Intravitreal ocriplasmin injection provides a generally well-tolerated pharmacologic treatment option for patients with symptomatic vitreomacular adhesion/vitreomacular traction , including when associated with full-thickness macular holes @ m in diameter .


The majority of mid-life and older adults in the UK are not achieving recommended physical activity levels and inactivity is associated with many health problems .


Walking is a safe , appropriate exercise .


The PACE-UP trial sought to increase walking through the structured use of a pedometer and handbook , with and without support from a practice nurse trained in behaviour change techniques ( BCTs ) .


Understanding barriers and facilitators to engagement with a primary care based physical activity intervention is essential for future trials and programmes .


We conducted semi-structured telephone interviews using a topic guide with purposive samples of participants who did and did not increase their walking from both intervention groups .


Interviews were audio-recorded , transcribed and coded independently by researchers prior to performing a thematic analysis .


Responsiveness to the specific BCTs used was also analysed .


Forty-three trial participants were interviewed in early @ .


Almost all felt they had benefitted , irrespective of their change in step-count , and that primary care was an appropriate setting.Important facilitators included a desire for a healthy lifestyle , improved physical health , enjoyment of walking in the local environment , having a flexible routine allowing for an increase in walking , appropriate self and external monitoring and support from others.Important barriers included physical health problems , an inflexible routine , work and other commitments , the weather and a mistrust of the monitoring equipment.BCTs that were reported to have the most impact included : providing information about behaviour-health link ; prompting self-monitoring and review of goals and outcomes ; providing feedback ; providing specific information about how to increase walking ; planning social support/change ; and relapse prevention .


Rewards were unhelpful .


Despite our expectation that there would be a difference between the experiences of those who did and did not objectively increase their walking , we found that most participants considered themselves to have succeeded in the trial and benefitted from taking part .


Barriers and facilitators were similar across demographic groups and trial outcomes .


Findings indicated several BCTs on which PA trial and programme planners could focus efforts with the expectation of greatest impact as well as strong support for primary care as an appropriate venue .


this study investigated the influence of anatomical predictors on difficult laryngoscopy and orotracheal intubation in obese patients by comparing Macintosh and Airtraq laryngoscopes .


from @ bariatric surgery patients ( body mass index @ kgm ( -@ ) ) , cervical perimeter , sternomental distance , interincisor distance , and Mallampati score were recorded .


The patients were randomized into two groups according to whether a Macintosh ( n = @ ) or an Airtraq ( n = @ ) laryngoscope was used for tracheal intubation .


Time required for intubation was the first outcome .


Cormack-Lehane score , number of intubation attempts , the Macintosh blade used , any need for external tracheal compression or the use of gum elastic bougie were recorded .


Intubation failure and strategies adopted were also registered .


intubation failed in two patients in the Macintosh laryngoscope group , and these patients were included as worst cases scenario .


The intubation times were @ +@ s and @ +@ s for the Macintosh and Airtraq laryngoscope groups ( p < @ ) , respectively .


Cormack-Lehane scores were also lower for the Airtraq group .


One patient in the Macintosh group with intubation failure was quickly intubated with the Airtraq .


Cervical circumference ( p < @ ) and interincisor distance ( p < @ ) influenced the time required for intubation in the Macintosh group but not in the Airtraq group .


in obese patients despite increased neck circumference and limited mouth opening , the Airtraq laryngoscope affords faster tracheal intubation than the Macintosh laryngoscope , and it may serve as an alternative when conventional laryngoscopy fails .


In this prospective trial we compared ultralow dose computerized tomography reconstruction algorithms and routine low dose computerized tomography for detecting urolithiasis .


A total of @ consenting adults prospectively underwent routine low dose noncontrast computerized tomography immediately followed by an ultralow dose series targeted at a @ % to @ % reduction from the routine low dose technique ( sub mSv range ) .


Ultralow dose series were reconstructed with filtered back projection , and adaptive statistical and model based iterative reconstruction techniques .


Transverse ( axial ) and coronal images were sequentially reviewed by @ relatively inexperienced trainees , including a radiology resident , a urology fellow and an abdominal imaging fellow .


Three experienced abdominal radiologists independently reviewed the routine low dose filtered back projection images , which served as the reference standard .


The mean effective dose for the ultralow dose scans was @ mSv ( median @ ) , representing a mean SD @ % @ % decrease compared to the routine low dose .


Overall sensitivity and positive predictive value per stone for ultralow dose computerized tomography at a @ mm threshold was @ and @ , respectively .


Sensitivity , specificity , positive and negative predictive values , and accuracy per patient were @ , @ , @ , @ and @ , respectively .


At a @ mm threshold the sensitivity and positive predictive value per stone of the ultralow dose series for filtered back projection , and adaptive statistical and model based iterative reconstruction was @ and @ , @ and @ , and @ and @ , respectively .


Sensitivity , specificity , positive and negative predictive values , and accuracy per patient at the @ mm threshold were @ , @ , @ , @ and @ for filtered back projection , @ , @ , @ , @ and @ for adaptive statistical iterative reconstruction , and @ , @ , @ , @ and @ for model based iterative reconstruction , respectively .


Sequential review of coronal images changed the final stone reading in @ % of cases and improved diagnostic confidence in @ % .


At a @ mm renal calculus size threshold ultralow dose computerized tomography is accurate for detection when referenced against routine low dose series with dose reduction to below the level of a typical @-view plain x-ray ofthekidneys , ureters and bladder .


Slight differences were seen among the reconstruction algorithms .


There was mild improvement with model based iterative reconstruction over filtered back projection and adaptive statistical iterative reconstruction .


Coronal images improved detection and diagnostic confidence over axial images alone .


This secondary analysis of data from a randomised controlled trial explores associations between common symptom clusters and evaluates pre-treatment to post-treatment changes in clinical levels of these symptoms following cognitive behaviour therapy for insomnia ( CBT-I ) .


Baseline data from @ participants with insomnia were explored to establish rates of and associations between clinical levels of fatigue , anxiety and depression across the sample .


Effects of CBT-I on this symptom cluster were also explored by examining changes in pre-treatment to post-treatment levels of fatigue , anxiety and depression .


At baseline , the most common symptom presentation was insomnia + fatigue , and @ % of the sample reported at least three co-morbid symptoms .


Post-CBT , the number of those experiencing clinical insomnia and clinical fatigue decreased .


There were no changes in anxiety rates from baseline to post-treatment in the CBT group and modest reductions in rates of those with clinical depression .


Seven individuals ( @ % ) from the CBT group were completely symptom free at post-treatment compared with @ % from the treatment as usual condition .


Chi-square analysis revealed a significant relationship between group allocation and changes in symptoms of insomnia and fatigue .


No such relationship was found between group allocation and mood variables .


These findings confirm the high rate of symptom co-morbidities among cancer patients and highlight strong associations between sleep and fatigue .


CBT-I appears to offer generalised benefit to the symptom cluster as a whole and , specifically , is effective in reducing fatigue , which exceeded clinical cut-offs prior to implementation of the intervention .


This has implications for the diagnosis/management of common symptoms in cancer patients .


Approximately one third of @-@ year olds in England are now overweight or obese suggesting that population approaches are urgently required .


However , despite the increasing number of school-based interventions to prevent obesity , results continue to be inconsistent and it is still unclear what the necessary conditions are that lead to the sustained behaviour change required to affect weight status .


The Healthy Lifestyles Programme is a theoretically informed four phase multi-component intervention which seeks to create supportive school and home environments for healthy behaviours .


A process evaluation has run alongside the exploratory trial of the Healthy Lifestyles Programme to ascertain the feasibility and acceptability of ; the trial design ( including the trial outcomes ) and the HeLP Programme and whether it is able to engage schools , children and their families .


Data was collected using interviews with teachers ( n = @ ) and parents ( n = @ ) and six focus groups with children ( n = @ ) and a questionnaire for parents of children in the intervention schools .


Interview and focus group data relating to the intervention was analysed using framework analysis .


Four schools and @ children participated in the exploratory trial .


The data showed that the trial design was feasible and acceptable for schools and children .


