In spite of widespread usage , the effectiveness and safety of combined treatments between conventional and complementary alternative medical treatment modalities has not been fully established in a rigorous randomized clinical trial ( RCT ) .


This pilot study will provide the clinical evidence to evaluate the feasibility and refine the protocol for a full-scale RCT on combined treatment of bee venom acupuncture ( BVA ) and non-steroidal anti-inflammatory drugs ( NSAIDs ) in patients with CNP .


This is a randomized , single-blind clinical trial with three parallel arms .


Sixty patients between @ and @years of age with non-specific , uncomplicated neck pain lasting for at least three months will be enrolled .


Participants will be randomly allocated into the BVA , NSAIDs or combined treatment group .


Assessors and statisticians will be blinded to the random allocation .


All researchers will receive training to ensure their strict adherence to the study protocol .


Patients from the BVA and combined treatment group will be treated with a bee venom increment protocol into predefined acupoints for six sessions over a three week period .


BVA intervention is developed through a comprehensive discussion among interdisciplinary spine disorder experts , according to the guidelines of Standards for Reporting Interventions in Clinical Trials of Acupuncture ( STRICTA ) .


Patients from the NSAIDs and combined treatment groups will be prescribed loxoprofen ( one tablet to be taken orally , three times a day for three weeks ) .


Bothersomeness from CNP measured using a visual analogue scale ( VAS ) will be the primary outcome assessed at screening , visit two ( baseline ) , four , six , eight ( @th week assessment ) and nine ( @th week assessment ) follow-up session .


VAS for pain intensity , neck disability index ( NDI ) , quality of life , depressive status and adverse experiences will also be analyzed .


Our study results will contribute to feasibility evaluation and to relevant RCT protocol development for a full-scale RCT on combined treatment of BVA and NSAIDs for CNP patients .


To discuss the impacts of moxibustion for regulating spleen and stomach function on the survival quality of the patients of end stage renal disease ( ESRD ) with maintenance hemodialysis ( MHD ) .


One hundred and nine cases of uremia with MHD from @ hemodialysis centers were randomized into an observation group ( @ cases ) and a control group ( @ cases ) .


The regular hemodialysis and conventional medication were used in the two groups .


In the observation group , on the basis of the common treatment , moxibustion was applied to Zusanli ( ST @ ) and Sanyinjiao ( SP @ ) , @-@ times a day , the treatment of @ weeks made one session .


Totally , @ sessions were required and the follow-up lasted for @ months .


KDQOL-SF ( kidney disease quality of life short form,KDQOL-SFTM @ ) was adopted for the questionnaire investigation on survival quality before treatment , after treatment and at the end of follow-up separately in the two groups .


After treatment , the survival quality scores in terms of physical functioning ( @ + / -@ vs @ + / - @ ) , general health ( @ + / - @ vs @ + / -@ ) and vitality ( @ + / -@ vs @ + / -@ ) in the observation group were higher than those in the control group ( all P < @ ) .


In comparison before and after treatment in the same group , the survival quality scores in terms of physical functioning , general health , vitality and symptoms/problems were all improved in the observation group ( all P < @ ) .


At the end of follow-up , the survival quality scores in terms of physical functioning , general health , mental health , social functioning , vitality , effects of kidney disease and cognitive function were higher in the observation group as compared with those in the control group ( all P < @ ) .


In comparison of the results at the end of follow-up with those before treatment , the survival quality scores in terms of vitality , symptoms/problems and cognitive function in the observation group were improved ( all P < @ ) .


The differences were not significant in all of the @ fields of survival quality evaluation before and after treatment , and after follow-up in the control group ( all P > @ ) .


Moxibustion for regulating spleen and stomach function improves the survival quality of the patients with hemodialysis in terms of physical functioning , general health and vitality , which benefits the psychological condition of the patients , resulting in the improvements of the survival quality in the fields of mental health , social functioning , effects of kidney disease and cognitive function .


The optimal duration of a public heart failure ( HF ) clinic programme is unknown .


This substudy of the NT-proBNP stratified follow-up in outpatient heart failure clinics ( NorthStar ) trial was designed to evaluate the effect of extended follow-up in an outpatient HF clinic on long-term adherence to guideline-based therapy .


Patients with HF with reduced EF on optimal medical therapy ( n = @ ) were randomized to either extended follow-up in the HF clinic ( n = @ ) or discharge to primary care ( n = @ ) and followed for a median of @ years ( range : @ months to @ years ) .


The effect of the HF clinic intervention on treatment adherence ( time to at least a @ day break in treatment ) was estimated by drug dispensing from pharmacies of an ACE inhibitor/ARB , beta-blocker ( BB ) , or mineralocorticoid receptor antagonist ( MRA ) .


Median age was @ years , @ % were females , LVEF was @ % , and @ % were in NYHA class II-III .


The HF clinic intervention did not reduce time to a @ day break in treatment with either an ACE inhibitor/ARB -LSB- hazard ratio ( HR ) @ , @ % confidence interval ( CI ) @-@ @ , P = @ -RSB- , a BB ( HR @ , @ % CI @-@ @ , P = @ ) , or an MRA ( HR @ , @ % CI @-@ @ , P = @ ) .


Extended follow-up in an outpatient HF clinic did not improve long-term adherence to guideline-based therapy , and adherence did not deteriorate when follow-up was shifted from the HF clinic to primary care .


This phase II , open-label , randomised study evaluated whether patients with metastatic pancreatic cancer receiving erlotinib/gemcitabine derived survival benefits from increasing the erlotinib dose .


After a @-week run-in period ( gemcitabine @ mg m ( -@ ) once weekly plus erlotinib @ mg per day ) , patients with metastatic pancreatic cancer who developed grade @/@ rash were randomised to receive gemcitabine plus erlotinib dose escalation ( @ mg , increasing by @ mg every @ weeks ( maximum @ mg ) ; n = @ ) or gemcitabine plus standard-dose erlotinib ( @ mg per day ; n = @ ) .


The primary end point was to determine whether overall survival ( OS ) was improved by increasing the erlotinib dose .


Secondary end points included progression-free survival ( PFS ) , incidence of grade @ rash , and safety .


Erlotinib dose escalation induced grade @ rash in @ out of @ ( @ % ) patients compared with @ out of @ ( @ % ) patients on standard dose .


Efficacy was not significantly different in the dose-escalation arm compared with the standard-dose arm ( OS : median @ vs @ months , respectively , hazard ratio ( HR ) , @ , @ % confidence interval ( CI ) : @-@ @ ; P = @ ; PFS : median @ vs @ months , respectively , HR , @ , @ % CI : @-@ @ ; P = @ ) .


Incidence of adverse events was comparable between randomised arms .


The erlotinib dose-escalation strategy induced rash in some patients ; there was no evidence that the higher dose translated into increased benefit .


Globally , non-attendance for immunization appointments remains a challenge to healthcare providers .


A review of the @ immunization coverage for Kadoma City , Zimbabwe was @ % for Oral Polio Vaccine ( OPV ) , Pneumococcal and Pentavalent antigens .


The immunization coverage was less than @ % , which is the target for Kadoma City .


Adoption of short message services ( SMS ) reminders has been shown to enhance attendance in some medical settings .


The study was conducted to determine the effectiveness of SMS reminders on immunization programme for Kadoma City .


A randomized controlled trial was conducted at Kadoma City clinics in Zimbabwe .


Women who delivered and were residents of Kadoma City were recruited into the study .


In the intervention group , SMS reminders were sent at @ , @ and @weeks in addition to routine health education .


In the non-intervention no SMS reminders were used , however routine health education was offered .


Data were collected using interviewer administered questionnaire .


Data were analyzed using Epi Info @ , where frequencies , means , risk ratios and risk differences were generated .


A total of @ participants were recruited , @ for the intervention group and @ for the non-intervention group .


The immunization coverage at @weeks was @ % in the intervention group and @ % in the non-intervention group ( p < @ ) .


At @weeks immunization coverage was @ % for intervention and @ % for non-intervention group ( p < @ ) .


Those who did not delay receiving immunization at @weeks was @ % for the intervention and @ % for non-intervention group .


Median delay for intervention was @days ( Q@ = @ ; Q@ = @ ) and @days ( Q@ = @ ; Q@ = @ ) for non-intervention group .


The risk difference ( RD ) for those who received SMS reminders than those in the non intervention group was @ % ( @ % CI : @-@ @ ) at @weeks .


Immunization coverage in the intervention group was significantly higher than in non-intervention group .


Overall increase in immunization coverage can be attributed to use of SMS .


Psoriasis and psoriatic arthritis ( PsA ) impair quality of life , including reduction in employment or job duties .


The PRESTA ( Psoriasis Randomized Etanercept STudy in Patients with Psoriatic Arthritis ) study , a randomized , double-blind , two-dose trial , examined the efficacy of etanercept treatment in patients with moderate-to-severe plaque psoriasis and PsA and the main results have been presented previously .


This analysis examined employment status , job duties and sick days , pre-defined endpoints in PRESTA , among this patient population .


Participants ( N = @ ) were randomized to receive etanercept @ mg twice weekly ( BIW ; n = @ ) or @ mg once weekly ( QW ; n = @ ) for @ weeks by subcutaneous injection .


All participants then received open-label etanercept @ mg QW for @ additional weeks , while remaining blinded to the randomization .


A pharmacoeconomic questionnaire was administered at baseline , week @ and week @ of treatment .


The questionnaire included employment status and changing job responsibilities and sick time taken due to psoriasis or PsA .


The statistical methods included analysis of covariance , t-test , Fisher 's exact test and McNemar 's test .


Last-observation-carried-forward imputation was used for missing data .


Employment was at least maintained from baseline to week @ in both dose groups ( @ % -LSB- BIW/QW -RSB- and @ % -LSB- QW/QW -RSB- at baseline , @ % and @ % , respectively , at week @ ) .


Among employed participants , the proportion of patients whose job responsibilities changed due to PsA decreased significantly from baseline to week @ ( @-@ % to @-@ % ; p < @ ) .


Similar results were seen with job responsibility changes due to psoriasis ( @-@ % to @ % ; p < @ ) .


The number of monthly sick days also decreased from baseline to week @ ( @ days for both treatment groups to @ ( BIW/QW ) and @ ( QW/QW ) ; p@ @ for each ) .


No significant differences between the treatment groups were observed for any economic endpoint at any time point .


For patients with moderate-to-severe plaque psoriasis and PsA , etanercept treatment resulted in reducing job responsibility changes due to disease and in reducing sick time .


Effective treatment of psoriasis and PsA may reduce missed work days .


A decision of the Federal Joint Committee Germany in @ stated that negative pressure wound therapy is not accepted as a standard therapy for full reimbursement by the health insurance companies in Germany .


This decision is based on the final report of the Institute for Quality and Efficiency in Health Care in @ , which demonstrated through systematic reviews and meta-analysis of previous study projects , that an insufficient state of evidence regarding the use of negative pressure wound therapy for the treatment of acute and chronic wounds exists .


