One hour prior to their second visit , participants consumed three tablets of L-arginine or placebo .


Urea concentration was significantly lower at second measurement for both the study and control group .


The magnitude of the change was not significant between the groups .


pH was higher for both groups at second measurement , but only significant for the study group .


The magnitude of the change was significant between the groups .


Participants who intermittently ingested protein dietary supplements and those with a Body Mass Index ( BMI ) higher than @ had significantly higher basal urea concentration .


The results of this study did not confirm the hypothesis .


Further studies are needed to determine the effects of different doses of L-arginine supplements on the biochemical composition of saliva and the influence of their long-term consumption on the risk of developing dental diseases .


Several studies suggest that a healthy diet with high emphasis on nutritious , low-energy components such as fruits , vegetables , and seafood tends to be more costly for consumers .


Derived from the ideas from the New Nordic Cuisine -- and inspired by the Mediterranean diet , the New Nordic Diet ( NND ) has been developed as a palatable , healthy and sustainable diet based on products from the Nordic region .


The objective of the study is to investigate economic consequences for the consumers of the NND , compared with an Average Danish Diet ( ADD ) .


Combine quantity data from a randomized controlled ad libitum dietary @ month intervention for central obese adults ( @-@ years ) and market retail price data of the products consumed in the intervention .


Adjust consumed quantities to market price incentives using econometrically estimated price elasticities .


Average daily food expenditure of the ADD as represented in the unadjusted intervention ( ADD-i ) amounted to @ DKK for the participants .


The daily food expenditure in the unadjusted New Nordic Diet ( NND-i ) costs @ DKK per day per head , and is hence about @ % more expensive than the Average Danish Diet ( or about @ % when adjusting for energy content of the diet ) .


Adjusting for price incentives in a real market setting , the estimated cost of the Average Danish Diet is reduced by @ DKK ( ADD-m ) , compared to the unadjusted ADD-i diet , whereas the adjusted cost of the New Nordic Diet ( NND-m ) is reduced by about @ DKK , compared to the unadjusted NND-i .


The distribution of food cost is however much more heterogeneous among consumers within the NND than within the ADD .


On average , the New Nordic Diet is @-@ per cent more expensive than an Average Danish Diet at the current market prices in Denmark ( and @-@ per cent , when adjusting for energy content ) .


The relatively large heterogeneity in food costs in the NND suggests that it is possible to compose an NND where the cost exceeds that of ADD by less than the @-@ per cent .


To investigate the effectiveness of a @-month Liuzijue qigong ( LQG ) program in promoting physical and psychosocial function in individuals with chronic obstructive pulmonary disease ( COPD ) .


Single-blind , randomized controlled trial .


Seven hospital respiratory care centers in Beijing .


Individuals with COPD ( N = @ ; mean age @ @ , range @-@ ) .


Participants were randomly assigned to one of two groups : LQG ( n = @ ) and control ( n = @ ) .


Subjects in the LQG group received a LQG program consisting of four @-minute sessions each week and daily walking for @ minutes for @ months .


Control subjects walked daily for @ minutes .


Data collection was performed at baseline , at @ weeks , and at @ months .


Primary outcomes involved functional capacity , and secondary outcomes involved quality of life .


The LQG group had greater improvements in the @-minute walk test ( P = @ ) ; specific airway conductance ( P = @ ) ; monitored functional task evaluation ( P = @ ) ; Medical Outcomes Study @-item Short-Form Health Survey ( SF-@ ; general health ( P < @ ) , mental health ( P = @ ) ) ; Chronic Respiratory Questionnaire ( dyspnea ( P = @ ) , emotion ( P = @ ) , and mastery ( P = @ ) at @-month follow-up .


After @ months , the control group had significant improvement only on the SF-@ mental health ( P = @ ) .


LQG promoted functional capacity and quality of life in older adults with COPD at @ months and is a good alternative home exercise program for older adults in the rehabilitation of COPD .


Inflammation impairs cognitive performance and is implicated in the progression of neurodegenerative disorders .


Rodent studies demonstrated key roles for inflammatory mediators in many processes critical to memory , including long-term potentiation , synaptic plasticity , and neurogenesis .


They also demonstrated functional impairment of medial temporal lobe ( MTL ) structures by systemic inflammation .


However , human data to support this position are limited .


Sequential fluorodeoxyglucose positron emission tomography together with experimentally induced inflammation was used to investigate effects of a systemic inflammatory challenge on human MTL function .


Fluorodeoxyglucose positron emission tomography scanning was performed in @ healthy participants before and after typhoid vaccination and saline control injection .


After each scanning session , participants performed a virtual reality spatial memory task analogous to the Morris water maze and a mirror-tracing procedural memory control task .


Fluorodeoxyglucose positron emission tomography data demonstrated an acute reduction in human MTL glucose metabolism after inflammation .


The inflammatory challenge also selectively compromised human spatial , but not procedural , memory ; this effect that was independent of actions on motivation or psychomotor response .


Effects of inflammation on parahippocampal and rhinal glucose metabolism directly mediated actions of inflammation on spatial memory .


These data demonstrate acute sensitivity of human MTL to mild peripheral inflammation , giving rise to associated functional impairment in the form of reduced spatial memory performance .


Our findings suggest a mechanism for the observed epidemiologic link between inflammation and risk of age-related cognitive decline and progression of neurodegenerative disorders including Alzheimer 's disease .


Duration of bladder catheterisation after female genital fistula repair varies widely .


We aimed to establish whether @ day bladder catheterisation was non-inferior to @ days in terms of incidence of fistula repair breakdown in women with simple fistula .


In this randomised , controlled , open-label , non-inferiority trial , we enrolled patients at eight hospitals in the Democratic Republic of the Congo , Ethiopia , Guinea , Kenya , Niger , Nigeria , Sierra Leone , and Uganda .


Consenting patients were eligible if they had a simple fistula that was closed after surgery and remained closed @ days after surgery , understood study procedures and requirements , and agreed to return for follow-up @ months after surgery .


We excluded women if their fistula was not simple or was radiation-induced , associated with cancer , or due to lymphogranuloma venereum ; if they were pregnant ; or if they had multiple fistula .


A research assistant at each site randomly allocated participants @:@ ( randomly varying block sizes of @-@ ; stratified by country ) to @ day or @ day bladder catheterisation ( via a random allocation sequence computer generated centrally by WHO ) .


Outcome assessors were not masked to treatment assignment .


The primary outcome was fistula repair breakdown , on the basis of dye test results , any time between @ days after catheter removal and @ months after surgery .


The non-inferiority margin was @ % , assessed in the per-protocol population .


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


We randomly allocated @ participants between March @ , @ , and May @ , @ ; @ in the @ day group and @ in the @ day group .


In the per-protocol analysis , ten ( @ % ) of @ patients had repair breakdown in the @ day group ( @ % CI @-@ ) compared with eight ( @ % ) of @ ( @-@ ) in the @ day group ( risk difference @ % -LSB- @ % CI -@ to @ -RSB- ) , meeting the criteria for non-inferiority .


@ day bladder catheterisation after repair of simple fistula is non-inferior to @ day catheterisation and could be used for management of women after repair of simple fistula with no evidence of a significantly increased risk of repair breakdown , urinary retention , or residual incontinence up to @ months after surgery .


To compare the efficacy difference in treatment of borderline hypertension between acupuncture combined with anti-hypertensive plaster and simple acupuncture .


Sixty patients of borderline hypertension were randomized into an observation group and a control group , @ cases in each one .


In the observation group , acupuncture was applied to Fengchi ( GB @ ) , Taichong ( LR @ ) and the others , once a day , @ treatments made one session .


There were @ days at interval among the sessions .


Totally , @ sessions were required .


Additionally , in combination , the anti-hypertensive plaster was prepared with the fine powder of Chuanxiong ( ligusticum wallichii ) and Wuzhuyu ( fructus evodiae ) at @ and mixed with vinegar .


The plaster was applied to the umbilicus , once every two days , totally @ times were required .


In the control group , acupuncture was given simply .


The selected acupoints and operation were the same as the observation group .


Before and after treatment , blood pressure and syndrome score were observed and the short-term and long-term efficacies were assessed in the two groups .


After treatment , the systolic pressure and diastolic pressure were reduced as compared with those before treatment in the two groups ( all P < @ ) , and the differences were significant in comparison between the observation group and the control group ( P < @ , P < @ ) .


The syndrome score after treatment was reduced as compared with that before treatment in the two groups ( both P < @ ) and the difference was not significant in comparison between the two groups ( P > @ ) .


In follow-up of the effective cases and remarkably effective cases in @ months , the total effective rate in the observation group was @ % ( @/@ ) and was @ % ( @/@ ) in the control group , indicating the significant difference in comparison ( P < @ ) .


Acupuncture combined with anti-hypertensive plaster is the effective method in prevention and treatment of borderline hypertension .


Regarding the long-term efficacy , this combined therapy achieves the superior improvement in the symptoms and physical signs of the patients of borderline hypertension as compared with simple acupuncture .


Anticoagulation for the haemodialysis circuit in patients treated with oral anticoagulation poses additional haemorrhagic risk .


The few available data suggest that tapering or even stopping heparinization is feasible and the HeprAN membrane with grafted heparin was developed to decrease heparin dose .


The objective of our study was to evaluate the need for additional anticoagulation in patients on long-term oral anticoagulation , according to the type of membrane used .


This is a prospective , randomized , crossover bifactorial trial in haemodialysed patients on oral anticoagulation .


Each patient had four haemodialysis sessions with two different membranes -LSB- HeprAN or polysulphone ( PS ) -RSB- and with or without enoxaparin .


Clinical coagulation was evaluated by the need for premature ending and by a visual score ( Janssen scale ) .


Coagulation activation markers were also measured : d-dimers , prothrombin fragments @ + @ , thrombin-antithrombin complexes , tissue factor pathway inhibitor and platelet factor-@ .


Ten patients were included ( M/F = @/@ , mean age @ @ years ) .


None of the @ sessions ended prematurely .


The clotting scores were similar with or without enoxaparin ( dialyser : @ @ versus @ @ , P = @ ; bubble trap : @ @ versus @ @ , P = @ ) and with the polysulphone or the HeprAN membrane ( dialyser : @ @ versus @ @ , P = @ ; bubble trap : @ @ versus @ @ , P = @ ) .


There was no significant difference in coagulation activation markers between dialysis modalities ; however , dialysis efficacy was significantly greater with the PS membrane ( @ @ versus @ @ , P = @ ) .


These results suggest that haemodialysis without additional anticoagulation is possible in patients with oral anticoagulation .


The HeprAN membrane did not provide any additional benefit compared with a PS membrane .


In forensic settings , individuals who experience a traumatic event are often encouraged to recall it soon afterwards to preserve their memory for it .


Some theories of the development of post-traumatic stress disorder ( PTSD ) suggest that this may increase psychopathology .


