , placebo-controlled , crossover study evaluated @ days of once daily , topical intranasal SB-@ @ mg in @ patients with NAR using a CDA challenge experimental model in an environmental exposure chamber ( EEC , Cetero Research , Mississauga , Ontario ) .


The primary endpoint was total symptom score ( TSS ) , expressed as weighted mean over @ minutes ( WM@-@ ) or maximum TSS at @ hour and @ hours postdosing .


Treatment with SB-@ , relative to placebo , did not improve WM@-@ or maximum TSS at @ hour and @ hours post-dosing on days @ or @ .


Mean ( @ % CI ) treatment differences ( SB-@ - placebo ) on day @ were , for WM@-@ at @ hour : -@ ( -@ , @ ) ; for maximum TSS at @ hour : -@ ( -@ , @ ) .


SB-@ had no impact on any other efficacy parameters .


SB-@ was well tolerated and pharmacokinetics analysis supported the dosing regimen .


SB-@ @ mg for @ days did not alleviate the CDA-induced symptoms of NAR .


Despite engagement of the TRPV@ receptor , there was no translation to clinical efficacy , suggesting redundancy in symptom pathways .


A prospective randomized clinical trial was conducted to evaluate the efficacy of tamoxifen plus doxorubicin and cyclophosphamide compared to tamoxifen plus tegafur-uracil as an adjuvant therapy to treat node-positive premenopausal breast cancer ( PreMBC ) .


Eligibility criteria included pathologically node-positive ( n = @-@ ) preMBC with curative resection , in stages I-IIIA .


Patients were randomized to receive either tamoxifen @ mg/day plus tegafur-uracil @ mg/day ( TU ) for @ years or six courses of a @-day cycle of doxorubicin @ mg/m ( @ ) plus cyclophosphamide @ mg/m ( @ ) on day @ along with tamoxifen ( ACT ) given for @ years as adjuvant therapy .


Primary endpoint was overall survival ( OS ) , and secondary endpoint was recurrence-free survival ( RFS ) .


In total , @ patients were recruited ( TU arm @ , ACT arm @ ) between October @ and September @ .


The HR for OS was @ ( @ % CI @ , @ , log-rank p = @ ) and that for RFS was @ ( @ % CI @ , @ , log-rank p = @ ) , with ACT resulting in a better HR .


The @-year OS was @ % for patients in the TU arm and @ % for those in the ACT arm .


The @-year RFS was @ % for patients in the TU arm and @ % for those in the ACT arm .


A higher proportion of patients in the ACT arm experienced grade @ leucopenia ( @ % in the TU arm , @ % in the ACT arm ) .


There were no significant differences in the efficacy of TU and ACT as adjuvant therapy .


Obesity runs in families , and family-based behavioral treatment ( FBT ) is associated with weight loss in overweight/obese children and their overweight/obese parents .


This study was designed to estimate the costs and cost-effectiveness of FBT compared to separate group treatments of the overweight/obese parent and child ( PC ) .


Fifty overweight/obese @ - to @-year-old children with overweight/obese parents were randomly assigned to @ months of either FBT or PC treatment program .


Assessment of societal costs ( payer plus opportunity costs ) were completed based on two assumptions : ( @ ) programs for parent and child were available on separate days ( PC-@ ) or ( @ ) interventions for parent and child were available in the same location at sequential times on the same day ( PC-@ ) .


Cost-effectiveness was calculated based on societal cost per unit of change using percent overBMI for children and weight for parents .


The average societal cost per family was $ @,@ for FBT and $ @,@ for PC-@ ( p < @ ) and $ @,@ for PC-@ ( p < @ ) .


Child cost-effectiveness for FBT was $ @ / percent overBMI , compared to $ @,@ / percent overBMI for PC-@ and $ @ / percent overBMI for PC-@ .


Parent cost-effectiveness was $ @ / pound ( lb ) for FBT and $ @ / lb ( PC-@ ) or $ @ / lb ( PC-@ ) .


For families with overweight/obese children and parents , FBT presents a lower cost per unit of weight loss for parents and children than treating the parent and child separately .


