The number of cases of moderate or severe acute pancreatitis was similar in the somatostatin ( @ % ) and the placebo ( @ % ) groups ( RR @ , @ % CI @-@ @ , P = @ ) .


No side effects were observed related to the use of somatostatin .


Administration of an intravenous bolus of somatostatin followed by a short continuous infusion does not reduce the incidence of post-ERCP pancreatitis .


Clinical Trials.gov number : NCT@ .


Prospective data to examine the association of homocysteine with age-related macular degeneration ( AMD ) are limited .


We examined the prospective relation of plasma homocysteine level and AMD in a large cohort of apparently healthy women .


We evaluated the relationship between baseline levels of plasma homocysteine and incident AMD among @,@ female health professionals aged @ years or older .


Main outcome measures were total AMD , defined as self-report documented by medical record evidence of an initial diagnosis after randomization , and visually significant AMD , defined as confirmed incident AMD with visual acuity @/@ or worse attributable to this condition .


During an average @ years of follow-up , a total of @ cases of AMD , including @ cases of visually significant AMD , were documented .


Women in the highest versus lowest quartile of plasma homocysteine had modestly , but statistically non-significant , increased risks of total AMD ( hazard ratio , HR , @ , @ % confidence interval , CI , @-@ @ ; p for trend @ ) and visually significant AMD ( HR @ , @ % CI @-@ @ ; p for trend @ ) in age - and treatment-adjusted analyses .


These prospective data from a large cohort of apparently healthy women do not support a strong role for homocysteine in AMD occurrence .


The number of therapeutic drugs available for the treatment of alcohol use disorders ( AUDs ) is limited , and a well-tolerated , self-administrable drug is much needed .


Subgroups of alcohol-dependent individuals , for example , individuals with heredity for AUD , may respond differently to pharmacological treatments , particularly to drugs affecting the serotonergic system in the brain .


Clinical observations and case reports indicate that mirtazapine , a widely used and well-tolerated antidepressant drug , which increases both noradrenaline and serotonin release but simultaneously blocks serotonergic ( @-hydroxytryptamine ) @ receptors , reduces alcohol consumption .


Moreover , drugs affecting serotonergic ( @-hydroxytryptamine ) @ receptors have been shown to work differently in individuals with heredity for AUD .


This double-blind , randomized , placebo-controlled , @-armed clinical trial aimed to establish whether mirtazapine lowers alcohol consumption in male high consumers .


The study population was also subgrouped in accordance with heredity for AUD .


After @ lead-in weeks of single-blind placebo , @ males were randomly assigned to receive @ weeks of treatment with @-mg mirtazapine daily ( n = @ ) or placebo ( n = @ ) .


The main outcome was self-reported alcohol consumption ( drinks per day ) measured by an alcohol diary .


The alcohol consumption was calculated as weekly mean during the study period compared with baseline .


The data were analyzed in accordance with intention to treat and per protocol .


The results suggest that high consumers of alcohol with a heredity for AUD benefit from treatment with mirtazapine .


The results of this study did not support an advantage of mirtazapine over placebo on alcohol consumption in the intention-to-treat analysis .


However , mirtazapine could be an alternative to available treatments for alcohol dependence in patients with heredity for AUD .


This study assessed the efficacy of methylphenidate versus placebo for cancer-related fatigue reduction .


Other objectives were to analyze cytokine levels and to determine the effects of methylphenidate on other symptoms , cognitive function , work yield , and patients ' perceptions and preferences .


Patients were randomly assigned ( @:@ ) to receive methylphenidate-placebo or placebo-methylphenidate for @ weeks .


Patients crossed over after @ weeks .


Wilcoxon signed rank tests and McNemar tests were used to assess continuous and categorical variables .


The primary efficacy endpoint was change in the level of worst fatigue on the Brief Fatigue Inventory ( BFI ) at the end of each @-week period .


The mean baseline BFI score was moderate ( @ ) .


Methylphenidate treatment did not affect patients ' worst level of fatigue or other symptoms .


Results from the Wechsler Adult Intelligence Scale Digit Symbol Test and the Hopkins Verbal Learning Test with BFI interference questions and BFI activity questions showed significant improvement in the methylphenidate-treated patients ' verbal learning , memory , visual perception , analysis , and scanning speed .


Patients treated with methylphenidate missed significantly fewer work hours owing to health reasons and worked significantly more hours .


After @ weeks , @ % of patients reported that methylphenidate improved their cancer-related fatigue , and @ % wanted to continue treatment .


Significant difference in interleukin @R ( positive ) , interleukin @ ( negative ) , and tumor necrosis factor ( positive ) was noted between the methylphenidate and the placebo group .


Low-dose methylphenidate did not improve cancer-related fatigue .


Patients taking methylphenidate had better cognition and were able to work more hours .


Patients tolerated methylphenidate well , and the majority felt better and wanted to continue treatment .


A randomized study in @-@ of mechanical bowel preparation ( MBP ) preceding colonic resection found no decrease in postoperative complications .


The aim of the present study was to evaluate the long-term effect of MBP regarding cancer recurrence and survival after colonic resections .


The cohort of patients with colonic cancer in the MBP study was followed up for @ years .


Data were collected from registers run by the National Board of Health and Welfare .


Register data were validated against information in patient charts .


Cox proportional hazards model was used for multivariable analysis of factors predictive of cancer-specific survival .


Register analysis showed significantly fewer recurrences , and better cancer-specific and overall survival in the MBP group .


After validation , @ of @ patients remained for analysis ( @ MBP , @ no MBP ) .


Eighty ( @ per cent ) of @ patients in the MBP group and @ ( @ per cent ) of @ in the no-MBP group developed a cancer recurrence ( P = @ ) .


The @-year cancer-specific survival rate was @ per cent in the MBP group and @ per cent in the no-MBP group ( P = @ ) .


Overall survival rates were @ and @ per cent respectively ( P = @ ) .


Patients receiving MBP before elective colonic cancer surgery had significantly better cancer-specific survival after @ years .


Arm hemiparesis secondary to stroke is common and disabling .


We aimed to assess whether robotic training of an affected arm with ARMin -- an exoskeleton robot that allows task-specific training in three dimensions-reduces motor impairment more effectively than does conventional therapy .


In a prospective , multicentre , parallel-group randomised trial , we enrolled patients who had had motor impairment for more than @ months and moderate-to-severe arm paresis after a cerebrovascular accident who met our eligibility criteria from four centres in Switzerland .


Eligible patients were randomly assigned ( @:@ ) to receive robotic or conventional therapy using a centre-stratified randomisation procedure .


For both groups , therapy was given for at least @ min three times a week for @ weeks ( total @ sessions ) .


The primary outcome was change in score on the arm ( upper extremity ) section of the Fugl-Meyer assessment ( FMA-UE ) .


Assessors tested patients immediately before therapy , after @ weeks of therapy , at the end of therapy , and @ weeks and @ weeks after start of therapy .


Assessors were masked to treatment allocation , but patients , therapists , and data analysts were unmasked .


Analyses were by modified intention to treat .


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


Between May @ , @ , and Sept @ , @ , @ individuals were tested for eligibility , of whom @ were eligible and agreed to participate .


@ patients assigned to robotic therapy and @ assigned to conventional therapy were included in analyses .


Patients assigned to robotic therapy had significantly greater improvements in motor function in the affected arm over the course of the study as measured by FMA-UE than did those assigned to conventional therapy ( F = @ , p = @ ; mean difference in score @ points , @ % CI @-@ @ ) .


No serious adverse events related to the study occurred .


Neurorehabilitation therapy including task-oriented training with an exoskeleton robot can enhance improvement of motor function in a chronically impaired paretic arm after stroke more effectively than conventional therapy .


However , the absolute difference between effects of robotic and conventional therapy in our study was small and of weak significance , which leaves the clinical relevance in question .


Severely injured patients experiencing hemorrhagic shock often require massive transfusion .


Earlier transfusion with higher blood product ratios ( plasma , platelets , and red blood cells ) , defined as damage control resuscitation , has been associated with improved outcomes ; however , there have been no large multicenter clinical trials .


To determine the effectiveness and safety of transfusing patients with severe trauma and major bleeding using plasma , platelets , and red blood cells in a @:@:@ ratio compared with a @:@:@ ratio .


Pragmatic , phase @ , multisite , randomized clinical trial of @ severely injured patients who arrived at @ of @ level I trauma centers in North America directly from the scene and were predicted to require massive transfusion between August @ and December @ .


Blood product ratios of @:@:@ ( @ patients ) vs @:@:@ ( @ patients ) during active resuscitation in addition to all local standard-of-care interventions ( uncontrolled ) .


Primary outcomes were @-hour and @-day all-cause mortality .


Prespecified ancillary outcomes included time to hemostasis , blood product volumes transfused , complications , incidence of surgical procedures , and functional status .


No significant differences were detected in mortality at @ hours ( @ % in @:@:@ group vs @ % in @:@:@ group ; difference , -@ % -LSB- @ % CI , -@ % to @ % -RSB- ; P = @ ) or at @ days ( @ % vs @ % , respectively ; difference , -@ % -LSB- @ % CI , -@ % to @ % -RSB- ; P = @ ) .


Exsanguination , which was the predominant cause of death within the first @ hours , was significantly decreased in the @:@:@ group ( @ % vs @ % in @:@:@ group ; difference , -@ % -LSB- @ % CI , -@ % to -@ % -RSB- ; P = @ ) .


More patients in the @:@:@ group achieved hemostasis than in the @:@:@ group ( @ % vs @ % , respectively ; P = @ ) .


Despite the @:@:@ group receiving more plasma ( median of @ U vs @ U , P < @ ) and platelets ( @ U vs @ U , P < @ ) and similar amounts of red blood cells ( @ U ) over the first @ hours , no differences between the @ groups were found for the @ prespecified complications , including acute respiratory distress syndrome , multiple organ failure , venous thromboembolism , sepsis , and transfusion-related complications .


Among patients with severe trauma and major bleeding , early administration of plasma , platelets , and red blood cells in a @:@:@ ratio compared with a @:@:@ ratio did not result in significant differences in mortality at @ hours or at @ days .


However , more patients in the @:@:@ group achieved hemostasis and fewer experienced death due to exsanguination by @ hours .


Even though there was an increased use of plasma and platelets transfused in the @:@:@ group , no other safety differences were identified between the @ groups .


To evaluate factors that characterize employees who did not participate in a physical activity intervention in an occupational setting and assess how selective participation affects inferences from the data .


Employees were asked to complete a health risk appraisal .


The respondents were invited to participate in a physical activity intervention .


We compared predictors of sickness absence ( register data ) among all respondents and those who participated in the intervention , using Bayesian regression analysis .