The primary aim of the study was to examine the effect of immediate recall of a trauma analogue video on psychopathology .


Eighty-five undergraduate students were randomised to view a video of a car accident , described as either a real event ( high stress ) or training event ( low stress ) .


They then completed either the Self-Administered Interview ( SAI , Gabbert , Hope , & Fisher , @ ) or a filler task .


All participants returned one week later to provide an account of the event .


As predicted , participants in the SAI early recall task condition remembered the video content better one week after seeing the video , shown both by their greater recall of correct details and greater rejection of misinformation .


However , completing the SAI resulted in higher anxiety immediately afterwards , and more severe PTSD-like symptoms one week later , compared to control condition .


PTSD intrusion-like symptoms also predicted more accurate recall , while avoidance predicted poorer memory .


While the trauma analogue video used in this study has been previously used , and did effectively trigger post-traumatic-like symptoms , it is unclear how well these results generalise to actual trauma situations .


These results suggest the relationship between PTSD symptoms and memory might be more complex than previously recognised , with intrusive phenomena possibly promoting memory and avoidance symptoms compromising memory .


The study explores whether messages about the physical activity levels of the majority ( i.e. normative messages ) affect young adults ' intention to engage in regular physical activity .


An experimental survey among @ to @ year-olds in Bulgaria , Croatia and Romania ( n = @ ) was conducted in March @ .


A control group received no message ; one treatment group was told that the majority was physically active ( positive message ) ; and another treatment group was told that the majority was not physically active ( negative message ) .


Both the positive and ( unexpectedly ) the negative normative messages showed a significant and positive effect on intention to be physically active .


There was no difference between the effects of the messages .


Normative messages affect intention , which is encouraging for public health campaigns .


The effect of the positive message confirms previous findings on conformity to the norm ; the effect of the negative message is unexpected and requires further research to be understood .


Fibroblast growth factor @ ( FGF@ ) improves glycemic control in diabetic animals and is secreted from the gastrointestinal tract after meals in response to bile acid stimulation .


We sought to understand how ingestion of carbohydrates , protein or lipids affect both FGF@ and bile acid concentrations in human plasma , with the hypothesis that variation in the bile acid response to different macronutrients would predict differences in plasma FGF@ levels .


This was a randomized , within-subjects crossover study .


The study was conducted at a university clinical research center .


There were @ healthy human subjects included in the study .


Isocaloric , isovolemic beverages composed primarily of carbohydrates , proteins , or lipids were provided to each participant on @ separate occasions .


The magnitudes of postprandial rises of plasma FGF@ and total bile acid levels were determined .


All beverages induced an initial transient decline of plasma FGF@ levels during the first @ minutes after consumption .


For FGF@ , the ingestion of carbohydrate was associated with the fastest and highest increase of plasma levels , returning to baseline at @ hours .


By comparison , the protein beverage induced a modest but significant elevation of FGF@ levels that peaked at the end of the @-hour sampling interval , whereas a lipid beverage was without effect .


In contrast , total bile acid levels increased in plasma only in response to a high-lipid beverage , demonstrating a marked divergence between the FGF@ and bile acid response to lipid vs carbohydrate .


A bile acid-independent mechanism is implicated in the effect of meals to raise plasma FGF@ concentrations .


In this clinical trial , we aimed to compare three means of performing chronic hemodialysis in patients with contra-indication to systemic heparinization .


This open-label monocentric randomized n-of-one trial , conducted in a single tertiary care center , recruited chronic hemodialysis patients with a contra-indication to systemic heparinization for at least @ consecutive sessions .


All patients underwent hemodialysis with an AN@ST dialyzer , and were administered three alternative dialysis procedures in a random sequence : intermittent saline flushes , constant saline infusion , or pre-dialysis heparin coating of the membrane .


The primary outcome was the need to interrupt the dialysis session because of clotting events due to either ( i ) a complete coagulation of the circuit ; ( ii ) a partial coagulation of the circuit ; ( iii ) a > @ % rise over baseline in the venous pressure .


At the end of the inclusion period ( May , @ to December , @ ) , the number of patients to include ( n = @ ) was not reached : only @ patients were included and underwent randomization .


The study was terminated , and statistical analysis took into account @ hemodialysis sessions performed in @ patients with analyzable data .


Heparin adsorption was associated with a significant reduction of the need to interrupt the dialysis session because of clotting events : odds ratio @ ( CI @ % @ to @ ; p < @ , versus intermittent saline flushes ) .


Heparin adsorption was also associated with higher odds for performing > @ h dialysis sessions and for having complete blood restitution .


There were no significant effects of the dialysis procedure on weight loss , online ionic dialysance , and adverse events .


Heparin-coated AN@ST dialysis membrane is a safe and effective method to avoid or delay per-dialytic clotting events in patients with contra-indication to systemic anticoagulation .


However , results are not generalizable safely to patients with active bleeding , since weak heparinemia , not assessed in this study , may occur .


To examine the effects of galantamine and risperidone on agitation in patients with dementia .


A total of @ patients with dementia and neuropsychiatric symptoms ( mean age SD : @ @ years ; @ % female ) were included in this @-week , randomized , parallel-group , controlled , single-center trial .


The participants received galantamine ( n = @ ; target dose : @ mg ) or risperidone ( n = @ ; target dose : @ mg ) for @ weeks .


Both galantamine and risperidone treatment resulted in reduced agitation .


However , risperidone showed a significant advantage over galantamine both at week @ ( mean difference in total Cohen-Mansfield Agitation Inventory score : @ points ; p = @ ) and at week @ ( @ points ; p = @ ) .


Agitation improved in both groups , even if the treatment effects were more pronounced in the risperidone group ; however , the effects on cognition and other aspects of tolerability were stronger with galantamine .


To determine the reliability of patient reports of pain intensity during the application of physical tests .


A single examiner required participants to use the numeric pain rating scale ( NPRS ) to report the intensity of pain provoked during physical testing of the hip .


Standardized versions of @ physical tests were used on @ people with hip pain .


Tests were repeated at @ hour and @-@ days later .


Within - and between-session reliability of reports of pain intensity was calculated using intraclass correlation coefficients ( ICCs ) and Lin 's concordance correlation coefficients ( CCCs ) .


Standard errors of measurement ( SEMs ) were calculated .


ICC/CCC values for within-session reports of pain intensity ranged from @ ( @ % confidence interval -LSB- @ % CI -RSB- -@ , @ ) to @ ( @ % CI @ , @ ) .


Patients demonstrated `` substantial '' or `` almost perfect '' reliability in reporting pain intensity with @ of @ tests and `` moderate '' reliability with @ tests .


Two tests were unreliable ( ICC @ and @ ) .


ICC/CCC values for between-session reports of pain intensity ranged from -@ ( @ % CI -@ , @ ) to @ ( @ % CI @ , @ ) .


Patients demonstrated substantial or almost perfect reliability in reporting pain intensity with @ of @ tests .


Two tests were unreliable ( ICC @ and -@ ) .


The average SEM value of @ points on the NPRS was the same for both within - and between-session testing ( range @-@ @ ) .


Patient reports of the intensity of pain provoked by physical tests are sufficiently reliable to be clinically useful .


However , the SEM of @ points should be considered when precise calculations of changes in pain intensity are important .


Mechanisms , acute management , and outcomes for patients who experience intracerebral hemorrhage may differ from patients with ischemic stroke .


Studies of very early rehabilitation have been mainly undertaken in patients with ischemic stroke , and it is unknown if benefits apply to those with intracerebral hemorrhage .


We hypothesized that early rehabilitation , within @ hours of stroke , would improve survival and functional outcomes in patients with intracerebral hemorrhage .


This was a multicenter , randomized controlled study , with blinded assessment of outcome at @ and @ months .


Eligible patients were randomized to receive standard care or standard care plus early rehabilitation .


Primary outcome includes survival .


Secondary outcomes includes health-related quality of life using the @-item Short Form Questionnaire , function measured with the modified Barthel Index , and anxiety measured with the Zung Self-Rated Anxiety Scale .


Two hundred forty-three of @ patients were randomized ( mean age , @ years ; @ % men ) .


At @ months , patients receiving standard care were more likely to have died ( adjusted hazard ratio , @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ) ; for morbidity outcomes , a @-point difference in the Physical Component Summary score of the @-item Short Form Questionnaire ( @ % CI , @-@ @ ) , a @-point difference for the Mental Component Summary score ( @ % CI , @-@ @ ) , a @-point difference in Modified Barthel Index scores ( @ % CI , @-@ @ ) , and a @-point difference in Self-Rating Anxiety Scale scores ( @ % CI , @-@ @ ) was reported in favor of the intervention groups .


For the first time , we have shown that commencing rehabilitation within @ hours of intracerebral hemorrhage improves survival and functional outcomes at @ months after stroke in hospitalized patients in China .


This study sought to evaluate the outcomes of endovascular treatment with covered versus bare Cheatham-platinum stents ( NuMed , Hopkinton , New York ) in coarctation of aorta ( CoA ) patients .


Covered stenting has been newly recognized as a useful therapeutic method for patients with native CoA , but there has been no study comparing the use of covered stents with bare stents for treating CoA .


In this randomized clinical trial , @ patients with a mean age of @ @ years ( range @ to @ years , @ men ) , with post-ductal , short-segment , severe native CoA underwent implantation of bare Cheatham-Platinum ( bCP ) ( n = @ ) or covered Cheatham-Platinum ( cCP ) ( n = @ ) stents .


Patients were followed clinically at @ , @ , @ , and @ months after the stenting and yearly thereafter .


During follow-up , multislice computed tomography ( @ slices ) was scheduled to assess any complications .


The procedural success rate was @ % in both groups .


Patients were followed for @ @ months .


Although recoarctation was seen only in the bCP group during follow-up , the difference betweengroups did not reach statistical significance ( @ % vs. @ % ; p = NS ) .


Two cases of pseudoaneurysm ( @ % ) occurred in the cCP group , but none was observed in the bCP group ( p = NS ) .


Normotensive statussignificantly increased during follow-up in both groups ( from @ % to @ % in the bCP group and@ @ % to@ @ % in the cCP group , p < @ for each group and not significant between groups ) .


Implanting bCP and cCP stents have very high success rates with remarkable hemodynamic effects in severe native CoA patients .


Patients undergoing cCP stent implantation experienced a nonsignificantly lower recoarctation rate and a higher occurrence of pseudoaneurysm formation with respect to bCP stenting during follow-up .


These findings indicate that CoA stenting isasafe procedure .


( Endovascular Stenting With Covered CP Stent Compared With Bare CP Stent forAdultPatients With Coarctation : The Initial and Intermediate-Term Follow-Up Results ; IRCT@N@ ) .


To observe the clinical effect of low-dose once-daily tadalafil combined with Shuganyiyang Capsules in the treatment of mild-to-moderate erectile dysfunction ( ED ) .