Three themes emerged for the data in relation to the acceptability and feasibility of the HeLP Programme ( value , compatibility with the curriculum and enjoyment ) and two themes emerged in relation to engagement ( ` knowledge and awareness ' and ` taking messages on board ' ) .


The latter could be broken down into @ subthemes ( ` initiating discussion with family and friends ' , ` acceptance of family rules ' , ` increased responsibility ' and ` the importance of the mode and agent of delivery ' ) .


The use of highly inclusive and interactive delivery methods where the children were encouraged to identify with and take ownership of the healthy lifestyle messages were identified as important factors in motivating the children to take the messages home , seek parental support and initiate family lifestyle behaviour change .


The process evaluation of the exploratory trial has not only provided evidence of the feasibility and acceptability of the Programme , it has also allowed an understanding of how HeLP engages schools , children and their families .


These findings have informed the process evaluation for the definitive trial .


The aim of this study was to evaluate the shear bond strength to dentin of primary molars of a new self-adhering flowable resin composite with two ionomer-based cements and one flowable resin composite in combination with two different adhesive systems .


Fifty primary molars were grinded on the occlusal surface to obtain flat dentin substrate and randomly divided into @ groups ( n = @ ) : OFL : Phosphoric Acid/Optibond FL/Premise Flow ; OAO : Optibond All-In-One/Premise Flowable ; II : Polyacrylic Acid/Fuji II ; IX : Polyacrylic Acid/Fuji IX ; V : Vertise Flow .


Cylinders ( @mm diameter - @mm height ) of restorative material were built-up in three increments over the dentin surfaces .


A shear load was applied until failure .


Bond strength values were statistically analysed with Kruskall-Wallis ANOVA followed by Dunn 's test ( P < @ ) .


Differences in failure mode distribution were assessed with Chi-square ( P < @ ) .


OFL and OAO recorded significantly higher bond strengths than the other groups .


Adhesive failures were evident in all groups except OFL and OAO , in which also cohesive failures in dentin were observed .


Vertise Flow established on primary dentin bond strengths values similar to those of glass ionomer cements routinely used for restorations of primary teeth .


The combination of flowable resin with etch-and-rinse or all-in-one adhesives obtained higher bond strength values , thus involving a more complex handling .


Clinical trials in heart failure have focused on the improvement in symptoms or decreases in the risk of death and other cardiovascular events .


Little is known about the effect of drugs on the risk of clinical deterioration in surviving patients .


We compared the angiotensin-neprilysin inhibitor LCZ@ ( @ mg daily ) with the angiotensin-converting enzyme inhibitor enalapril ( @ mg daily ) in @ patients with heart failure and reduced ejection fraction in a double-blind trial .


The analyses focused on prespecified measures of nonfatal clinical deterioration .


In comparison with the enalapril group , fewer LCZ@-treated patients required intensification of medical treatment for heart failure ( @ versus @ ; hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) or an emergency department visit for worsening heart failure ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


The patients in the LCZ@ group had @ % fewer hospitalizations for worsening heart failure ( @ versus @ ; P < @ ) and were less likely to require intensive care ( @ versus @ ; @ % rate reduction , P = @ ) , to receive intravenous positive inotropic agents ( @ % risk reduction , P < @ ) , and to have implantation of a heart failure device or cardiac transplantation ( @ % risk reduction , P = @ ) .


The reduction in heart failure hospitalization with LCZ@ was evident within the first @ days after randomization .


Worsening of symptom scores in surviving patients was consistently more common in the enalapril group .


LCZ@ led to an early and sustained reduction in biomarkers of myocardial wall stress and injury ( N-terminal pro-B-type natriuretic peptide and troponin ) versus enalapril .


Angiotensin-neprilysin inhibition prevents the clinical progression of surviving patients with heart failure more effectively than angiotensin-converting enzyme inhibition .


Acute kidney injury ( AKI ) is observed in up to @ % of patients undergoing transcatheter aortic valve implantation ( TAVI ) and is associated with increased risk for mortality .


The aim of the present study is to evaluate whether furosemide-induced diuresis with matched isotonic intravenous hydration using the RenalGuard system reduces AKI in patients undergoing TAVI .


Reduce-AKI is a randomized sham-controlled study designed to examine the effect of an automated matched hydration system in the prevention of AKI in patients undergoing TAVI .


Patients will be randomized in a @:@ fashion to the RenalGuard system ( active group ) versus non-matched saline infusion ( sham-controlled group ) .


Both arms receive standard overnight saline infusion and N-acetyl cysteine before the procedure .


The Reduce-AKI trial will investigate whether the use of automated forced diuresis with matched saline infusion is an effective therapeutic tool to reduce the occurrence of AKI in patients undergoing TAVI .


To compare the efficacies of non-bismuth quadruple therapy for @ days versus standard triple therapy for @ or @ days in initial treatment of Helicobacter pylori ( H.pylori ) .


A randomized , open-labeled , controlled trial comparing non-bismuth quadruple therapy with standard triple therapy was performed at Peking University First Hospital from August @ to July @ .


A total of @ patients with a diagnosis of H.pylori infection by ( @ ) C-urea breath test and receiving no eradication therapy were randomly divided into non-bismuth quadruple therapy and standard triple therapy for @ or @ days .


There were @ males and @ females with an age range of @-@ years .


Among them , @ patients received non-bismuth quadruple therapy ( esomeprazole @ mg , amoxicillin @ @ mg , clarithromycin @ mg and tinidazole @ mg given twice daily for @ days ) ; @ standard triple therapy ( esomeprazole @ mg , amoxicillin @ @ mg and clarithromycin @ mg given twice daily ) for @ days and @ standard triple therapy for @ days .


The efficacies were examined at Week @ post-therapy by ( @ ) C-urea breath test .


The incidence of adverse drug reactions was recorded .


Among them , @ patients completed the follow-up .


The eradication rates for non-bismuth quadruple therapy and standard triple therapy for @ or @ days were @ % ( @/@ ) , @ % ( @/@ ) and @ % ( @/@ ) as determined by intention-to-treat analysis ( ITT ) .


The eradication rates were @ % ( @/@ ) , @ % ( @/@ ) and @ % ( @/@ ) respectively as determined by per-protocol analysis ( PP ) .


Non-bismuth quadruple therapy was superior to standard triple therapy for @ days ( ITT analysis P = @ , PP analysis P = @ ) and @ days ( ITT analysis P = @ , PP analysis P = @ ) .


The differences for the eradication rates between standard triple therapy for @ days and for @ days were insignificant ( ITT analysis P = @ , PP analysis P = @ ) : Adverse reaction rates for non-bismuth quadruple therapy ( @ % , @/@ ) and standard triple therapy for @ days ( @ % , @/@ ) and @ days ( @ % , @/@ ) were not significantly different ( P = @ ) .


Non-bismuth quadruple therapy for @ days is both effective and safe for the first-line eradication of H.pylori .


The Combined Approach to Lysis Utilizing Eptifibatide and rt-PA in Acute Ischemic Stroke-Enhanced Regimen ( CLEAR-ER ) trial demonstrated safety of recombinant tissue-type plasminogen activator ( r-tPA ) plus eptifibatide in acute ischemic stroke ( AIS ) .


CLEAR-ER randomized AIS patients ( @:@ ) to @ mg/kg r-tPA plus eptifibatide versus standard r-tPA ( @ mg/kg ) .


Interventional Management of Stroke III randomized AIS patients to r-tPA plus endovascular therapy versus standard r-tPA .


Albumin in Acute Stroke Part @ randomized patients to albuminr-tPA versus saliner-tPA .


Our aim was to compare outcomes in CLEAR-ER combination arm patients to propensity score-matched r-tPA only subjects in Albumin in Acute Stroke Part @ and Interventional Management of Stroke III .


The primary outcome was @-day severity-adjusted modified Rankin score ( mRS ) dichotomization based on baseline National Institutes of Health Stroke Scale .


Secondary outcomes were @-day mRS dichotomization as excellent ( mRS , @-@ ) ; mRS dichotomization as favorable ( mRS , @-@ ) ; and nonparametric analysis of the ordinal mRS.