Of @ employees , @ ( @ % ) responded , of whom @ ( @ % ) participated in the intervention .


Participants had better health behaviors and fewer health problems than those who did not participate .


The predictors of sickness absence in all respondents differed from those who participated in the intervention .


Selective participation may reduce the potential benefit of interventions and limit generalizability of findings .


To compare the clinical outcome of @-mm and @-mm long implants in partially edentulous posterior areas .


Twenty-four patients , with a partially edentulous area in the jaws with a height and width allowing the positioning of @ to @ adjacent @ @ mm implants without any augmentation procedure , were randomly allocated according to a parallel group design to receive @-mm long or @-mm long implants .


A total of @ implants were placed ( @ @ mm and @ @ mm implants ) .


Patients were restored @ weeks after surgery and were followed for @ years .


Outcome measures were prosthesis and implant survival , as well as marginal bone level changes and complications .


After @ years , @ patients were available .


One @ mm implant failed during the healing period and its related prosthesis could not be placed .


No implants were lost after loading .


The @ mm group registered @ complications ( @ mucositis , @ prosthesis decementations and @ chipping ) , while only @ were registered in the @ mm group ( @ decementations and @ chipping ) .


The difference in complications between the two groups was not statistically significant ( P = @ ) .


Marginal bone loss at @ years was @ and @ mm with the @ mm and @ mm groups , respectively ( not statistically significant ; difference between the two groups @ mm ; SD @ mm ; @ % CI -@ ; @ ; t test P = @ ) .


Implant and prosthetic survival and success rates were similar between prostheses supported by @-mm or @-mm long implants .


To investigate the effects of Yiqibushenhuoxue decoction on stable chronic obstructive pulmonary disease ( COPD ) by observing its influences on patients ' quality of life and airway inflammation .


Seventy patients with stable COPD were randomly divided into a treatment group ( n = @ ) treated with Yiqibushenhuoxue decoction plus Seretide and a control group ( n = @ ) treated with Seretide only .


The dosage of Yiqibushenhuoxue decoction was @ mL each time , twice a day , and the dosage of Seretide was salmeterol @ microg/fluticasone @ microg twice a day .


Both groups were treated for @ weeks .


Before and after the treatment , St George 's respiratory disease questionnaire ( SGRQ ) scores , forced expiratory volume , and forced expiratory volume in @ second/forced vital capacity ( FEV@ / FVC ) were measured .


The SGRQ scores in both groups were significantly lower than those before treatment ( P < @ ) .


After treatment , the total SGRQ scores and each subscore in the treatment group were significantly lower than those in the control group ( P < @ ) .


The percentage of the predicted FEV@ % and FEV@/FVC were higher in both groups , but no statistical differences were detected from before to after the treatment or between the two groups ( P > @ ) .


Yiqibushenhuoxue decoction could significantly decrease the SGRQ scores in patients with stable COPD , which suggests that it is able to improve patient symptoms .


To explore the effect of clinical pathway of health education in patients with kidney transplantation .


A total of @ patients with kidney transplantation were randomly divided into an experimental group and a control group ( n = @ in each group ) .


The patients in the control group received traditional health education , and the patients in the experimental group experienced the clinical pathway of health education .


The effect of health education was assessed and compared .


There was significant difference in the effect of health education between the two groups ( P < @ ) .


Clinical pathway of health education in patients after kidney transplantation can significantly improve the effect of health education .


Gait impairment is common in Parkinson 's disease ( PD ) and may result in greater energy expenditure , poorer walking economy , and fatigue during activities of daily living .


Auditory cueing is an effective technique to improve gait ; but the effects on energy expenditure are unknown .


To determine whether energy expenditure differs in individuals with PD compared with healthy controls and if auditory cueing improves walking economy in PD .


Twenty participants ( @ PD and @ controls ) came to the laboratory for three sessions .


Participants performed two , @-minute bouts of treadmill walking at two speeds ( @ msec-@ and @ msec-@ ) .


One session used cueing and the other without cueing .


A metabolic cart measured energy expenditure and walking economy was calculated ( energy expenditure/power ) .


PD had worse walking economy and higher energy expenditure than control participants during cued and non-cued walking at the @ msec-@ speed and during non-cued walking at the @ msec-@ .


With auditory cueing , energy expenditure and walking economy worsened in both participant groups .


People with PD use more energy and have worse walking economy than adults without PD .


Walking economy declines further with auditory cuing in persons with PD .


Androgen deprivation therapy ( ADT ) is the foundation of treatment for men with metastatic prostate cancer and is now frequently incorporated into multimodality strategies for the curative treatment of locally advanced prostate cancer .


Nevertheless , the catabolic effects of ADT result in meaningful adverse effects on physiological and quality of life outcomes , which may , in turn , increase the risk of functional decline , frailty , cardiovascular disease , and metabolic syndrome .


Recent evidence demonstrates that lifestyle intervention promoting change in exercise and dietary behaviors is a promising approach , and may offset , or even reverse , the adverse effects accompanying ADT .


Unfortunately , the limited existing studies of the effects of exercise and dietary interventions targeting patients with prostate cancer on ADT are characterized by high attrition rates and poor postintervention maintenance of treatment effects .


Consequently , the Individualized Diet and Exercise Adherence Pilot Trial ( IDEA-P ) is designed to contrast the effects of a lifestyle intervention designed to promote independent self-management of exercise and dietary behavior with those of standard care disease management approach in the treatment of prostate cancer .


A total of @ patients with prostate cancer undergoing ADT will be randomly assigned to lifestyle intervention or standard care .


Outcomes of interest in IDEA-P include changes in self-reported and objectively assessed physical function and physical activity , dietary behavior , body composition , muscular strength , and quality of life .


Outcomes will be obtained at baseline , @-month , and @-month assessments by trial personnel blinded to participants ' randomization assignment .


Findings from this study will establish the feasibility and preliminary efficacy of an innovative lifestyle intervention designed to promote progressively independent self-regulated exercise and dietary behavior change in the treatment of patients with prostate cancer undergoing ADT .


Metformin is the recommended first-line pharmacotherapy for patients with type @ diabetes .


There is no consensus on the optimum second-line pharmacotherapy .


We compared the efficacy and safety of the sodium glucose cotransporter @ inhibitor empagliflozin and the sulfonylurea glimepiride as add-on to metformin in patients with type @ diabetes .


In this double-blind phase @ trial , patients ( aged @ years ) with type @ diabetes and HbA@c concentrations of @-@ % , despite metformin treatment and diet and exercise counselling , were randomly assigned in a @:@ ratio with a computer-generated random sequence , stratified by HbA@c , estimated glomerular filtration rate ( eGFR ) , and region , to empagliflozin ( @ mg once daily , orally ) or glimepiride ( @-@ mg once daily , orally ) as add-on to metformin for @ weeks .


Patients and investigators were masked to treatment assignment .


The primary endpoint was change from baseline in HbA@c levels at weeks @ and @ .


Differences in the primary endpoint were first tested for non-inferiority ( based on a margin of @ % ) .


If non-inferiority was shown , differences in the primary endpoint at week @ were then tested for superiority .


Analysis was done on the full-analysis set-ie , patients who were treated with at least one dose of study drug and had a baseline HbA@c value .


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


A @-week extension is ongoing .


Between August , @ , and June , @ , @ patients were randomly assigned to receive empagliflozin ( n = @ ) or glimepiride ( n = @ ) ; four patients in the empagliflozin group did not receive the assigned treatment .


Empagliflozin was non-inferior to glimepiride at both timepoints .


At week @ , adjusted mean difference in change from baseline in HbA@c with empagliflozin versus glimepiride was -@ % ( @ % CI -@ to -@ ; p = @ for superiority ) .


Adverse events were reported in @ ( @ % ) patients treated with empagliflozin and @ ( @ % ) patients treated with glimepiride .


Severe adverse events were reported in @ ( @ % ) patients in the empagliflozin group and @ ( @ % ) in the glimepiride group .


Serious adverse events were reported in @ ( @ % ) patients in the empagliflozin group and @ ( @ % ) in the glimepiride group .


Confirmed hypoglycaemic adverse events ( plasma glucose @ mmol/L or requiring assistance ) at week @ were reported in @ ( @ % ) patients treated with empagliflozin and @ ( @ % ) patients treated with glimepiride .


Empagliflozin might be an effective and a well tolerated second-line treatment option for patients with type @ diabetes who have not achieved good glycaemic control on metformin .


Postprandial elevation of triglyceride-rich lipoproteins impairs endothelial function , which can initiate atherosclerosis .


We investigated the effects of bezafibrate on postprandial endothelial dysfunction and lipid profiles in patients with metabolic syndrome .


Ten patients with metabolic syndrome were treated with @ mg/day bezafibrate or untreated for @ weeks in a randomized crossover study .


Brachial artery flow-mediated dilation ( FMD ) and lipid profiles were assessed during fasting and after consumption of a standardized snack .


Serum triglyceride and cholesterol contents of lipoprotein fractions were analyzed by high-performance liquid chromatography .


Postprandial FMD decreased significantly and reached its lowest value @ h after the cookie test in both the bezafibrate and control groups , but the relative change in FMD from baseline to minimum in the bezafibrate group was significantly smaller than that in the control group ( -@ vs. -@ % , p = @ ) .


Bezafibrate significantly suppressed postprandial elevation of triglyceride ( incremental area under the curve ( AUC ) : @ vs. @ mg h/dl , p = @ ) and remnant lipoprotein cholesterol ( incremental AUC : @ vs. @ mg h/dl , p < @ ) .


High-performance liquid chromatography analysis revealed that postprandial triglyceride content of the chylomicron and very low-density lipoprotein fractions was significantly lower in the bezafibrate group than in the control group ( p < @ ) .


Bezafibrate significantly decreased postprandial endothelial dysfunction , and elevations of both exogenous and endogenous triglycerides in patients with metabolic syndrome , suggesting that bezafibrate may have vascular protective effects in these patients .


To compare the therapeutic efficacy of recombinant human brain natriuretic peptide and prostaglandin E@ in the treatment of pulmonary hypertension after mitral valve replacement .


Sixty patients with postoperative pulmonary hypertension were divided randomly into @ groups that received saline , prostaglandin E@ , and natriuretic peptide infusions for @ hours each .


The hemodynamics data were monitored consecutively , and the levels of thromboxane A@ and cyclic guanosine monophosphate were detected pretreatment , after treatment , and @ week after surgery .


The arterial pressure , pulmonary arterial pressure , and pulmonary capillary wedge pressure decreased @hour after prostaglandin E@ treatment and rebounded after treatment discontinuation .


The pulmonary arterial pressure and pulmonary capillary wedge pressure in the natriuretic peptide group decreased @ hours after treatment ; pulmonary arterial pressure decreased less than that of the prostaglandin group , and there was no evidence of hemodynamic rebound after treatment discontinuation .