Ninety patients with mild-to-moderate ED were equally randomized to groups A , B and C to receive Shuganyiyang Capsules , tadalafil , and tadalafil + Shuganyiyang Capsules , respectively .


The scores of the patients on IIEF-@ and SF-PAIRS ( @-Item Short Form of Psychological Interpersonal Relationship Scales ) were recorded before and at @ and @ months after treatment .


The IIEF-@ scores of groups A , B and C were @ + / - @ , @ + @ and @ + / - @ before treatment , and @ + / - @ , @ + / - @ and @ + / - @ at @ month after treatment , significantly higher in B and C than in A ( P < @ ) , but with no remarkable difference between B and C ( P = @ ) .


At @ months after treatment , the IIEF-@ scores were @ + / - @ , @ + / - @ and @ + / - @ in the three groups , dramatically higher in B and C than in A ( P < @ ) as well as in C than in B ( P < @ ) .


The scores on sexual self-confidence , sexual spontaneity and time concerns in SF-PAIRS were @ + / -@ , @ + / - @ and @ + / - @ before medication , @ + / - @ , @ + / - @ and @ + / - @ at @ month and @ + / - @ , @ + / - @ and @ + / -@ at @ months after medication in group A ; @ + / - @ , @ + / -@ and @ + / -@ before medication , @ + / -@ , @ + / - @ and @ + / -@ at @ month and @ + / -@ , @ + / - @ and @ + / - @ at @ months in group B ; and @ + / -@ , @ + / - @ and @ + / - @ before medication , @ + / - @ , @ + / -@ and @ + / -@ at @ month and @ + / - @ , @ + / - @ and @ + / - @ at @ months in group C. Compared with the baseline , the SF-PAIRS scores of the three groups were all significantly improved after treatment ( P < @ ) , and markedly higher in C than in the other two groups ( P < @ ) .


Low-dose once-daily tadalafil combined with Shuganyiyang Capsules is obviously effective in the treatment of mild-to-moderate ED , which not only improves the patients ` erectile function , sexual self-confidence and sexual spontaneity , but also reduces their time concerns .


Milligan-Morgan hemorrhoidectomy ( MM ) is still the most common treatment for grades III and IV hemorrhoids despite prolonged post-operative anal pain and wound healing .


This multicenter , double blind , randomized , controlled trial was designed to assess the safety and the efficacy of anal wound cleansing with Triclosan ( Proctocid ) in the control of symptoms and healing time after MM .


A total of @ patients with grades III and IV hemorrhoids , undergoing open hemorroidectomy by diathermy or Ligasure vessel sealing device , were randomly assigned to Triclosan or sodium hypochlorite solution .


All patients received analgesics and a fiber-rich diet after hemorrhoidectomy .


Postoperative anal pain , bleeding and/or secretion and itch were assessed @ , @ and @ days after hemorrhoidectomy by a Visual Analogue Scale ( VAS ) and the day of complete re-epithelialization of anal wounds was recorded .


Fifty-five patients were randomized for Triclosan treatment and @ for the control drug .


The two groups were comparable for demographics , severity of hemorrhoids and technique used for the hemorrhoidectomy .


The comparison of days to get complete anal wound healing shows a trend of significance ( P = @ ) for the Triclosan group .


Bleeding and/or secretion , anal pain and itch were significantly better ( P = @ ; P < @ and P = @ , respectively ) .


Triclosan solution for the treatment of post-hemorrhoidectomy wounds is safe and improves the control of post-operative symptoms and wound healing time compared to sodium hypochlorite .


To determine if transversus abdominis plane anesthetic blockage ( TAP block ) diminishes early postoperative pain scores and facilitates ambulatory management following total laparoscopic hysterectomy .


Randomized triple blind trial .


Gynecological endoscopy unit at a referral center for laparoscopic surgery .


A total of @ patients .


Comparison of a treatment group receiving TAP block with bupivacaine @ % and placebo group with comparably placed bilateral injection of sterile saline solution .


Pain scores at discharge @ , @ and @h after surgery , opioid requirement after procedure .


Patients who had TAP block had a significant reduction in their pain score at discharge compared with the placebo group ( p = @ ) .


There were no significant differences in the pain scores between groups at @h ( @ % CI @-@ @ , p = @ ) , @h ( @ % CI @-@ @ , p = @ ) and @h ( @ % CI -@ to @ , p = @ ) .


No differences were found between the groups regarding opioid requirements following the procedure ( ( @ ) = @ , p = @ ) .


Although TAP block after a total laparoscopic hysterectomy reduced the pain score at discharge compared with placebo , its role in this setting is debatable due to the possible lack of clinical significance of the small difference found .


Studies done in Asia have shown that a regimen of S-@ plus oxaliplatin ( SOX ) has promising efficacy and safety in patients with metastatic colorectal cancer .


We aimed to establish whether SOX plus bevacizumab is non-inferior to mFOLFOX@ ( modified regimen of leucovorin , fluorouracil , and oxaliplatin ) plus bevacizumab as first-line chemotherapy for metastatic colorectal cancer .


We undertook an open-label , non-inferiority , randomised phase @ trial in @ sites in Japan .


We enrolled individuals aged @-@ years who had metastatic colorectal cancer , had an Eastern Cooperative Oncology Group performance status of @ or @ , had assessable lesions , had received no previous chemotherapy or radiotherapy , could take drugs orally , and had adequate organ function .


Eligible patients were randomly assigned ( @:@ ) to receive either mFOLFOX@ plus bevacizumab ( on day @ of each @-week cycle , @ mg/kg intravenous infusion of bevacizumab and a simultaneous intravenous infusion of @ mg/m ( @ ) oxaliplatin , @ mg/m ( @ ) l-leucovorin , @ mg/m ( @ ) bolus fluorouracil , and @ mg/m ( @ ) infusional fluorouracil ) or SOX plus bevacizumab ( on day @ of each @-week cycle , @ mg/kg intravenous infusion of bevacizumab and @ mg/m ( @ ) intravenous infusion of oxaliplatin ; assigned dose of S-@ twice a day from after dinner on day @ to after breakfast on day @ , followed by @-day break ) .


Randomisation was done centrally with the minimisation method , with stratification by institution and whether postoperative adjuvant chemotherapy had been given .


Participants , investigators , and data analysts were not masked to treatment assignment .


The primary endpoint was progression-free survival ( PFS ) , which was defined as the interval between enrolment and progressive disease ( @ % increase in sum of longest dimensions of target lesions from baseline , or appearance of new lesions ) or death , whichever came first .


The primary analysis was done by modified intention to treat .


This trial is registered with the Japan Pharmaceutical Information Center , number JapicCTI-@ .


Between Feb @ , @ , and March @ , @ , @ patients underwent randomisation .


@ patients assigned to receive SOX plus bevacizumab and @ assigned to receive mFOLFOX@ plus bevacizumab were included in the primary analysis .


Median PFS was @ months ( @ % CI @-@ ) in the group assigned to mFOLFOX@ plus bevacizumab and @ months ( @-@ ) in the group assigned to SOX plus bevacizumab ( HR @ , @ % CI @-@ ; less than non-inferiority margin of @ , pnon-inferiority = @ ) .


The most common haematological adverse events of grade @ or higher were leucopenia ( @ -LSB- @ % -RSB- of @ patients given mFOLFOX@ plus bevacizumab included in safety analysis vs six -LSB- @ % -RSB- of @ given SOX plus bevacizumab ; p = @ ) and neutropenia ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ; p < @ ) .


Grade @ or higher anorexia ( @ -LSB- @ % -RSB- vs three -LSB- @ % -RSB- ; p = @ ) and diarrhoea ( @ -LSB- @ % -RSB- vs seven -LSB- @ % -RSB- ; p = @ ) were significantly more common in patients given SOX plus bevacizumab than in those given mFOLFOX@ plus bevacizumab .


We recorded seven treatment-related deaths ( three in the group given mFOLFOX@ plus bevacizumab ; four in that given SOX plus bevacizumab ) .


SOX plus bevacizumab is non-inferior to mFOLFOX@ plus bevacizumab with respect to PFS as first-line treatment for metastatic colorectal cancer , and could become standard treatment in Asian populations .


The use of @-hydroxylated vitamin D therapy to control secondary hyperparathyroidism in renal failure patients has been a success story , culminating with the demonstration of increased life expectancy in patients treated with these compounds .


However , hypercalcemic episodes have been a recurrent problem with these therapies and have resulted in the added use of calcium mimetics .


Clearly there is good reason to search for improved vitamin D therapy .


In our inventory of vitamin D compounds , @-methylene-@-nor - ( @S ) -@,@ - dihydroxyvitamin D@ ( @MD ) surfaced as a potential candidate .


This was based on its preferential localization in the parathyroid gland and a clear suppression of serum parathyroid hormone ( PTH ) levels without a change in serum calcium in a clinical trial in postmenopausal women .


@MD has now been tested in the rat @/@-nephrectomy model of renal failure , and in postmenopausal women to determine if it can suppress serum PTH at doses that do not elevate serum calcium and serum phosphorus concentrations .


Daily oral treatment of uremic rats on @ ng/bw/day of @MD dramatically suppressed PTH without a change in serum calcium or serum phosphorus .


Further , PTH was suppressed in postmenopausal women after only @ daily oral doses of @MD that continued for @ weeks with no change in serum calcium or serum phosphorus .


These results coupled with a pharmacokinetic half-life of ~ @ h suggest that @MD given either daily or at the time of dialysis may be a superior therapy for secondary hyperparathyroidism in chronic renal failure patients .


Our aim was to investigate the relationship between mutant p@ and the prognosis of malignant glioma treated with temozolomide , and the regulation of mutant TP@ induced drug resistance , by molecular experimentation and a clinical trial .


Adult patients with newly surgical diagnosed glioblastoma were randomly assigned to receive either temozolomide or semustine after radiation treatment .


The statuses of TP@ and expression of TP@ and O ( @ ) - methylguanine DNA-methyltransferase ( MGMT ) were determined retrospectively in tumor tissue from enrolled patients .


The primary end point was overall survival .


Synthetic small interfering RNA was used to knock down mutant TP@ in T@G and U@ cells , which are human glioblastoma cells with a P@ mutation , by screening of exons @-@ .


Viable cell survival was measured when these cells were exposed to temozolomide or semustine .


Expression of MGMT at the messenger RNA level was also determined .


The overall survival was @ % at @ years , @ % at @ years , @ % at @ years , and @ % at @ years with temozolomide , versus @ , @ , @ , and @ % , respectively , with semustine .


TP@ mutation and expression of mutant TP@ and MGMT showed significant inverse correlations with overall survival .


Knockdown of mutant TP@ led to a fivefold increase in chemosensitivity to temozolomide but not semustine .