Further studies were therefore indicated .


The study is designed as a multinational , multicenter , prospective randomized controlled , adaptive design , clinical superiority trial , with blinded photographic analysis of the primary endpoint .


Efficacy and effectiveness of negative pressure wound therapy for wounds in both medical sectors ( in - and outpatient care ) will be evaluated .


The trial compares the treatment outcome of the application of a technical medical device which is based on the principle of negative pressure wound therapy ( intervention group ) and standard conventional wound therapy ( control group ) in the treatment of subcutaneous abdominal wounds after surgery .


The aim of the SAWHI-VAC study is to compare the clinical , safety and economic results of both treatment arms .


The study project is designed and conducted with the aim of providing solid evidence regarding the efficacy of negative pressure wound therapy .


Study results will be provided until the end of @ to contribute to the final decision of the Federal Joint Committee Germany regarding the general admission of negative pressure wound therapy as a standard of performance within both medical sectors .


Cough protects the lungs from aspiration .


We investigated whether respiratory muscle training may improve respiratory muscle and cough function , and potentially reduce pneumonia risk in acute stroke .


We conducted a single-blind randomized placebo-controlled trial in @ patients with stroke ( mean age , @ years ; @ men ) within @ weeks of stroke onset .


Participants were masked to treatment allocation and randomized to @ weeks of daily expiratory ( n = @ ) , inspiratory ( n = @ ) , or sham training ( n = @ ) , using threshold resistance devices .


Primary outcome was the change in peak expiratory cough flow of maximal voluntary cough .


Intention-to-treat analyses were conducted using ANCOVA , adjusting for baseline prognostic covariates .


There were significant improvements in the mean maximal inspiratory ( @ cmH@O ; P < @ ) and expiratory ( @ cmH@O ; P < @ ) mouth pressure and peak expiratory cough flow of voluntary cough ( @ L/min ; P = @ ) between baseline and @ days in all groups .


Peak expiratory cough flow of capsaicin-induced reflex cough was unchanged .


There were no between-group differences that could be attributed to respiratory muscle training .


There were also no differences in the @-day incidence of pneumonia between the groups ( P = @ ) .


Respiratory muscle function and cough flow improve with time after acute stroke .


Additional inspiratory or expiratory respiratory muscle training does not augment or expedite this improvement .


To determine whether prolonged androgen suppression ( AS ) duration before radiotherapy improves survival and disease control in prostate cancer .


One thousand five hundred seventy-nine men with intermediate-risk prostate cancer were randomly assigned to @ weeks of AS followed by radiotherapy with an additional @ weeks of concurrent AS ( @ weeks total ) or to @ weeks of AS followed by radiotherapy with an additional @ weeks of AS ( @ weeks total ) .


The trial sought primarily to detect a @ % reduction in the hazard of prostate cancer death in the @-week assignment .


Time-to-event end points are reported for up to @ years of follow-up .


There were no between-group differences in baseline characteristics of @,@ eligible patients with follow-up .


For the @ - and @-week assignments , @-year disease-specific survival rates were @ % ( @ % CI , @ % to @ % ) and @ % ( @ % CI , @ % to @ % ; hazard ratio -LSB- HR -RSB- , @ ; P = @ ) , respectively , and @-year overall survival rates were @ % ( @ % CI , @ % to @ % ) and @ % ( @ % CI , @ % to @ % ; HR , @ ; P = @ ) , respectively .


For the @ - and @-week assignments , @-year cumulative incidences of locoregional progression were @ % ( @ % CI , @ % to @ % ) and @ % ( @ % CI , @ % to @ % ; HR , @ ; P = @ ) , respectively ; @-year distant metastasis cumulative incidences were @ % ( @ % CI , @ % to @ % ) and @ % ( @ % CI , @ % to @ % ; HR , @ ; P = @ ) , respectively ; and @-year prostate-specific antigen-based recurrence cumulative incidences were @ % ( @ % CI , @ % to @ % ) and @ % ( @ % CI , @ % to @ % ; HR , @ ; P = @ ) , respectively .


Extending AS duration from @ weeks to @ weeks before radiotherapy did not improve outcomes .


A lower than expected prostate cancer death rate reduced ability to detect a between-group difference in disease-specific survival .


The schedule of @ weeks of AS before radiotherapy plus @ weeks of AS during radiotherapy remains a standard of care in intermediate-risk prostate cancer .


Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are the cornerstones of pharmacologic therapy in diabetic nephropathy .


Mineralocorticoid receptor blockers reduce proteinuria as single agents or add-on therapy to other renin-angiotensin-aldosterone system-inhibiting drugs in these patients .


The long-term benefits and ultimate role of mineralocorticoid receptor blockers in diabetic nephropathy remain unknown .


A clinical trial previously showed that the kalemic effect of spironolactone is higher than losartan when added to lisinopril in patients with diabetic nephropathy .


The purpose of this study was to investigate if renal potassium handling was primarily responsible for that observation .


In a blinded , randomized , three-arm placebo-controlled clinical trial , @ participants with diabetic nephropathy taking lisinopril ( @ mg ) were randomized to spironolactone ( @ mg daily ) , losartan ( @ mg daily ) , or placebo ( trial dates from July of @ to December of @ ) .


Serum potassium , aldosterone , and @-hour urine sodium , potassium , and creatinine were measured over @ weeks .


Differences were analyzed with repeated measures mixed models .


Mean follow-up serum potassium was @ mEq/L for spironolactone , @ mEq/L for losartan ( P = @ versus spironolactone ) , and @ mEq/L for placebo ( P < @ versus spironolactone ; P = @ versus losartan ) .


The difference in serum potassium was @ mEq/L for losartan versus placebo ( P = @ ) , @ mEq/L for spironolactone versus placebo ( P < @ ) , and @ mEq/L for spironolactone versus losartan ( P = @ ) .


Serum and urine potassium excretion and secretion rates were similar between groups throughout the study .


Spironolactone raised serum potassium more than losartan in patients with diabetic nephropathy receiving lisinopril , despite similar renal sodium and potassium excretion .


This finding suggests that extrarenal potassium homeostasis contributes to hyperkalemia in these patients .


A better understanding of extrarenal potassium homeostasis will provide an opportunity to use this drug more safely in patients with diabetic nephropathy as well as other patient populations .


The management of postoperative pain is paramount to facilitate the delivery of day case surgical programs .


In recent years , the complexity of procedures carried out has increased to include laparoscopic cholecystectomy .


The aim of this study was to evaluate the impact of laparoscopic-assisted @-quadrant transversus abdominis plane ( TAP ) block vs periportal local anesthetic wound infiltration in managing postoperative pain .


A prospective , randomized , double-blinded trial was conducted with patients undergoing elective laparoscopic cholecystectomy .


Patients were randomized using computerized `` random number table '' into a test group that received laparoscopic-assisted TAP block with bupivacaine with periportal saline injection and a control group that received a laparoscopic-assisted TAP block with saline and periportal bupivacaine .


All patients received intraperitoneal instillation of bupivacaine in the gallbladder bed .


Postoperative pain scores were recorded using numerical rating scores at rest and coughing at dedicated time points .


Statistical analysis was carried out using GraphPad Prism software , version @ ( GraphPad Software ) and p < @ was considered significant .


Eighty patients ( @ female and @ male ) were enrolled ; @ patients were randomized to each group .


Age , American Society of Anesthesiologists score , operative time , and BMI were comparable between the groups .


No adverse events were encountered with the administration of TAP blocks .


Numerical rating scores were significantly reduced in the test group at @ , @ , and @ hours at rest ( p = @ , p = @ , and p = @ , respectively ) .


Numerical rating score was significantly reduced at @ , @ , and @ hours during coughing ( p = @ , p = @ , and p = @ , respectively ) .


Difference in postoperative analgesic requirements between both groups was statistically insignificant ( p = @ ) .


This analysis has confirmed the therapeutic benefit of laparoscopically delivered TAP blocks in elective laparoscopic cholecystectomy .


Sex differences in Parkinson disease clinical features have been reported , but few studies have examined sex influences on use of dopaminergic medication in early Parkinson disease .


The objective of this study was to test if there are differences in the type of dopaminergic medication used and levodopa equivalent daily dose between men and women with early Parkinson disease enrolled in a large multicenter study of Creatine as a potential disease modifying therapy - the National Institute of Neurological Disorders and Stroke Exploratory Trials in Parkinson Disease Long-Term Study-@ .


Baseline data of @,@ participants from @ participating sites were analyzed .


Participants from the United States and Canada were enrolled within five years of Parkinson Disease diagnosis .


Two outcome variables were studied : type of dopaminergic medication used and levodopa equivalent daily dose at baseline in the Long-Term Study-@ .


Chi-square statistic and linear regression models were used for statistical analysis .


There were no statistically significant differences in the frequency of use of different types of dopaminergic medications at baseline between men and women with Parkinson Disease .


A small but statistically significant difference was observed in the median unadjusted levodopa equivalent daily dose at baseline between women ( @ mg ) and men ( @ mg ) , but this was not observed after controlling for disease duration ( years since Parkinson disease diagnosis ) , disease severity ( Unified Parkinson 's Disease Rating Scale Motor and Activities of Daily Living Scores ) , and body weight .


In this large multicenter study , we did not observe sex differences in the type and dose of dopaminergic medications used in early Parkinson Disease .


Further research is needed to evaluate the influence of male or female sex on use of dopaminergic medication in mid - and late-stage Parkinson Disease .


to evaluate the clinical , hemodynamic , gas analysis and metabolic repercussions of high transient pressures of pneumoperitoneum for a short period of time to ensure greater security for introduction of the first trocar .


sixty-seven patients undergoing laparoscopic procedures were studied and randomly distributed in P@ group : n = @ ( intraperitoneal pressure -LSB- IPP -RSB- @mmHg ) and P@ group : n = @ ( IPP of @mmHg ) .


Mean arterial pressure ( MAP ) was evaluated by catheterization of the radial artery ; and through gas analysis , pH , partial pressure of oxygen ( PaO@ ) , partial pressure of CO@ ( PaCO@ ) , bicarbonate ( HCO@ ) and alkalinity ( BE ) were evaluated .


These parameters were measured in both groups at time zero before pneumoperitoneum ( TP@ ) ; at time @ ( TP@ ) when IPP reaches @mmHg in both groups ; at time @ ( TP@ ) after five min with IPP = @mmHg in P@ and after @min with IPP = @mmHg at P@ ; and at time @ ( TP@ ) after @min with IPP = @mmHg in P@ and with return of IPP from @ to @mmHg , starting @min after TP@ in P@ .


Different values from those considered normal for all parameters assessed , or the appearance of atypical organic phenomena , were considered as clinical changes .


there were statistically significant differences in P@ group in MAP , pH , HCO@ and BE , but within normal limits .


No clinical and pathological changes were observed .


high and transient intra-abdominal pressure causes changes in MAP , pH , HCO@ and BE , but without any clinical impact on the patient .