Eighty-five combination arm CLEAR-ER subjects were matched with @ Albumin in Acute Stroke Part @ and Interventional Management of Stroke III trials ' r-tPA only patients ( controls ) .


Median age in CLEAR-ER and control subjects was @years ; median National Institutes of Health Stroke Scale in the CLEAR-ER subjects was @ and in control subjects @ .


At @ days , CLEAR-ER subjects had a nonsignificantly greater proportion of patients with favorable outcomes ( @ % versus @ % ; unadjusted relative risks , @ ; @ % confidence intervals , @-@ @ ; P = @ ) .


Secondary outcomes were @ % versus @ % excellent outcomes ( relative risks , @ ; @ % confidence intervals , @-@ @ ; P = @ ) ; @ % versus @ % favorable outcome ( relative risks , @ ; @ % confidence intervals , @-@ @ ; P = @ ) ; and ordinal Cochran-Mantel-Haenszel P = @ .


r-tPA plus eptifibatide showed a favorable direction of effect that was consistent across multiple approaches for AIS outcome evaluation .


A phase III trial to establish the efficacy of r-tPA plus eptifibatide for improving AIS outcomes is warranted .


A randomized prospective study .


The study included @ children aged from @ to @ , ASA I-II .


The patients were divided into two groups .


We assessed the impact of reamberin @ % ( succinate-containing infusion solution ) on the level of metabolism and recovery after surgery in patients of main group ( n = @ ) and control group ( n = @ ) during different surgeries .


All patients received general anaesthesia with sevoflurane , fentanyl , and rocuronium .


Reamberin @ % promotes to increase the level of basal metabolism in the early postoperative period , decreases the duration of awakening periods , improves recovery of motor activity and adequate breathing .


It is difficult to choose the correct fertility treatment in women with poor ovarian reserve .


Although various methods have been used , the management of controlled ovarian hyperstimulation is not easy in poor responders .


The aim of this study was to evaluate the efficacy of dehydroepiandrosterone ( DHEA ) on in vitro fertilization-intracytoplasmic sperm injection ( IVF-ICSI ) outcome of poor responders .


This was a randomized , prospective controlled trial .


Women with serum antimullerian hormone < @ ng/ml or serum follicle-stimulating hormone > @ IU/l and antral follicle count < @ on day @ of the menstrual cycle were considered to have poor ovarian reserve .


All women were treated with a microdose induction protocol .


Women in the study group received IVF-ICSI and DHEA @ mg daily for @ weeks .


Women in the control group received IVF-ICSI without DHEA supplementation .


In total , @ women with diminished ovarian reserve was enrolled in the study , @ in the study group and @ in the control group .


The number of oocytes retrieved and the fertilization rate were slightly higher in the study group , but the pregnancy rate was higher in the control group .


The differences were not significant .


The results failed to show that DHEA supplementation enhances IVF-ICSI outcome in women with poor ovarian reserve .


Ischemic preconditioning ( IPC ) and anesthetic preconditioning ( APC ) have been reported to attenuate ischemia-reperfusion ( IR ) injury after liver resection under continuous inflow occlusion .


This study evaluates whether these strategies enhance hepatic protection of remnant liver against IR after liver resection with intermittent clamping ( INT ) .


A total of @ patients without underlying liver disease and submitted to liver resection using INT were randomized into @ groups : IPC ( @ minutes of inflow occlusion followed by @ minutes of reperfusion before liver transection ) , APC ( sevoflurane administration for @ minutes before liver transection ) , and INT ( no preconditioning ) .


Patients were also stratified according to the extent of the hepatectomy .


Cytoprotection was evaluated by comparing hepatocyte and endothelial dysfunction markers , apoptosis , histologic lesions , and postoperative outcome .


No differences were observed in preoperative chemotherapy and steatosis , total warm ischemia time , operative time , or blood loss .


Kinetics of transaminases ( aspartate aminotransferase , P = @ ; alanine aminotransferase , P = @ ) , bilirubin ( P = @ ) , and hyaluronic acid increase ( P = @ ) revealed no differences .


Significant apoptosis was present in @ % of patients , mild-to-moderate leukocyte infiltration and steatosis in @ % and @ % , respectively , and mild sinusoidal congestion in @ % , with a similar distribution in the @ groups .


When patients were stratified by major versus minor resections , no differences were observed in any of the variables studied .


Postoperative clinical outcomes were also similar .


These results suggest that these protocols of IPC and APC used in this study do not provide better cytoprotection from IR when INT is used .


The effects of the use of the stapler or hand-sewn method in oesophagogastric anastomosis on postoperative morbidity , mortality and quality of life after oesophagectomy remain controversial .


The purpose of his study was to compare clinical outcomes of hand-sewn and stapler techniques in oesophagogastric anastomosis after oesophagectomy for oesophageal carcinoma .


We performed a prospective randomized controlled trial on @ patients treated for oesophageal tumour between February @ and December @ .


Patients were randomly assigned to two treatment groups with @ patients in the hand-sewn group and @ patients in the circular stapler group ( http://www.chictr.org: ChiCTR-TRC-@ ) .


The mean follow-up time was @ months .


The mean operating time of the stapled group and the hand-sewn group were @ and @ min , respectively ( P < @ ) .


Seventeen clinical and radiological leakages occurred in the hand-sewn group compared with @ in the stapler group ( P = @ ) .


In the stapler group hospital mortality occurred in @ patients ( @ % ) and in the hand-sewn group in @ patients ( @ % ) ( P = @ ) .


Anastomotic strictures were noted in @ patients from the stapler group ( @ % ) and in @ patients from the hand-sewn group ( @ % ) ( P = @ ) .


Using the circular stapler method in oesophagogastric anastomoses had a lower anastomotic leakage rate and shorter operating time compared with the hand-sewn method .


However , the circular stapler method was associated with a significantly increased risk of anastomotic strictures .


To evaluate the long-term efficacy and safety of certolizumab pegol ( CZP ) plus methotrexate treatment and to assess the efficacy of two CZP maintenance dosing schedules in Japanese rheumatoid arthritis ( RA ) patients with an inadequate response to methotrexate .


J-RAPID double-blind patients were entered into an open-label extension ( OLE ) study .


Patients withdrawn due to lack of efficacy at @ weeks and double-blind completers without a week-@ American College of Rheumatology ( ACR ) @ response received CZP @ mg every other week ( Q@W ) plus methotrexate .


Double-blind completers with week-@ ACR@ responses were randomized to CZP @ mg Q@W plus methotrexate or CZP @ mg every @ weeks plus methotrexate .


The ACR@/ACR@/ACR@ response rates of double-blind completers ( n = @ ) were @ % / @ % / @ % at OLE entry and @ % / @ % / @ % at @ weeks , respectively .


Other clinical , functional and radiographic outcomes were sustained with long-term CZP plus methotrexate .


Long-term treatment with CZP was well-tolerated with no new unexpected adverse events observed .


The efficacy and safety of CZP treatment were similar between the two dosing schedules .


Continued CZP administration with methotrexate maintained efficacy over @ weeks and was well-tolerated for Japanese RA patients .


No obvious differences in clinical efficacy and safety were observed between the two dosing schedules , giving flexibility in maintenance administration schedules .


To explore the efficacy of electric acupoint stimulation on shivering in cesarean section .


Eighty cases of parturients , under the America Society of Anesthesiologists ( ASA ) physical status II , were randomized into a transcutaneous electrical acupoint stimulation ( TEAS ) assisted anesthesia group ( group A ) and an anesthesia group ( group B ) .


Spinal-epidural anesthesia ( CSEA ) puncture was applied to both groups and @ mg of @ % bubivacaine was given by spinal injection , the block level was T@ T@ .


In group A , TEAS was applied before CSEA at paired acupoints-ipsilateral Hegu ( LI @ ) - Laogong ( PC @ ) and Sanyinjiao ( SP @ ) - Zusanli ( ST @ ) till ending the surgery .