Mutant TP@ knockdown induced down-regulation of MGMT expression .


Mutant TP@ is strongly associated with a poor prognosis for overall survival in patients with glioblastoma .


Also , TP@ mutation may decrease the chemosensitivity of glioblastoma to temozolomide by increasing MGMT expression .


Coronary bifurcation lesions can be approached using a simple or a complex strategy .


In clinical trials with first-generation drug-eluting stents , the complex strategy was not superior to the simple approach .


However , to date , the best strategy when using second-generation drug-eluting stents has not been defined .


We performed a prospective randomized study comparing a simple vs a complex strategy involving T-stenting for the percutaneous revascularization of bifurcation lesions using the everolimus-eluting stent .


Angiographic and clinical follow-up were performed at @ months .


We included @ lesions in @ patients , who were randomized to the simple ( @ lesions , @ patients ) or complex strategy ( @ lesions and patients ) .


In all , @ % of the lesions included were true bifurcations .


The crossover rate was @ % .


The binary restenosis rate was @ % , with no differences between the groups .


Side branch restenosis tended to be higher with the simple strategy in the intention to treat analysis ( @ % vs @ % ) but not in the per protocol analysis ( @ % vs @ % ) .


The incidence of major adverse cardiac events ( cardiac death , myocardial infarction , and target vessel revascularization ) was @ % , with no differences between groups .


There were no cases of stent thrombosis .


According to the clinical and angiographic findings , the complex strategy was not significantly superior to the simple approach in the revascularization of bifurcation lesions with second-generation everolimus-drug eluting stents .


Current literature supports the thought that anesthesia and analgesia administered perioperatively for an anterior cruciate ligament ( ACL ) reconstruction have a great influence on time to effective rehabilitation during the first week after hospital discharge .


The aim of this study is to answer the research question is there a difference in clinical outcomes between the use of a femoral nerve block with spinal anesthesia versus spinal analgesia alone for people undergoing ACL reconstruction ?


ACL reconstruction with spinal anesthesia and patient sedation ( Group one ) ; and spinal anesthesia with patient sedation and an additional femoral nerve block ( Group two ) .


Patients were re-evaluated for pain , range of motion ( ROM ) , active contraction of the quadriceps , and a Functional Independence Measure ( FIM ) scoring scale .


Spinal anesthesia with a femoral nerve block demonstrates pain relief @h after surgery ( VAS @ ; p = @ ) .


From the third ( VAS = @ ; p = @ ) to the seventh ( VAS = @ ; p = @ ) days after surgery , this same nerve blockage delivered higher pain scores .


Patients had a similar progressive improvement on knee joint range of motion with or without femoral nerve block ( p < @ ) .


Group one and two had @ and @ @h after surgery and @ and @ of knee flexion after @h post op .


Spinal anesthesia associated with a femoral nerve block had no additional benefits on pain control after the third postoperative day .


There were no differences between groups concerning ability for knee flexion and to complete daily activities during postoperative period .


Randomized Clinical Trial Level I.


Tasquinimod ( Active Biotech ) is an oral immunomodulatory , anti-angiogenic , and anti-metastatic agent that delayed metastatic disease progression in a randomized placebo-controlled phase II trial in men with metastatic castration-resistant prostate cancer ( mCRPC ) .


Here , we report long-term survival with biomarker correlates from this trial .


Two hundred and one ( @ tasquinimod and @ placebo ) men with mCRPC were evaluated .


Forty-one men randomized to placebo crossed over to tasquinimod .


Survival data were collected with a median follow-up time of @ months .


Exploratory biomarker studies at baseline and over time were collected to evaluate potential mechanism-based correlates with tasquinimod efficacy including progression-free survival ( PFS ) and overall survival ( OS ) .


With @ mortality events , median OS was @ months for tasquinimod versus @ months for placebo overall , and @ versus @ months in men with bone metastases ( n = @ ) , respectively .


Multivariable analysis demonstrated an adjusted HR of @ -LSB- @ % confidence interval ( CI ) , @-@ @ ; P = @ -RSB- for PFS and @ ( @ % CI , @-@ @ ; P = @ ) for OS , favoring tasquinimod .


Time-to-symptomatic progression was improved with tasquinimod ( P = @ , HR = @ ) .


Toxicities tended to be mild in nature and improved over time .


Biomarker analyses suggested a favorable impact on bone alkaline phosphatase and lactate dehydrogenase ( LDH ) over time and a transient induction of inflammatory biomarkers , VEGF-A , and thrombospondin-@ levels with tasquinimod .


Baseline levels of thrombospondin-@ less than the median were predictive of treatment benefit .


The survival observed in this trial of men with minimally symptomatic mCRPC suggests that the prolongation in PFS with tasquinimod may lead to a survival advantage in this setting , particularly among men with skeletal metastases , and has a favorable risk : benefit ratio .


The efficacy of clipping for preventing the delayed bleeding after the removal of colon polyps is still controversial .


In order to clarify this efficacy , a randomized controlled study was performed .


One hundred and fifty-six patients with colon neoplasms ( @ lesions ) were enrolled in the study .


The patients were randomly divided into two groups : clipping or nonclipping groups using a sealed envelope method before the endoscopic resections .


Eight specialists and nine residents were invited to perform this procedure .


The risk factors and the rates of delayed bleeding after the endoscopic resections in each group were investigated .


There were no significant differences in the bleeding rate between the clipping and nonclipping groups , while the length of the procedure was significantly longer and the cost was higher in the clipping group than in the nonclipping group .


The rate of bleeding was significantly higher in cases with polyps @ cm or larger and with a longer procedure time , while none of the other factors affected the bleeding rate .


This randomized controlled study revealed no significant effect of prophylactic clipping for preventing delayed bleeding after the endoscopic resection of colon polyps .


The CLASSIC trial was done to compare adjuvant capecitabine plus oxaliplatin versus observation after D@ gastrectomy for patients with stage II or III gastric cancer .


The planned interim analysis of CLASSIC ( median follow-up @ months ) showed that adjuvant capecitabine plus oxaliplatin significantly improved disease-free survival , the primary endpoint , compared with observation after D@ gastrectomy .


We report the @-year follow-up data from the trial .


CLASSIC was a phase @ , randomised , open-label study done at @ cancer centres , medical centres , and hospitals in China , South Korea , and Taiwan .


Patients with stage II-IIIB gastric cancer who underwent curative D@ gastrectomy were randomly assigned ( @:@ ) after surgery to receive adjuvant chemotherapy with capecitabine and oxaliplatin ( eight @-week cycles of oral capecitabine @ mg/m ( @ ) twice daily on days @-@ plus intravenous oxaliplatin @ mg/m ( @ ) on day @ ) for @ months or observation alone .


Randomisation was stratified by country and disease stage with a permuted block ( size four ) design .


Neither patients nor investigators were masked to treatment assignment .


The primary outcome was @-year disease-free survival in the intention-to-treat population .


This analysis presents the final preplanned assessment of outcomes after @ years .


The study is registered with ClinicalTrials.gov , NCT@ .


We enrolled @ patients : @ were randomly assigned to adjuvant capecitabine and oxaliplatin , and @ to observation .


Median follow-up for this analysis in the intention-to-treat population was @ months ( IQR @-@ ) .


@ ( @ % ) patients had disease-free survival events in the adjuvant capecitabine and oxaliplatin group versus @ ( @ % ) patients in the observation group ( stratified hazard ratio -LSB- HR -RSB- @ , @ % CI @-@ ; p < @ ) .


Estimated @-year disease-free survival was @ % ( @ % CI @-@ ) in the adjuvant capecitabine and oxaliplatin group versus @ % ( @-@ ) in the observation alone group .


By the clinical cutoff date , @ patients ( @ % ) had died in the adjuvant capecitabine and oxaliplatin group versus @ patients ( @ % ) in the observation group ( stratified HR @ , @ % CI @-@ ; p = @ ) .


Estimated @-year overall survival was @ % ( @ % CI @-@ ) in the adjuvant capecitabine and oxaliplatin group versus @ % ( @-@ ) in the observation group .


Adverse event data were not collected after the primary analysis .


Adjuvant treatment with capecitabine plus oxaliplatin after D@ gastrectomy should be considered for patients with operable stage II or III gastric cancer .


The financial costs associated with asthma care continue to increase while care remains suboptimal .


Promoting optimal self-management , including the use of asthma action plans , along with regular health professional review has been shown to be an effective strategy and is recommended in asthma guidelines internationally .


Despite evidence of benefit , guided self-management remains underused , however the potential for online resources to promote self-management behaviors is gaining increasing recognition .


The aim of this paper is to describe the protocol for a pilot evaluation of a website ` Living well with asthma ' which has been developed with the aim of promoting self-management behaviors shown to improve outcomes .


The study is a parallel randomized controlled trial , where adults with asthma are randomly assigned to either access to the website for @ weeks , or usual asthma care for @ weeks ( followed by access to the website if desired ) .


Individuals are included if they are over @-years-old , have a diagnosis of asthma with an Asthma Control Questionnaire ( ACQ ) score of greater than , or equal to @ , and have access to the internet .


Primary outcomes for this evaluation include recruitment and retention rates , changes at @ weeks from baseline for both ACQ and Asthma Quality of Life Questionnaire ( AQLQ ) scores , and quantitative data describing website usage ( number of times logged on , length of time logged on , number of times individual pages looked at , and for how long ) .


Secondary outcomes include clinical outcomes ( medication use , health services use , lung function ) and patient reported outcomes ( including adherence , patient activation measures , and health status ) .


Piloting of complex interventions is considered best practice and will maximise the potential of any future large-scale randomized controlled trial to successfully recruit and be able to report on necessary outcomes .


Here we will provide results across a range of outcomes which will provide estimates of efficacy to inform the design of a future full-scale randomized controlled trial of the ` Living well with asthma ' website .


Arformoterol tartrate ( arformoterol , @ g bid ) is a nebulized long-acting @-agonist approved for maintenance treatment of COPD .


This was a multicenter , double-blind , randomized , placebo-controlled study .


Patients ( aged @ years with baseline FEV@ @ % predicted , FEV@ > @ L , FEV@/FVC @ % , and @ pack-year smoking history ) received arformoterol ( n = @ ) or placebo ( n = @ ) for @ year .


The primary assessment was time from randomization to respiratory death or first COPD exacerbation-related hospitalization .


Among @ patients randomized , @ had @ primary event ( @ % vs @ % , for arformoterol vs placebo , respectively ) .


Patients who discontinued treatment for any reason ( @ % vs @ % , for arformoterol vs placebo , respectively ) were followed for up to @ year postrandomization to assess for primary events .


Fewer patients receiving arformoterol than placebo experienced COPD exacerbation-related hospitalizations ( @ % vs @ % , respectively ) .


Twelve patients ( @ % ) receiving arformoterol and @ patients ( @ % ) receiving placebo died during the study .