To evaluate the effect of oral prednisolone on recovery from tonsillectomy .


Prospective , randomized , controlled trial of @ consecutive patients , aged @ years and older , with no previous or known contraindications to steroid therapy .


All @ patients scheduled for elective tonsillectomy with or without adenoidectomy from April @ to April @ were included .


The participants were then randomly assigned to receive a postoperative course of prednisolone @ mg/kg/d or no prednisolone over @ days .


During the first postoperative day , pain , type of diet ( none , fluid , soft , normal ) , type of activity ( none , bed rest , quiet , restricted , normal ) , presence of nausea and vomiting , postoperative bleeding rate , and sleep disturbance were assessed using questionnaires .


All patients were followed up on days @ and @ by endoscopic photographic examination of both tonsillar fossa and by completion of questionnaires .


No statistically significant differences in pain , diet , activity , rate of minor bleeding , nausea/vomiting , fever , or sleep disturbance were observed between the groups on day @ .


On day @ , however , in pediatric patients , differences in pain ( P = @ ) , diet ( P = @ ) , activity ( P = @ ) , mean area of re-epithelialization ( P = @ ) , fever ( P = @ ) , and sleep disturbance ( P = @ ) were observed .


On day @ , differences in the mean area of re-epithelialization ( P = @ , @ ) remained in both pediatric and adult patients .


Oral prednisolone may be beneficial during recovery from tonsillectomy without causing any serious complications .


Advanced glycation end products and their cell-bound receptors are thought to mediate the adverse effects of vascular disease through oxidative stress , inflammation and endothelial dysfunction .


We examined the association between the soluble form of receptor for advanced glycation end products ( sRAGE ) and kidney disease .


In this case-cohort study nested within the Atherosclerosis Risk in Communities ( ARIC ) study , baseline sRAGE levels were measured in a cohort random sample of participants without kidney disease ( n = @ ) , and among participants who developed incident chronic kidney disease ( CKD ) -LSB- estimated glomerular filtration rate ( eGFR ) < @ mL/min/@ @ m ( @ ) and @ % eGFR decline , n = @ -RSB- and end-stage renal disease ( ESRD ) -LSB- entry in the US Renal Data System ( USRDS ) registry , n = @ -RSB- .


Baseline sRAGE levels were inversely related to baseline eGFR ( r = -@ ) .


After adjusting for age , sex and race , one interquartile range higher log@-transformed sRAGE was associated with development of CKD -LSB- odds ratio : @ ; @ % confidence interval ( @ % CI ) @-@ @ ; P = @ -RSB- and ESRD ( hazard ratio : @ ; @ % CI @-@ @ ; P < @ ) .


These associations were not significant after eGFR adjustment .


High sRAGE levels are associated with incident CKD and ESRD risk , but not after adjustment for kidney function at baseline .


Future studies are needed to investigate specific mechanisms underlying the association of sRAGE with kidney disease risk .


The continuous progress in treatment options for pancreatic adenocarcinoma has lead to a re-evaluation of prognostic markers .


In this study the prognostic relevance of DNA Index and classical histopathological parameters with regard to disease-free ( DFS ) and overall survival ( OS ) was analyzed within the CONKO-@ patient population .


One hundred forty three fresh-frozen paraffin-embedded tissue samples of the resected tumor specimen of the CONKO-@ patient population were available for DNA index analysis to evaluate its impact on patient outcome .


Median DFS ( @ vs. @ months ; P = @ ) and median OS ( @ vs. @ months ; P = @ ) were significantly decreased in patients with a high DNA index ( > @ ) .


Multivariate analysis revealed both DNA index ( DFS : P = @ ; OS : P = @ ) and tumor grading ( DFS : P = @ ; OS : P = @ ) as individual prognostic markers for DFS and OS .


The following prognostic subgroups were identified : good ( low DNA Index + G@/@ tumor grading ) , intermediate ( low DNA Index + G@ tumor grading or high DNA Index + G@/@ tumor grading ) , poor ( high DNA Index + G@ tumor grading ) .


The DNA index/tumor grading constellation may serve as a helpful guide for personalized treatment recommendations for adjuvant therapy of patients with pancreatic adenocarcinoma .


Lung cancer has high mortality rates , with up to @ % of patients dying within one to two years of its onset .


It is essential to carry out research to attempt to solve the problems .


Most patients suffer serious fatigue resulting from various symptoms and its long-term treatment .


Furthermore , the other related complications such as underlying disease , anemia , malnutrition , nausea , and vomiting can reduced tolerance of chemotherapy .


Study showed that nurses are the only hospital staff involved in managing fatigue .


As it remains unclear to how fatigue should be managed , it is important to devise a strategy for providing a better service to help these patients survive longer .


To examine fatigue scores in patients with lung cancer after chemotherapy treatment , and to compare the scores of the group receiving the multidisciplinary education program in self-care group with those of the control group .


A randomized controlled trial was conducted in two groups .


The control group and the trial group were @ patients in each .


Studied aged from @ to @ years old who were receiving chemotherapy at the Chemotherapy Unit in the Out-Patients Department , Rajavithi Hospital .


For a nine-week period , the control group received the hospital 's normal care program while the trial group received the multidisciplinary education program in self-care on fatigue .


Scores were allocated to each individual to reflect their levels of fatigue , nutrition , physical fitness , and depression , compared using Independent t-test , Fisher exact test , and Mann-Whitney U-test .


Sixty patients were enrolled into the study ( mean age = @ ( @-@ ) , male = @ % ) .


The basic characteristics of each individual were not significantly different between the two groups .


The mean ( + / - SD ) fatigue scores were @ + / - @ and @ + / - @ for the control and the trial group respectively , and these figures were statistically significant ( p = @ ) .


Nutrition scores were significantly higher in the trial group than in the control group ( p = @ ) , but the other scores weight , albumin , physical fitness , and depression were not significantly different between the two groups .


The multidisciplinary education program in self-care results in decreased fatigue in patients with lung cancer who are receiving chemotherapy .


Therefore , it is recommended that more health professionals and specialists participate actively inpatient care to respond directly to patients ' needs .


This strategy should be adopted as the standard guideline for caring for patients with cancer who are receiving chemotherapy , and for patients with other conditions .


The present study aimed to determine that whether L-carnitine infusion could ameliorate fasting-induced adverse effects and improve outcomes .


In this @-day , randomized , single-blind , placebo-controlled , pilot study , @ metabolic syndrome ( MetS ) patients ( @/@ F/M ; age @ @ years ; body mass index -LSB- BMI -RSB- @ @ kg/m@ ) were in the L-carnitine group ( LC ) and @ ( @/@ F/M ; age @ @ years ; BMI @ @ kg/m@ ) were in the control group ( CT ) .


All participants underwent a @-day modified fasting therapy introduced with @-day moderate calorie restriction .


Patients in the LC group received @ g/day of intravenous L-carnitine , while patients in the CT group were injected with saline .


Blood pressure ( BP ) , anthropometric characteristics , markers of liver function , metabolic indices ( plasma glucose , lipid profiles , uric acid , free fatty acid and insulin ) and hypersensitivity C-reactive protein were measured .


Perceived hunger was recorded daily by self-rating visual analogue scales .


Fatigue was evaluated by Wessely and Powell scores .


In contrast to the CT group , total cholesterol , alanine aminotransferase , systolic and diastolic BP did not change significantly in the LC group after prolonged fasting .


There were significant differences in weight loss ( LC -@ @ vs. CT -@ @ kg , P = @ ) , and waist circumference ( LC -@ @ vs. CT -@ @ cm , P < @ ) , waist hip ratio ( LC -@ @ vs. CT @ @ , P < @ ) , insulin concentration ( LC -@ @ vs. CT -@ @ U/mL , P = @ ) , and - glutamyltransferase concentration ( LC -@ @ vs. CT -@ @ , P = @ ) .


Perceived hunger scores were significantly increased ( P < @ ) in the CT group during starvation , which was alleviated with L-carnitine administration in the LC group .


Physical fatigue ( LC -@ @ vs. CT @ @ , P < @ ) and fatigue severity ( LC -@ @ vs. CT @ @ , P < @ ) were significantly reduced in the LC group but were aggravated in the CT group .


Intravenous L-carnitine can ameliorate fasting-induced hunger , fatigue , cholesterol abnormalities and hepatic metabolic changes and facilitate fasting-induced weight loss in MetS patients .


Caustic substance ingestion in childhood is a public health issue in developing countries , and several management protocols have been proposed to prevent the resulting esophageal strictures .


The role of corticosteroids in preventing corrosive-induced strictures is controversial .


Our aim was to study the influence of high doses of corticosteroids in preventing esophageal strictures .


Eighty-three children with a mean age of @ @ @ years and with grade IIb esophageal burns ( an esophagogastroscopy was performed within @ hours of injury ) due to corrosive substance ingestion were enrolled in our study between @ and @ .


Forty-two children ( study group ) received methylprednisolone ( @ g/@ @ m@ per day for @ days ) , ranitidine , ceftriaxone , and total parenteral nutrition .


Forty-one children ( control group ) were administered the same regimen excluding methylprednisolone .


Stricture development was compared between groups based on endoscopic and radiologic findings .


During the endoscopic examination , stricture development was observed in @ patients ( @ % ) in the study group and in @ patients ( @ % ) in the control group .


The difference was statistically significant ( P = @ ) .


The stricture development rate in the upper gastrointestinal system with barium meal was @ % and @ % in the study and control groups , respectively .


The duration of total parenteral nutrition was shorter in the study group compared with the control group ( P = @ ) .


High doses of methylprednisolone were well tolerated in the study group without any side effects .


High doses of methylprednisolone used for the management of grade IIb esophageal burns may reduce stricture development .


To study the protective effects of Dongchongxiacao ( Cordyceps ) ( DCXC ) on contrast-induced nephropathy ( CIN ) in patients with type @ diabetes and renal insufficiency undergoing coronary angiography .


A total of @ patients with type @ diabetes whose estimated glomerular filtration rater ( eGFR ) was @ mL/min @ in@ , were divided randomly into three groups , basic treatment group ( n = @ ) , standard DCXC therapy group ( n = @ , @-g corbrin capsules , @ times/d , @ days before and after angiography ) , and intensive DCXC therapy group ( n = @ , @-g corbrin capsules , @ times/d , @ days before and after angiography ) .


Serum creatinine ( cr ) and eGFR were assessed at the time of admission to hospital , and on days @ , @ and @ after angiography .


Urine neutrophil-gelatinase-associated-lipo - calin ( NGAL ) , kidney injury molecule-@ ( KIM-@ ) and interleukin-@ ( IL-@ ) were measured before angiography and at day @ after angiography for all patients .


The primary end point was the prevalence of CIN .


The secondary end point was a @ % or greater reduction in eGFR .


CIN occurred in @ of @ patients ( @ % ) .