Given the high rates of pediatric and adult obesity , FBT may provide a unique cost-effective platform for obesity intervention that alters weight in overweight/obese parents and their overweight/obese children .


Pseudogynecomastia refers to benign male breast enlargement due to excess subareolar fat .


Standard treatment is surgical excision under general anesthesia , liposuction , or a combination of both .


The safety and efficacy of cryolipolysis was investigated for nonsurgical treatment of pseudogynecomastia .


Enrollment consisted of @ males with pseudogynecomastia .


Subjects received a first treatment consisting of a @-minute cryolipolysis cycle , followed by a two-minute massage , and a second @-minute cycle with @ % treatment area overlap .


At @ days of follow-up , subjects received a second @-minute treatment .


Safety was evaluated by monitoring side effects and adverse events .


Efficacy was assessed by ultrasound , clinical photographs , and subject surveys .


Surveys revealed that @ % of subjects reported improved visual appearance and @ % reported reduced embarrassment associated with pseudogynecomastia .


Ultrasound showed mean fat layer reduction of @ @ mm .


Blinded reviewers correctly identified @ % of baseline photographs .


Side effects included mild discomfort during treatment and transient paresthesia and tenderness .


One case of paradoxical hyperplasia ( PH ) occurred but likelihood of PH in the male breast is not believed to be greater than in any other treatment area .


This study demonstrated feasibility of cryolipolysis for safe , effective , and well-tolerated nonsurgical treatment of pseudogynecomastia .


Although fatigue , sleep disturbance , depression , and anxiety are associated with pain in breast cancer patients , it is unknown whether acupuncture can decrease these comorbid symptoms in cancer patients with pain .


The objective of this study was to evaluate the effect of electroacupuncture ( EA ) on fatigue , sleep , and psychological distress in breast cancer survivors who experience joint pain related to aromatase inhibitors ( AIs ) .


The authors performed a randomized controlled trial of an @-week course of EA compared with a waitlist control ( WLC ) group and a sham acupuncture ( SA ) group in postmenopausal women with breast cancer who self-reported joint pain attributable to AIs .


Fatigue , sleep disturbance , anxiety , and depression were measured using the Brief Fatigue Inventory ( BFI ) , the Pittsburgh Sleep Quality Index ( PSQI ) , and the Hospital Anxiety and Depression Scale ( HADS ) .


The effects of EA and SA versus WLC on these outcomes were evaluated using mixed-effects models .


Of the @ randomly assigned patients , baseline pain interference was associated with fatigue ( Pearson correlation coefficient -LSB- r -RSB- = @ ; P < @ ) , sleep disturbance ( r = @ ; P = @ ) , and depression ( r = @ ; P < @ ) .


Compared with the WLC condition , EA produced significant improvements in fatigue ( P = @ ) , anxiety ( P = @ ) , and depression ( P = @ ) and a nonsignificant improvement in sleep disturbance ( P = @ ) during the @-week intervention and follow-up period .


In contrast , SA did not produce significant reductions in fatigue or anxiety symptoms but did produce a significant improvement in depression compared with the WLC condition ( P = @ ) .


Compared with usual care , EA produced significant improvements in fatigue , anxiety , and depression ; whereas SA improved only depression in women experiencing AI-related arthralgia .


The present study examined self-affirmation theory , cigarette smoking , and health-related images depicting adverse effects of smoking .


Previous research examining self-affirmation and negative health-related images has shown that individuals who engage in a self-affirmation activity are more receptive to messages when compared to those who do not affirm .


We were interested in examining the extent to which self-affirmation would reduce defensive responding to negative health images related to cigarette smoking .


Participants included @ daily smokers who were undergraduate students at a large southern university .


Participants completed a battery of questionnaires and were then randomly assigned to one of four conditions ( non-smoking image control , smoking image control , low affirmation , and high affirmation ) .


Analyses evaluated the effectiveness of affirmation condition as it related to defensive responding .


Results indicated that both affirmation conditions were effective in reducing defensive responding for those at greatest risk ( heavier smokers ) and those more resistant to health benefits associated with quitting .


Findings are discussed in terms of potential public health implications as well as the role defensive responding plays in the evaluation and processing of negative health messages .