Risk for first respiratory serious adverse event was @ % lower with arformoterol than placebo ( P = @ ) .


Numerically more patients on arformoterol ( @ ; @ % ) than placebo ( @ ; @ % ) experienced cardiac serious adverse events ; however , time-to-first cardiac serious adverse event was not significantly different .


Improvements in trough FEV@ and FVC were greater with arformoterol ( least-squares mean change from baseline vs placebo : @ L , P = @ and @ L , P = @ , respectively ) .


Significant improvements in quality of life ( overall St. George 's Hospital Respiratory Questionnaire and Clinical COPD Questionnaire ) were observed with arformoterol vs placebo ( P < @ ) .


Arformoterol demonstrated an approximately @ % lower risk of respiratory death or COPD exacerbation-related hospitalization over @ year vs placebo .


Arformoterol was well-tolerated and improved lung function vs placebo .


Postexercise protein or amino acid ingestion restores muscle protein synthesis in older adults and represents an important therapeutic strategy for aging muscle .


However , the precise nutritional factors involved are unknown .


The purpose of this study was to determine the role of increased postexercise Leu ingestion on skeletal muscle myofibrillar protein synthesis ( MyoPS ) , mammalian/mechanistic target of rapamycin complex @ signaling , and amino acid transporter ( AAT ) mRNA expression in older men over a @-h post-resistance exercise ( RE ) time course .


During a stable isotope infusion trial ( l - -LSB- ring - ( @ ) C@ -RSB- Phe ; l - -LSB- @ - ( @ ) C -RSB- Leu ) , older men performed RE and , at @ h after exercise , ingested @ g of essential amino acids ( EAAs ) containing either a Leu content similar to quality protein ( control , @ g of Leu , n = @ ) or enriched Leu ( LEU ; @ g of Leu , n = @ ) .


Muscle biopsies ( vastus lateralis ) were obtained at rest and @ , @ , and @ h after exercise .


p@ S@ kinase @ phosphorylation was increased in each group at @ h ( P < @ ) , whereas @E binding protein @ phosphorylation increased only in the LEU group ( P < @ ) .


MyoPS was similarly increased ( @ % ) above basal in each group at @ h ( P < @ ) and remained elevated ( @ % ) at @ h only in the LEU group ( P < @ ) .


The mRNA expression of select AATs was increased at @ and @ h in each group ( P < @ ) , but AAT expression was increased at @ h only in the LEU group ( P < @ ) .


Leu-enriched EAA ingestion after RE may prolong the anabolic response and sensitivity of skeletal muscle to amino acids in older adults .


These data emphasize the potential importance of adequate postexercise Leu ingestion to enhance the response of aging muscle to preventive or therapeutic exercise-based rehabilitation programs .


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


Antibiotics are of limited overall clinical benefit for uncomplicated lower respiratory tract infection ( LRTI ) but there is uncertainty about their effectiveness for patients with features associated with higher levels of antibiotic prescribing .


To estimate the benefits and harms of antibiotics for acute LRTI among those producing coloured sputum , smokers , those with fever or prior comorbidities , and longer duration of prior illness .


Secondary analysis of a randomised controlled trial of antibiotic placebo for acute LRTI in primary care .


Two thousand and sixty-one adults with acute LRTI , where pneumonia was not suspected clinically , were given amoxicillin or matching placebo .


The duration of symptoms , rated moderately bad or worse ( primary outcome ) , symptom severity on days @-@ ( @-@ scale ) , and the development of new or worsening symptoms were analysed in pre-specified subgroups of interest .


Evidence of differential treatment effectiveness was assessed in prespecified subgroups by interaction terms .


No subgroups were identified that were significantly more likely to benefit from antibiotics in terms of symptom duration or the development of new or worsening symptoms .


Those with a history of significant comorbidities experienced a significantly greater reduction in symptom severity between days @ and @ ( interaction term -@ , P = @ ; estimated effect of antibiotics among those with a past history -@ -LSB- @ % confidence interval = -@ to -@ -RSB- , P = @ ) , equivalent to three people in @ rating symptoms as a slight rather than a moderately bad problem .


For subgroups not specified in advance antibiotics provided a modest reduction in symptom severity for non-smokers and for those with short prior illness duration ( < @ days ) , and a modest reduction in symptom duration for those with short prior illness duration .


There is no clear evidence of clinically meaningful benefit from antibiotics in the studied high-risk groups of patients presenting in general practice with uncomplicated LRTIs where prescribing is highest .


Any possible benefit must be balanced against the side-effects and longer-term effects on antibiotic resistance .


Postural tachycardia syndrome ( POTS ) induces disabling chronic orthostatic intolerance with an excessive increase in heart rate ( HR ) upon standing , and many POTS patients have a hyperadrenergic state .


Medications that restrain HR are a promising approach to this problem .


We tested the hypothesis that melatonin will attenuate the tachycardia and improve symptom burden in patients with POTS .


Patients with POTS ( n = @ ) underwent acute drug trials with melatonin @ mg orally and placebo , on separate mornings , in a randomized crossover design .


Blood pressure , HR , and symptoms were assessed while seated and after standing for up to @ min prior to , and hourly for @ h following study drug administration .


The reduction in standing HR was significantly greater @ h after melatonin compared with placebo ( P = @ ) .


There was no significant difference in the reduction of systolic blood pressure between melatonin and placebo , either with standing or while seated .


The symptom burden was not improved with melatonin compared with placebo .


Oral melatonin produced a modest decrease in standing tachycardia in POTS .


Further research is needed to determine the effects of regular night-time use of this medication in POTS .


Management of AO type B and C fractures of the distal radius is controversial .


This study compares outcomes and complications of AO type B and C fractures of the distal radius treated with volar locked plating and nonoperative methods .


Sixty-four patients with fractures of the distal radius ( AO type B and C ) were included in this study , according to inclusion criteria , and were allocated to the volar plating group or nonoperative group by alternate randomization : @ patients with odd numbers went into the nonoperative group and the other @ with even numbers went into the volar plating group .


Patients in the nonoperative group were managed with closed reduction of the fracture and plaster cast application under an image intensifier .


Those in the volar plating group were managed by open reduction and fixation with a volar locked plate .


Preoperative and postoperative serial clinico-radiological follow-up was done .


The range of movement , grip strength , functional outcome scores and radiological parameters were compared .


Student 's t-test was used for statistical analysis with significance at p < @ .


Range of movement and functional scores were significantly ( p < @ ) better in the volar plating group , but the difference in ulnar variance and radial and ulnar deviation was insignificant as compared to the nonoperative group .


At @ months follow-up , the nonoperative group had significantly more cases with malunion , articular incongruity and osteoarthritis .


In cases of AO type B or C fractures of the distal radius , volar locked plating provides anatomical stable fixation and early mobilization with better clinico-radiological outcome as compared to conservative treatment .


Ingrown toe nail is common problem presenting to the surgeon .


Partial Nail avulsion only results in recurrence of the ingrown toe nail .


The aim of this study was too see the effect of phenolization in preventing recurrence after partial nail avulsion .


This was a randomized controlled trial carried out at Department of Surgery , Pakistan Institute of Medical Sciences , Islamabad .


This study included @ patients ( @ in each group ) with ingrown toe nail presented from November @ to October @ .


This study compared the application of phenol after partial avulsion with partial avulsion alone in the treatment of ingrown toe nail .


Sixty-nine percent of the patients were males and @ % were female .


The mean age in both groups was @ years .


Patient in the partial nail avulsion with application of phenol group had less pain as compared to patient with partial nail avulsion group only .


Our study has shown that patient in phenol group had less post operative infection , spike formation and recurrence as compared to wedge resection group only .


Partial nail avulsion with phenolization is better than nartial nail avulsion only for the management of the in-growing toe nail .


A post-hoc analysis was performed to determine the relationship between the timing and magnitude of DAS@ ( ESR ) response and long term outcomes in Japanese patients after @ year of CZP treatment .


Our analysis included @ J-RAPID trial patients treated with CZP @ mg and methotrexate , and @ HIKARI trial patients treated with CZP @ mg alone or with disease-modifying agents other than methotrexate .


Remission rates and changes in mTSS at year @ were compared to the DAS@ ( ESR ) response at week @ of CZP treatment .


After @ year of treatment , remission was achieved in @ % of the J-RAPID and @ % of the HIKARI patients with a week @ DAS@ ( ESR ) response of @ .


In comparison , patients with a DAS@ ( ESR ) response of < @ at week @ only had a < @ % probability of achieving remission and displayed higher change in mTSS after @-year treatment .


The likelihood of remission and extent of radiographic progression after @ year was associated with the week @ DAS@ ( ESR ) response .


The DAS@ ( ESR ) response at @ weeks could be beneficial for identifying patients that are unlikely to respond to prolonged CZP treatment .


The likelihood of an adolescent taking up smoking may be influenced by his or her society , school and family .


Thus , changes in the immediate environment may alter a young person 's perception of smoking .


The proposed multi-center , cluster-randomized controlled trial will be stratified by the baseline prevalence of smoking in schools .


Municipalities with fewer than @,@ inhabitants will be randomly assigned to a control or intervention group .


One secondary school will be randomly selected from each municipality .


These schools will be randomized to two groups : the students of one will receive any existing educational course regarding smoking , while those of the other school will receive a four-year , class-based curriculum intervention ( @ classroom lessons ) aimed at reinforcing a smoke-free school policy and encouraging smoking cessation in parents , pupils , and teachers .


The intervention will also include annual meetings with parents and efforts to empower adolescents to change the smoking-related attitudes and behaviors in their homes , classrooms and communities.We will enroll children aged @-@ years as they enter secondary school during two consecutive school years ( to obtain sufficient enrolled subjects ) .


We will follow them for five years , until two years after they leave secondary school .


All external evaluators and analysts will be blinded to school allocation.The aim of this study is to analyze the effectiveness of a complex intervention in reducing the prevalence of smoking in the third year of compulsory secondary education ( ESO ) and two years after secondary school , when the participants are @-@ and @-@ years old , respectively .


Most interventions aimed at preventing smoking among adolescents yield little to no positive long-term effects .


This clinical trial will analyze the effectiveness of a complex intervention aimed at reducing the incidence and prevalence of smoking in this vulnerable age group .


Although evidence exists for the effectiveness of web-based smoking cessation interventions , information about the cost-effectiveness of these interventions is limited .


The study investigated the cost-effectiveness and cost-utility of two web-based computer-tailored ( CT ) smoking cessation interventions ( video - vs. text-based CT ) compared to a control condition that received general text-based advice .


In a randomized controlled trial , respondents were allocated to the video-based condition ( N = @ ) , the text-based condition ( N = @ ) or the control condition ( N = @ ) .


Societal costs , smoking status , and quality-adjusted life years ( QALYs ; EQ-@D-@L ) were assessed at baseline , six-and twelve-month follow-up .