The prevalence of CIN was lower in the DCXC treatment groups than in the basic treatment group ( P < @ ) , with a more significant decrease in the prevalence of CIN in the intensive DCXC therapy group ( P < @ ) .


Compared with the basic treatment group , a lower proportion of patients in the DCXC treatment groups had an eGFR decrease of @ % or greater ( P < @ ) ; patients with an eGFR decrease of @ % or greater accounted for an even lower proportion in the intensive DCXC therapy group ( P < @ ) .


Within @ day of the procedure , urine levels of KIM-@ , NGAL and IL-@ in patients in the intensive DCXC therapy group were lower than those in the basic treatment group and standard therapy group ( P < @ ) .


DCXC treatment may protect against CIN in patients with type @ diabetes and renal insufficiency undergoing coronary angiography , with intensive DCXC therapy being more effective .


Carotid intima-media thickness ( CIMT ) is a marker for atherosclerosis .


Adult post-coarctectomy patients ( CoA ) demonstrate an increased cardiovascular risk and increased CIMT compared to controls .


This study evaluates the effect of high dose statins on the change in CIMT and cardiovascular risk .


We designed a multicenter , prospective , randomized , open label trial with blinded endpoint ( PROBE design ) to evaluate the effect of three year treatment with atorvastatin @ mg on CIMT and cardiovascular risk .


Primary endpoint was CIMT measured by B mode ultrasonography .


Secondary endpoints were mortality and morbidity due to cardiovascular disease and serum lipids .


@ patients ( @ @ years , @ ( @ % ) male ) were randomized ( atorvastatin = @ , no treatment = @ ) .


There was no significant effect of atorvastatin on the change in CIMT ( treatment effect -@ , @ % CI , -@ -@ ; P = @ ) .


A significant effect on serum cholesterol and LDL levels was found ( - @ , @ % CI , - @ to - @ ; P = @ vs - @ , @ % CI - @ to - @ ; P = @ ) .


There was no difference in secondary outcome measures .


Baseline CIMT was higher in hypertensive compared to normotensive CoA .


( @ @ mm vs @ @ mm ; P = @ ) .


Hypertension ( = @ , P = @ ) was the strongest determinant CIMT .


Three year treatment with atorvastatin does not lead to a reduction of CIMT and secondary outcome measures , despite a decrease in total cholesterol and LDL levels .


Hypertensive CoA demonstrate the highest CIMT and the largest CIMT progression .


Blood pressure control should be the main focus in CoA to decrease cardiovascular risk .


The problem of image quality in a large number of upper airway obstructed patients is the superimposition of the airway over the bone of the spine on the AP view .


This problem was resolved by increasing KVp to high KVp technique and adding extra radiographic filters ( copper filter ) to reduce the sharpness of the bone and increase the clarity of the airway .


However , this raises a concern that patients might be receiving an unnecessarily higher dose of radiation , as well as the effectiveness of the invented filter compared to the traditional filter .


To evaluate the level of radiation dose that patients receive with the use of multi-layer filter compared to non-filter and to evaluate the image quality of the upper airways between using the radiographic filter ( multi-layer filter ) and the traditional filter ( copperfilter ) .


The attenuation curve of both filter materials was first identified .


Then , both the filters were tested with Alderson Rando phantom to determine the appropriate exposure .


Using the method described , a new type of filter called the multi-layer filter for imaging patients was developed .


A randomized control trial was then performed to compare the effectiveness of the newly developed multi-layer filter to the copper filter .


The research was conducted in patients with upper airway obstruction treated at Queen Sirikit National Institute of Child Health from October @ to September @ .


A total of @ patients were divided into two groups .


The experimental group used high kVp technique with multi-layer filter , while the control group used copper filter .


A comparison of film interpretation between the multi-layer filter and the copper filter was made by a number of radiologists who were blinded to both to the technique and type of filter used .


Patients had less radiation from undergoing the kVp technique with copper filter and multi-layer filter compared to the conventional technique , where no filter is used .


Patients received approximately @ % less radiation dose using high kVp technique with multi-layer filter compared to the conventional technique , and @ % less than using the traditional copper filter @ % of the radiologists who participated in this study reported that the high kVp technique with multi-layer filter was better for diagnosing stenosis , or narrowing of the upper airways .


@ % reported that , both techniques were equal , while @ % reported that the traditional copper filter allowed for better details of airway obstruction .


These findings showed that the multi-layered filter was comparable to the copper filter in terms of film interpretation .


Using the multi-layer filter resulted in patients receiving a lower dose of radiation , as well as similar film interpretation when compared to the traditional copper filter .


The objective of this study was to test the efficacy of cognitive-behavioral therapy plus hypnosis ( CBTH ) to control fatigue in patients with breast cancer undergoing radiotherapy .


We hypothesized that patients in the CBTH group receiving radiotherapy would have lower levels of fatigue than patients in an attention control group .


Patients ( n = @ ) were randomly assigned to either the CBTH ( n = @ ; mean age , @ years ) or attention control ( n = @ ; mean age , @ years ) group .


Fatigue was measured at four time points ( baseline , end of radiotherapy , @ weeks , and @ months after radiotherapy ) .


Fatigue was measured using the Functional Assessment of Chronic Illness Therapy ( FACIT ) - Fatigue subscale and Visual Analog Scales ( VASs ; Fatigue and Muscle Weakness ) .


The CBTH group had significantly lower levels of fatigue ( FACIT ) at the end of radiotherapy ( z , @ ; P < @ ) , @-week follow-up ( z , @ ; P < @ ) , and @-month follow-up ( z , @ ; P < @ ) assessments .


Fatigue VAS scores were significantly lower in the CBTH group at the end of treatment ( z , @ ; P < @ ) and at the @-month follow-up ( z , @ ; P < @ ) , but not at the @-week follow-up ( P < @ ) .


Muscle Weakness VAS scores were significantly lower in the CBTH group at the end of treatment ( z , @ ; P < @ ) and at the @-month follow-up ( z , @ ; P < @ ) , but not at the @-week follow-up ( P < @ ) .


The results support CBTH as an evidence-based intervention to control fatigue in patients undergoing radiotherapy for breast cancer .


CBTH is noninvasive , has no adverse effects , and its beneficial effects persist long after the last intervention session .


CBTH seems to be a candidate for future dissemination and implementation .


The use of mobile phone technologies for health promotion and disease prevention has advanced rapidly in recent years .


Text@baby is a theory-based mobile health ( mHealth ) program in which text messages are delivered to pregnant women and new mothers to improve their health care beliefs and behaviors and improve health status and clinical outcomes .


Recent evaluations of Text@baby have found that it improves targeted health attitudes and beliefs , but effects on behavior have not yet been determined .


In this study , investigators aimed to evaluate Text@baby in the military women 's population .


Investigators conducted a randomized controlled trial at Madigan Army Medical Center in Tacoma , Washington , from December @ through September @ .


All participants were pregnant women first presenting for care at Madigan .


Investigators conducted a baseline assessment using a @-item , self-administered online survey of attitudes and behaviors related to Text@baby message content .


Participants were randomized to Text@baby plus usual care ( intervention ) or usual care alone ( control ) .


Investigators analyzed treatment effects of Text@baby on short-term targeted outcomes @ weeks post enrollment .


For this study , @ patients were randomized and completed a baseline assessment .


The average patient age was @ years and nearly @ % self-identified as Caucasian .


@ % of enrollees ( @/@ ) completed the first follow-up assessment .


Higher rates of single and working/in-school patients dropped out of the intervention arm of the study , and we adjusted for this finding in subsequent models .


However , while investigators were unable to re-survey these participants , only @ % of Text@baby enrollees ( @/@ ) dropped the service during the study period .


Adjusted and unadjusted logistic generalized estimating equation models were developed to assess intervention effects on measured outcomes .


In the model adjusting for age , marital status , having had a previous baby , and race/ethnicity , there was a significant effect of Text@baby intervention exposure on increased agreement with belief in the importance of taking prenatal vitamins ( OR @ , @ % CI @-@ @ , P = @ ) .


All of these attitudes had been targeted by at least one text message during the @-week evaluation period examined in this study .


In unadjusted models , there was a significant effect of intervention exposure on belief in the importance of visiting a health care provider to be a healthy new mother ( OR @ , @ % CI @-@ @ , P = @ ) and in the health risks of alcohol during pregnancy ( OR @ , @ % CI @-@ @ , P = @ ) .


No behavioral effects of the intervention were observed in this analysis .


Text@baby is a promising program that offers lessons for future mHealth activities .


This large-scale study demonstrated initial effects of the program on attitudes and beliefs targeted by the messages received by women during the study period .


Results confirm previous findings from Text@baby studies and other mHealth research .


Future analyses will examine dosage effects of the intervention on behaviors and clinical outcomes .


The influence of rehabilitation on the outcomes after arthroscopic rotator cuff repair remains unknown .


The purpose of this study was to compare clinical results and tendon healing rates following arthroscopic rotator cuff repair utilizing two distinct rehabilitation protocols .


Over a thirty-month period , @ patients under the age of sixty-five years underwent arthroscopic repair of a full-thickness rotator cuff tear measuring < @ mm in width .


Postoperatively , patients were randomized either to a traditional rehabilitation program with early range of motion or to an immobilization group with delayed range of motion for six weeks .


Clinical outcomes assessment included visual analog pain scale score , American Shoulder and Elbow Surgeons ( ASES ) score , Simple Shoulder Test ( SST ) , relative Constant score , and strength measurements at six , twelve , and twenty-four months .


Tendon integrity was assessed with ultrasonography at a minimum of twelve months postoperatively .


There were no significant differences in patient age , tear size , or measures of preoperative function between groups at baseline .


Final clinical follow-up was available for @ subjects ( @ % ) .


Active elevation and external rotation were better in the traditional rehabilitation group at three months .


No significant differences were seen in functional scores , active motion , and shoulder strength between rehabilitation groups at later time points .


Functional outcomes plateaued at six or twelve months except for the relative Constant score , which improved up to twenty-four months following surgery .


Ninety-two percent of the tears were healed , with no difference between rehabilitation protocols ( p = @ ) .


Arthroscopic repair of small and medium full-thickness rotator cuff tears results in reliable improvements in clinical outcomes and a high rate of tendon integrity using a double-row repair technique in patients under the age of sixty-five years .


There is no apparent advantage or disadvantage of early passive range of motion compared with immobilization with regard to healing or functional outcome .


Micronutrients play an important role in immune function .


To our knowledge , there have been no comprehensive studies on the role of micronutrient supplementation in children with tuberculosis .


We assessed the effect of micronutrient supplementation in children treated with antituberculosis therapy ( ATT ) .


A randomized , double-blind , placebo-controlled trial that used a @ @ factorial design was undertaken at @ teaching hospitals in Delhi .


Children with newly diagnosed intrathoracic tuberculosis were enrolled , and they received ATT together with daily supplementation for @ mo with either zinc alone , micronutrients without zinc , micronutrients in combination with zinc , or a placebo .