The @ pair of bilateral acupoints were fixed with self-adhesive electrodes and connected with Han 's acupoint and nerve stimulator ( HANS , LH@H ) , the frequency was @ Hz / @ Hz , the intensity was @ - @ mA and the form was densedisperse wave within the patients ' tolarance .


The heart rate ( HR ) , mean arterial pressure ( MAP ) , oxyhemoglobin saturation ( SPO ) and shivering degree were recorded before anesthesia ( To ) , @ min after anesthesia puncture ( Ti ) , @ min after the delivery ( Tz ) , during abdomen closure ( T@ ) and at the end of surgery ( T@ ) .


The occurrence rate of shivering was @ % ( @/@ ) in group A , which was lower to @ % ( @/@ , P < @ ) in group B ; the degree of shivering was lighter in group A than that in group B at T@ , T@ and T@ ( all P < @ ) .


In group A , HR was faster at T@ and T@ compared to that at To ( all P < @ ) , while at T@ and T@ , the HR was the same with that before anesthesia ( all P > @ ) .


In group B , the HR was faster at T@ , T@ , T@ and T@ compared to that at T@ ( P < @ , P < @ ) .


In both groups , the MAP was lower at T@ , T@ ( P < @ , P < @ ) and resumed to that before anesthesia at T@ and T@ ( all P > @ ) ; there was no statistical significance of SPO@ in both groups ( all P > @ ) .


TEAS can reduce the occurrence rate of shivering and steady the heart rate in cesarean section .


There is increasing recognition of the potential use of reminiscence in maintaining or improving the quality of life of people with dementia .


Despite being used widely in dementia care , evidence on the effectiveness of reminiscence remains uncertain .


This study aims to evaluate the effectiveness of a structured education-based reminiscence programme-the Dementia Education Programme Incorporating Reminiscence for Staff-for people with dementia residing in long-stay care settings in Ireland .


Dementia Education Programme Incorporating Reminiscence for Staff is a two-group , single-blind , cluster randomised trial conducted in long-stay residential care settings in Ireland .


The primary outcome was the self-rated quality of life of residents as measured by the Quality of Life-Alzheimer 's Disease instrument .


Using an intention-to-treat analysis , we found that the estimated effect of the intervention on the quality of life of residents was a non-significant @ ( p = @ ; @ % confidence interval -@ , @ ) , expressed as the difference in mean improvement between the intervention and control groups .


However , the per-protocol analysis yielded a significant effect for the intervention on the quality of life of residents of @ ( p = @ ; @ % confidence interval @ , @ ) .


Reminiscence may , in certain circumstances , be an effective care option for people with dementia in long-stay settings with potential to impact positively on the quality of life of residents .


Infection after shoulder surgery can have devastating consequences .


Recent literature has implicated Propionibacterium acnes as a causative agent for postoperative shoulder infections .


Axillary hair removal has been suggested as a method for infection prevention , although data quantifying its effect on the bacterial load around the shoulder are lacking .


We clipped one randomly selected axilla in @ healthy male volunteers with commercially available surgical clippers .


Aerobic and anaerobic culture specimens were taken from the clipped and unclipped axillae .


Each shoulder was then prepared with @ % chlorhexidine gluconate and @ % isopropyl alcohol .


Repeated culture specimens were then taken from both axillae .


Cultures were held for @days and recorded with a semiquantitative system ( @-@ points ) .


Results were compared by the Wilcoxon signed rank test .


There was no difference in the burden of P. acnes between the clipped and unclipped axillae before or after surgical preparation ( P = @ , P = @ , respectively ) .


There was a significantly greater bacterial burden in the clipped shoulder compared with the unclipped shoulder before preparation ( P < @ ) but not after preparation ( P = @ ) .


There was a significant reduction in total bacterial load and P. acnes load for both axillae after surgical preparation ( P < @ for all ) .


Removal of axillary hair has no effect on the burden of P. acnes in the axilla .


Clipped axillae had a higher total bacterial burden .


A @ % chlorhexidine gluconate surgical preparation is effective at removal of all bacteria and specifically P. acnes from the axilla .


Major depressive disorder ( MDD ) is one of the most common psychiatric disorders , conferring considerable individual , family , and community burden .


To date , treatments for MDD have been derived from the monoamine hypothesis , and there is a paucity of emerging antidepressants , especially with novel mechanisms of action and treatment targets .


N-acetylcysteine ( NAC ) is a redox-active glutathione precursor that decreases inflammatory cytokines , modulates glutamate , promotes neurogenesis , and decreases apoptosis , all of which contribute to the neurobiology of depression .


Participants with a current episode of MDD diagnosed according to DSM-IV-TR criteria ( N = @ ) were treated with NAC or placebo in addition to treatment as usual for @ weeks and were followed to @ weeks .


Data were collected between @ and @ .


The omnibus interaction between group and visit for the Montgomery-Asberg Depression Rating Scale ( MADRS ) , the primary outcome measure , was not significant ( F , .


= @ , P = @ ) , and the groups did not separate at week @ ( t. = -@ , P = @ ) .


However , at week @ , the scores on the Longitudinal Interval Follow-Up Evaluation-Range of Impaired Functioning Tool ( LIFE-RIFT ) differed from placebo ( P = @ ) .


Among participants with a MADRS score @ , NAC separated from placebo at weeks @ , @ , @ , and @ ( P < @ ) .


Additionally , the rate of change between baseline and week @ was significant ( t. = -@ , P = @ ) .


NAC treatment was superior to placebo at week @ for secondary readouts of function and clinical impression .


Remission and response were greater in the NAC group at week @ , but not at week @ .


The NAC group had a greater rate of gastrointestinal and musculoskeletal adverse events .


Being negative at the week @ end point , and with some positive secondary signals , the study provides only limited support for the role of NAC as a novel adjunctive therapy for MDD .


These data implicate the pathways influenced by NAC in depression pathogenesis , principally oxidative and inflammatory stress and glutamate , although definitive confirmation remains necessary .


Prevention and early detection measures for melanoma , such as sun avoidance and skin examinations , are important , but are practiced inconsistently .


In this replication of the Project SCAPE trial , we sought to determine whether tailored print materials were more effective at improving adherence than generic print materials for patients at increased risk of skin cancer .


Participants were randomized to receive personalized mailed communications about their skin cancer risk and recommended sun protection , or generic mailings .


Participants were Caucasian adults , at moderate or high risk for skin cancer , recruited in outpatient primary care .


The main outcomes were overall sun protection behaviors and specific protective behaviors including use of sunscreen , shirt , hat , sunglasses , shade , and sun avoidance ; recent sunburns ; and skin self-examination and provider skin examination .


One hundred ninety-two ( @ % ) subjects completed the study .


Six outcome variables showed significant intervention condition effects in mixed effects models : overall sun protection behavior ( P = @ ) ; sunscreen use ( P = @ ) ; use of sunglasses ( P = @ ) ; sunburns in the past three months ( P = @ ) ; recency of last skin self-exam ( P = @ ) ; and frequency of skin exams by health care provider ( P = @ ) .


Relative to generic communications , tailored risk communications resulted in improved adherence to six skin cancer protective behaviors , including a composite sun protection behavior measure , sunburns , and health care provider skin examinations .


Tailored interventions can be more effective in improving patient prevention behaviors than nontailored , generic information for patients at moderate to high risk of skin cancer .


Existing anthelmintic drugs ( eg , albendazole and mebendazole ) have low efficacy against the intestinal nematode species Trichuris trichiura and the drug pipeline is exhausted .


We aimed to investigate the strategy of combination chemotherapy with existing drugs to establish whether their efficacy could be enhanced and broadened .


In this randomised controlled trial , we compared three drug combinations and one standard drug alone in children aged @-@ years in two schools on Pemba Island , Tanzania infected with T trichiura and concomitant intestinal nematodes .


We assigned children , via a randomisation list with block sizes of either four or eight , to orally receive albendazole ( @ mg ) plus ivermectin ( @ g/kg ) ; albendazole ( @ mg ) plus mebendazole ( @ mg ) ; albendazole ( @ mg ) plus oxantel pamoate ( @ mg/kg ) ; or mebendazole ( @ mg ) alone .