The natriuretic peptide had no significant effects on arterial pressure .


In both the prostaglandin and natriuretic peptide groups , cyclic guanosine monophosphate increased after the treatment , which was even higher in the latter group .


Prostaglandin E@ could lead to the decrease of thromboxane A@ , which was not seen in the natriuretic peptide group .


Both brain natriuretic peptide and prostaglandin E@ can effectively reduce pulmonary hypertension ; however , natriuretic peptide has a slower and milder efficacy .


The effects of these @ drugs in reducing thepulmonary arterial pressure may be mediated through different pathways .


Anemia is a common complication among chronic kidney disease patients on hemodialysis , occurring mostly due to erythropoietin deficiency .


This randomized noninferiority trial sought to compare the efficacy and safety of a new epoetin formulation developed by Bio-Manguinhos , a biologics manufacturer affiliated with the Brazilian government , with those of a commercially available product currently used in Brazil ( a biosimilar epoetin formulation ) .


The sample size needed to enable demonstration of noninferiority with a statistical power of @ % for a between-group difference in hemoglobin levels of no more than @ g/dL was calculated .


In total , @ patients were randomly assigned to receive the epoetin formulation from Bio-Manguinhos ( n = @ ) or the biosimilar epoetin formulation ( n = @ ) in a double-blind fashion .


The inclusion criteria were current epoetin therapy and stable hemoglobin levels for at least @ months prior to the study .


The primary and secondary outcomes were mean monthly hemoglobin levels and safety , respectively .


The dose was calculated according to international criteria and adjusted monthly in both groups according to hemoglobin levels and at the assistant physicians ' discretion .


Iron storage was estimated at baseline and once monthly .


Clinicaltrials.gov : NCT@ .


The study was conducted for @ months after randomization .


The mean baseline hemoglobin levels were @ and @ g/dL ( p = @ ) in the Bio-Manguinhos epoetin and biosimilar epoetin groups , respectively .


During the study period , there was no significant change in hemoglobin levels in either group ( p = @ , ANOVA ) .


The epoetin from Bio-Manguinhos was slightly superior in the last @ months of follow-up .


The adverse event profiles of the two formulations were also similar .


The epoetin formulations tested in this study are equivalent in efficacy and safety .


This study aims to compare the effectiveness of desloratadine monotherapy and desloratadine plus montelukast combination therapy on quality of life in patients with persistent allergic rhinitis .


This study consists of @ patients ( @ females , @ males , mean age @ years ; range @ to @ years ) referred to ear , nose , and throat outpatient clinic between May @ and September @ .


A six-week randomized , double-blind , cross-sectional study was performed in two arms : In group @ , @ patients received desloratadine ( @ mg/d ) alone ; in group @ , @ patients received desloratadine ( @ mg ) plus montelukast ( @ mg ) combination therapy .


Quality of life was assessed on the day before starting treatment and on the last day of each treatment period using the Rhinoconjunctivitis Quality of Life Questionnaire and Nighttime Symptom Scores .


In group @ , the mean quality of life scores before and after treatment were @ and @ , respectively .


Desloratadine plus montelukast combination therapy may have a positive impact on quality of life , sleep symptoms in particular .


Our hypothesis was that deep anaesthesia , as estimated by a low target bispectral index ( BIS ) of @-@ , would result in less postoperative pain than that achieved at a conventional depth of anaesthesia .


We undertook a randomized double-blind controlled study at two tertiary teaching hospitals in New Zealand ( @-@ ) recruiting @ adult patients ASA I-II presenting for non-emergent surgery under general anaesthesia requiring tracheal intubation .


Anaesthesia was maintained with desflurane and a multimodal analgesia regimen comprising fentanyl infusion , i.v. paracetamol , and parecoxib .


Patients were randomly assigned to either a low BIS ( @-@ ) group or a high BIS ( @-@ ) group .


Desflurane concentrations were titrated to achieve these targets .


Postoperative pain was assessed by : the pain on awakening ( @-@ , verbal rating scale , VRS ( awake ) ) in the post-anaesthetic care unit ; pain on activity at @-@ h after operation ( VRS ( d@A ) ) ; and the rate of morphine patient-controlled analgesia ( PCA ) usage over the first @ h.


There was no statistically significant difference between the two groups for any of the pain scores .


The median -LSB- inter-quartile range ( IQR ) -RSB- VRS ( awake ) was @ ( @-@ ) for the low and @ ( @-@ ) for the high BIS groups ( P = @ ) .


The median ( IQR ) VRS ( d@A ) was @ ( @-@ ) for the low and @ ( @-@ @ ) for the high BIS groups ( P = @ ) .


The median PCA morphine consumption in the low BIS group was @ mg h ( -@ ) ( @-@ @ ) vs @ mg h ( -@ ) ( @-@ @ ) in the high BIS group ( P = @ ) .


We conclude that there is no clinically useful analgesic effect of a deep anaesthesia regimen .


Poor adherence to treatment diminishes its individual and public health benefit .


Financial incentives , provided on the condition of treatment attendance , could address this problem .


Injecting drug users are a high-risk group for hepatitis B virus ( HBV ) infection and transmission , but adherence to vaccination programmes is poor .


We aimed to assess whether contingency management delivered in routine clinical practice increased the completion of HBV vaccination in individuals receiving opioid substitution therapy .


In our cluster randomised controlled trial , we enrolled participants at @ National Health Service drug treatment services in the UK that provided opioid substitution therapy and nurse-led HBV vaccination with a super-accelerated schedule ( vaccination days @ , @ , and @ ) .


Clusters were randomly allocated @:@:@ to provide vaccination without incentive ( treatment as usual ) , with fixed value contingency management ( three @ vouchers ) , or escalating value contingency management ( @ , @ , and @ vouchers ) .


Both contingency management schedules rewarded on-time attendance at appointments .


The primary outcome was completion of clinically appropriate HBV vaccination within @ days .


We also did sensitivity analyses that examined vaccination completion with full adherence to appointment times and within a @ month window .


The trial is registered with Current Controlled Trials , number ISRCTN@ .


Between March @ , @ , and April @ , @ , we enrolled @ eligible participants .


Compared with six ( @ % ) of @ participants treated as usual , @ ( @ % ) of @ participants in the fixed value contingency management group met the primary outcome measure ( odds ratio @ , @ % CI @-@ ; p < @ ) , as did @ ( @ % ) of @ participants in the escalating value contingency management group ( @ , @-@ ; p < @ ) .


These differences remained significant with sensitivity analyses .


Modest financial incentives delivered in routine clinical practice significantly improve adherence to , and completion of , HBV vaccination programmes in patients receiving opioid substitution therapy .


Achievement of this improvement in routine clinical practice should now prompt actual implementation .


Drug treatment providers should employ contingency management to promote adherence to vaccination programmes .


The effectiveness of routine use of contingency management to achieve long-term behaviour change remains unknown .


To evaluate the effectiveness of a telephonic medication therapy management ( MTM ) service on reducing hospitalizations among home health patients .


Forty randomly selected , geographically diverse home health care centers in the United States .


Two-stage , randomized , controlled trial with @-day follow-up .


All Medicare - insured home health care patients were eligible to participate .


Twenty-eight consecutive patients within each care center were recruited and randomized to usual care or MTM intervention .


The MTM intervention consisted of the following : ( @ ) initial phone call by a pharmacy technician to verify active medications ; ( @ ) pharmacist-provided medication regimen review by telephone ; and ( @ ) follow-up pharmacist phone calls at day seven and as needed for @ days .


The primary outcome was @-day all-cause hospitalization .


Data were collected from in-home nursing assessments using the OASIS-C .


Multivariate logistic regression modeled the effect of the MTM intervention on the probability of hospitalization while adjusting for patients ' baseline risk of hospitalization , number of medications taken daily , and other OASIS-C data elements .


A total of @ patients ( intervention n = @ , control n = @ ) were block-randomized to the intervention or usual care .


There was no significant difference in the @-day probability of hospitalization between the MTM intervention and control groups ( Adjusted OR : @ , @ percent CI : @-@ @ , p = @ ) .


For patients within the lowest baseline risk quartile ( n = @ ) , the intervention group was three times more likely to remain out of the hospital at @ days ( Adjusted OR : @ , @ percent CI : @-@ @ , p = @ ) compared to the usual care group .


This MTM intervention may not be effective for all home health patients ; however , for those patients with the lowest-risk profile , the MTM intervention prevented patients from being hospitalized at @ days .


Regular paracetamol is the recommended first-line analgesic for acute low-back pain ; however , no high-quality evidence supports this recommendation .


We aimed to assess the efficacy of paracetamol taken regularly or as-needed to improve time to recovery from pain , compared with placebo , in patients with low-back pain .


We did a multicentre , double-dummy , randomised , placebo controlled trial across @ primary care centres in Sydney , Australia , from Nov @ , @ , to March @ , @ .


We randomly allocated patients with acute low-back pain in a @:@:@ ratio to receive up to @ weeks of regular doses of paracetamol ( three times per day ; equivalent to @ mg paracetamol per day ) , as-needed doses of paracetamol ( taken when needed for pain relief ; maximum @ mg paracetamol per day ) , or placebo .


Randomisation was done according to a centralised randomisation schedule prepared by a researcher who was not involved in patient recruitment or data collection .


Patients and staff at all sites were masked to treatment allocation .


All participants received best-evidence advice and were followed up for @ months .


The primary outcome was time until recovery from low-back pain , with recovery defined as a pain score of @ or @ ( on a @-@ pain scale ) sustained for @ consecutive days .


All data were analysed by intention to treat .


This study is registered with the Australian and New Zealand Clinical Trial Registry , number ACTN @ .


@ participants were assigned to the regular group ( @ analysed ) , @ were assigned to the as-needed group ( @ analysed ) , and @ were assigned to the placebo group ( @ analysed ) .


Median time to recovery was @ days ( @ % CI @-@ ) in the regular group , @ days ( @-@ ) in the as-needed group , and @ days ( @-@ ) in the placebo group ( regular vs placebo hazard ratio @ , @ % CI @-@ ; as-needed vs placebo @ , @-@ ; regular vs as-needed @ , @-@ ) .


We recorded no difference between treatment groups for time to recovery ( adjusted p = @ ) .


Adherence to regular tablets ( median tablets consumed per participant per day of maximum @ ; @ -LSB- IQR @-@ -RSB- in the regular group , @ -LSB- @-@ -RSB- in the as-needed group , and @ -LSB- @-@ -RSB- in the placebo group ) , and number of participants reporting adverse events ( @ -LSB- @ % -RSB- in the regular group , @ -LSB- @ % -RSB- in the as-needed group , and @ -LSB- @ % -RSB- in the placebo group ) were similar between groups .