Main outcomes were weight gain and an improvement in a chest X-ray ( CXR ) lesion assessed at @ mo of treatment .


A total of @ children were enrolled and randomly assigned .


A microbiological diagnosis of tuberculosis was confirmed in @ children ( @ % ) .


The median ( @ % CI ) increase in weight-for-age z score at @ mo was not significantly different between subjects who received micronutrients -LSB- @ ( @ , @ ) -RSB- and those who did not receive micronutrients -LSB- @ ( @ , @ ) -RSB- and between subjects who received zinc -LSB- @ ( @ , @ ) -RSB- and those who did not receive zinc -LSB- @ ( @ , @ ) -RSB- .


An improvement in CXR was observed in @ children , but there was no difference between those receiving zinc and no zinc or between those receiving micronutrients and no micronutrients after @ mo of ATT .


However , children who received micronutrients had a faster gain in height over @ mo than did those who did not receive micronutrients ( height-for-age z score = @ ; P = @ ) .


Micronutrient supplementation did not modify the weight gain or clearance of lesions on CXR in children with intrathoracic tuberculosis .


However , micronutrient supplementation during treatment may improve height gain in children with intrathoracic tuberculosis .


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


To modify the Prostate Cancer Prevention Trial risk calculator ( PCPTRC ) to predict low - vs high-grade ( Gleason grade@ ) prostate cancer and incorporate percent free-prostate-specific antigen ( PSA ) .


Data from @ Prostate Cancer Prevention Trial placebo arm biopsies ( @ individuals ) , where prostate-specific antigen and digital rectal examination results were available within @ year before the biopsy and PSA was @ ng/mL , were used to develop a nominal logistic regression model to predict the risk of no vs low-grade ( Gleason grade < @ ) vs high-grade cancer ( Gleason grade@ ) .


Percent free-PSA was incorporated into the model based on likelihood ratio analysis of a San Antonio Biomarkers of Risk cohort .


Models were externally validated on @ Prostate Biopsy Collaborative Group cohorts and @ Early Detection Research Network reference set .


Of all the Prostate Cancer Prevention Trial biopsies , @ ( @ % ) were negative for prostate cancer , @ ( @ % ) detected low-grade , and @ ( @ % ) detected high-grade disease .


Significant predictors were ( log base @ ) PSA ( odds ratio for low-grade vs no cancer , @ * ; high-grade vs no cancer , @ * ; high-grade vs low-grade cancer , @ * ) , digital rectal examination ( @ , @ * , @ * , respectively ) , age ( @ * , @ * , @ * , respectively ) , African American race ( @ , @ * , @ * , respectively ) , prior biopsy ( @ * , @ , @ , respectively ) , and family history ( @ * , @ , @ , respectively ) , where * indicates P value < @ .


The new PCPTRC @ either with or without percent free-PSA ( also significant by the likelihood ratio method ) validated well externally .


By differentiating the risk of low - vs high-grade disease on biopsy , PCPTRC @ better enables physician-patient counseling concerning whether to proceed to biopsy .


Phosphatidylinositol-@-kinase delta ( PI@K ) mediates B-cell receptor signaling and microenvironmental support signals that promote the growth and survival of malignant B lymphocytes .


In a phase @ study , idelalisib , an orally active selective PI@K inhibitor , showed antitumor activity in patients with previously treated indolent non-Hodgkin 's lymphomas .


In this single-group , open-label , phase @ study , @ patients with indolent non-Hodgkin 's lymphomas who had not had a response to rituximab and an alkylating agent or had had a relapse within @ months after receipt of those therapies were administered idelalisib , @ mg twice daily , until the disease progressed or the patient withdrew from the study .


The primary end point was the overall rate of response ; secondary end points included the duration of response , progression-free survival , and safety .


The median age of the patients was @ years ( range , @ to @ ) ; patients had received a median of four prior therapies ( range , @ to @ ) .


Subtypes of indolent non-Hodgkin 's lymphoma included follicular lymphoma ( @ patients ) , small lymphocytic lymphoma ( @ ) , marginal-zone lymphoma ( @ ) , and lymphoplasmacytic lymphoma with or without Waldenstrm 's macroglobulinemia ( @ ) .


The response rate was @ % ( @ of @ patients ) , with @ % meeting the criteria for a complete response .


The median time to a response was @ months , the median duration of response was @ months , and the median progression-free survival was @ months .


Similar response rates were observed across all subtypes of indolent non-Hodgkin 's lymphoma , though the numbers were small for some categories .


The most common adverse events of grade @ or higher were neutropenia ( in @ % of the patients ) , elevations in aminotransferase levels ( in @ % ) , diarrhea ( in @ % ) , and pneumonia ( in @ % ) .


In this single-group study , idelalisib showed antitumor activity with an acceptable safety profile in patients with indolent non-Hodgkin 's lymphoma who had received extensive prior treatment .


( Funded by Gilead Sciences and others ; ClinicalTrials.gov number , NCT@ . )


PRONOUNCE compared the efficacy and safety of pemetrexed + carboplatin followed by pemetrexed ( Pem + Cb ) with paclitaxel + carboplatin + bevacizumab followed by bevacizumab ( Pac + Cb + Bev ) in patients with advanced nonsquamous non-small-cell lung cancer ( NSCLC ) .


Patients @ years of age with stage IV nonsquamous NSCLC ( American Joint Committee on Cancer v@ @ ) , and Eastern Cooperative Oncology Group performance status @/@ were randomized ( @:@ ) to four cycles of induction Pem + Cb ( pemetrexed , @ mg/m , carboplatin , area under the curve = @ ) followed by Pem maintenance or Pac + Cb + Bev ( paclitaxel , @ mg/m , carboplatin , area under the curve = @ , and bevacizumab , @ mg/kg ) followed by Bev maintenance in the absence of progressive disease or discontinuation .


The primary objective was progression-free survival ( PFS ) without grade @ toxicity ( G@PFS ) .


Secondary end points were PFS , overall survival ( OS ) , overall response rate ( ORR ) , disease control rate ( DCR ) , and safety .


Resource utilization was also assessed .


Baseline characteristics of the patients randomized to Pem + Cb ( N = @ ) and Pac + Cb + Bev ( N = @ ) were well balanced between the arms .


Median ( months ) G@PFS was @ for Pem + Cb and @ for Pac + Cb + Bev ( hazard ratio = @ , @ % confidence interval , @-@ @ ; p = @ ) ; PFS , OS , ORR , or DCR did not differ significantly between the arms .


Significantly more drug-related grade @/@ anemia ( @ % versus @ % ) and thrombocytopenia ( @ % versus @ % ) were reported for Pem + Cb .


Significantly more grade @/@ neutropenia ( @ % versus @ % ) , grade @/@ alopecia ( @ % versus @ % ) , and grade @/@ sensory neuropathy were reported for Pac + Cb + Bev .


Number of hospitalizations and overall length of stay did not differ significantly between the arms .


Pem + Cb did not produce significantly better G@PFS compared with Pac + Cb + Bev .


Pem + Cb was not superior in PFS , OS , ORR , or DCR compared with Pac + Cb + Bev .


Both regimens were well tolerated , although , toxicity profiles differed .


Hamstring injuries are the most common muscle injury in male amateur soccer players and have a high rate of recurrence , often despite extensive treatment and long rehabilitation periods .


Eccentric strength and flexibility are recognised as important modifiable risk factors , which have led to the development of eccentric hamstring exercises , such as the Nordic hamstring exercise .


As the effectiveness of the Nordic hamstring exercise in reducing hamstring injuries has never been investigated in amateur soccer players , the aim of this study is to investigate the effect of this exercise on the incidence and severity of hamstring injuries in male amateur soccer players .


An additional aim is to determine whether flexibility is associated with hamstring injuries .


Cluster-randomised controlled trial with soccer teams as the unit of cluster .


Dutch male amateur soccer players , aged @-@years , were allocated to an intervention or control group .


Both study groups continued regular soccer training during @ , but the intervention group additionally performed the Nordic hamstring exercise ( @ sessions over @weeks ) .


Primary outcomes are the incidence of initial and recurrent hamstring injury and injury severity .


Secondary outcomes are hamstring-and-lower-back flexibility and compliance .


Compliance to the intervention protocol was also monitored .


Eccentric hamstring strength exercises are hypothesised to reduce the incidence of hamstring injury among male amateur soccer players by @ % .


The prevention of such injuries will be beneficial to soccer players , clubs , football associations , health insurance companies and society .


To evaluate computed tomography ( CT ) perfusion for assessment of early treatment response after transarterial radioembolization of patients with liver malignancy .


Dynamic contrast-enhanced CT liver perfusion was performed before and @ weeks after transarterial radioembolization in @ patients ( @ men and @ women ; mean age , @ y @ ; range , @-@ y ) with liver metastases ( n = @ ) or hepatocellular carcinoma ( HCC ) ( n = @ ) .


Arterial perfusion ( AP ) of tumors derived from CT perfusion and tumor diameters were measured on CT perfusion before and after transarterial radioembolization .


Success of transarterial radioembolization was evaluated on morphologic follow-up imaging ( median follow-up time , @ mo ) based on Response Evaluation Criteria in Solid Tumors ( Version @ ) .


CT perfusion parameters before and after transarterial radioembolization for different response groups were compared .


Kaplan-Meier curves were plotted to illustrate overall @-year survival rates .


Liver metastases showed significant differences in AP before and after transarterial radioembolization in responders ( P < @ ) but not in nonresponders ( P = @ ) .


In HCC , AP values before and after transarterial radioembolization were not significantly different in responders and nonresponders ( P = @ and P = @ ) .


Tumor diameters were not significantly different on CT perfusion before and after transarterial radioembolization in responders and nonresponders with liver metastases and HCC ( P = @ , P = @ , P = @ , P = @ ) .


In patients with significant decrease of AP in liver metastases after transarterial radioembolization , @-year overall survival was significantly higher than in patients showing no reduction of AP .


CT perfusion showed early reduction of AP in liver metastases responding to transarterial radioembolization ; tumor diameter remained unchanged early after treatment .


No significant early treatment response to transarterial radioembolization was found in patients with HCC .


In patients with liver metastases , a decrease of AP after transarterial radioembolization was associated with a higher @-year overall survival rate .


To assess the intraocular penetration of @ % moxifloxacin hydrochloride into aqueous humour after oral and topical administration .


A prospective , interventional study of @ patients scheduled to undergo cataract surgery was carried out .


Out of the @ subjects , @ were randomly categorised into Group I and received one drop of @ % topical moxifloxacin four times , at @min intervals starting @min before the surgery .


Another @ subjects were categorised into Group II and all subjects in this group were administered a single tablet of @mg of moxifloxacin , @h before the surgery .


Estimation of moxifloxacin in aqueous samples was carried out using high-performance liquid chromatography .


Results were analysed using Student unpaired ` t ' test and analysis of variance .


The value of p < @ was considered to be significant .