The incremental costs per abstinent respondent and per QALYs gained were calculated .


To account for uncertainty , bootstrapping techniques and sensitivity analyses were carried out .


No significant differences were found in the three conditions regarding demographics , baseline values of outcomes and societal costs over the three months prior to baseline .


Analyses using prolonged abstinence as outcome measure indicated that from a willingness to pay of @,@ , the video-based intervention was likely to be the most cost-effective treatment , whereas from a willingness to pay of @,@ , the text-based intervention was likely to be the most cost-effective .


With regard to cost-utilities , when quality of life was used as outcome measure , the control condition had the highest probability of being the most preferable treatment .


Sensitivity analyses yielded comparable results .


The video-based CT smoking cessation intervention was the most cost-effective treatment for smoking abstinence after twelve months , varying the willingness to pay per abstinent respondent from @ up to @,@ .


With regard to cost-utility , the control condition seemed to be the most preferable treatment .


Probably , more time will be required to assess changes in quality of life .


Future studies with longer follow-up periods are needed to investigate whether cost-utility results regarding quality of life may change in the long run .


To compare the effects of two maternal feeding policies-early versus conventional oral feeding-after cesarean delivery .


This prospective multicenter randomized comparative trial was conducted at tertiary care hospitals in Sindh , Pakistan , from @ to @ .


Women with an uncomplicated cesarean delivery under spinal anesthesia were allocated to an intervention of early ( after @ hours ) or conventional ( after @ hours ) initiation of oral feeding .


Outcomes included maternal ambulation , maternal satisfaction , gastrointestinal functions , and length of hospital stay .


In total , @ women ( n = @ per group ) were included in the final analysis .


Gastrointestinal complications were not significantly different between the two groups .


Lower intensities of thirst and hunger and a higher rate of maternal satisfaction were observed in the early feeding group ( P < @ ) , and @ % of women in this group were able to ambulate within @ hours of surgery , compared with @ % of women in the conventional feeding group .


The frequencies of readmission , febrile morbidity , and wound infection were insignificant .


Early oral dietary initiation after cesarean delivery resulted in early ambulation , greater maternal satisfaction , and reduced length of hospital stay , with no detrimental outcomes , making this practice cost-effective .


Hence , day-care cesarean delivery might be an option in resource-constrained settings .


There is lack of well-designed trials evaluating structural benefits of non-pharmacologic therapies in knee osteoarthritis ( OA ) .


In this parallel-group randomized controlled trial , we aim to compare the possible advantages of lateral wedge insole and acupuncture in patients with medial knee OA .


Patients with grade two or three of medial knee OA were randomly allocated to group one who received an in shoe lateral wedge and group two who underwent acupuncture .


We assessed patients ' pain , function and knee joint cartilage thickness before and after intervention .


Paired t-test and independent samples t-test were used for in group and between group analyses .


Twenty patients in each group were recruited in the study .


Pain significantly decreased after therapy in both groups one and two ( paired t test , P < @ , @ % CI : @-@ @ and @-@ @ respectively ) .


Function improved in each group ( paired t test , P = @ , @ % CI of @-@ @ in group one and @-@ @ in group two ) .


A non-clinically statistically significant difference regarding the femoral and tibial cartilage thickness was obtained in both groups one ( P = @ , CI : -@ -@ and P = @ , CI : -@ -@ respectively ) and two ( P = @ , CI : -@ -@ and P = @ , CI : -@ -@ respectively ) .


Between groups analysis showed no significant difference regarding abovementioned measures .


Both lateral wedge insole and acupuncture can be effective in the treatment of medial knee osteoarthritis without any superiority of one over the other .


Iranian Registry of Clinical Trials : IRCT@N@ .


URL : http://irct.ir/searchen.php .


Glucose-insulin-potassium ( GIK ) administration during cardiac surgery inconsistently improves myocardial function , perhaps because hyperglycemia negates the beneficial effects of GIK .


The hyperinsulinemic normoglycemic clamp ( HNC ) technique may better enhance the myocardial benefits of GIK .


The authors extended previous GIK investigations by ( @ ) targeting normoglycemia while administering a GIK infusion ( HNC ) ; ( @ ) using improved echocardiographic measures of myocardial deformation , specifically myocardial longitudinal strain and strain rate ; and ( @ ) assessing the activation of glucose metabolic pathways .


A total of @ patients having aortic valve replacement for aortic stenosis were randomly assigned to HNC ( high-dose insulin with concomitant glucose infusion titrated to normoglycemia ) versus standard therapy ( insulin treatment if glucose > @mg/dl ) .


The primary outcomes were left ventricular longitudinal strain and strain rate , assessed using speckle-tracking echocardiography .


Right atrial tissue was analyzed for activation of glycolysis/pyruvate oxidation and alternative metabolic pathways .


Time-weighted mean glucose concentrations were lower with HNC ( @mg/dl ) than standard care ( @mg/dl ; P < @ ) .


Echocardiographic data were adequate in @ patients for strain analysis and @ patients for strain rate analysis .


HNC did not improve myocardial strain , with an HNC minus standard therapy difference of -@ % ( @ % CI , -@ to @ % ; P = @ ) .


Strain rate was significantly better , but by a clinically unimportant amount : -@ s ( -@ to -@ s ; P = @ ) .


There was no evidence of increased glycolytic , pyruvate oxidation , or hexosamine biosynthetic pathway activation in right atrial samples ( HNC , n = @ ; standard therapy , @ ) .


Administration of glucose and insulin while targeting normoglycemia during aortic valve replacement did not meaningfully improve myocardial function .


Infectious illnesses such as influenza and diarrhea are leading causes of absenteeism among Danish school children .


Interventions in school settings addressing hand hygiene have shown to reduce the number of infectious illnesses .


However , most of these studies include small populations and almost none of them are conducted as randomized controlled trials .


The overall aim of the Hi Five study was to develop , implement and evaluate a multi-component school-based intervention to improve hand hygiene and well-being and to reduce the prevalence of infections among school children in intervention schools by @ % compared to control schools .


This paper describes the development and the evaluation design of Hi Five .


The Hi Five study was designed as a tree-armed cluster-randomized controlled trial .


A national random sample of schools ( n = @ ) was randomized to one of two intervention groups ( n = @ ) or to a control group with no intervention ( n = @ ) .


A total of @,@ six to fifteen-year-old school children were enrolled in the study .


The Hi Five intervention consisted of three components : @ ) a curriculum component @ ) mandatory daily hand washing before lunch @ ) extra cleaning of school toilets during the school day .


Baseline data was collected from December @ to April @ .


The intervention period was August @ to June @ .


The follow-up data was collected from December @ to April @ .


The Hi Five study fills a gap in international research .


This large randomized multi-component school-based hand hygiene intervention is the first to include education on healthy and appropriate toilet behavior as part of the curriculum .


No previous studies have involved supplementary cleaning at the school toilets as an intervention component .


The study will have the added value of providing new knowledge about usability of short message service ( SMS , text message ) for collecting data on infectious illness and absenteeism in large study populations .


Bacterial screening offers the possibility of extending platelet ( PLT ) storage to Day @ .


We conducted a noninferiority , crossover trial comparing PLTs stored for @ or @ days versus @ to @ days .


Stable hematology patients were allocated to receive blocks of @ - to @ - and @ - or @-day PLTs in random order .


The primary outcome was the proportion of successful transfusions during the first block , defined as a corrected count increment ( CCI ) of more than @ at @ to @ hours posttransfusion .


Of @ patients with an evaluable first block , @ ( @ % ) and @ ( @ % ) had successful transfusions after @ - to @ - and @ - or @-day PLTs of mean ( SD ) ages of @ ( @ ) and @ ( @ ) days , respectively .


Six - or @-day PLTs were declared noninferior to @ - to @-day PLTs since the upper confidence interval ( CI ) limit was less than the predefined noninferiority margin of @ % ( @ % CI , -@ % to @ % ; p = @ ) .


Logistic regression analysis gave an adjusted odds ratio of @ ( @ % CI , @-@ @ ; p = @ ) .


Mean ( SD ) @ - to @-hour CCIs were @ ( @ ) and @ ( @ ) after transfusion with @ - to @ - or @ - or @-day PLTs ( @ % CI , -@ to @ ; p = @ ) .


The proportions of days with bleeding scores of WHO Grade @ or higher were @ % ( @/@ days ) and @ % ( @/@ days ; @ % CI , -@ to @ ; p = @ ) .


Median interval to next PLT transfusion ( @ days ) was unaffected ( @ % CI , -@ to @ ; p = @ ) .


In hematology patients , there was no evidence that @ - or @-day PLTs were inferior to @ - to @-day PLTs , as measured by proportion of patients with successful transfusions , bleeding events , or interval to next transfusion .


To evaluate the effect of the resin cement thickness ( RCT ) on bond strength ( BS ) and gap formation ( GF ) of fiber posts bonded to root dentin .


The roots of @ extracted human mandibular premolars were treated endodontically and the post spaces were prepared using drills with different diameters according to the following groups ( n = @ ) : well adapted ( WA ) , moderately well adapted ( MA ) and poorly adapted ( PA ) .


The fiber glass posts were cemented ( Excite DSC and Variolink II ) in accordance with the manufacturer 's instructions .


After @ week , the roots were transversely sectioned into six @-mm-thick disks and photographed using an optical microscope to determine the RCT .


After this , epoxy resin replicas of each sample were observed using SEM , and the mean length and width of the gaps formed in the cement/dentin/post interface were measured .


Finally , each sample was subjected to the push-out test ( @ mm/min ) , and the data were statistically analyzed using one-way ANOVA and Tukey 's tests at the @ % level of significance .


The lowest RCT ( m ) was observed for WA and the highest for PA. .


The group MA showed an intermediate value .


Significantly higher push-out BS values were observed for WA compared to the other groups .


The MA and PA groups were statistically similar .


The highest mean gap length ( % ) and width ( m ) were observed for PA. .


The groups MA and WA were statistically similar .


Lower resin cement thickness resulted in better fiber post adhesion , that is , in higher bond strength and less gap formation .


We assessed the effects of reduction and withdrawal of treatment in patients with rheumatoid arthritis who had a remission while receiving etanercept-plus-methotrexate therapy .


Patients with early active disease who had not previously received methotrexate or biologic therapy received @ mg of etanercept plus methotrexate weekly for @ weeks ( open-label phase ) .


We then randomly assigned patients who had qualifying responses at weeks @ and @ to receive @ mg of etanercept plus methotrexate ( combination-therapy group ) , methotrexate alone , or placebo for @ weeks ( double-blind phase ) .


Patients who had qualifying responses at week @ of the double-blind phase had all treatment withdrawn at that time and were followed to week @ ( treatment-withdrawal phase ) .


The primary end point was the proportion of patients with sustained remission in the double-blind phase .