Our findings suggest that regular or as-needed dosing with paracetamol does not affect recovery time compared with placebo in low-back pain , and question the universal endorsement of paracetamol in this patient group .


The aim of the present study was to investigate whether addition of transcutaneous electrical nerve stimulation ( TENS ) treatment improves the results of standard urotherapy in children with overactive bladder ( OAB ) symptoms .


Sixty-two children with symptoms of OAB and incontinence were included .


The children were randomized either to standard urotherapy treatment alone or a combination of standard urotherapy and TENS .


The effect variables were taken from a voiding-drinking diary : number of voiding , number of incontinence episodes , and maximum voided volume .


Both treatment groups had good treatment results , with no significant difference between the groups .


In the standard treatment group @/@ ( @ % ) were completely dry and @/@ ( @ % ) had a decrease in incontinence episodes , compared to @/@ ( @ % ) and @/@ ( @ % ) , respectively , in the standard + TENS group ( p = @ ) .


The number of voiding decreased in two-thirds of the patients in both groups .


However , maximal voided volume only increased in the standard treatment group .


Subjectively @ % and @ % considered themselves significantly improved or free of symptoms .


Previous treatment was registered in @/@ ( @ % ) .


All efficacy variables decreased in those with previous treatment , but with no difference between the standard and standard + TENS treatment groups .


The only difference noted was when comparing the children without previous treatment in the groups : a significantly higher proportion were completely dry in the TENS group ( @/@ -LSB- @ % -RSB- versus @/@ -LSB- @ % -RSB- , p = @ ) .


Our results showed no significant difference overall in treatment response to OAB symptoms between urotherapy only and urotherapy + TENS , whereas a tendency to difference was found in children without previous treatment .


Thus with good urotherapy support , TENS only seems to have marginal additional effects on OAB symptoms .


Pancreatic cancer is the sixth leading cause of cancer death with an increasing trend in China .


Dietary intake is believed to play an important role in pancreatic cancer carcinogenesis .


The aim of this paper was to evaluate associations between some dietary factors and risk of pancreatic cancer in a multi-centre case-control study conducted in China .


Cases ( n = @ ) were ascertained from four provincial cancer hospitals .


Controls ( n = @ ) were randomly selected from the family members of patients without pancreatic cancer in the same hospitals , @:@ matched to cases by gender , age and study center .


Data were collected with a questionnaire by personal interview .


Odds ratios ( OR ) and @ % confidence intervals ( @ % CI ) were estimated using conditional logistic regression .


Tea intake ( OR = @ ; @ % CI : @-@ @ ) was associated with a half reduction in risk of pancreatic cancer .


Reduced vegetable consumption ( P trend : @ ) was significant related to pancreatic cancer .


Although no significant association was found for meat and fruit , ORs were all above or below the reference group .


A protective effect was found for fruit ( OR = @ for consumption of @-@ times/week vs more than @ times/week ; @ % CI : @-@ @ ) .


A high intake of meat was associated to a higher risk of pancreatic cancer ( OR = @ for consumption of @-@ times / week vs. more than @ times / week ; @ % CI : @-@ @ ) .


The present study supports fruit consumption to reduce pancreatic cancer risk and indicates that high consumption of meat is related to an elevated risk .


Direct inverse relations with tea and vegetable intake were also confirmed .


Rapid treatment of acute coronary syndromes ( ACS ) is important ; causes of delay in emergency medical services care of ACS are poorly understood .


We performed an analysis of data from IMMEDIATE ( Immediate Myocardial Metabolic Enhancement during Initial Assessment and Treatment in Emergency Care ) , a randomized controlled trial of emergency medical services treatment of people with symptoms suggesting ACS , using hierarchical multiple regression of elapsed time .


Out-of-hospital ECGs were performed on @,@ adults calling @-@-@ ; @ had presumed ACS , @ of whom had ST-segment elevation myocardial infarction and underwent percutaneous coronary intervention .


Women , participants with diabetes mellitus , and participants without previous cardiovascular disease waited longer to call @-@-@ ( by @ minutes , P < @ ; @ minutes , P = @ ; and @ minutes , P = @ , respectively ) , compared with their counterparts .


Time from emergency medical services arrival to ECG was longer for women ( @ minutes ; P < @ ) , older individuals ( @ minutes ; P < @ ) , and those without a primary complaint of chest pain ( @ minutes ; P < @ ) .


On-scene times were longer for women ( @ minutes ; P < @ ) and older individuals ( @ minutes ; P < @ ) .


Older individuals and participants presenting on weekends and nights had longer door-to-balloon times ( by @ , @ , and @ minutes , respectively ; P < @ ) .


Women and older individuals had longer total times ( medical contact to balloon inflation : @ minutes , P = @ , and @ minutes , P < @ , respectively ; symptom onset to balloon inflation : @ minutes for women ; P = @ ) .


We found delays throughout ACS care , resulting in substantial differences in total times for women and older individuals .


These delays may impact outcomes ; a comprehensive approach to reduce delay is needed .


To evaluate and compare the efficacy and safety of Intranasal ( IN ) Dexmedetomidine , Midazolam and Ketamine in producing moderate sedation among uncooperative pediatric dental patients .


This randomized triple blind comparative study comprises of eighty four ASA grade I children of both sexes aged @-@ years , who were uncooperative and could not be managed by conventional behavior management techniques .


All the children were randomized to receive one of the four drug groups Dexmedetomidine @ microg / kg ( D@ ) , @ microg/kg ( D@ ) , Midazolam @ mg/kg ( M@ ) and Ketamine @ mg/kg ( K@ ) through IN route .


These drug groups were assessed for efficacy and safety by gauging overall success rate and by monitoring vital signs , respectively .


The onset of sedation was significantly rapid with M@ and K@ as compared to D@ and D@ ( p = < @ ) .


The overall success rate was highest in D@ ( @ % ) followed by D@ ( @ % ) , K@ ( @ % ) and M@ ( @ % ) , however , the difference among them was not statistically significant ( p = > @ ) .


Even though all the vital signs were within physiological limits , there was significant reduction in pulse rate ( PR ) ( p = < @ ) and systolic blood pressure ( SBP ) ( p = < @ ) among D@ and D@ as compared to M@ and K@ .


D@ , D@ and K@ produced greater intra - and post-operative analgesia as compared to M@ .


There were no significant adverse effects with any group .


Dexmedetomidine , Midazolam and Ketamine , all the three drugs evaluated in the present study can be used safely and effectively through IN route in uncooperative pediatric dental patients for producing moderate sedation .


There are no medications approved for treating cannabis dependence or withdrawal .


The cannabis extract nabiximols ( Sativex ) , developed as a multiple sclerosis treatment , offers a potential agonist medication for cannabis withdrawal .


To evaluate the safety and efficacy of nabiximols in treating cannabis withdrawal .


A @-site , double-blind randomized clinical inpatient trial with a @-day follow-up was conducted in New South Wales , Australia .


Participants included @ DSM-IV-TR cannabis-dependent treatment seekers .


A @-day regimen of nabiximols ( maximum daily dose , @ mg of @-tetrahydrocannabinol and @ mg of cannabidiol ) or placebo with standardized psychosocial interventions during a @-day admission .


Severity of cannabis withdrawal and cravings ( Cannabis Withdrawal Scale ) , retention in withdrawal treatment , and adverse events .


Secondary outcomes include postwithdrawal cannabis use , health outcomes , and psychosocial outcomes .


Nabiximols treatment significantly reduced the overall severity of cannabis withdrawal relative to placebo ( F@ ,@ = @ ; P = @ ) , including effects on withdrawal-related irritability , depression , and cannabis cravings .


Nabiximols had a more limited , but still positive , therapeutic benefit on sleep disturbance , anxiety , appetite loss , physical symptoms , and restlessness .


Nabiximols patients remained in treatment longer during medication use ( unadjusted hazard ratio , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) , with @ the number needed to treat to achieve successful retention in treatment .


Participants could not reliably differentiate between nabiximols and placebo treatment ( @ = @ ; P = @ ) , and those receiving nabiximols did not report greater intoxication ( F@ ,@ = @ ; P = @ ) .


The number ( F@ ,@ = @ ; P = @ ) and severity ( F@ ,@ = @ ; P = @ ) of adverse events did not differ significantly between groups .


Both groups showed reduced cannabis use at follow-up , with no advantage of nabiximols over placebo for self-reported cannabis use ( F@ ,@ = @ ; P = @ ) , cannabis-related problems ( F@ ,@ = @ ; P = @ ) , or cannabis dependence ( F@ ,@ < @ ; P = @ ) .


In a treatment-seeking cohort , nabiximols attenuated cannabis withdrawal symptoms and improved patient retention in treatment .


However , placebo was as effective as nabiximols in promoting long-term reductions in cannabis use following medication cessation .


The data support further evaluation of nabiximols for management of cannabis dependence and withdrawal in treatment-seeking populations .


According to the present evidences suggesting association between low testosterone level and prediction of reduced exercise capacity as well as poor clinical outcome in patients with heart failure , we sought to determine if testosterone therapy improves clinical and cardiovascular conditions as well as quality of life status in patients with stable chronic heart failure .


A total of @ male patients who suffered from congestive heart failure were recruited in a double-blind , placebo-controlled trial and randomized to receive an intramuscular ( gluteal ) long-acting androgen injection ( @mL of testosterone enanthate @mg/mL ) once every four weeks for @ weeks or receive intramuscular injections of saline ( @mL of @ % wt/vol NaCl ) with the same protocol .


The changes in body weight , hemodynamic parameters , and left ventricular dimensional echocardiographic indices were all comparable between the two groups .


Regarding changes in diastolic functional state and using Tei index , this parameter was significantly improved .


Unlike the group received placebo , those who received testosterone had a significant increasing trend in @-walk mean distance ( @MWD ) parameter within the study period ( P = @ ) .


The discrepancy in the trends of changes in @MWD between study groups remained significant after adjusting baseline variables ( mean square = @ , F index = @ , and P = @ ) .


Our study strengthens insights into the beneficial role of testosterone in improvement of functional capacity and quality of life in heart failure patients .


Cytopenias are the most common HIV-associated hematological abnormality .


Cytopenias have been associated with several factors including sex , race/ethnicity , geographical location and comorbidities such as tuberculosis , hepatitis B infection , fever and oral candidiasis .


Cytopenias become more prevalent as HIV progresses and are often fatal .


Data from resource-limited settings about the prevalence and correlates of cytopenia are limited .


Therefore we conducted this cross-sectional study to assess the prevalence and correlates of cytopenia among adult AIDS patients at initiation of HAART in Uganda .