Mean aqueous concentration of moxifloxacin attained in the oral group ( n = @ ) was @ g/mL while that in the topical group ( n = @ ) was @ g/mL , and this difference in levels was statistically significant ( p < @ ) .


The levels attained by both the groups well exceeded the MIC@ ( minimum inhibitory concentration of antibiotic required to inhibit growth of @ % of bacteria strains ) levels for most of the organisms causing endophthalmitis .


Penetration of moxifloxacin in aqueous in both the groups was not affected by gender , intraocular pressure or comorbidities significantly .


However , aqueous levels were found to be higher among the younger subjects within the topical group .


Moxifloxacin has an impressive spectrum of coverage and this pharmacokinetic study reinforces its potential as a prophylactic drug against intraocular infections , given the high aqueous levels post topical administration .


To evaluate the postoperative analgesic effect and postoperative nausea and vomiting ( PONV ) after using epidural low-dose morphine-soaked microfibrillar collagen sponge ( MMCS ) , as compared with placebo .


A prospective randomized double-blind placebo-controlled study was performed on patients under-going single-level posterior lumbar spinal decompression and instrumented fusion at the Department of Orthopedic Surgery , Siriraj Hospital , between August @ and December @ .


Patients were randomly allocated into two groups to receive either an epidural MMCS or an epidural normal saline-soaked microfibrillar collagen sponge ( placebo ) .


Intensity ofpain , PONV and total amount of morphine were recorded at @ , @ , @ , and @ hours , postoperatively .


The analgesic effect was enhanced significantly in the epidural MMCS group , as the amount ofmorphine used was statistically less than in the placebo group at @ and @ hours ( p < @ ) .


A single low-dose epidural MMCS is effectiveforpain control after posterior lumbar spinal surgery with a low incidence of PONV .


Massive resources are expended every year on cross-cultural communication training for physicians .


Such training is a focus of continuing medical education nationwide and is part of the curriculum of virtually every medical school in America .


There is a pressing need for evidence regarding the effects on patients of cross-cultural communication training for physicians .


There is a need to understand the added benefit of such training compared to more general communication .


We know of no rigorous study that has assessed whether cross-cultural communication training for physicians results in better health outcomes for their patients .


The current study aims to answer this question by enhancing the Physician Asthma Care Education ( PACE ) program to cross cultural communication ( PACE Plus ) , and comparing the effect of the enhanced program to PACE on the health outcomes of African American and Latino/Hispanic children with asthma .


A three-arm randomized control trial is used to compare PACE Plus , PACE , and usual care .


Both PACE and PACE Plus are delivered in two , two-hour sessions over a period of two weeks to @-@ primary care physicians who treat African American and Latino/Hispanic children with asthma .


One hundred twelve physicians and @ of their pediatric patients were recruited who self-identify as African American or Latino/Hispanic and experience persistent asthma .


Physicians were randomized into receiving either the PACE Plus or PACE intervention or into the control group .


The comparative effectiveness of PACE and PACE Plus on clinician 's therapeutic and communication practices with the family/patient , children 's urgent care use for asthma , asthma control , and quality of life , and parent/caretaker satisfaction with physician performance will be assessed .


Data are collected via telephone survey and medical record review at baseline , @ months following the intervention , and @ months following the intervention .


This study aims to reduce disparities in asthma outcomes among African American and Latino/Hispanic children through cross-cultural communication training of their physicians and assessing the added value of this training compared to general communication .


The results of this study will provide important information about the value of cross-cultural training in helping to address persistent racial disparities in outcomes .


Isothiocyanates in cruciferous vegetables modulate signaling pathways critical to carcinogenesis , including nuclear factor kappa-light-chain-enhancer of activated B cells ( NF-B ) , a central regulator of inflammation .


Glutathione S-transferase ( GST ) M@ and GSTT@ metabolize isothiocyanates ; genetic variants may result in differences in biologic response .


The objective of this study was to test whether consumption of cruciferous or cruciferous plus apiaceous vegetables altered serum concentrations of interleukin ( IL ) -@ , IL-@ , C-reactive protein ( CRP ) , tumor necrosis factor ( TNF ) , and soluble TNF receptor ( sTNFR ) I and II , and whether this response was GSTM@/GSTT@ genotype dependent .


In a randomized crossover trial , healthy men ( n = @ ) and women ( n = @ ) aged @-@ y consumed @ @-d controlled diets : basal ( vegetable-free ) , single-dose cruciferous ( @xC ) -LSB- @ g vegetables/kg body weight ( BW ) -RSB- , double-dose cruciferous ( @xC ) ( @ g/kg BW ) , and cruciferous plus apiaceous ( carrot family ) ( @xC + A ) vegetables ( @ and @ g/kg BW , respectively ) , with a @-d washout period between each intervention .


Urinary isothiocyanate excretion was also evaluated as a marker of systemic isothiocyanate exposure .


Fasting morning blood and urine samples were collected on days @ and @ and analyzed .


IL-@ concentrations were significantly lower on day @ of the @xC and @xC + A diets than with the basal diet -LSB- -@ % ( @ % CI : -@ % , -@ % ) and -@ % ( @ % CI : -@ % , -@ % ) , respectively -RSB- .


IL-@ concentrations were higher after the @xC + A diet ( +@ % ; @ % CI : @ % , @ % ) than after the basal diet .


There were no effects of diet on CRP , TNF - , or sTNFRI or II .


There were significant differences between GSTM@-null/GSTT@ + individuals for several biomarkers in response to @xC + A compared with basal diets ( CRP : -@ % ; @ % CI : -@ % , -@ % ; IL-@ : -@ % ; @ % CI : -@ % , -@ % ; IL-@ : @ % ; @ % CI : @ % , @ % ) and with the @xC diet compared with the basal diet ( IL-@ : -@ % ; @ % CI : -@ % , -@ % ; sTNFRI : -@ % ; @ % CI : -@ % , -@ % ) .


There were no significant reductions in biomarker concentrations in response to diet among GSTM@ + / GSTT@ + or GSTM@-null/GSTT@-null individuals .


Twenty-four-hour urinary isothiocyanate excretion was not associated with any of the inflammation markers overall ; however , IL-@ was inversely associated with total isothiocyanate excretion in GSTM@-null/GSTT@-null individuals ( = -@ ; @ % CI : -@ , -@ ) .


In this young , healthy population , consumption of cruciferous and apiaceous vegetables reduced circulating IL-@ ; however , results for other biomarkers of inflammation were not consistent .


Frailty is a highly prevalent condition in old age leading to vulnerability and greater risk of adverse health outcomes and disability .


Detecting and tackling frailty at an early stage can prevent disability .


The purpose of this study is to evaluate the effectiveness of a multifactorial intervention program to modify frailty parameters , muscle strength , and physical and cognitive performance in people aged @ years or more .


It also assesses changes from baseline in falls , hospitalizations , nutritional risk , disability , institutionalization , and home-care .


The current study is a randomised single-blind , parallel-group clinical trial , with a one and a half year follow-up , conducted in eight Primary Health Care Centres located in the city of Barcelona .


Inclusion criteria are to be aged @ years or older with positive frailty screening , timed get-up-and-go test between @ to @ seconds , and Cognition Mini-Exam ( MEC-@ ) of Lobo greater than or equal to @ .


A total of @ patients have been equally divided into two groups : intervention and control .


Sample size calculated to detect a @ unit difference in the Short Physical Performance Battery ( Common SD : @ , @ % lost to follow-up ) .


In the intervention group three different actions on frailty dimensions : rehabilitative therapy plus intake of hyperproteic nutritional shakes , memory workshop , and medication review are applied to sets of @ patients .


Participants in both intervention and control groups receive recommendations on nutrition , healthy lifestyles , and home risks.Evaluations are blinded and conducted at @ , @ , and @ months .


Intention to treat analyses will be performed .


Multivariate analysis will be carried out to assess time changes of dependent variables .


It is expected that this study will provide evidence of the effectiveness of a multidisciplinary intervention on delaying the progression from frailty to disability in the elderly .


It will help improve the individual 's quality of life and also reduce the rates of falls , hospital admissions , and institutionalizations , thus making the health care system more efficient .


This preventive intervention can be adapted to diverse settings and be routinely included in Primary Care Centres as a Preventive Health Programme .


According to a recent report from the European Brain Council and the European Colleague of Neuropsychopharmacology the one year prevalence of some kind of mental disorder is around @ % among the adult population in Europe .


Research has shown a lack of mental health literacy in the population in general and it is thus important to find ways to improve the public 's knowledge and skills to provide first hand support to people with mental disorders .


Mental Health First Aid ( MHFA ) is a training program that has shown positive changes in knowledge and helping behavior .


This study investigates if MHFA training in a Swedish context provides a sustained improvement in knowledge about mental disorders , a better ability to be helpful in contacts with people who are ill and if it changes attitudes in a positive direction .


The introduction of the training program was made in accordance with the constructor 's instructions .


Participants were mainly public sector employees from a county in the west of Sweden .


The study was a randomized controlled trial with an experiment group ( n = @ ) and a control group ( n = @ ) placed on a waiting list during a @-month follow-up .


A two-year follow-up was conducted for participants ( n = @ ) from both the intervention and waiting list group who had completed the training and during the follow-up been in contact with persons with mental disorders .


The intervention group improved in knowledge as well as in confidence in providing help for someone in need .


The two-year follow-up showed that the improvements were to a great extent maintained .


Mental Health First Aid might raise the level of awareness of mental disorders and have an influence on the number of people who can receive professional treatment for their problems .


Olive oil ( OO ) consumption is associated with cardiovascular disease prevention because of both its oleic acid and phenolic contents .


The capacity of OO phenolics to protect against low-density lipoprotein ( LDL ) oxidation is the basis for a health claim by the European Food Safety Authority .


Proteomic biomarkers enable an early , presymptomatic diagnosis of disease , which makes them important and effective , but understudied , tools for primary prevention .


We evaluated the impact of supplementation with OO , either low or high in phenolics , on urinary proteomic biomarkers of coronary artery disease ( CAD ) , chronic kidney disease ( CKD ) , and diabetes .


Self-reported healthy participants ( n = @ ) were randomly allocated ( stratified block random assignment ) according to age and body mass index to supplementation with a daily @-mL dose of OO either low or high in phenolics ( @ compared with @ mg caffeic acid equivalents per kg , respectively ) for @ wk .


Urinary proteomic biomarkers were measured at baseline and @ and @ wk alongside blood lipids , the antioxidant capacity , and glycation markers .


The consumption of both OOs improved the proteomic CAD score at endpoint compared with baseline ( mean improvement : -@ for low-phenolic OO and -@ for high-phenolic OO ; P < @ ) but not CKD or diabetes proteomic biomarkers .


However , there was no difference between groups for changes in proteomic biomarkers or any secondary outcomes including plasma triacylglycerols , oxidized LDL , and LDL cholesterol .