Ketamine is one of the most commonly used sedatives for facilitating painful procedures for paediatric patients in the emergency department ( ED ) .


However , the use of ketamine is associated with a common , though not serious , adverse event usually called ketamine-associated vomiting ( KAV ) .


The purpose of this study is to evaluate the anti-emetic effect of adjunctive ondansetron in paediatric patients receiving ketamine sedation in the ED .


We conducted a prospective , randomised , open , controlled study in children from @ to @ years of age who had undergone intramuscular ketamine sedation in the ED .


The patients were randomised into two groups : a ketamine-only group and a ketamine/ondansetron group .


The patients in the first group received ketamine alone , while those in the second group received ketamine with oral ondansetron .


The incidence of KAV was estimated in the ED and after discharge , and the time to resumption of a normal diet was measured after sedation .


A total of @ patients were analysed .


The incidence of KAV was @ % in the ketamine-only group and @ % in the ketamine/ondansetron group ( P = @ ) .


After administration of ketamine , the mean time to resumption of a normal diet was @ h @ min in the ketamine-only group and @ h @ min in the ketamine/ondansetron group ( P = @ ) .


A relatively high rate of KAV ( @ % ) was observed , and the time to resumption of a normal diet after ketamine sedation was rather long .


It turned out that , however , the adjunctive administration of ondansetron did not effectively reduce the incidence of KAV .


Neurologic diseases such as stroke are risk factors for new-onset epilepsy in older adults .


Recent evidence suggests that psychiatric disorders independently predict epilepsy in older male veterans .


Our aim was to examine the relationship between these disorders in a population-based study of older adults that also included women and minorities .


We used a national @ % random sample of @ Medicare beneficiaries including all @ US states and Washington , DC .


Beneficiaries were @ years of age or older , with continuous Medicare Part A and Part B coverage and not in managed care plans .


Epilepsy cases were identified from claims for physician visits , hospitalizations , and outpatient procedures .


We used logistic regressions for the overall sample and stratified by gender to determine whether risk of new-onset epilepsy was associated with prior history of psychiatric ( i.e. , depression , psychosis , bipolar disorder , schizophrenia , posttraumatic stress disorder ( PTSD ) , adjustment disorder , and substance abuse/dependence ) and neurologic conditions ( i.e. , cerebrovascular disease , dementia , traumatic brain injury , brain tumor , metastatic cancer ) .


Preexisting psychiatric disorders were significantly associated with new-onset epilepsy in the study population as were the neurologic conditions evaluated .


Five of the seven psychiatric disorders examined were independently associated with new-onset epilepsy ; substance abuse , psychosis , bipolar disorder , schizophrenia , and depression .


Gender interaction effects were found for substance abuse/dependence and brain tumors .


Both neurologic and psychiatric factors significantly predicted new-onset epilepsy in a population-based sample of male and female older adults .


These results support earlier findings and extend the understanding of risk models for new-onset epilepsy in broader older adult populations .


Whereas it is established that endothelin-@ elicits sustained deleterious effects on the cardiovascular system during cardiopulmonary bypass ( CPB ) , presently it remains unknown whether the inhaled administration of the dual ETA and ETB antagonist tezosentan prevents the development of pulmonary endothelial dysfunction .


A prospective , randomized laboratory investigation .


University research laboratory .


Landrace swine .


Three groups of animals underwent a @-minute period of full bypass followed by a @-minute period of reperfusion .


Among treated groups , one received tezosentan through inhalation prior to CPB , whereas the other one received it intravenously at weaning from CPB ; the third group remained untreated .


Pulmonary vascular reactivity studies , realized on a total of @ rings , were performed in all groups , including @ sham .


The contractility of pulmonary arteries to prostaglandin F@ and to the thromboxane A@ mimetic U@ was preserved in animals submitted to CPB .


By contrast , there were significant increases both in the maximal contraction to endothelin-@ and in the plasma levels of the peptide @minutes after reperfusion .


Tezosentan administered by inhalation or intravenously did not prevent the development of pulmonary CPB-associated endothelial dysfunction .


However , while hemodynamic disturbances were improved with both routes , the inhaled administration had a beneficial effect on oxygen parameters over intravenous administration .