@ HIV-infected subjects who were HAART-nave or on HAART for@months were enrolled into the Multivitamins , HAART and HIV/AIDS Trial .


Anemia was defined according to WHO guidelines as any hemoglobin concentration < @g/dl for non-pregnant females and < @g/dl for males .


Leucopenia and thrombocytopenia were defined using study site laboratory reference ranges for lack of generally accepted definitions for these @ cell lines as leucopenia if white blood cell count < @ cells/litre and thrombocytopenia if platelets < @ cells/litre for females and < @ cells/litre for males .


Univariate and bivariate analyses were done to describe the patient population and log-binomial regression was used to quantify the correlates of cytopenia .


Sixty five percent of the @ subjects had at least one form of cytopenia .


Anemia occurred in @ % , leucopenia in @ % , thrombocytopenia in @ % , bicytopenia in @ % and only @ had a pancytopenia .


Cytopenia was more prevalent in females ( prevalence ratio -LSB- PR -RSB- :@ , @ % confidence interval -LSB- CI -RSB- :@ -@ ) ; CD@ count category @ to < @ ( PR : @ , @ % CI : @ -@ ) and CD@ count category @ to < @ ( PR : @ , @ % CI : @ - @ ) compared to CD@ count category < @ ; normal BMI ( PR : @ , @ % CI :@ -@ ) and overweight BMI ( PR : @ , @ % CI :@ - @ ) compared to underweight BMI and those with a history or presence of oral candidiasis .


Cytopenias are a frequent complication in HIV-infected adults at initiation of HAART in Uganda .


The presence of any cytopenia was associated with female sex , decreasing CD@ count and decreasing body mass index .


Prospective studies in resource-limited settings on the trend in HIV-related cytopenias are needed .


Although balance is generally recognized to be an important feature in ensuring good performance in soccer , its link with functional performance remains mostly unexplored , especially in young athletes .


To investigate changes in balance induced by fatigue for unipedal and bipedal static stances in young soccer players .


Crossover study .


Biomechanics laboratory and outdoor soccer field .


Twenty-one male soccer players ( age = @ @ years , height = @ @ cm , mass = @ @ kg ) .


Static balance was assessed with postural-sway analysis in unipedal and bipedal upright stance before and after a fatigue protocol consisting of a repeated sprint ability ( RSA ) test ( @ @-m shuttle sprint interspersed with @ seconds of passive recovery , repeated @ times ) .


On the basis of the center-of-pressure ( COP ) time series acquired during the experimental tests , we measured sway area , COP path length , and COP maximum displacement and velocity in the anteroposterior and mediolateral directions .


Fatigue increased all sway values in bipedal stance and all values except COP velocity in the mediolateral direction in unipedal stance .


Fatigue index ( calculated on the basis of RSA performance ) was positively correlated with fatigue/rest sway ratio for COP path length and COP velocity in the anteroposterior and mediolateral directions for nondominant single-legged stance .


Fatigued players exhibited reduced performance of the postural-control system .


Participants with better performance in the RSA test appeared less affected by balance impairment , especially in single-legged stance .


We performed a proof of concept trial to evaluate relative safety and efficacy of Rhodiola rosea ( R. rosea ) versus sertraline for mild to moderate major depressive disorder .


We hypothesize that R. rosea would have similar therapeutic effects as sertraline but with less adverse events .


Phase II randomized placebo controlled clinical trial .


@ subjects were randomized to @ weeks of standardized R. rosea extract , sertraline , or placebo .


Changes over time in Hamilton Depression Rating ( HAM-D ) , Beck Depression Inventory ( BDI ) , and Clinical Global Impression Change ( CGI/C ) scores among groups were examined using mixed-effects models .


Modest , albeit statistically non-significant , reductions were observed for HAM-D , BDI , and CGI/C scores for all treatment conditions with no significant difference between groups ( p = @ , p = @ , and p = @ , respectively ) .


The decline in HAM-D scores was greater for sertraline ( -@ , @ % confidence interval -LSB- CI -RSB- , -@ to -@ ) versus R. rosea ( -@ , @ % CI : -@ to -@ ) and placebo ( -@ , @ % CI : -@ to -@ ) .


While the odds of improving ( versus placebo ) were greater for sertraline ( @ -LSB- @-@ @ -RSB- ; odds ratio -LSB- @ % CI -RSB- ) than R. rosea ( @ -LSB- @-@ @ -RSB- ) , more subjects on sertraline reported adverse events ( @ % ) than R. rosea ( @ % ) or placebo ( @ % ) ( p = @ ) .


Although R. rosea produced less antidepressant effect versus sertraline , it also resulted in significantly fewer adverse events and was better tolerated .


These findings suggest that R. rosea , although less effective than sertraline , may possess a more favorable risk to benefit ratio for individuals with mild to moderate depression .


Falls are common among older adults .


It is reported that approximately @ % of residents of aged care facilities fall each year .


This is a major cause of morbidity and mortality , and a significant burden for health care providers and the health system .


Among community dwelling older adults , exercise appears to be an effective countermeasure , but data are limited and inconsistent among studies in residents of aged care communities .


This trial has been designed to evaluate whether the SUNBEAM program ( Strength and Balance Exercise in Aged Care ) reduces falls in residents of aged care facilities .


Is the program more effective and cost-effective than usual care for the prevention of falls ?


Single-blinded , two group , cluster randomized trial .


@ residents , living in @ aged care facilities .


Progressive resistance and balance training under the guidance of a physiotherapist for @ months , then facility-guided maintenance training for @ months .


Usual care .


Number of falls , number of fallers , quality of life , mobility , balance , fear of falling , cognitive well-being , resource use , and cost-effectiveness .


Measurements will be taken at baseline , @ months , and @ months .


The number of falls will be analyzed using a Poisson mixed model .


A logistic mixed model will be used to analyze the number of residents who fall during the study period .


Intention-to-treat analysis will be used .


This study addresses a significant shortcoming in aged care research , and has potential to impact upon a substantial health care problem .


Outcomes will be used to inform care providers , and guide health care policies .


To evaluate the efficacy of early video-assisted thoracoscopic debridement in patients with the fibropurulent phase of parapneumonic empyema .


@ patients with parapneumonic empyema resistant to @ weeks of antibiotic therapy , were randomly divided into @ groups .


In group @ ( @ patients ) , antibiotic therapy and irrigation was continued , and in group @ ( @ patients ) , video-assisted thoracoscopic debridement was performed .


The @ groups were compared in terms of therapeutic results .


The male/female ratio was @/@ .


Group @ included @ men and @ women with a mean age of @ years , and mean hospital stay was @ days .


Group @ consisted of @ men and @ women with a mean age of @ years , and mean hospital stay was @ days .


Considering the therapeutic results , @ patients in group @ were cured by antibiotic therapy and irrigation , whereas @ required decortication and pleurectomy with thoracotomy .


In group @ , @ patients were cured by video-assisted thoracoscopic debridement , and @ underwent thoracotomy and decortication due to intraoperative bleeding .


A significant difference in therapeutic results was noted between the groups ( p = @ ) .


Video-assisted thoracoscopic debridement provides a high success rate and less invasive treatment for the early stages of empyema .


Dyspepsia is common among end-stage renal disease ( ESRD ) patients and its association with delayed gastric emptying is not well established .


We assessed the association of dyspepsia with gastric emptying time in ESRD patients undergoing hemodialysis ( HD ) .


Dyspepsia was assessed through the Porto Alegre Dyspeptic Symptoms Questionnaire ( PADYQ ) .


PADYQ 's scores @ classified participants as dyspeptic .


The octanoic acid breath test using carbon was employed to assess the gastric emptying time .


Based on the test , time in minutes to metabolize the first half of the carbon in the test meal ( t@/@ ) was calculated .


Association of dyspepsia with gastric emptying time was tested by the correlation between PADYQ scores and t@/@ , and also by comparing t@/@ between dyspeptics and non-dyspeptics .


There were @ ( @ % ) dyspeptic patients .


Dyspepsia score was positively correlated with t@/@ ( r = @ ; p = @ ) .


Dyspeptics had longer t@/@ compared to non-dyspeptics , respectively , @ @ versus @ @ minutes ( p = @ ) .


Delayed gastric emptying was associated with dyspepsia .


Prokinetic medications could have a role in preventing or relieving dyspeptic symptoms among HD patients .


Future research in larger samples is necessary to confirm this association .


To observe the clinical efficacy of Busuishengxue granules on non-severe aplastic anemia ( NSAA ) and investigate its effect on the mitogen-activated protein kinase/extracellular signal-regulated kinase ( MAPK/ERK ) pathway .


Sixty NSAA patients were divided equally into two groups .


Subjects in the experimental group were treated with Busuishengxue granules , and the control group with Zaizaoshengxue tablets .


The treatment course was @ months and curative efficacy was compared between the two groups as well as with @ healthy individuals .


Flow cytometry ( FCM ) was used to detect the intracellular concentration of Ca@ + ( -LSB- Ca@ + -RSB- i ) .


Western blotting was employed to detect the expression of enzymes in the MAPK/ERK pathway .


The efficacy of Busuishengxue granules was significantly better than that of Zaizaoshengxue tablets ( P < @ ) .


Before treatment , expression of JNK , phospho-ERK @/@ and p-JNK was higher , and -LSB- Ca@ + -RSB- i higher , than that of the control group ( P < @ ) .


After treatment with Busuishengxue granules , expression of all enzymes related to signal transduction pathways in the blood cells of NSSA patients were altered to different degrees .


Busuishengxue granules had a better effect with regard to improving symptom scores , increasing the number of blood leukocytes , and increasing hemoglobin levels than Zaizaosh-engxue tablets , and they differed slightly in terms of increasing the number of platelets .


Manual wheelchairs ( MWCs ) can improve mobility and social participation for individuals who experience difficulty walking ; however , older adults receive little training for wheelchair use .


The Wheelchair Self-Efficacy Enhanced for Use ( WheelSeeU ) research program provides peer-led training that may positively influence wheelchair use while reducing clinician burden .


The purpose of this study is to evaluate the feasibility and clinical outcomes of WheelSeeU .


A randomized control trial ( RCT ) recruits and randomly assigns @ MWC users ( @ + years ) .


Feasibility indicators assessing process , resource , management , and treatment issues are measured , and clinical outcomes ( wheelchair skills , safety , confidence , mobility , social participation , quality of life , health utility ) are collected at three time points .


WheelSeeU provides an innovative approach for teaching wheelchair skills to an aging population that may improve wheelchair use and decrease clinician burden .


Since RCTs are expensive and challenging in rehabilitation , establishing feasibility prior to larger effectiveness trials is prudent .


Screening for Barrett 's esophagus ( BE ) and adenocarcinoma ( EAC ) is controversial , but interest remains in finding the optimal method .