In comparison with low-phenolic OO , supplementation for @ wk with high-phenolic OO does not lead to an improvement in cardiovascular health markers in a healthy cohort .


Non-steroidal anti-inflammatory drugs ( NSAIDs ) may cause gastrointestinal damage in dogs .


To determine the extent to which lansoprazole , liquorice extract , and a herbal solution exhibit protective effects on colonic mucosa when administered to dogs concurrently with the NSAIDs carprofen or robenacoxib .


Thirty-five healthy beagle dogs ( @ male and @ female ) aged @-@ weeks and weighing @-@ @ kg at the beginning of the experiment were included .


Endoscopy and biopsy of the caudal gastrointestinal tract were performed pretreatment and on the last day of a @-day treatment period with ( @ ) oral carprofen ; ( @ ) carprofen and the proton-pump inhibitor lansoprazole ; ( @ ) carprofen , liquorice extract , and a herbal solution that contained extracts of thyme , icelandic lichen , hyssop , and saponariae root ; ( @ ) robenacoxib ; ( @ ) robenacoxib and lansoprazole ; ( @ ) robenacoxib , liquorice extract , and herbal solution ; or ( @ ) an empty gelatin capsule .


Statistical analyses were performed with the Kruskal-Wallis , Cochran 's Q , and chi-squared test with p < @ considered significant .


Both carprofen and robenacoxib tested damaged the colonic mucosa with most severe microscopic lesions following administration of robenacoxib with lansoprazole .


The risk of histopathological lesions in the colon increased most rapidly in robenacoxib with lansoprazole ( absolute risk increase -@ ) similar to robenacoxib only ( -@ ) , whereas the best result was recorded following the plant remedies together with carprofen ( -@ ) and the plant remedies together with robenacoxib ( -@ ) .


Concurrent administration of liquorice extract and an herbal solution with robenacoxib was associated with decreased severity of the NSAID-induced mucosal lesions .


To compare @ different training paradigms , massed vs interval training , when novice students learn a surgical procedure , myringotomy with ventilation tube insertion , on a validated surgical simulator .


Medical students were randomized into @ training groups : the interval group ( n = @ ) was trained to perform the procedure in @ trials/d over @ days , and the massed group ( n = @ ) was trained to perform the procedure in @ trials all in @ session .


One week later , all students were tested in @ additional final trials .


Pre - and posttest surveys were administered .


Academic medical center .


Forty medical students : @ students in the interval group were compared with @ students in the massed group .


Time to complete the procedure and number and type of error made were recorded and compared between groups .


Pre - and poststudy surveys examined confidence levels working under a microscope and with the procedure .


Students in both groups had a significant decrease in time between practice and final trials .


In the final @ trials , there was no difference in average time to complete the procedure between the massed and interval training groups .


No difference was observed in the number of errors committed per trial between initial and final trials ( both groups ) or between massed and interval training groups .


The students ' confidence levels significantly increased across the trials , regardless of group .


Surgical training improves proficiency , but method of training had little impact on proficiency in performing a simulated surgical procedure in this setting .


The incretin hormone , glucagon-like peptide-@ , promotes myocardial glucose uptake and may improve myocardial tolerance to ischemia .


Endogenous glucagon-like peptide-@ ( @-@ ) is augmented by pharmacological inhibition of dipeptidyl peptidase-@ .


We investigated whether chronic dipeptidyl peptidase-@ inhibition by sitagliptin protected against ischemic left ventricular dysfunction during dobutamine stress in patients with type @ diabetes mellitus and coronary artery disease .


A total of @ patients with type @ diabetes mellitus underwent dobutamine stress echocardiography with tissue Doppler imaging on @ separate occasions : the first ( control ) while receiving oral hypoglycemic agents , and the second after the addition of sitagliptin ( @ mg once daily ) for @ weeks .


Sitagliptin increased plasma glucagon-like peptide-@ ( @-@ ) levels and , at peak stress , enhanced both global ( ejection fraction , @ versus @ % ; P < @ ; mitral annular systolic velocity , @ versus @ cm/s ; P = @ ) and regional left ventricular function , assessed by peak systolic velocity and strain rate in @ paired , nonapical segments .


This was predominantly because of a cardioprotective effect on ischemic segments ( strain rate in ischemic segments , -@ versus -@ s ( -@ ) ; P = @ ) , whereas no effect was seen in nonischemic segments ( -@ versus -@ s ( -@ ) ; P = @ ) .


At @ minutes recovery , dipeptidyl peptidase-@ inhibition mitigated the postischemic stunning seen in the control scan .


The addition of dipeptidyl peptidase-@ inhibitor therapy with sitagliptin to the treatment regime of patients with type @ diabetes mellitus and coronary artery disease is associated with a sustained improvement in myocardial performance during dobutamine stress and a reduction in postischemic stunning .


Several reports have investigated amino acid administration in premature infants during the early postnatal phase .


Most of these previous studies , however , have only evaluated short-term in-hospital outcomes .


Our aim was to describe long-term outcomes in premature infants previously subjected to different nutritional regimens in a randomized controlled trial .


The primary outcome was survival without major disabilities , and the secondary outcomes included anthropometry and mental development .


Infants born < @ weeks ' gestation and < @ g were randomized to receive glucose ( n = @ ) or glucose with @ g kg ( -@ ) day ( -@ amino acids ) ( n = @ ) from birth .


From postnatal day @ onward , the nutritional intake was similar .


At @ years of corrected age , the surviving infants were assessed for neurodevelopmental outcome and anthropometry .


Ninety-seven percent of the surviving infants were examined at follow-up , with no overall effect on survival without major disabilities .


Boys , however , had a normal outcome significantly more often if amino acids were administered from birth onward ( crude odds ratio @ , @ % confidence interval @-@ @ ) and following adjustment for confounders ( odds ratio @ , @ % confidence interval @-@ @ ) .


The secondary outcomes exhibited no differences in anthropometric data .


The mental developmental index was lower in the small number of girls who survived without major disabilities following the early administration of amino acids .


In this hypothesis-generating outcome study , premature boys , but not girls , benefited from amino acid administration directly following birth .


The observed lower mental developmental index in a subgroup of girls , however , warrants further studies .


Exercise may improve psychosocial distress in patients with cancer ; however , few studies have examined the effects of different types or doses of exercise , or whether exercise effects are related to baseline depression levels .


In a multicenter trial in Canada , we randomized @ patients with breast cancer initiating chemotherapy to thrice weekly , supervised exercise consisting of either a standard dose of @ to @ minutes of aerobic exercise ( STAN ; n = @ ) , a higher dose of @ to @ minutes of aerobic exercise ( HIGH ; n = @ ) , or a combined dose of @ to @ minutes of aerobic and resistance exercise ( COMB ; n = @ ) .


The primary endpoint was depression assessed by the Center for Epidemiological Studies-Depression scale at baseline , twice during chemotherapy , and postchemotherapy .


Secondary endpoints were anxiety , perceived stress , and self-esteem .


Repeated measures ANOVA indicated that neither HIGH -LSB- mean difference = -@ ; @ % confidence interval ( CI ) , +@ to -@ ; P = @ -RSB- nor COMB ( mean difference = -@ ; @ % CI , +@ to -@ ; P = @ ) was superior to STAN for managing depressive symptoms .


In a planned subgroup analysis , there was a significant interaction with baseline depression levels ( P interaction = @ ) indicating that COMB and HIGH were effective for managing depressive symptoms in patients with clinical levels of depressive symptoms at baseline .


Compared with a standard volume of aerobic exercise , higher volumes of exercise did not help manage depressive symptoms in unselected patients with breast cancer receiving chemotherapy , but they were effective in patients with clinical levels of depressive symptoms at baseline .


A phase III exercise trial targeting depressed patients with breast cancer is warranted .


To investigate the topical effect of dorzolamide versus ketorolac on retinitis pigmentosa ( RP ) and Usher 's syndrome ( US ) macular edema .


Prospective , randomized and interventional study .


A total of @ eyes of @ patients were included .


Five eyes had US , @ had RP .


Fifteen eyes were allocated to ketorolac tromethamine @ % ( @ drops daily regimen ) and @ eyes to dorzolamide hydrochloride @ % ( @ drops daily regimen ) treatment groups .


Snellen 's best-corrected visual acuity ( BCVA ) , foveal thickness ( FT ) and foveal zone thickness ( FZT ) measured by Stratus optical coherence tomography ( OCT ) were evaluated at baseline , @ , @ , @ and @ months after treatment .


Patients assigned to ketorolac had a baseline BCVA of @ @ logMAR which improved at the end of @ year to @ @ ( p = @ ) .


Three eyes ( @ % ) of @ patients improved by @ letters or more .


Mean FT and FZT did not change significantly during the study follow-up .


After @ year of treatment , @ eyes ( @ % ) of @ patients showed an improvement of at least @ % of FT and @ % of FZT .


Patients assigned to dorzolamide had a baseline BCVA of @ @ logMAR which improved in the first @ months ( @ @ ; p = @ ) , with a decrease at @ year ( @ @ ; p = @ ) .


Seven eyes ( @ % ) of @ patients had an improvement of @ letters or more .


Mean FT and FZT did not change significantly either .


After @ year of treatment , @ eyes ( @ % ) of @ patients showed an improvement of at least @ % on FT and @ % on FZT .


RESULTS suggest that dorzolamide and ketorolac might improve visual acuity and therefore be of interest in selected cases .


No relationship between retinal thickness fluctuation and visual acuity was found .


Sample size was a limitation to the study .


Public health research on sedentary behavior ( SB ) in youth has heavily relied on accelerometers .


However , it has been limited by the lack of consensus on the most accurate accelerometer cut-points as well as by unknown effects caused by accelerometer position ( wrist vs. hip ) and output ( single axis vs. multiple axes ) .


The present study systematically evaluates classification accuracy of different Actigraph cut-points for classifying SB using hip and wrist-worn monitors and establishes new cut-points to enable use of the @-dimensional vector magnitude data ( for both hip and wrist placement ) .


A total of @ children ages @-@ yrs performed @ randomly selected activities ( from a set of @ different activities ) for @ min each while wearing tri-axial Actigraph accelerometers on both the hip and wrist .


The accelerometer data were categorized as either sedentary or non-sedentary minutes using six previously studied cut-points : @ counts-per-minute ( CPM ) , @ CPM , @ CPM , @ CPM , @ CPM and @ CPM .


Classification accuracy was evaluated with Cohen 's Kappa ( ) and new cut-points were identified from Receiver Operating Characteristic ( ROC ) .


Of the six cut-points , the @ CPM value yielded the highest classification accuracy ( = @ ) for hip placement .


For wrist placement , all of the cut-points produced low classification accuracy ( ranges of from @ to @ ) .


Optimal sedentary cut-points derived from ROC were @ CPM ( ROC-AUC of @ ) for vector magnitude for hip , @ CPM ( ROC-AUC of @ ) for vertical axis for wrist , and @ CPM ( ROC-AUC of @ ) for vector magnitude for wrist placement .