The primary endpoints were the proportion of children cured of T trichiura infection and the reduction of T trichiura eggs in stool based on geometric means , both analysed by available case .


This study is registered with ISRCTN , number ISRCTN@ .


We randomly assigned @ eligible children infected with T trichiura between Sept @ , and Oct @ , @ , to one of the four treatment groups ( @ children per group ) .


Data for @ children were included in the analysis for the primary endpoints .


Albendazole plus oxantel pamoate ( @ of @ children cured -LSB- @ % , @ % CI @-@ -RSB- ; egg reduction @ % , @-@ ) and albendazole plus ivermectin ( @ of @ cured -LSB- @ % , @-@ -RSB- ; egg reduction @ % , @-@ ) were significantly more effective against T trichiura than mebendazole alone ( nine of @ cured -LSB- @ % , @-@ -RSB- ; egg reduction @ % , @-@ ) .


Albendazole plus mebendazole had similar low efficacy ( nine of @ cured -LSB- @ % , @-@ ; egg reduction @ % , @-@ ) to mebendazole alone .


About a fifth of the children reported adverse events , which were mainly mild .


Abdominal cramps and headache were the most common adverse events after treatment ; abdominal cramps were reported by @ ( @ % ) children for albendazole plus ivermectin , @ ( @ % ) for albendazole plus mebendazole , @ ( @ % ) for albendazole plus oxantel pamoate , and @ ( @ % ) for mebendazole ; headaches were reported by @ ( @ % ) children for albendazole plus ivermectin , @ ( @ % ) for albendazole plus mebendazole , @ ( @ % ) for albendazole plus oxantel pamoate , and @ ( @ % ) for mebendazole .


Our head-to-head comparison of three combination chemotherapies showed the highest efficacy for albendazole plus oxantel pamoate for the treatment of infection with T trichiura .


Further studies should investigate the combination of albendazole plus oxantel pamoate so that it can be considered for soil-transmitted helminthiasis control programmes .


This trial aimed to evaluate the short-term effectiveness of acupuncture plus stretching to reduce pain and improve range of motion in patients afflicted by cervical myofascial pain syndrome .


Randomized , blinded , placebo-controlled crossover study .


Nineteen patients ( @ females , eight males , @ @ years ) with myofascial neck pain in randomized order received the following treatments with one week washout between : acupuncture , acupuncture plus stretching , and placebo laser acupuncture .


Mechanical pain threshold ( MPT , measured with a pressure algometer ) represented the primary outcome .


Secondary outcomes were motion-related pain ( Visual Analogue Scale , VAS ) and cervical range of motion ( ROM , recorded by means of an ultrasonic @D movement analysis system ) .


Outcomes were assessed immediately prior as well as @ , @ and @ min post treatment .


Friedman tests with post hoc Bonferroni-Holm correction were applied to compare differences between treatments .


Both acupuncture as well as acupuncture plus stretching increased MPT by five , respectively , @ percent post treatment .


However , only acupuncture in combination with stretching was superior to placebo ( p < @ ) .


There were no significant differences between interventions at @ and @ min post treatment .


VAS did not differ between treatments at any measurement .


Five minutes after application of acupuncture plus stretching , ROM was significantly increased in the frontal and the transversal plane compared to placebo ( p < @ ) .


The combination of acupuncture and stretching could represent a suitable treatment option to improve cervical movement behavior and reduce trigger point pain in the short-term .


However , additional studies further discriminating the placebo effects are still warranted .


HIV and malaria infections occur in the same individuals , particularly in sub-Saharan Africa .


We examined whether daily multivitamin supplementation ( vitamins B complex , C , and E ) or vitamin A supplementation altered malaria incidence in HIV-infected women of reproductive age .


HIV-infected pregnant Tanzanian women recruited into the study were randomly assigned to daily multivitamins ( B complex , C , and E ) , vitamin A alone , both multivitamins and vitamin A , or placebo .


Women received malaria prophylaxis during pregnancy and were followed monthly during the prenatal and postpartum periods .


Malaria was defined in @ ways : presumptive diagnosis based on a physician 's or nurse 's clinical judgment , which in many cases led to laboratory investigations , and periodic examination of blood smears for malaria parasites .


Multivitamin supplementation compared with no multivitamins significantly lowered women 's risk of presumptively diagnosed clinical malaria ( relative risk : @ , @ % confidence interval : @ to @ ) , although multivitamins increased their risk of any malaria parasitemia ( relative risk : @ , @ % confidence interval : @ to @ ) .


Vitamin A supplementation did not change malaria incidence during the study .


Multivitamin supplements have been previously shown to reduce HIV disease progression among HIV-infected women , and consistent with that , these supplements protected against development of symptomatic malaria .


The clinical significance of increased risk of malaria parasitemia among supplemented women deserves further research , however .


Preventive measures for malaria are warranted as part of an integrated approach to the care of HIV-infected individuals exposed to malaria .


The use of intravenous proton-pump inhibitors ( PPIs ) has shown to reduce recurrent bleeding and improve patient outcome after endoscopic hemostasis on patients with peptic ulcer .


However , the efficacy of oral PPI is uncertain .


Studies from Asia indicated that even oral PPI can achieve the same therapeutic effect .


This study is designed to compare the efficacy of high-dose intravenous PPI to oral PPI in preventing recurrent bleeding after endoscopic hemostasis .


This is a single-center , randomized-controlled , double-blind , and double-dummy study .


Patients had Forrest IA/IB or IIA/IIB peptic ulcer bleeding and received endoscopic hemostasis before recruitment into the study .


They were randomized to receive either ( i ) esomeprazole IV bolus at a dose of @ mg plus infusion at @ mg/h for @ h and oral placebo every @ h ( IVP group ) , or ( ii ) IV placebo bolus plus infusion for @ h and high-dose oral esomeprazole at a dose of @ mg every @ h ( ORP group ) .


Patients were followed up for @ days after index bleeding .


The primary end point was defined as the @-day recurrent bleeding after successful endoscopic hemostasis .


A total of @ patients were randomized to the IVP group and @ to the ORP group in this study .


In all , @ % in the IVP and @ % in the ORP group used non-steroidal anti-inflammatory drug and/or aspirin before bleeding .


In the IVP group ( vs. ORP ) , Forrest IA represented @ % ( @ % ) , IB @ % ( @ % ) , IIA @ % ( @ % ) , and IIB @ % ( @ % ) .


Recurrent bleeding in @ days was reported in @ % of patients in the IVP group and @ % of patients in the ORP group , and the difference of recurrent bleeding was -@ % ( @ % CI : -@ % , @ % ) .


There was no difference in blood transfusion , repeated endoscopic therapy , and hospital stay between the two groups .


High-dose oral esomeprazole at @ mg BID may be considered as a useful alternative to IV bolus plus infusion of esomeprazole in the management of ulcer bleeding in patients who are not candidates for high-dose IV infusion .


However , as this study was stopped prematurely and was not designed as an equivalency trial , a much larger study would be necessary to document whether there is equivalency or non-inferiority of the two treatments in a heterogeneous patient population .


The genetic polymorphism of drug metabolizing enzymes of the cytochrome P@ ( CYP ) families , especially CYP@D@ and CYP@C@ , is the most important cause of variable responses of many drugs .


Enzyme activity ranges from complete deficiency , so called poor metabolizers ( PMs ) , to an ultrafast metabolism .


While PMs and extensive metabolizers ( EMs ) can be well distinguished by genotyping , phenotyping is necessary to subdivide EMs from intermediate metabolizers ( IMs ) .


The aim of the study was to evaluate if messenger RNA ( mRNA ) concentration for CYP-enzymes in peripheral blood leukocytes ( PBLs ) will be predictive of systemic enzyme activity , allowing an easy and safe determination of metabolic activity .


The genotype , phenotype , and mRNA-expression in PBLs were evaluated in @ healthy Caucasian volunteers ( males and females , age range @ - @ years ) on three occasions ( every @ weeks ) .