Attitudes on screening within the community are unknown .


We aimed to assess these attitudes via a survey .


A mixed-mode survey was conducted in adults > @ years to assess awareness regarding BE , willingness to participate in screening , and preferences regarding method of screening .


Methods evaluated were sedated endoscopy ( sEGD ) , unsedated transnasal endoscopy ( uTNE ) and video capsule ( VCE ) .


A total of @ from @ ( @ % ) adults responded -LSB- @ % males , mean ( SD ) age @ ( @ ) years -RSB- , and @ % of responders knew of BE at baseline .


After reading the information on BE , @ % were interested in screening .


A history of undergoing screening tests and GI symptoms were predictive of interest .


Unsedated techniques were preferred by @ % ( VCE : @ % and uTNE : @ % ) versus sEGD ( @ % ) .


The majority of adults were willing to undergo screening for BE/EAC , with a preference for unsedated techniques .


Nitric oxide donors , such as isosorbide dinitrate ointment ( ISDN ) , are considered as first-choice agents in the treatment of chronic anal fissure .


Injection with botulinum toxin A in the internal anal sphincter is often used as a second-line therapy , although it may give better results and fewer side effects than nitric oxide donors .


The aim of this randomized clinical trial was to investigate whether botulinum toxin A ( Dysport ) is more effective than ISDN in the primary treatment of chronic anal fissure .


From April @ until October @ , @ patients ( @ men ) with a median age of @ ( @-@ ) years were randomized to receive either ISDN @ mg/ml ( @ % ) ( n = @ ) or injection with @ units of Dysport ( n = @ ) .


The primary end-point was the percentage of complete fissure healing after @ weeks .


After a median of @ weeks complete fissure healing was noted in @ of @ patients in the Dysport group and in @ of @ patients in the ISDN group ( P = @ ) .


Absolute improvement of pain scores after @ weeks was similar in both groups ( P = @ ) .


Patients treated with Dysport had fewer side effects than patients treated with ISDN ( P = @ ) .


Of the patients with a healed fissure , @ % of the Dysport group and @ % of the ISDN group had a recurrence within @ year ( P = @ ; hazard ratio @ ; @ % CI = @-@ @ ) .


Dysport is more effective than ISDN ointment and has fewer side effects in the primary treatment of chronic anal fissure .


The recurrence rate within @ year in both treatment groups is high .


The authors prospectively assessed anxiety , depression , and behavior in children with standard-risk acute lymphoblastic leukemia ( SR-ALL ) during the first year of therapy and identified associated risk factors .


A cohort study was performed of @ children ( aged @ years-@ @ years ) with SR-ALL who were enrolled on Children 's Oncology Group protocol AALL@ at @ sites .


Parents completed the Behavior Assessment System for Children , the General Functioning Scale of the Family Assessment Device , and the Coping Health Inventory for Parents at approximately @ , @ , and @ months after diagnosis .


Overall , mean scores for anxiety , depression , aggression , and hyperactivity were similar to population norms .


However , more children scored in the at-risk/clinical range for depression than the expected @ % at @ month ( @ % ; P = @ ) , @ months ( @ % ; P < @ ) , and @ months ( @ % ; P = @ ) .


For anxiety , more children scored in the at-risk/clinical range at @ month ( @ % vs @ % ; P = @ ) , but then reverted to expected levels .


On adjusted analysis , unhealthy family functioning was found to be predictive of anxiety ( odds ratio -LSB- OR -RSB- , @ ; P = @ ) and depression ( OR , @ ; P = @ ) .


Hispanic ethnicity was associated with anxiety ( OR , @ ; P = @ ) .


Worse physical functioning ( P = @ ) , unmarried parents ( P = @ ) , and less reliance on social support ( P = @ ) were found to be associated with depression .


Emotional distress at @ month predicted anxiety ( OR , @ ; P = @ ) and depression ( OR , @ ; P = @ ) at @ months .


Anxiety is a significant problem in a subpopulation of patients with SR-ALL immediately after diagnosis , whereas depression remains a significant problem for at least @ year .


Children of Hispanic ethnicity or those with unhealthy family functioning may be particularly vulnerable .


These data suggest that clinicians should screen for anxiety and depression throughout the first year of therapy .


In a multicenter , prospectively randomized study we evaluated the @-year outcomes of bacillus Calmette-Gurin alone compared to a combination of epirubicin and interferon-@b in the treatment of patients with T@ bladder cancer .


Transurethral resection was followed by a second resection and bladder mapping .


Stratification was for grade and carcinoma in situ .


Followup entailed regular cystoscopy and cytology during the first @ years .


The end points assessed in this analysis were recurrence-free survival , time to treatment failure and progression , cancer specific survival and prognostic factors .


The study recruited @ eligible patients .


The @-year recurrence-free survival rate was @ % in the combination arm and @ % in the bacillus Calmette-Gurin arm ( p = @ ) .


The corresponding rates for the other end points were not significantly different , as free of progression @ % and @ % , treatment failure @ % and @ % , and cancer specific survival @ % and @ % , respectively .


The type of treatment , tumor size and tumor status at second resection were independent variables associated with recurrence .


Concomitant carcinoma in situ was not predictive of failure of bacillus Calmette-Gurin therapy .


An independent factor for treatment failure was remaining T@ stage at second resection .


Bacillus Calmette-Gurin was more effective than the tested combination therapy .


The currently recommended management with second resection and @-week maintenance bacillus Calmette-Gurin entails a low risk of cancer specific death .


More aggressive treatment in patients with infiltrative tumors at second resection might improve these results .


In particular , concomitant carcinoma in situ was not a predictive factor for poor outcome after bacillus Calmette-Gurin therapy .


The Le Fort I osteotomy ( L-I ) requires extensive dissection and manipulation of tissue , causing hemodynamic instability and an undesirable postoperative stress response .


This study aimed to clarify the most effective dose of remifentanil during L-I .


This study was designed as a prospective , randomized , controlled double-blinded study .


Patients ( American Society of Anesthesiologists physical status I to II ) undergoing L-I were randomly assigned to receive anesthesia with propofol and remifentanil under @ remifentanil dose conditions : @ g/kg/minute ( group @ ) , @ g/kg/minute ( group @ ) , and @ g/kg/minute ( group @ ) .


All patients underwent L-I with propofol and remifentanil target-controlled anesthesia .


The study endpoints were mean arterial pressure ( MAP ) and heart rate .


Data were recorded before L-I ( @-minute period before surgery ) , during L-I ( from the beginning of surgery to downfracture ) , and after L-I ( @-minute period after downfracture ) .


Average age , gender , average body mass index , aimed maxillary position , average bispectral index , average surgery time , and average blood loss also were examined .


Data were analyzed using the Bartlett test and then @-way analysis of variance with the Bonferroni multiple comparison test .


Data were obtained from @ patients ( @ men , @ women ) .


The average operating times for groups @ , @ , and @ were @ , @ , and @minutes , respectively .


The age range was @ to @years ( average , @ yr ) .


The rate of MAP increase from before to during L-I in group @ was @ % ( n = @ ) .


Group @ showed a significantly lower rate of MAP increase during and after L-I compared with group @ ( P < @ ) .


Remifentanil administration at @ g/kg/minute stabilized hemodynamics during L-I without major side effects .


Results indicated that the standard index of remifentanil administration during L-I should be @ g/kg/minute when using oxygen , propofol , and remifentanil for general anesthesia .


The clamshell incision ( CI ) offers a better exposure than the left anterolateral thoracotomy ( LAT ) as a resuscitative thoracotomy .


Most surgeons will have to manage a heart wound only once or twice in their career .


The patient 's survival depends on how fast the surgeon can control the heart wound ; however , it is unclear which of the two incisions allows for faster control in the hands of inexperienced surgeons .


The aim of this study was to compare the time needed to access and control a standardized stab wound to the right ventricle , by inexperienced surgical trainees , by LAT or CI ; we hypothesized that the CI does not take longer than the LAT .


Sixteen residents were shown a video on how to perform both procedures .


They were randomly assigned to control a standardized stab wound of the right ventricle on perfused human cadavers by LAT ( n = @ ) or CI ( n = @ ) .


Access time ( skin to maximal exposure ) , control time ( maximal exposure until control of the heart wound ) and total time ( the sum of access and control times ) were recorded .


Total time was @ min -LSB- @-@ @ -RSB- ( median -LSB- interquartile range -RSB- ) for LAT and @ min -LSB- @-@ @ -RSB- for CI ( p = @ ) .


Access time was @ min -LSB- @-@ @ -RSB- for LAT and @ min -LSB- @-@ @ -RSB- for CI ( p = @ ) .


Control time was @ min -LSB- @-@ @ -RSB- for LAT and @ min -LSB- @-@ @ -RSB- for CI ( p = @ ) .


The time needed from skin incision until cardiac wound control via CI was not longer than via LAT and the easier control of the cardiac wound when using CI was confirmed .


The number of total knee replacements performed each year is increasing .


Among the main impediments to functional recovery after these surgeries include postoperative edema , pain , lower limb muscle strength deficits , all of which point to a need to identify safe , effective postoperative rehabilitation modalities .


The aim of this paper was to evaluate the effectiveness of Kinesio Taping ( KT ) method in reducing postoperative pain , edema , and improved knee range of motion recovery after total knee replacement ( TKR ) operation in early postoperative rehabilitation period .


Randomized clinical trial .


Inpatient rehabilitation facility .


Ninety-four patients , who underwent primary TKR surgery .


Using simple randomization , participants were divided into KT group and control group .


Both groups received same rehabilitation program and procedures after surgery , except KT group also received KT applications throughout all rehabilitation period .


Postoperative pain , edema , restoration of the operated knee flexion and extension were evaluated .


The chosen level of significance was P < @ ; in evaluation power of the test @ .


Groups were homogenous to sex , age , BMI , comorbidities , preoperative knee flexion/extension impairment , preoperative pain intensity , anaesthesia , prosthesis implanted ( P > @ ) .


In both groups postoperative pain decreased significantly during rehabilitation period , however less pain was found in KT group from the second postoperative week till the end of inpatient rehabilitation ( @th postoperative day ) ( P < @ ; @ ) .


Postoperative edema was less intense and subsided more quickly in KT group as well ( P < @ ; @ ) .


No difference was found in improvement of knee flexion ( P > @ ) .


Operated knee extension was found better in KT group then in control at the end of in-patient rehabilitation ( P < @ ; @ ) .


KT was well tolerated by patients .


KT technique appeared to be beneficial for reducing postoperative pain , edema , improving knee extension in early postoperative rehabilitation period .


This finding implies for health care professionals working in the field of physical medicine and rehabilitation that Kinesio Taping method is safe and can be used as additional rehabilitation means for patients after TKR .