Despite the blockade of the endothelin-@ pathway with tezosentan , the development of the pulmonary endothelial dysfunction associated with CPB still occurred .


However , only the inhalation route had a significant impact on gas exchange during CPB .


Recently , the UK CCLG and COG reported that an intrachromosomal amplification of chromosome @ ( iAMP@ ) in acute lymphoblastic leukemia ( ALL ) loses its adverse prognostic impact with intensified therapy .


We evaluated the prognosis of iAMP@ among patients from the ALL-BFM ( Berlin-Frankfurt-Mnster ) @ trial with @ of @ ( @ % ) patients iAMP@ + .


@-year event-free-survival ( EFS , @ @ % vs. @ @ % , p = @ ) and cumulative incidence of relapse ( CIR , @ @ % vs. @ @ % , p = @ ) of the iAMP@ cases were significantly worse compared with non-iAMP@ patients .


Within the MRD low-risk group , iAMP@ cases ( n = @ ) had an inferior @-year EFS ( @ @ % vs. @ @ % , p = @ ) , but no increased CIR ( @ @ % vs. @ @ % , p = @ ) .


Within the MRD intermediate-risk group , iAMP@ cases ( n = @ ) had a worse @-year EFS ( @ @ % vs. @ @ % , p = @ ) and CIR ( @ @ % vs. @ @ % , p = @ ) with @/@ relapses occurring after @ years .


Conclusively , we believe that there is no necessity for enrolling all iAMP@ patients into the high-risk arm of ongoing ALL-BFM trials because MRD low-risk patients have a moderate relapse risk under current therapy .


Whether the increased relapse risk in MRD intermediate-risk patients can be avoided by late treatment intensification remains to be answered by the AIEOP-BFM ALL @ trial randomly using protracted pegylated L-asparaginase during delayed intensification and early maintenance .


We investigated which factors can best predict relapse in older patients with major depressive disorder ( MDD ) who have achieved remission with escitalopram .


A total of @ patients who were @ years or older with a primary diagnosis of MDD received @ week , open-label escitalopram @ or @mg/day .


Patients in remission ( MADRS @ ) at Week @ were randomized to @ weeks of double-blind treatment with either placebo or escitalopram ( fixed dose from Week @ ) .


After randomization of @ patients in remission , patients whose dose had been increased to @mg escitalopram after @ weeks of open-label treatment had a high escitalopram relapse rate ( @ % ) and a placebo relapse rate of @ % with a hazard ratio ( HR ) of @ , whereas patients titrated to @mg escitalopram at Weeks @ or @ had a high placebo relapse rate ( @ % ) and an escitalopram relapse rate of @ % with a HR = @ .


A high placebo relapse rate was also observed for patients with a baseline MADRS below median , while low escitalopram relapse rates were characteristic of patients who had achieved remission by Week @ or @ ( HR = @ ) , had a current depressive episode length below median , baseline MADRS below median ( HR = @ ) , or received @mg for @ weeks ( HR = @ ) .


A key limitation of the study was that some analyses were post-hoc and that none of the comparisons between complementary subgroups had nominal p-values < @ .


In this post-hoc analysis of elderly patients with MDD , several factors , including female gender , early remission , low baseline MADRS score , major depressive episode ( MDE ) duration , and escitalopram dosage , significantly affected the relapse rate after randomization to escitalopram or placebo .


The study aims to compare the stress shielding effects of implantable anatomical and traditional prostheses after in vitro total hip joint replacement simulation .


The study serves as a biomechanical basis for novel artificial prostheses and for clinical hip joint replacements .


Sixteen femoral specimens from adult male corpses were randomly divided into two groups : the traditional prosthesis group implanted into femur specimens using simulated total hip joint replacement ( n = @ ) and the femoral neck-preserved anatomical prosthesis implantation group that used a collum femoris preserving stem/trabeculae oriented pattern ( CFP/TOP ) acetabular cup ( n = @ ) .


The strain values in the two groups before and after prosthesis implantation were measured at different test points using electric resistance strain gauges .


The stress shielding rate was calculated according to the related formula .


The results showed that the rates of proximal femoral stress shielding were significantly higher at test points @-@ in the traditional femoral prosthesis transplantation group than in the anatomical prosthesis group ( p < @ ) .