Of @ patients enrolled , @ underwent randomization in the double-blind phase ; @ qualified for the treatment-withdrawal phase .


More patients in the combination-therapy group than in the methotrexate-alone group or the placebo group met the criterion for the primary end point ( @ of @ -LSB- @ % -RSB- vs. @ of @ -LSB- @ % -RSB- and @ of @ -LSB- @ % -RSB- , respectively ; P = @ for combination therapy vs. methotrexate alone ; P < @ for combination therapy vs. placebo ) .


At @ weeks , @ patients ( @ % ) who had received combination therapy , @ ( @ % ) who had received methotrexate alone , and @ ( @ % ) who had received placebo were in remission ( P = @ for combination therapy vs. methotrexate alone ; P = @ for combination therapy vs. placebo ; P = @ for methotrexate alone vs. placebo ) .


No significant between-group differences were observed in radiographic progression of disease .


Serious adverse events were reported in @ patients ( @ % ) in the combination-therapy group , @ ( @ % ) in the methotrexate-alone group , and @ ( @ % ) in the placebo group .


In patients with early rheumatoid arthritis who had a remission while receiving full-dose etanercept-plus-methotrexate therapy , continuing combination therapy at a reduced dose resulted in better disease control than switching to methotrexate alone or placebo , but no significant difference was observed in radiographic progression .


( Funded by Pfizer ; ClinicalTrials.gov number , NCT@ . )


Heart failure with reduced ejection fraction and obstructive sleep apnea ( OSA ) , @ states of increased metabolic demand and sympathetic nervous system activation , often coexist .


Continuous positive airway pressure ( CPAP ) , which alleviates OSA , can improve ventricular function .


It is unknown whether this is due to altered oxidative metabolism or presynaptic sympathetic nerve function .


We hypothesized that short-term ( @-@ weeks ) CPAP in patients with OSA and heart failure with reduced ejection fraction would improve myocardial sympathetic nerve function and energetics .


Forty-five patients with OSA and heart failure with reduced ejection fraction ( left ventricular ejection fraction @ % -LSB- meanSD -RSB- ) were evaluated with the use of echocardiography and @C-acetate and @C-hydroxyephedrine positron emission tomography before and @ to @ weeks after randomization to receive short-term CPAP ( n = @ ) or no CPAP ( n = @ ) .


Work metabolic index , an estimate of myocardial efficiency , was calculated as follows : ( stroke volume indexheart ratesystolic blood pressureKmono ) , where Kmono is the monoexponential function fit to the myocardial @C-acetate time-activity data , reflecting oxidative metabolism .


Presynaptic sympathetic nerve function was measured with the use of the @C-hydroxyephedrine retention index .


CPAP significantly increased hydroxyephedrine retention versus no CPAP ( retention : +@ -LSB- @ , @ -RSB- versus -@ -LSB- -@ , @ -RSB- min ( -@ ) ; P = @ ) .


There was no significant change in work metabolic index between groups .


However , in those with more severe OSA ( apnea-hypopnea index > @ events per hour ) , CPAP significantly increased both work metabolic index and systolic blood pressure ( P < @ ) .


In patients with heart failure with reduced ejection fraction and OSA , short-term CPAP increased hydroxyephedrine retention , indicating improved myocardial sympathetic nerve function , but overall did not affect energetics .


In those with more severe OSA , CPAP may improve cardiac efficiency .


Further outcome-based investigation of the consequences of CPAP is warranted .


We performed a pilot study examining the safety and tolerability of valacyclovir in veterans with herpes simplex virus type @ and hepatitis C virus ( HCV ) coinfection .


We performed a randomized double-blind , placebo-controlled , crossover clinical trial in U.S. veterans with genotype @ HCV/herpes simplex virus type @ coinfection .


Patients were randomized @:@ in blocks of @ to receive either @ g twice-daily valacyclovir or matching placebo for @ weeks followed by a @-week washout phase with daily placebo .


The alternate therapy ( valacyclovir or placebo ) was given for an additional @-week period .


Safety assessments were performed every @ weeks .


Changes in HCV RNA and alanine aminotransferase ( ALT ) were estimated using linear mixed models ( SAS Proc Mixed ) .


Thirty patients were enrolled .


Valacyclovir was not associated with toxicity or adverse events .


ALT levels declined @ % to @ % ; mean HCV RNA levels were reduced @ % ( @ million IU/mL -LSB- @ log@ IU/mL -RSB- ) during the valacyclovir phase ( P = @ ) with no carryover effect observed ( P = @ ) .


Valacyclovir @ g twice daily showed no evidence of hepatotoxicity in U.S. veterans with hepatitis C.


A modest reduction in serum levels of ALT and plasma levels of HCV RNA was observed .


Leucovorin is commonly used as folate supplement in @-fluorouracil-based chemotherapy , but needs to be converted to active @,@-methylenetetrahydrofolate ( methyleneTHF ) intracellularly .


This provides for interindividual differences .


MethyleneTHF has recently been developed into the stable , distributable drug , Modufolin .


The aim was to compare the concentration of folate metabolites in tumor , mucosa , and plasma of patients with colon cancer after administration of Modufolin or Isovorin ( levo-leucovorin ) .


Thirty-two patients scheduled for colon resection were randomized to receive Modufolin or Isovorin at dosage of @ or @ mg/m .


The study drug was given as one i.v. bolus injection after anesthesia .


Plasma was collected for pharmacokinetic ( PK ) analysis before , during , and after surgery .


Tissue biopsies were collected at surgery .


Folate metabolites were analyzed by LC-MS/MS .


MethyleneTHF and THF concentrations were significantly higher in mucosa ( p < @ , both dosages ) and tumors ( p < @ , @ mg/m ) after Modufolin as compared to Isovorin administration .


The results correlated with PK observations .


The Modufolin to Isovorin C ( max ) ratio for methyleneTHF was @ at @ mg/m and @ at @ mg/m ; the AUC ( last ) ratios were @ and @ , respectively .


The THF plasma concentrations were also higher after Modufolin administration ( C ( max ) ratio @ , AUC ( last ) ratio @ at @ mg/m ; C ( max ) ratio @ , AUC ( last ) ratio @ at @ mg/m ) .


Modufolin administration resulted in significantly higher methyleneTHF levels than Isovorin and may potentially increase the efficacy of @-fluorouracil-based chemotherapy .


The results encourage further evaluation of Modufolin as a substitute to Isovorin including the potential clinical benefits .


Therapy guided by N-terminal-pro-B-type natriuretic peptide ( NT-proBNP ) levels may improve outcomes in patients with chronic heart failure ( HF ) , especially in younger patients with reduced left ventricular ejection fraction .


It remains unclear whether treatment effects persist after discontinuation of the NT-proBNP-guided treatment strategy .


Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure randomized @ patients with HF aged@ years with left ventricular ejection fraction@ % to intensified , NT-proBNP-guided versus standard , symptom-guided therapy into prespecified age groups ( @-@ and @ years ) during @ months .


A total of @ patients ( @ % ) alive at @ months agreed to long-term follow-up .


HF medication was intensified to a larger extent in the NT-proBNP-guided group .


During long-term , NT-proBNP-guided therapy did not improve hospital-free ( primary end point : hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) or overall survival ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) but did improve HF hospitalization-free survival ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


Patients aged @ to @ years had benefit from NT-proBNP-guided therapy on the primary end point and HF hospitalization-free survival , whereas patients aged@ years did not ( P < @ for interaction ) .


In landmark analysis , there was no regression to the mean after cessation of the NT-proBNP-guided strategy .


More intensified HF medication at month @ was associated with better long-term HF hospitalization-free and overall survival .


Intensified , NT-proBNP-guided therapy did not improve the primary end point compared with symptom-guided therapy but did improve HF hospitalization-free survival .


Within the subgroup of patients aged @ to @ years , it improved clinical outcome including the primary end point .


These effects did not disappear after cessation of the NT-proBNP-guided strategy on the long-term .


This is possibly attributable to a more intensified HF medical therapy in the NT-proBNP-guided group .


Probiotics can modulate the immune system in healthy individuals and may help reduce symptoms related to respiratory infections .


The objective of the study was to investigate the effect of the probiotic strain Lactobacillus paracasei subsp .


paracasei , L. casei @ ( Chr .


Hansen A/S ) ( hereafter , L. casei @ ) on immune response to influenza vaccination and respiratory symptoms in healthy adults .


A randomized double-blind , placebo-controlled trial was conducted in @ healthy subjects aged @-@ y at @ centers in Germany and Denmark .


Subjects were randomly assigned to receive an acidified milk drink containing @ ( @ ) colony-forming units of L. casei @ ( n = @ ) or placebo ( n = @ ) for @ d.


After @ d , subjects received the seasonal influenza vaccination .


The primary outcome was seroprotection rate ( anti-influenza antibody titers by hemagglutination inhibition ) @ d after vaccination .


Other outcomes were seroconversion rate and mean titers , influenza A-specific antibodies and incidence , and duration and severity of upper respiratory symptoms .


Antibiotic use and use of health care resources were recorded .


There was no effect of L. casei @ on immune responses to influenza vaccination .


Generalized linear mixed modeling showed a shorter duration of upper respiratory symptoms in the probiotic group than in the placebo group ( mean SD : @ @ vs. @ @ d , P = @ ) in the last @ wk of the intervention period .


No statistically significant differences were found for incidence or severity .


Daily consumption of L. casei @ resulted in no observable effect on the components of the immune response to influenza vaccination but reduced the duration of upper respiratory symptoms .


The trial was registered at www.isrctn.com as ISRCTN@ .


Influenza vaccination is recommended for inflammatory bowel disease ( IBD ) patients on immunosuppressive therapy .


The objective was to evaluate the antibody and cell-mediated immune response to the split and whole virion influenza vaccine in patients with IBD treated with anti-TNF - and immunosuppressive therapy .


One hundred and fifty-six immunocompromised IBD patients were vaccinated .


Fifty-three patients ( control group ) refused vaccination .


Split virion vaccine and whole virion vaccine were used .


Serum samples were obtained for pre - and postimmunization antibody titers to influenza vaccine ( A/California/@ / @ -LSB- H@N@ -RSB- , A/Victoria/@ / @ -LSB- H@N@ -RSB- , B/Wisconsin/@ / @-like B/Hubei-Wujiagang/@ / @ ) .


Cell-mediated response was evaluated using an interferon ( INF ) - , interleukine ( IL ) -@ and tumor necrosis factor ( TNF ) - ELISA .


Postimmunization titers of both influenza subtypes increased significantly after the administration of split virion vaccines compared to the controls and to those who received whole virion vaccine .


The antibody titers of Influenza B also increased significantly in patients immunized with split vaccine and treated with anti-TNF - therapy .


After influenza vaccination , the level of serum IL-@ significantly decreased .