Genotyping was performed by Taqman allelic discrimination on the most common null alleles for CYP@D@ ( * @ , * @ , * @ , * @ , and * @ ) and CYP@C@ ( * @ and * @ ) .


For phenotyping CYP@D@ , dextromethorphan/dextrorphan metabolic ratios were determined in collected urine ( @ hours ) after administration of @ mg dextromethorphan .


For phenotyping CYP@C@ , we used the plasma concentration ratio of omeprazole/hydroxyomeprazole @ hours after ingestion of @ mg omeprazole .


mRNA-expression in PBLs for CYP@D@ and CYP@C@ was measured by Taqman real-time PCR before medication and @ hours afterwards .


Genotyping for CYP@D@ and CYP@C@ showed a regular distribution of EMs and PMs compared to studies of a comparable population .


The median dextromethorphan/dextrorphan metabolic ratio was @ in EMs/IMs and @ in PMs .


The median omeprazole/hydroxyomeprazole metabolic ratio was @ in EMs/IMs and @ in PMs .


CYP@D@ and CYP@C@ mRNA expression was detected without evidence of correlation to the respective metabolic ratio .


The results do not support the concept of using mRNA expression profiles for CYP@D@ and CYP@C@ enzymes in PBLs for prediction of systemic enzyme activity .


Lipid emulsions containing fish oil , as source of long chain omega @ fatty acids , have recently became available for parenteral nutrition in infants , but scanty data exist in extremely low birth weight preterms .


The objective of this study was to compare plasma fatty acids and lipid tolerance in preterm infants receiving different doses of a @ % fish oil vs. a soybean oil based lipid emulsion .


Preterm infants ( birth weight @-@g ) were randomized to receive parenteral nutrition with MOSF ( @ % Medium-chain triglycerides , @ % Olive oil , @ % Soybean oil , @ % Fish oil ) or S ( S , @ % Soybean oil ) both at two levels of fat intake : @ or @ gkg ( -@ ) d ( -@ ) , named @ Fat and @ Fat respectively .


Plasma lipid classes and their fatty acid composition were determined on postnatal day @ and @ by gas chromatography together with routine biochemistry .


We studied @ infants .


MOSF infants had significantly higher plasma phospholipid Docosahexaenoic acid and Eicosapentaenoic and lower Arachidonic acid .


Plasma phospholipids , triglycerides and free cholesterol were all significantly higher in the MOSF-@ @ Fat group , while cholesterol esters were lower with MOSF than with S.


The area under the curve of total bilirubin was significantly lower with MOSF than with S.


The use of a lipid emulsion with @ % FO resulted in marked changes of plasma long-chain fatty acids .


Whether the benefits of increasing Docosahexaenoic acid outweigh the potential negative effect of reduced Arachidonic acid should be further studied .


MOSF patients exhibited reduced lipid tolerance at @ gkg ( -@ ) d ( -@ ) fat intake .


The trial was conducted between January @ and December @ so we had not registered it in a public trials registry as it is now required for trials that started after July @ .


Meningococcal disease is rare but can cause death or disabilities .


Although the Advisory Committee on Immunization Practices has recommended meningococcal vaccination for at-risk children aged @ through @ months , it has not endorsed universal vaccination .


Health insurance payments for the vaccination of children who are not at risk are likely to be limited.Use of infant meningococcal vaccines by these families will thus depend on the preferences of physicians who might recommend vaccination to parents , as well as parents ' preferences .


To quantify pediatricians ' preferences for specific features of hypothetical infant meningococcal vaccines .


A sample of pediatricians ( n = @ ) completed a Web-enabled , discrete choice experiment survey in which respondents chose between pairs of hypothetical vaccines in a series of trade-off questions .


The questions described vaccines with six attributes .


A random-parameters logit regression model was used to estimate the relative importance weights physicians place on vaccine features .


These weights were used to calculate the predicted probability that a physician chooses hypothetical vaccines with given characteristics .


Pediatricians ' choices indicated that increases in vaccine effectiveness were among the most important factors in their vaccine recommendations , followed by increases in the number of injections .


The age at which protection begins and the number of additional office visits were less important .


Whether a booster was required after @ years was the least important factor in vaccine recommendations .


The results suggest that virtually all ( @ % ) physicians in the sample would recommend a vaccine even with the least-preferred features rather than no infant meningococcal vaccine .


Physicians ' responses indicate a strong preference for infant meningococcal vaccination .


The perceived risk of serious bleeding is an obstacle to the use of oral anticoagulation in East Asia .


The efficacy and safety of apixaban in East Asian patients with atrial fibrillation are unknown .


ARISTOTLE included @,@ patients with nonvalvular atrial fibrillation randomized to apixaban @mg twice daily or warfarin .


The efficacy and safety of apixaban and warfarin among patients recruited from East Asia ( n = @,@ ) were compared with those recruited from outside East Asia ( n = @,@ ) .


Compared with warfarin , apixaban resulted in a consistent reduction in stroke or systemic embolism in East Asian ( hazard ratio -LSB- HR -RSB- @ , @ % CI @-@ @ ) and non-East Asian ( HR @ , @ % CI @-@ @ ) patients ( interaction P = @ ) .


Consistent benefits of apixaban over warfarin were also seen for major bleeding in East Asian ( HR @ , @ % CI @-@ @ ) and non-East Asian ( HR @ , @ % CI @-@ @ ) patients ( interaction P = @ ) .


There was a greater reduction in major or clinically relevant nonmajor bleeding with apixaban compared with warfarin in East Asian ( HR @ , @ % CI @-@ @ ) than in non-East Asian ( HR @ , @ % CI @-@ @ ) patients ( interaction P = @ ) .


Numerically higher rates of intracranial bleeding were seen in East Asian patients with warfarin but not with apixaban .


Apixaban resulted in similar reductions in stroke or systemic embolism and major bleeding and greater reductions in major or clinically relevant nonmajor bleeding in patients from East Asia .


Warfarin is associated with more intracranial bleeding , particularly in patients from East Asia .


Inhibition of tumor angiogenesis by the interruption of VEGF pathway signaling is of therapeutic value in several solid tumors .


Preclinical evidence supports similar importance of the pathway in non-Hodgkin lymphoma .


In this randomized phase II trial , we compared the efficacy and toxicity of rituximab with bevacizumab versus single-agent rituximab , in patients with previously-treated follicular lymphoma .


Patients ( n = @ ) were randomized ( @:@ ) to receive rituximab ( @ mg/m ( @ ) intravenously -LSB- I.V. -RSB- weekly for @ weeks ) either as a single agent or with bevacizumab ( @ mg/kg I.V. on days @ and @ ) .


Patients with an objective response or stable disease at week @ received @ additional doses of rituximab ( at months @ , @ , @ , and @ ) ; patients who received rituximab/bevacizumab also received bevacizumab @ mg/kg I.V. every @ weeks for @ doses .


After a median follow-up of @ months , PFS was improved in patients who received rituximab/bevacizumab compared with patients who received rituximab alone ( median @ vs. @ months respectively ; HR , @ ( @ % confidence interval -LSB- CI -RSB- , @-@ @ ) ; P = @ ) .


Overall survival was also improved numerically ( @ % vs. @ % at @ years ) , but did not reach statistical significance ( HR , @ ( @ % CI , @-@ @ ) ; P = @ ) .


The addition of bevacizumab increased the toxicity of therapy , but both regimens were well tolerated ( no grade @ toxicity ) .


The addition of bevacizumab to rituximab significantly improved PFS .


The role of angiogenesis inhibition in the treatment of follicular lymphoma requires further definition in larger clinical trials .


Apremilast , an oral phosphodiesterase @ inhibitor , regulates inflammatory mediators .


Psoriatic Arthritis Long-term Assessment of Clinical Efficacy @ ( PALACE @ ) compared apremilast with placebo in patients with active psoriatic arthritis despite prior traditional disease-modifying antirheumatic drug ( DMARD ) and/or biologic therapy .


In the @-week , placebo-controlled phase of PALACE @ , patients ( N = @ ) were randomised ( @:@:@ ) to placebo , apremilast @ mg twice a day ( BID ) or apremilast @ mg BID .