There were different effects of stress shielding between the anatomical and traditional prostheses .


Retained femoral anatomical implants should reduce stress shielding and increase the stability of anatomical prosthesis implants .


The self-control strength model suggests that exertion of self-control leads to poorer subsequent self-control performance .


Failure of self-control has been suggested as an important underlying mechanism of excessive drinking .


This study tested the effects of self-control failure on ad libitum drinking , and the potential moderating role of glucose and self-awareness on this relationship .


The current research examined in two experiments whether the effects of self-control failure were different for males and females , and whether glucose ( experiment @ ) and self-awareness ( experiment @ ) would counteract the effects of self-control failure .


A between-participants design with four conditions was employed in each experiment .


A semi-naturalistic drinking setting in the form of a laboratory bar .


Undergraduate students recruited at Radboud University Nijmegen , the Netherlands ( experiment @ : n = @ ; experiment @ : n = @ ) .


The total amount of alcohol consumed during an experimental break ( observational data ) and questionnaire data on drinking patterns .


Self-control failure led to increased levels of drinking in males ( P < @ ) , whereas females drank less after being depleted ( P < @ ) .


Self-awareness , but not glucose , was found to counteract the effects of self-control failure among males ( P < @ ) .


Self-control failure leads to increased drinking of alcohol in males and decreased levels of drinking alcohol in females .


However , increasing self-awareness appears to be a promising strategy in facing the temptation to drink when cognitive resources to inhibit intake are low .


Access to fruit and vegetables ( FV ) is associated with adolescents ' FV consumption .


However , little is known about implementation of strategies to increase access to FV at schools .


We examined the implementation of two environmental components designed to increase access to FV at Danish schools .


We used data from @ intervention schools involved in the school-based multicomponent Boost trial targeting @-year-olds ' FV consumption .


The environmental components at school included daily provision of free FV and promotion of a pleasant eating environment .


Questionnaire data was collected by the end of the nine-month intervention period among @,@ pupils ( @ % ) , from all school principals ( n = @ ) and half way through the intervention period and by the end of the intervention among @ teachers ( @ % ) .


The implementation of the components was examined descriptively using the following process evaluation measures ; fidelity , dose delivered , dose received and reach .


Schools with stable high implementation levels over time were characterised by context , intervention appreciation and implementation of other components .


For all process evaluation measures , the level of implementation varied by schools , classes and over time .


Dose received : @ % of pupils ( school range : @-@ % , class range : @-@ % ) ate the provided FV daily ; @ % of pupils ( school range : @-@ % , class range : @-@ % ) reported that time was allocated to eating FV in class .


Reach : The intake of FV provided did not differ by SEP nor gender , but more girls and low SEP pupils enjoyed eating FV together .


Dose delivered : The proportion of teachers offering FV at a daily basis decreased over time , while the proportion of teachers cutting up FV increased over time .


Schools in which high proportions of teachers offered FV daily throughout the intervention period were characterized by being : small ; having a low proportion of low SEP pupils ; having a school food policy ; high teacher - and pupil intervention appreciation ; having fewer teachers who cut up FV ; and having high implementation of educational components .


The appliance of different approaches and levels of analyses to describe data provided comprehension and knowledge of the implementation process .


This knowledge is crucial for the interpretation of intervention effect .


Garlic is effective against Candida species invitro , and along with other alternative therapies , is used by women with vulvovaginal candidiasis .


The objective of this study was to ascertain whether oral garlic reduced vaginal candida counts during the second half of the menstrual cycle in asymptomatic women colonised with Candida species .


A simple randomised double-blinded controlled trial .


Melbourne , Australia .


Sixty-three asymptomatic women who were culture-positive for Candida species at screening .


Participants were randomised to three garlic tablets or placebo orally , twice daily , for @days .


The primary outcome was the proportion of women with colony counts of candida > @ colony-forming units per ml in any given day during the last @days before menstruation , defined as a ` case ' .


Secondary outcomes included the mean quantitative colony counts of candida over @days prior to menses .