A pair of simulated driving experiments studied the effects of cognitive load on drivers ' lane-keeping performance .


Cognitive load while driving often reduces the variability of lane position .


However , there is no agreement as to whether this effect should be interpreted as a performance loss , consistent with other effects of distraction on driving , or as an anomalous performance gain .


Participants in a high-fidelity driving simulator performed a lane-keeping task in lateral wind , with instructions to keep a steady lane position .


Under high load conditions , participants performed a concurrent working memory task with auditory stimuli .


Cross-spectral analysis measured the relationship between wind force and steering inputs .


Cognitive load reduced the variability of lane position and increased the coupling between steering wheel position and crosswind strength .


Although cognitive load disrupts driver performance in a variety of ways , it produces a performance gain in lane keeping.This effect appears to reflect drivers ' efforts to protect lateral control against the risk of distraction , at the apparent neglect of other elements of driving performance .


Results may inform educational efforts to help drivers understand the risks of distraction and the inadequacies of compensatory driving strategies .


Setting a target quit date ( TQD ) is often an important component in smoking cessation treatment , but ambiguity remains concerning the optimal timing ( ie , quitting spontaneously versus delaying to prepare ) .


We examined four questions about the timing of TQDs and smoking outcomes in secondary analyses of The iQUITT Study , a randomized trial of Internet and telephone treatment for cessation : ( @ ) What are the characteristics of TQDs set using an online interactive quit date tool ?


, ( @ ) What are the characteristics of individuals who use a quit date tool and do they differ from those who do not ?


, ( @ ) Are there differences in smoker characteristics , treatment utilization , and cessation outcomes based TQD timing ?


, and ( @ ) Is maintenance of an initial TQD predictive of abstinence or do changes to TQDs lead to cessation ?


A total of @ adult current cigarette smokers were randomized to enhanced Internet or enhanced Internet plus telephone counseling .


Latency to TQD in days was calculated as the date difference between the initial TQD and enhanced Internet registration ; prospective TQD setters were stratified into four latency groups ( @ , @-@ , @-@ , @ + days ) .


Baseline variables , website utilization , and @-month cessation outcomes were examined between prospective TQD groups .


Desire and confidence to quit , number of TQDs , and website logins were tested as predictors of @-day point prevalence abstinence ( ppa ) at @ months ( responder-only analyses ) .


Classification and regression tree ( CART ) analysis explored interactions among baseline variables , website utilization , and latency to TQD as predictors of @-day ppa .


There were few baseline differences between individuals who used the quit date tool and those who did not .


Prospective TQDs were set as follows : registration day was @ % ( @/@ ) , @-@ days was @ % ( @/@ ) , @-@ days was @ % ( @/@ ) , and @ + days was @ % ( @/@ ) .


Participants with a TQD within @ weeks had higher baseline self-efficacy scores but did not differ on smoking variables .


Individuals whose TQD was the same day as registration had the highest logins , page views , number of TQDs set using the tool , and messages sent to other members .


Logistic regression revealed a significant interaction between number of TQDs and website logins for @-day ppa ( P = @ ) .


Among those with high logins , @ % ( @/@ ) with @ TQD were abstinent versus @ % ( @/@ ) with @ + TQDs .


Logins and self-efficacy predicted @-day ppa in the CART model .


TQD timing did not predict cessation outcomes in standard or exploratory analyses .


Self-efficacy and an apparent commitment to an initial TQD were the components most highly related to abstinence but only via interactions with website utilization .


Findings highlight the importance of feeling efficacious about handling specific smoking situations and engaging with treatment .


Additional research focused on increasing engagement in Web-based cessation studies is needed .


To compare the effectiveness and patient preference of different routes of misoprostol administration before operative hysteroscopy in premenopausal women .


Randomized , controlled trial .


University hospital .


One hundred sixty women undergoing operative hysteroscopy .


Patients were randomly assigned to receive @ g misoprostol orally ( n = @ ) , sublingually ( n = @ ) , or vaginally ( n = @ ) before operative hysteroscopy ; the control group ( n = @ ) did not receive any cervical priming agent .


Preoperative cervical width , adverse effects , and patient preference .


The mean ( SD ) cervical widths for the oral , sublingual , vaginal , and control groups were @ mm , @ mm , @ mm , and @ mm , respectively , which was statistically significant .


Time to cervical dilatation was also significantly longer in the control group than in the other three groups .


Misoprostol-related adverse effects and hysteroscopy-related complications were comparable among the four study groups .


Of all @ subjects , @ ( @ % ) preferred the oral route for misoprostol administration to the sublingual or vaginal routes , or had no preference .


All orally , sublingually , and vaginally administrated misoprostol is equally effective in inducing proper cervical priming before operative hysteroscopy .


Considering patient preference , oral administration may be the optimal route for misoprostol administration .


To evaluate and determine the effectiveness of surgical excision , aspiration and injection in the treatment of symptomatic ganglions .


The prospective randomized control trial based on non-probability convenience sampling was conducted at the Department of Surgery , Combined Military Hospital , Sialkot , from June @ to August @ , and at the Department of Surgery , Islam Teaching Hospital , Sialkot , from September @ to December @ .


The last patient was included in June @ .


Adult patients referred by general practitioners with ganglia of wrist , ankle and knee were included .


All the patients were offered treatment options of intralesional steroid injection or excision of ganglion.The study population was distributed in two groups : Group I opted for aspiration and injection treatment , while Group II went for surgical treatment .


A minimum follow-up of six months was mandatory for inclusion in the study .


Data was compared and analyzed using SPSS version @ .


The study had @ patients with @ ganglia .


Group I had @ ( @ % ) patients , while Group II had @ ( @ % ) .


In the short term , @ ( @ % ) of the patients achieved complete resolution after one episode of aspiration and injection , and success rate after second injection repeated after @ weeks was @ ( @ % ) .


Overall success rate of aspiration and injection of Triamcinolone acetonide six months after the treatment was @ ( @ % ) .


On the surgical side the success rate was @ ( @ % ) .


Complications like pain , joint stiffness and ugly scar were few and not significant .


Comparison of failure rates of the two groups ( @ % vs @ % ) showed significant difference ( p < @ ) .


In symptomatic ganglia , surgical excision was a better treatment option as the failure rate was less compared to injection-aspiration .


The injection treatment should be offered to those who are not willing for surgery , but they should be properly counselled about the chances of failure .


Parkinson 's disease is a common movement disorder affecting approximately @,@ people in the UK , with an estimated two thirds having speech-related problems .


Currently there is no preferred approach to speech and language therapy within the NHS and there is little evidence for the effectiveness of standard NHS therapy or Lee Silverman voice treatment .


This trial aims to investigate the feasibility and acceptability of randomizing people with Parkinson 's disease-related speech or voice problems to Lee Silverman voice treatment or standard speech and language therapy compared to a no-intervention control .


The PD COMM pilot is a three arm , assessor-blinded , randomized controlled trial .


Randomization will be computer-generated with participants randomized at a ratio of @:@:@ .


Participants randomized to intervention arms will be immediately referred to the appropriate speech and language therapist .


The target population are patients with a confirmed diagnosis of idiopathic Parkinson 's disease who have problems with their speech or voice .


The Lee Silverman voice treatment intervention group will receive the standard regime of @ sessions between @ and @minutes in length over four weeks , with extra home practice .


The standard speech and language therapy intervention group will receive a dose determined by patients ' individual needs , but not exceeding eight weeks of treatment .


The control group will receive standard care with no speech and language therapy input for at least six months post-randomization .


Outcomes will be assessed at baseline ( pre-randomization ) and post - randomization at three , six , and @months .


The outcome measures include patient-reported voice measures , quality of life , resource use , and assessor-rated speech recordings .


The recruitment aim is at least @ participants over @months from @ sites , equating to at least @ participants in each arm of the trial .


This trial is ongoing and recruitment commenced in May @ .


This study will provide information on the feasibility and acceptability of randomizing participants to different speech and language therapies or control/deferred treatment .


The findings relating to recruitment , treatment compliance , outcome measures , and effect size will inform a future phase III randomized controlled trial .


To compare the effects of neuromuscular exercise ( NEXA ) and quadriceps strengthening ( QS ) on the knee adduction moment ( an indicator of mediolateral distribution of knee load ) , pain , and physical function in patients with medial knee joint osteoarthritis ( OA ) and varus malalignment .


One hundred patients with medial knee pain , mostly moderate-to-severe radiographic medial knee OA , and varus malalignment were randomly allocated to one of two @-week exercise programs .


Each program involved @ individually supervised exercise sessions with a physiotherapist plus a home exercise component .


Primary outcomes were peak external knee adduction moment ( @-dimensional gait analysis ) , pain ( visual analog scale ) , and self-reported physical function ( Western Ontario and McMaster Universities Osteoarthritis Index ) .


Eighty-two patients ( @ -LSB- @ % -RSB- of @ in the NEXA group and @ -LSB- @ % -RSB- of @ in the QS group ) completed the trial .


There was no significant between-group difference in the change in the peak knee adduction moment ( mean difference @ Nm / -LSB- body weight height -RSB- % -LSB- @ % confidence interval ( @ % CI ) -@ , @ -RSB- ) , pain ( mean difference @ mm -LSB- @ % CI -@ , @ -RSB- ) , or physical function ( mean difference -@ units -LSB- @ % CI -@ , @ -RSB- ) .


Neither group showed a change in knee moments following exercise , whereas both groups showed similar significant reductions in pain and improvement in physical function .


Although comparable improvements in clinical outcomes were observed with both neuromuscular and quadriceps strengthening exercise in patients with moderate varus malalignment and mostly moderate-to-severe medial knee OA , these forms of exercise did not affect the knee adduction moment , a key predictor of structural disease progression .


The purpose of this study was to evaluate the advantages of exenatide treatment on obesity and non-alcoholic fatty liver disease ( NAFLD ) with elevated liver enzymes in patients with type @ diabetes ( T@D ) .


A total of @ newly diagnosed patients with obesity , NAFLD with elevated liver enzymes and T@D were included in the study .


The patients were randomly divided into two groups .


The exenatide treatment group ( n = @ ) were treated with exenatide and insulin glargine , and the intensive insulin therapy group ( n = @ ) were treated with insulin aspart and insulin glargine for @weeks .


Selected clinical characteristics were determined , and ultrasonography was performed at both baseline and @weeks following treatment .


At baseline , the clinical characteristics were matched between the two groups .


After @weeks , fasting blood glucose ( FBG ) , postprandial blood glucose ( PBG ) , glycosylated haemoglobin ( HbA@c ) , total cholesterol ( TC ) , triglyceride ( TG ) and total bilirubin levels were significantly decreased in the two groups ( p < @ ) .