At week @ , patients without @ % reduction in swollen and tender joint counts were required to be re-randomised equally to either apremilast dose if initially randomised to placebo or remained on their initial apremilast dose .


Patients on background concurrent DMARDs continued stable doses ( methotrexate , leflunomide and/or sulfasalazine ) .


Primary outcome was the proportion of patients achieving @ % improvement in modified American College of Rheumatology response criteria ( ACR@ ) at week @ .


At week @ , significantly more apremilast @ mg BID ( @ % ) and @ mg BID ( @ % ) patients achieved ACR@ versus placebo ( @ % ) ( p < @ ) .


Significant improvements in key secondary measures ( physical function , psoriasis ) were evident with both apremilast doses versus placebo .


Across outcome measures , the @-mg group generally had higher and more consistent response rates , although statistical comparison was not conducted .


The most common adverse events were gastrointestinal and generally occurred early , were self-limiting and infrequently led to discontinuation .


No imbalance in major adverse cardiac events , serious or opportunistic infections , malignancies or laboratory abnormalities was observed .


Apremilast was effective in the treatment of psoriatic arthritis , improving signs and symptoms and physical function .


Apremilast demonstrated an acceptable safety profile and was generally well tolerated .


To define longitudinal childhood wheeze phenotypes and identify their early-life risk factors .


Current wheeze was recorded @ times up to age @ years in a birth cohort at high risk for allergy ( n = @ ) .


Latent class analysis of wheeze responses identified @ classes .


Multinomial logistic regression estimated associations of probability-weighted wheezing classes with early-life factors .


All phenotypes were compared with never/infrequent wheezers .


Lower respiratory tract infection ( LRTI ) by @ year ( relative risk -LSB- RR -RSB- , @ ; @ % CI , @-@ @ ) , childcare by @ year ( RR , @ ; @ % CI , @-@ @ ) , and higher body mass index ( RR , @ ; @ % CI , @-@ @ ) were associated with increased risk of early transient wheeze , whereas breastfeeding was protective ( RR , @ ; @ % CI , @-@ @ ) .


LRTI ( RR , @ ; @ % CI , @-@ @ ) and aeroallergen sensitization ( RR , @ ; @ % CI , @-@ @ ) increased the risk of early persistent wheeze .


LRTI ( RR , @ ; @ % CI , @-@ @ ) , eczema ( RR , @ ; @ % CI , @-@ @ ) , aeroallergen sensitization ( RR , @ ; @ % CI , @-@ @ ) , and food sensitization ( RR , @ ; @ % CI , @-@ @ ) increased the risk of intermediate-onset wheeze , whereas dog exposure at baseline ( RR , @ ; @ % CI , @-@ @ ) and first-born status ( RR , @ ; @ % CI , @-@ @ ) were protective .


Heavy parental smoking at birth ( RR , @ ; @ % CI , @-@ @ ) increased the risk of late-onset wheeze , whereas breastfeeding reduced it ( RR , @ ; @ % CI , @-@ @ ) .


All wheeze classes except early transient had greater risk of wheeze at age @ years compared with never/infrequent wheezers .


We found distinct early-life risk factor profiles for each wheeze phenotype .


These findings provide insight into possible wheeze mechanisms and have implications for identifying preventive strategies and addressing clinical management of early-life wheeze .


The authors sought to compare the newest U.S. Food and Drug Administration-approved botulinum toxin type A product , incobotulinumtoxinA , to onabotulinumtoxinA for upper face wrinkles .


This is the first prospective , split-face , randomized , double-blind study addressing three types of facial wrinkles using a @:@ dose ratio .


The study was designed , institutional review board approval was obtained , and @ patients were enrolled .


A three-judge independent reviewer panel compared photographs of patients to the upper face validated assessment scales , selecting a grade ranging from @ ( no lines ) to @ ( very severe ) for the degree of glabellar lines , crow 's feet , and forehead lines for each side of the face for photographs taken before treatment and @ days , @ weeks , @ months , and @ months after treatment .


For toxin comparison , the difference in the magnitude of the degree of wrinkle scale at each period compared to before treatment was calculated and statistical analysis performed .


Individual wrinkle types and all three wrinkle types combined were analyzed .


Both products offered significant reduction in individual and combined wrinkles at comparable time points ; however , onabotulinumtoxinA had significantly greater combined dynamic wrinkle reduction at @ days ( p < @ ) , @ weeks ( p < @ ) , @ months ( p < @ ) , and @ months ( p < @ ) .


For identical dosage , both onabotulinumtoxinA and incobotulinumtoxinA are safe and effective in reducing dynamic wrinkles in the upper face ; however , for the authors ' dosages , onabotulinumtoxinA had statistically greater efficacy at @ days , @ weeks , @ months , and @ months .


Therapeutic , II .


To investigate the efficacy of a single prophylactic dose of ampicillin combined with metronidazole to prevent postcesarean section infections compared with a multiple day regimen in low-resource settings .


An evaluator-blinded randomized , controlled , noninferiority trial .


Two rural hospitals in Tanzania .


Of @ enrolled eligible women with an indication for cesarean section , information on @ was analyzed by intention-to-treat .


The women were randomly assigned to either the intervention group who received a single dose of ampicillin and metronidazole , or to the control group who received a multiple-day regimen of ampicillin/amoxicillin and metronidazole .


The primary outcome was maternal postcesarean infection .


Secondary outcomes were severity of these infections , other maternal complications , and the duration of hospital stay .


In the intervention group ( n = @ ) , six women ( @ % ) developed a wound infection compared with nine ( @ % ) in the control group ( n = @ ) ( difference @ ; @ % CI -@ to @ ) ( p = @ ) .


A single dose of prophylactic ampicillin and metronidazole is equally effective as a multiple-day regimen in preventing postcesarean wound infections in low-resource settings , therefore it can be considered as a good strategy in low-resource settings .


The reduced quantity of prophylactic antibiotics will reduce costs without increasing the risk of maternal infection .


Nonvalvular atrial fibrillation is common in elderly patients , who face an elevated risk of stroke but difficulty sustaining warfarin treatment .


The oral factor Xa inhibitor rivaroxaban was noninferior to warfarin in the Rivaroxaban Once Daily , Oral , Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation ( ROCKET AF ) .


This prespecified secondary analysis compares outcomes in older and younger patients .


There were @ patients ( @ % ) aged @ years with atrial fibrillation and @ stroke risk factors randomized to warfarin ( target international normalized ratio = @-@ @ ) or rivaroxaban ( @ mg daily ; @ mg if creatinine clearance < @ mL/min ) , double blind .


The primary end point was stroke and systemic embolism by intention to treat .


Over @ @ patient-years , older participants had more primary events ( @ % versus @ % / @ patient-years ; P = @ ) and major bleeding ( @ % versus @ % / @ patient-years ; P < @ ) .


Stroke/systemic embolism rates were consistent among older ( @ % rivaroxaban versus @ % warfarin per @ patient-years ; hazard ratio = @ ; @ % confidence interval , @-@ @ ) and younger patients ( @ % versus @ % / @ patient-years ; hazard ratio = @ ; @ % confidence interval , @-@ @ ; interaction P = @ ) , as were major bleeding rates ( @ years : @ % rivaroxaban versus @ % warfarin per @ patient-years ; hazard ratio = @ ; @ % confidence interval , @-@ @ ; < @ years : @ % versus @ % / @ patient-years ; hazard ratio = @ ; @ % confidence interval , @-@ @ ; interaction P = @ ) .


Hemorrhagic stroke rates were similar in both age groups ; there was no interaction between age and rivaroxaban response .


Elderly patients had higher stroke and major bleeding rates than younger patients , but the efficacy and safety of rivaroxaban relative to warfarin did not differ with age , supporting rivaroxaban as an alternative for the elderly .


The aim of this study was to investigate if argon plasma cleaning increases the shear bond strength between zirconia and veneering ceramic surfaces .