There was no evidence of a difference between the proportion of cases in the garlic and placebo groups ( @ versus @ % ; relative risk , RR@ @ ; @ % confidence interval , @ % CI @-@ @ ) , in the mean colony counts in both groups ( ratio of geometric means of candidal colony counts @ ; @ % CI @-@ @ ; P = @ ) , or difference in the number of women reporting abnormal vaginal symptoms during the @weeks before menstruation ( RR@ @ ; @ % CI @-@ @ ; P = @ ) .


The garlic group reported more adverse effects ( @ % compared @ % in the placebo group ; difference in proportions @ % ; @ % CI @ - % ; P < @ ) .


This study provided data for sample size calculations in future studies on the antifungal effect of garlic , but provided no evidence to inform clinical practice regarding the use of garlic in vaginal candidiasis .


Further studies might investigate longer courses or topical formulations .


Evaluate the performance of a robotic system for CT-guided lung biopsy in comparison to the conventional manual technique .


One hundred patients referred for CT-guided lung biopsy were randomly assigned to group A ( robot-assisted procedure ) or group B ( conventional procedure ) .


Size , distance from entry point and position in lung of target lesions were evaluated to assess homogeneity differences between the two groups .


Procedure duration , dose length product ( DLP ) , precision of needle positioning , diagnostic performance of the biopsy and rate of complications were evaluated to assess the clinical performance of the robotic system as compared to the conventional technique .


All biopsies were successfully performed .


The size ( p = @ ) , distance from entry point ( p = @ ) and position in lung ( p = @ ) of target lesions were similar in both groups ( p = @ ) .


Procedure duration and radiation dose were significantly reduced in group A as compared to group B ( p = @ ) .


Precision of needle positioning , diagnostic performance of the biopsy and rate of complications were similar in both groups ( p = @ ) .


Robot-assisted CT-guided lung biopsy can be performed safely and with high diagnostic accuracy , reducing procedure duration and radiation dose in comparison to the conventional manual technique .


CT-guided biopsy is the main procedure to obtain diagnosis in lung tumours .


The robotic device facilitates percutaneous needle placement under CT guidance .


Robot-assisted CT-guided lung biopsy reduces procedure duration and radiation dose .


To pilot-test the feasibility and preliminary effect of a community health worker ( CHW ) intervention to reduce hospital readmissions .


Patient-level randomized quality improvement intervention .


An academic medical center serving a predominantly low-income population in the Boston , Massachusetts area and @ affiliated primary care practices .


Medical service patients with an in-network primary care physician who were discharged to home ( n = @ ) and had one of five risk factors for readmission within @ days .


Inpatient introductory visit and weekly post-discharge telephonic support for @ weeks to assist patient in coordinating medical visits , obtaining and using medications , and in self-management .


Number of completed CHW contacts ; CHW-reported barriers and facilitators to assisting patients ; primary care , emergency department and inpatient care use .


Roughly @ % of patients received at least one post-discharge CHW call ; only @ % of patients received at least four calls as intended .


Hospital readmission rates were lower among CHW patients ( @ % ) compared with usual care ( @ % ) ; the difference was not statistically significant .


Under performance-based payment systems , identifying cost-effective solutions for reducing hospital readmissions will be crucial to the economic survival of all hospitals , especially safety-net systems .


This pilot study suggests that with appropriate supportive infrastructure , hospital-based CHWs may represent a feasible strategy for improving transitional care among vulnerable populations .


An ongoing , randomized , controlled trial of a CHW intervention , developed according to the lessons of this pilot , will provide further insight into the utility of this approach to reducing readmissions .


Fluid management in the perioperative period has been extensively studied but , despite that , `` the right amount '' still remains uncertain .


The purpose of this paper is to summarize the state of the art of intraoperative fluid approach today .


In the current medical literature there are only heterogeneous viewpoints that gives the idea of how confusing the situation is .


The approach to the intraoperative fluid management is complex and it should be based on human physiology and the current evidence .


An intraoperative restrictive fluid approach in major surgery may be beneficial while Goal-directed Therapy should be superior to the liberal fluid strategy .


Finally , we propose a rational approach currently used at our institution .


High primary stability is important for long-term survival of uncemented femoral stems .


Different stem designs are currently in use .