The @ CPM was supported for use with vertical axis for hip placement , but not for wrist placement .


The ROC-derived cut-points can be used to classify youth SB with the wrist and with vector magnitude data .


Fractional non-ablative lasers keep the epidermis intact , while fractional ablative lasers remove it , making them theoretically more effective .


To evaluate the clinical and histological alterations induced by fractional photothermolysis for treating photoaging , comparing the possible equivalence of multiple sessions of @nm Erbium , to one session of @nm Erbium .


Eighteen patients ( mean age @ ) completed the treatment with three sessions of @nm fractional Erbium laser on one side of the face ( @ mJ/mB , @ms , @ passes ) , and one session of @nm on the other side ( @mJ/mB , @ ms , @ passes ) .


Biopsies were performed before and @ months after treatment .


Clinical , histological and morphometric evaluations were carried out .


All patients presented clinical improvement with no statistically significant difference ( p > @ ) between the treated sides .


Histopathology revealed a new organization of collagen and elastic fibers , accompanied by edema , which was more evident with the @nm laser .


This finding was confirmed by morphometry , which showed a decrease in collagen density for both treatments , with a statistical significance for the @nm laser ( p > @ ) .


Three @nm sessions were clinically equivalent to one @nm session .


The edema probably contributed to the positive results after three months , togheter with the new collagen and elastic fibers organization .


The greater edema after the @nm session indicates that dermal remodeling takes longer than with @nm .


It is possible that this histological superiority relates to a more prolonged effect , but a cohort longer than three months is needed to confirm that supposition .


We examine effects of school support as a structural HIV prevention intervention for adolescent female orphans in Zimbabwe after @years .


Three hundred twenty-eight orphan adolescent girls were followed in a clustered randomized controlled trial from @ to @ .


The experimental group received school fees , uniforms , and school supplies and were assigned a school-based `` helper . ''


In @-@ , the control group received delayed partial treatment of school fees only .


At the final data point in @ , survey , HIV , and Herpes Simplex Virus Type @ ( HSV-@ ) biomarker data were collected from approximately @ % of the sample .


Bivariate and multivariate analyses were conducted on end point outcomes , controlling for age , religious affiliation , and baseline socioeconomic status .


The two groups did not differ on HIV or HSV-@ biomarkers .


The comprehensive @-year intervention continued to reduce the likelihood of marriage , improve school retention , improve socioeconomic status ( food security ) , and marginally maintain gains in quality of life , even after providing school fees to the control group .


Paying school fees and expenses resulted in significant improvements in life outcomes for orphan adolescent girls .


Biological evidence of HIV infection prevention , however , was not observed .


Our study adds to the growing body of research on school support as HIV prevention for girls in sub-Saharan Africa , but as yet , no clear picture of effectiveness has emerged .


Elevated plasma homocysteine concentrations are a risk factor for osteoporotic fractures .


Lowering homocysteine with combined vitamin B-@ and folic acid supplementation may reduce fracture risk .


This study -LSB- B-vitamins for the PRevention Of Osteoporotic Fractures ( B-PROOF ) -RSB- aimed to determine whether vitamin B-@ and folic acid supplementation reduces osteoporotic fracture incidence in hyperhomocysteinemic elderly individuals .


This was a double-blind , randomized , placebo-controlled trial in @ participants aged @ y with elevated homocysteine concentrations ( @-@ mol/L ) .


Participants were assigned to receive daily @ g vitamin B-@ plus @ g folic acid or placebo supplementation for @ y. Both intervention and placebo tablets also contained @ IU vitamin D@ .


The primary endpoint was time to first osteoporotic fracture .


Exploratory prespecified subgroup analyses were performed in men and women and in individuals younger than and older than age @ y. Data were analyzed according to intention-to-treat and per-protocol principles .


Osteoporotic fractures occurred in @ persons ( @ % ) in the intervention group and @ persons ( @ % ) in the placebo group .


Osteoporotic fracture risk was not significantly different between groups in the intention-to-treat analyses ( HR : @ ; @ % CI : @ , @ ) or per-protocol analyses ( HR : @ ; @ % CI : @ , @ ) .


For persons aged > @ y , in per-protocol analyses , osteoporotic fracture risk was lower in the intervention group than in the placebo group ( HR : @ ; @ % CI : @ , @ ) .


The total number of adverse events ( including mortality ) did not differ between groups .


However , @ and @ participants in the intervention and placebo groups , respectively , reported incident cancer ( HR : @ ; @ % CI : @ , @ ) .


These data show that combined vitamin B-@ and folic acid supplementation had no effect on osteoporotic fracture incidence in this elderly population .


Exploratory subgroup analyses suggest a beneficial effect on osteoporotic fracture prevention in compliant persons aged > @ y. However , treatment was also associated with increased incidence of cancer , although the study was not designed for assessing cancer outcomes .


Therefore , vitamin B-@ plus folic acid supplementation can not be recommended at present for fracture prevention in elderly people .


The B-PROOF study was registered with the Netherlands Trial Register ( trialregister.nl ) as NTR@ and at clinicaltrials.gov as NCT@ .


To assess the role of migraine history in the development of postoperative nausea and vomiting ( PONV ) in patients undergoing general and combined general-epidural anaesthesia .


@ women with oncogynecological pathology were randomized into @ groups according to anaesthesia method .


Patients of the group C ( comparative group ; n = @ ; @ with migraine ) received general anaesthesia .


Patients of the Group CA ( n = @ ; @ with migraine ) received combined general-epidural anaesthesia .


Patients of the group D ( n = @ ; @ with migraine ) received general anaesthesia with adding of Droperidolum .


All patients received standard prophylactics of PONV - Ondansetronum @ mg and dexamethasone @ mg intravenous .


In the group C a PONV occurred in @ of @ women ( @ % ) .


PONV occurred in @ of @ women with migraine ( @ % ) and in @ of @ women without migraine ( @ % ) .


In the group CA a PONV occurred in @ of @ women ( @ % ) .


PONV occurred in @ of @ women with migraine ( @ % ) and in @ of @ women without migraine ( @ % ; p = @ in comparison with group C ) .


In the group D a PONV occurred in @ of @ women ( @ % ) .


PONV occurred in @ of @ women with migraine ( @ % p = @ in comparison with group C and p = @ with group CA ) and in @ of @ women without migraine ( @ % ; there was no significant difference with groups C and CA ) .


Migraine history is a significant risk factor of PONV .


Epidural component of anaesthesia does not effect on frequency of PONV in women with migraine , but Droperidolum use allows increasing the frequency of PONV .


Mobile technologies have wide-scale reach and disseminability , but no known studies have examined mobile technologies as a stand-alone tool to improve obesity-related behaviors of at-risk youth .


To test a @-week mobile technology intervention for use and estimate effect sizes for a fully powered trial .


Fifty-one low-income , racial/ethnic-minority girls aged @-@ years were randomized to a mobile technology ( n = @ ) or control ( n = @ ) condition .


Both conditions lasted @ weeks and targeted fruits/vegetables ( FVs ; Weeks @-@ ) ; sugar-sweetened beverages ( SSBs ; Weeks @-@ ) , and screen time ( Weeks @-@ ) .


The mobile intervention prompted real-time goal setting and self-monitoring and provided tips , feedback , and positive reinforcement related to the target behaviors .


Controls received the same content in a written manual but no prompting .


Outcomes included device utilization and effect size estimates of FVs , SSBs , screen time , and BMI .


Data were collected and analyzed in @-@ .


Mobile technology girls used the program on @ % of days and exhibited trends toward increased FVs ( +@ , p = @ ) and decreased SSBs ( -@ , p = @ ) .


The adjusted difference between groups of @ servings of FVs ( p = @ ) and @ servings of SSBs ( p = @ ) indicated small to moderate effects of the intervention ( Cohen 's d = @ and -@ , respectively ) .


No differences were observed for screen time or BMI .


A stand-alone mobile app may produce small to moderate effects for FVs and SSBs .


Given the extensive reach of mobile devices , this pilot study demonstrates the need for larger-scale testing of similar programs to address obesity-related behaviors in high-risk youth .


Preliminary studies have suggested the efficacy of sublingual tablets of house dust mite ( HDM ) extracts in adults with allergic rhinitis .


We sought to assess the efficacy and safety of @ doses of HDM sublingual tablets over @ treatment year and the subsequent immunotherapy-free year .


Adults with HDM-associated allergic rhinitis were randomized in a double-blind , placebo-controlled study to receive @ index of reactivity ( IR ) tablets , @IR tablets , or placebo administered once daily for @ year and were followed for the subsequent year .


The primary efficacy variable was the Average Adjusted Symptom Score over the year @ primary period ( ie , October @ to December @ ) .


Symptoms and rescue medication scores , onset of action , patient-reported outcomes , and safety were secondary variables .


The same end points were evaluated during the immunotherapy-free year .


The primary efficacy end point was analyzed by using analysis of covariance .


Five hundred nine participants were randomized , and @ continued in the immunotherapy-free year .


Both the @IR and @IR HDM sublingual tablets significantly reduced mean Average Adjusted Symptom Scores compared with placebo by -@ % ( P = @ ) and -@ % ( P = @ ) , respectively .


Efficacy of both doses was maintained during the treatment-free follow-up phase .


The onset of action was at @ months .


Participants ' global evaluation of treatment success was significantly higher in the @IR and @IR groups compared with the placebo group ( P = @ and P = @ , respectively ) .


Adverse events were generally application-site reactions .


There were no reports of anaphylaxis .


Twelve months of treatment with @IR and @IR sublingual tablets of HDM allergen extracts was efficacious and well tolerated .


Efficacy was maintained during the treatment-free follow-up year .


Advanced imaging may refine patient selection for ischemic stroke treatment but delays to acquire and process the imaging have limited implementation .


We examined the feasibility of imaging selection in clinical practice using fully automated software in the EXTEND trial program .


CTP and perfusion-diffusion MRI data were processed using fully-automated software to generate a yes/no ` mismatch ' classification that determined eligibility for trial therapies .


The technical failure/mismatch classification error rate and time to image and treat with CT vs. MR-based selection were examined .


In a consecutive series of @ patients from five sites over six-months the technical failure rate of CTP acquisition/processing ( uninterpretable maps ) was @ % ( @/@ , @ % CI @-@ % ) .


Mismatch classification was overruled by expert review in an additional @ % ( @/@ , @ % CI @-@ % ) due to artifactual ` perfusion lesion ' .


In @ consecutive patients at one site , median additional time to acquire CTP after non-contrast CT was @min .


Subsequent RAPID processing time varied from @-@min across @ trial centers ( median @min @s ) .


In the EXTEND trial , door-to-needle times in patients randomized on the basis of CTP ( n = @ ) were median @min shorter than MRI-selected ( n = @ ) patients ( P < @ ) .


Automated CTP-based mismatch selection is rapid , robust in clinical practice , and associated with faster treatment decisions than MRI .