No serious side effects developed occurred after influenza vaccination , and the influenza-like symptoms did not differ significantly between vaccinated versus control patients .


The relapse of the disease was observed in only @ % of the patients and was more common in vaccinated than in control subjects .


Split virion vaccines seem to be more effective than whole virion vaccines .


Measuring the antibody responses is worthwhile in patients treated with immunosuppressants to determine the efficacy of influenza vaccination .


Bevacizumab improves outcome for patients with advanced colorectal cancer ( CRC ) when added to chemotherapy .


The HORIZON I trial resulted in similar outcome with bevacizumab or cediranib , a small-molecule tyrosine kinase inhibitor of vascular endothelial growth factor ( VEGF ) receptor , as treatment of advanced CRC .


The spectrum of lactate dehydrogenase ( LDH ) isoenzyme expression was examined in serum samples of HORIZON I participants to identify biomarkers predictive of efficacy of VEGF pathway inhibitors .


Total LDH levels , as well as LDH isoenzyme levels in frozen baseline serum samples , were retrospectively evaluated .


Total LDH serum levels measured during the study , progression-free survival ( PFS ) , and overall survival ( OS ) were available from the HORIZON I study data .


Total LDH levels measured in the frozen serum samples correlated with those measured in fresh samples .


The expected reciprocal correlation was found between hypoxic and oxic LDH isoenzymes .


High total LDH correlated with shorter PFS , and high hypoxia-related LDH isoenzymes correlated with shorter PFS and OS .


The difference in outcome of the cediranib-treated patients vs. those treated with bevacizumab was not substantially different in the various LDH isoform expression subgroups .


In patients with a hypoxic LDH pattern of expression , there was a nonsignificant trend of better outcome in cediranib-treated patients .


Evaluation of total LDH and its isoforms in frozen serum samples is feasible .


High total LDH and high hypoxic LDH isoenzymes were associated with poor prognosis .


Further studies are needed to evaluate the predictive value of LDH isoenzyme expression pattern for VEGF-pathway inhibition efficacy .


The aim of this study was to evaluate the clinical outcomes of intrastromal MyoRing ( Dioptex , GmbH , Linz , Austria ) implantation at @ different depths of @ and @ m.


This was a prospective interventional randomized controlled trial , a pilot study .


Keratoconic patients with keratometry values between @ and @ diopters were randomly divided into @ groups .


A continuous intrastromal corneal ring of the same size was implanted at @ different stromal depths of @ m ( group @ ) and @ m ( group @ ) using femtosecond laser technology for both groups .


Visual and refractive outcomes , keratometry , corneal biomechanical characteristics , and higher order aberrations were compared at the @-year postoperative follow-up .


In both groups , uncorrected distance visual acuity significantly improved after MyoRing implantation , whereas neither of these showed any improvement in the corrected distance visual acuity .


In addition , the mean central keratometry and spherical and cylindrical refraction reduced significantly in both groups , and spherical aberration increased significantly in both groups .


On one hand , coma was reduced almost significantly in both groups , and on the other hand , corneal hysteresis and corneal resistance factor did not change significantly after the operation .


None of the patients in both groups had intraoperative or postoperative complications .


There were no differences observed in any of the measured variables of the @ study groups .


An implantation depth of @ m has comparable outcomes with the previously applied @-m implantation depth .


It may be appropriate for selected cases of keratoconus with lower pachymetry .


Taxane-based adjuvant chemotherapy is standard in node-positive ( N + ) early breast cancer ( BC ) .


The magnitude of benefit in intermediate-risk N + early BC is still unclear .


WSG-AGO epiribicine and cyclophosphamide ( EC ) - Doc is a large trial evaluating modern taxane-based chemotherapy in patients with @-@ positive lymph nodes ( LNs ) only .


A total of @ BC patients ( @-@ years , pN@ ) were entered into a randomized phase III trial comparing @ E@C@ q@w followed by @ docetaxel @ q@w ( n = @ ) with the current standard : @ F@E@C@ q@w ( n = @ ) or C@M@F@ d@ , @ q@w ( n = @ ) .


Primary end point was event-free survival ( EFS ) ; secondary end points were overall survival ( OS ) , toxicity , translational research , and quality of life .


Central tumor bank samples were evaluable in a representative collective ( n = @ ; @ % ) .


Ki-@ was assessed centrally in hormone receptor-positive disease as a surrogate marker for the distinction of luminal A/B-like tumors .


Baseline characteristics were well balanced between study arms in both main study and central tumor bank subset .


At @-month median follow-up , superior efficacy of EC-Doc -LSB- versus FEC ( a combination of @-fluorouracil , epirubicin , and cyclophosphamide ) -RSB- was seen in EFS and OS : @-year EFS : @ % versus @ % ( P = @ ) ; @-year OS : @ % versus @ % ( P = @ ) ; both tests one-tailed .


EC-Doc caused more toxicity .


In hormone receptor-positive ( HR ) + disease , only high-Ki-@ tumors ( @ % ) derived significant benefit from taxane-based therapy : hazard ratio = @ ( @ % CI @-@ @ ) for EC-Doc versus FEC ( test for interaction ; P = @ ) .


EC-Doc significantly improved EFS and OS versus FEC in intermediate-risk BC ( @-@ LNs ) within all subgroups as defined by local pathology .


In HR + disease , patients with luminal A-like tumors may be potentially over-treated by taxane-based chemotherapy .


To clarify whether the results of repair of a complex mitral lesion ( Barlow valve ) at the intermediate-term follow-up are independent of the mode of surgical access -LSB- minithoracotomy vs. median sternotomy ( MS ) -RSB- .


In a prospective randomized study of mitral repair for Barlow disease using either a minimally invasive ( MI ) approach or MS , we achieved an average follow-up of @ years ( echocardiography , physical examination and quality of life ) .


Mitral repair was achieved with polytetrafluoroethylene chordal implantation for both leaflets .


Both groups included @ patients .


Mechanical ventilation time and intensive care unit and hospital stay were shorter in the MI group ( p = @ , p = @ and p = @ , respectively ) .


During the follow-up , @ patients in each group ( @ % ) displayed mild mitral regurgitation , while @ patients in each group ( @ % ) developed recurrent regurgitation graded as at least moderate/severe .


The rate of mitral reoperation was @ % in the MI group and @ % in the MS group ( p = @ ) .


The overall follow-up mortality was @ % in both the MI and the MS groups .


The @-year results of repair of Barlow valves were satisfactory irrespective of the approach used to repair the valve .


The advantages of MI surgery can be achieved in patients with mitral Barlow disease without concerns over the durability of repair .


To study the clinical value of the preeclampsia risk assessment system , and to explore the preventive effect of Qiju Dihuang Oral Liquid ( QDOL ) on preeclampsia patients .


Totally @ @ pregnant women in the gestational week @ -@ were equally assigned to Group A and Group B by randomized sampling .


Their preeclampsia incidence was respectively assessed by preeclampsia risk assessment system and mean arterial pressure method .


Of them , @ pregnant women at predicted high risk of preeclampsia were assigned to the control group and the treatment group , @ in each group .


All received routine treatment .


Patients in the treatment group additionally took QDOL , @ mL each time , twice daily ; @ consecutive weeks per month for totally @ weeks ; lasting for six consecutive courses or ending according to the therapeutic course .


The incidence was observed and compared between the two groups .


The predicted coincidence rate of the risk assessment system was @ % , higher than that of mean arterial pressure method ( @ % , P < @ ) .


The incidence rate of the treatment group was @ % , lower than that of the control group ( @ % , P < @ ) .


The preeclampsia risk assessment system was more accurate .


QDOL could lower the incidence of preeclampsia as intervention .


To compare the efficacy of two modes of delivery of information for patients undergoing functional endoscopic sinus surgery : website and printed leaflet .


A two-centre , prospective , single-blinded , randomised , controlled trial was conducted , comparing mode of information delivery .


Adult patients were randomly allocated to receive pre-operative information regarding functional endoscopic sinus surgery , either via a website or a printed leaflet .


Primary outcomes , measured by questionnaire , were : readability , usability and recall of complications .


Fifty-eight patients were recruited .


Fifty met the inclusion criteria , of which @ were analysed in the study ( @ patients per group ) , meeting the power criteria set .


There were @ male and @ female patients , ranging in age from @ to @ years ( mean , @ years ) .


Patients found both the printed leaflet and the website readable , and were satisfied with the usability of both modes .


There were similar rates for recall of complications in both study arms .


Patient information on functional endoscopic sinus surgery can be provided either as a printed leaflet or a website , with similar rates for usability , readability and recall of complications .


These findings could help tailor the provision of pre-operative information for patients undergoing functional endoscopic sinus surgery , based on patient preference .


Phenolization is often used to treat ingrown toenails .


Alcohol lavage with or without supplemental chlorhexidine may be used to remove residual phenol , which can contribute to side effects such as persistent oozing or drainage .


We sought to compare the effectiveness in removing residual phenol of lavage with alcohol plus chlorhexidine versus alcohol alone .


We studied @ patients who underwent unilateral phenol matricectomy : @ who received irrigation with alcohol alone and @ who received irrigation with alcohol plus chlorhexidine .


Phenol levels were measured after each of @ rounds of @-mL irrigations .


After the first irrigation , an average of @ % and @ % of the phenol remained in the nailfold in the alcohol and the alcohol/chlorhexidine groups , respectively ( P < @ ) .


After all @ irrigations , no difference in efficacy between the @ solutions was found ( P > @ ) .


It was not possible to calculate the quantity of phenol initially introduced into the nail bed .


The percentage remaining was calculated from the total amount of phenol recovered .


When a single irrigation step is performed after phenolization , alcohol plus chlorhexidine is more effective than alcohol alone for removing residual phenol .


When multiple irrigations are performed , the @ solutions are equally effective .


This study aimed to investigate the clinical significance of @-dimensional ( @D ) reconstruction of peripancreatic vessels for patients with suspected pancreatic cancer ( PC ) .


A total of @ patients with PC were included ; @ patients randomly underwent computed tomographic angiography .


Based on the findings of @D reconstruction of peripancreatic vessels , the appropriate method for individualized tumor resection was determined .


These patients were compared with @ conventionally treated patients with PC .


The rate of visualization was @ % for great vessels around the pancreas .


The detection rates for anterior superior pancreaticoduodenal artery , posterior superior pancreaticoduodenal artery , anterior inferior pancreaticoduodenal artery , posterior inferior pancreaticoduodenal artery , dorsal pancreatic artery , superior marginal arterial branch of the pancreatic head , anterior superior pancreaticoduodenal vein , posterior superior pancreaticoduodenal vein , anterior inferior pancreaticoduodenal vein , and posterior inferior pancreaticoduodenal vein were @ % , @ % , @ % , @ % , @ % , @ % , @ % , @ % , @ % , and @ % , respectively .