The ABG-I is a well-documented anatomical stem with a press-fit design .


The Unique stem is designed for a tight customized fit to the cortical bone of the upper femur .


This implant was initially developed for patients with abnormal anatomy , but the concept can also be used in patients with normal femoral anatomy .


We present @-year radiostereometric analysis ( RSA ) results from a randomized study comparing the ABG-I anatomical stem with the Unique femoral stem .


@ hips with regular upper femur anatomy were randomized to either the ABG-I stem or the Unique femoral stem .


RSA measurements were performed postoperatively and after @ , @ , @ , @ , and @ months .


RSA measurements from @ hips were available for analysis at the @-year follow-up .


Small amounts of movement were observed for both stems , with no statistically significant differences between the @ types .


No improvement in long-term stability was found from using a customized stem design .


However , no patients with abnormal geometry of the upper femur were included in this study .


Paracetamol / codeine has shown a strong analgesic activity in several studies conducted among different kind of subjects , including those with trauma .


Nevertheless , its efficacy in patients accessing the Emergency Department ( ED ) for different kind of pain has never been tested .


This is a cross-sectional , observational , prospective , cohort study .


Inclusion criteria were patients > @ year old presenting to the ED for localized traumatic or inflammatory pain involving only extremities .


Numeric scale ( NRS ) was recorded thirty minutes and two hours after the administration of the analgesic therapy , consisting of @ mg of ketorolac or @ mg/@ mg of paracetamol / codeine , both orally .


Two-hundred patients were consecutively enrolled ; @ were treated with paracetamol/codeine and @ with ketorolac .


The combination paracetamol/codeine resulted to be not inferior to ketorolac in non-traumatic pain group and trauma group ( p = @ and p = @ , respectively ) .


Compared to ketorolac , the combination paracetamol/codeine exerted a significantly higher analgesic activity in patients with fractures and muscular pain ( p = @ ) and was more effective in acute pain ( p = @ ) , with a significant effect two hours after the administration ( p = @ ) .


Paracetamol/codeine is equivalent to ketorolac in non-traumatic pain and post-traumatic pain , but is superior in acute pain and in patients with fractures and muscular pain .


Those results play in favor of the use of the combination paracetamol/codeine in patients accessing the ED for non-traumatic or traumatic pain of the extremities .


The purpose of this study was to objectively determine and compare the efficacy and effectiveness of xylitol solution ( Xlear Nasal Sprey ) compared with xylometazoline and physiological saline with respect to quality of life ( QoL ) in patients with nasal congestion .


A prospective , randomized study was performed in @ patients who had nasal obstruction and hypertrophied turbinate mucosa that was refractory to medical treatment .


The study population was randomized into @ groups according to the application of xylometazoline , physiological saline , and xylitol hyperosmolar solution .


The efficacy of treatment was evaluated objectively ( @-phase rhinomanometry ) and subjectively ( visual analogue scale VAS . )


before and after the application of the nasal solutions .


QoL was evaluated by means of Rhinoconjunctivitis Quality of Life Questionnaire ( RQLQ ) .


VAS scores and @-phase rhinomanometry scores were better in the group treated with xylometazoline compared to those treated with xylitol or saline .


The xylitol procedure yielded better results than the saline procedure , but differences were not statistically significant in both objective and subjective evaluation methods .


For overall QoL , there was a significant improvement from baseline for the xylometazoline and xylitol groups .


However , the improvement in the xylometazoline group was significantly greater than that obtained in the xylitol group .


Xlear Nasal Spray is an effective modality in the treatment of nasal congestion and has positive effect on the QoL of patients .


Further studies are needed in order to plan an ongoing treatment of Xlear Nasal Sprey at certain intervals for continuous relief of symptoms and a better and longstanding QoL .


Frequent use and serious adverse effects related to non-steroidal anti-inflammatory drugs ( NSAIDs ) underscore the need to raise patient awareness about potential risks .


Partial success of patient - or provider-based interventions has recently led to interest in combined approaches focusing on both patient and physician .


This research tested a shared decision-making intervention for increasing patient-reported awareness of NSAID risk .


A group randomized trial was performed in Alabama from @ to @ .