Body weight and waist circumference were significantly decreased in the exenatide group but increased in the intensive insulin group ( p < @ ) .


The levels of alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) and - glutamyl transpeptidase ( GGT ) in the exenatide group were significantly lower than in the intensive insulin group ( p < @ ) .


The mean body weight change correlated with the levels of ALT , AST and GGT change ( ALT , r = @ ; AST , r = @ ; GGT , r = @ ; p < @ ) .


Moreover , the reversal rate of fatty liver was significantly higher in the exenatide group ( @ % ) than the intensive insulin group ( @ % ) ( p < @ ) .


Exenatide has a better hepatic-protective effect than intensive insulin therapy and perhaps represents a unique option for adjunctive therapy for patients with obesity , non-alcoholic fatty liver disease with elevated liver enzymes and T@D .


This study sought to determine the frequency and impact of coronary calcification among patients undergoing percutaneous coronary intervention ( PCI ) for acute coronary syndromes ( ACS ) .


Small studies in patients with stable coronary artery disease have suggested a worse prognosis after PCI of calcified compared with noncalcified lesions .


Little is known about the impact of coronary calcification on outcomes after PCI for patients presenting with non-ST-segment elevation and ST-segment elevation ACS .


Data from @,@ patients presenting with ACS in whom PCI was performed were pooled from @ large-scale randomized , controlled trials , ACUITY ( Acute Catheterization and Urgent Intervention Triage Strategy ) and HORIZONS-AMI ( Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction ) .


One-year outcomes were analyzed according to the severity of PCI target lesion calcification ( none/mild , moderate , or severe ) as assessed by an independent angiographic core laboratory .


Target lesion calcification was severe in @ patients ( @ % ) , moderate in @,@ ( @ % ) , and none/mild in @,@ ( @ % ) .


Moderate/severe target lesion calcification was more frequent in older patients , men , hypertensive patients , and those presenting with ST-segment elevation myocardial infarction ( STEMI ) .


The unadjusted @-year rates of death , cardiac death , definite stent thrombosis , and ischemic target lesion revascularization ( TLR ) and target vessel revascularization were significantly increased in patients with moderate/severe target lesion calcification .


By multivariable analysis , the presence of moderate/severe target lesion calcification was an independent predictor of @-year definite stent thrombosis ( hazard ratio -LSB- HR -RSB- : @ ; @ % confidence interval -LSB- CI -RSB- : @ to @ ; p = @ ) and ischemic TLR ( HR :@ ; @ % CI : @ to @ ; p = @ ) .


Moderate/severe lesion calcification was relatively frequent in patients with non-ST-segment elevation ACS and STEMI and was strongly predictive of stent thrombosis and ischemic TLR at @ year .


( Comparison of Angiomax Versus Heparin in Acute Coronary Syndromes -LSB- ACS -RSB- ; NCT@ ; Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction ; NCT@ ) .


The potential epidemiological impact of isoniazid preventive therapy ( IPT ) , delivered at levels that could be feasibly scaled up among people living with HIV ( PLHIV ) in modern , moderate-burden settings , remains uncertain .


We used routine surveillance and implementation data from a cluster-randomized trial of IPT among HIV-infected clinic patients with good access to antiretroviral therapy in Rio de Janeiro , Brazil , to populate a parsimonious transmission model of tuberculosis ( TB ) / HIV .


We modeled IPT delivery as a constant process capturing a proportion of the eligible population every year .


We projected feasible reductions in TB incidence and mortality in the general population and among PLHIV specifically at the end of @ years after implementing an IPT program .


Data on time to IPT fit an exponential curve well , suggesting that IPT was delivered at a rate covering @ % ( @ % confidence interval : @ % to @ % ) of the @ eligible individuals each year .


By the end of year @ after modeled program rollout , IPT had reduced TB incidence by @ % -LSB- @ % uncertainty range ( UR ) : @ % to @ % -RSB- in the general population and by @ % ( @ % UR : @ % to @ % ) among PLHIV .


Corresponding reductions in TB mortality were @ % ( @ % UR : @ % to @ % ) and @ % ( @ % to @ % ) .


Results were robust to wide variations in parameter values on sensitivity analysis .


TB screening and IPT delivery can substantially reduce TB incidence and mortality among PLHIV in urban , moderate-burden settings .


In such settings , IPT can be an important component of a multi-faceted strategy to feasibly reduce the burden of TB in PLHIV .


To investigate in a randomized , double-blind design , cumulative effects of anodal tDCS on EEG oscillations and neuropsychological tests among patients with traumatic brain injury ( TBI ) undergoing subacute neurorehabilitation .


Twenty-six patients were randomly assigned to active ( n = @ ) or sham ( n = @ ) tDCS groups .


EEGs were recorded at @ different time points , assessing both immediate and cumulative effects of tDCS on EEG oscillations .


Twenty minute sessions of @mA anodal stimulation to the left dorsolateral prefrontal cortex ( F@ , cathode placed at right supraorbital site , Fp@ ) , were provided on @ consecutive days .


Neuropsychological tests were administered before and after the series of tDCS sessions .


Theta was significantly reduced for active tDCS patients following the first tDCS session .


Delta decreased and alpha increased , both significantly , for the active tDCS group after @ consecutive tDCS sessions .


No significant changes were seen for sham group .


Decreases in delta were significantly correlated with improved performance on neuropsychological tests for the active tDCS group to far greater degree than for the sham group .


Participants in the active tDCS group who had excess slow EEG activity in their initial recordings showed greater improvement on neuropsychological tests than other groups .


Results suggest that @ anodal tDCS sessions may beneficially modulate regulation of cortical excitability for patients with TBI .


EEG-guided tDCS warrants further investigation as a potential intervention for TBI during subacute neurorehabilitation .


This study aimed at assessing the effects of a self-regulation-based brief physical activity program for patients suffering from unexplained chronic fatigue , the `` @-STEPS to control your fatigue program '' .


A @-week randomized controlled trial was conducted .


Adult patients meeting the CDC criteria for idiopathic chronic fatigue were randomized to either the control condition ( standard care ) or the intervention condition ( @-STEPS ) .


The @-STEPS was based on self-regulation principles and consisted of motivational interviewing and self-regulation skills training .


All patients were assessed at baseline and post-treatment ( @ weeks ) for fatigue severity ( primary outcome ) and impact , physical activity ( leisure time physical activity , number of daily steps and personal activity goal progress ) , health-related quality of life , somatic distress and psychological distress ( depression and anxiety ) .


Ninety-one patients ( @ intervention and @ control patients ) received the allocated intervention .


At post-treatment , statistical analysis revealed a significant difference for subjective experience of fatigue ( @ points ; g = @ ) in favour of the intervention group .


Mixed design ANCOVAs showed a significant effect of the @-STEPS on fatigue severity , leisure time physical activity , personal activity goal progress and health-related quality of life .


No significant effects were found for number of daily steps and somatic and psychological distress .


The @-STEPS program has significant beneficial effects at post-treatment .


This brief self-regulation-based intervention looks promising for the management of unexplained chronic fatigue .


Patients undergoing coronary artery bypass grafting ( CABG ) are still at significant risk for postoperative major adverse cardiac and cerebrovascular events ( MACCEs ) .


Recent clinical evidence shows that cardioprotection in patients receiving a chronic statin treatment can be `` recaptured '' by a high-dose statin therapy given shortly before an ischemia-reperfusion sequence .


Evaluation of this novel therapeutic approach in the setting of CABG seems promising because myocardial ischemia-reperfusion injury plays a pivotal role in poor clinical outcomes that may be improved by a simple preoperative statin recapture treatment .


The investigator-initiated StaRT-CABG trial is a multicenter , randomized , double-blinded , @-parallel group controlled clinical study in @,@ patients .


The trial aims to evaluate whether a high-dose statin recapture therapy given shortly before CABG reduces the incidence of MACCE at @ days after surgery ( primary composite outcome : all-cause mortality , nonfatal myocardial infarction , and cerebrovascular events ) .


Consenting patients who are on chronic statin therapy before surgery will be randomized to receive either oral statin reloading therapy or matching placebo @ and @ hours before CABG .


Key secondary end points include enzymatic myocardial injury ; new-onset atrial fibrillation ; length of stay in the intensive care unit and hospital ; need for repeat coronary revascularization at @ days ; and , finally , all-cause mortality at @ months after surgery .


The StaRT-CABG trial is expected to provide highly relevant clinical data on the efficacy of this novel therapeutic approach to optimize the care for patients with coronary artery disease undergoing CABG .


Mumps , a communicable , acute and previously well-controlled disease , has had recent and occasional resurgences in some areas .


A randomized , double-blind , controlled and multistep phase I study of an F-genotype attenuated mumps vaccine produced in human diploid cells was conducted .


A total of @ subjects were enrolled and divided into @ age groups : @-@ years , @-@ years , @-@ years and @-@ months .


The groups were immunized with one injection per subject .


Three different doses of the F-genotype attenuated mumps vaccine , A ( @ @ logCCID@ ) , B ( @ @ logCCID@ ) and C ( @ @ logCCID@ ) , as well as a placebo control and a positive control of a licensed A-genotype vaccine ( S@ strain ) were used .


The safety and immunogenicity of this vaccine were compared with those of the controls .


The safety evaluation suggested that mild adverse reactions were observed in all groups .


No serious adverse event ( SAE ) was reported throughout the trial .


The immunogenicity test showed a similar seroconversion rate of the neutralizing and ELISA antibody in the @ - to @-year-old and @ - to @-month-old groups compared with the seroconversion rate in the positive control .


The GMT of the neutralizing anti-F-genotype virus antibodies in the vaccine groups was slightly higher than that in the positive control group .


The F-genotype attenuated mumps vaccine evaluated in this clinical trial was demonstrated to be safe and have effective immunogenicity vs. control .


This study addressed the problem of evaluating the effectiveness of two protocols of physiotherapy for functional recovery after stroke .


In particular , the study explored the use of Functional Principal Component Analysis ( FPCA ) , a multivariate data analysis in order to assess and clarify the process of regaining independence after stroke .


A randomized double-blind controlled trial was performed .


Thirteen subjects with residual hemiparesis after a single stroke episode were measured in both in - and outpatient settings at a district hospital .


All subjects were able to walk before suffering the stroke and were hemodynamically stable within the first week after stroke .


Control and target groups were treated with conventional physiotherapy for stroke , but specific techniques were added for treatment of the target group depending on patients ' functional levels.Independence level was assessed with the Barthel Index ( BI ) throughout @ evolution stages ( hemodynamic stability , beginning of standing , beginning of physical therapy sessions in the physiotherapy ward and monthly assessment for @ months after stroke ) .


FPCA was applied for data analysis .


Statistically significant differences were found in the dynamics of the recovery process between the two physiotherapy protocols .