Ninety tablets of densely sintered yttriastabilized tetragonal zirconia polycrystal were divided into three groups according to cleaning treatment ( steam cleaning or plasma of Argon for @ or @ seconds ) .


Groups were divided into two subgroups according to the application of a ceramic liner ( A = liner , B = no liner ) .


Within subgroup A , argon plasma cleaning significantly decreased shear bond strength .


In subgroup B , the plasma treatment increased the shear bond strength , but the differences were not statistically significant .


Subgroup A demonstrated lower shear bond strength compared to subgroup B.


Argon plasma cleaning was suggested to improve the bond between ceramic and zirconia surfaces ; however , when plasma cleaning was followed by a glassy liner application , the veneering ceramic/zirconia bond was significantly reduced .


To identify variables that predict adherence with annual eye examinations using the Compliance with Annual Diabetic Eye Exams Survey ( CADEES ) , a new questionnaire designed to measure health beliefs related to diabetic retinopathy and annual eye examinations .


Questionnaire development .


Three hundred sixteen adults with diabetes .


We developed the CADEES based on a review of the literature , the framework of the Health Belief Model , expert opinion , and pilot study data .


To examine content validity , we analyzed participant responses to an open-ended question asking for reasons why people do not obtain annual eye examinations .


We evaluated construct validity with principal components analysis and examined internal consistency with Cronbach 's .


To assess predictive validity , we used multivariate logistic regression with self-reported adherence as the dependent variable .


Associations with self-reported adherence ( defined as having a dilated eye examination in the past year ) .


The content analysis showed that CADEES items covered @ % of the reasons given by participants for not obtaining an annual eye examination .


The principal components analysis identified @ informative components that made up @ % of the variance .


Multivariate logistic regression modeling revealed several significant predictors of adherence , including beliefs concerning whether insurance covered most of the eye examination cost ( P < @ ) , whether there were general barriers that make it difficult to obtain an eye examination ( P < @ ) , whether obtaining an eye examination was a top priority ( P = @ ) , and whether diabetic eye disease can be seen with an examination ( P = @ ) .


Lower hemoglobin A@c levels ( P < @ ) , having insurance ( P = @ ) , and a longer duration of diabetes ( P = @ ) also were associated with adherence .


A multivariate model containing CADEES items and demographic variables classified cases with @ % accuracy and explained approximately @ % of the variance in adherence .


The CADEES showed good content and predictive validity .


Although additional research is needed before finalizing a shorter version of the survey , our findings suggest that researchers and clinicians may be able to improve adherence by ( @ ) counseling newly diagnosed patients , as well as those with uncontrolled blood glucose , on the importance of annual eye examinations and ( @ ) discussing perceived barriers and misconceptions .


In many units , the standard mesh ratio is @:@ , but in our unit we have a @:@ mesher , which does not expand the skin but provides regular fenestrations .


There is some evidence that the unexpanded @:@ meshed graft compares favourably with sheet grafts from a cosmetic perspective whilst reducing the risk of graft failure secondary to a subgraft haematoma , but none comparing the @:@ meshed graft with the sheet graft .


We conducted a randomized trial to compare surgical outcomes in unfenestrated sheet grafts with @:@ meshed grafts .


All patients aged @ years undergoing skin grafts with either a sheet or a @:@ mesh for burn reconstruction were included .


Patients on steroids , those with conditions that impair healing , and burns > @ % were excluded .


Patients were randomized into the sheet grafting or mesh graft using a computer-generated allocation system .


The mean percentage of graft loss was assessed by a Visitrak overlay system .


At @-@ months , @-@ months and at @ year , photos were taken for scar assessment using the Vancouver Scar Score ( VSS ) .


Out of @ patients , @ patients ( @ sheet vs. @ mesh ) completed the trial at @ months .


The mean age was @ years ( range @-@ ) .


There was no total loss of graft in either group .


The mean percentage of graft loss due to haematoma formation was higher in the sheet graft group ( @ % ) compared to the @:@ mesh group ( @ % ) ( P < @ ) .


The VSS score was @ in both groups at @ months .


There was no significant difference in scar quality between the treatment groups .


These results show that the @:@ mesh graft is superior to the sheet graft with regard to graft loss , although this result is not statistically significant .


There are comparable findings in terms of cosmetic perspective at @ months post-operatively in both arms of the trial .


No data from controlled trials exists regarding the inflammatory response in patients with de novo heart failure ( HF ) complicating ST-elevation myocardial infarction ( STEMI ) and a possible role in the recovery of contractile function .


We therefore explored the time course and possible associations between levels of inflammatory markers and recovery of impaired left ventricular function as well as levosimendan treatment in STEMI patients in a substudy of the LEvosimendan in Acute heart Failure following myocardial infarction ( LEAF ) trial .


A total of @ patients developing HF within @ hours after a primary PCI-treated STEMI were randomised double-blind to a @ hours infusion of levosimendan or placebo .


Levels of IL-@ , CRP , sIL-@R , sgp@ , MCP-@ , IL-@ , MMP-@ , sICAM-@ , sVCAM-@ and TNF - were measured at inclusion ( median @ h , interquartile range ( IQR ) @ , @ after PCI ) , on day @ , day @ , day @ and @ weeks .


Improvement in left ventricular function was evaluated as change in wall motion score index ( WMSI ) by echocardiography .


Only circulating levels of IL-@ at inclusion were associated with change in WMSI from baseline to @ weeks , r = @ ( p = @ ) .


No association , however , was found between IL-@ and WMSI at inclusion or peak troponin T. Furthermore , there was a significant difference in change in WMSI from inclusion to @ weeks between patients with IL-@ levels below , compared to above median value , @ ( IQR @ , @ ) vs. @ ( IQR @ , @ ) , respectively ( p < @ ) .


Levosimendan did not affect the levels of inflammary markers compared to control .


High levels of IL-@ in STEMI patients complicated with HF were associated with less improvement in left ventricular function during the first @ weeks after PCI , suggesting a possible role of IL-@ in the reperfusion-related injury of post-ischemic myocardium .


Further studies are needed to confirm this hypothesis .


To evaluate the effect of an intervention based on the Precede-Proceed Model on attitudes towards prevention of Domestic Violence among Iranian girls .


The randomised controlled trial was conducted during @-@ at @ high schools in District @ ofTehran Municipality in Iran .


The subjects were divided into two equal groups of cases and controls .


Components of the Precede-Proceed Model for planning , implementation and evaluation of the study .


After need assessment , an appropriate environmental and educational intervention was implemented in the intervention group .


Changes in predisposing , reinforcing , enabling factors and especially attitudes towards prevention of Domestic Violence immediately and two months after the intervention were assessed in by questionnaires based on the Precede-Proceed Model .


SPSS @ was used for statistical analyses .


There were @ students who comprised the study population , with @ individuals in each of the two groups .


The intervention had significantly positive effect on predisposing , enabling and reinforcing factors immediately and two months after the intervention ( p < @ ) .


Repeated measures analysis of variance showed a significant positive increase in attitude score in the intervention group from baseline to two months ( p < @ ) .


The Precede-Proceed Model is one of the most widely used health planning models for identifying factors that influence health behaviours associated with domestic violence .


Implementation of an educational programme based on the model among young girls was effective in changing attitude towards domestic violence .


High-dose immunosuppressive therapy and autologous hematopoietic stem cell transplantation ( HSCT ) have shown efficacy in systemic sclerosis in phase @ and small phase @ trials .


To compare efficacy and safety of HSCT vs @ successive monthly intravenous pulses of cyclophosphamide .


The Autologous Stem Cell Transplantation International Scleroderma ( ASTIS ) trial , a phase @ , multicenter , randomized ( @:@ ) , open-label , parallel-group , clinical trial conducted in @ countries at @ centers with access to a European Group for Blood and Marrow Transplantation-registered transplant facility .


From March @ to October @ , @ patients with early diffuse cutaneous systemic sclerosis were recruited and followed up until October @ , @ .


HSCT vs intravenous pulse cyclophosphamide .


The primary end point was event-free survival , defined as time from randomization until the occurrence of death or persistent major organ failure .


A total of @ patients were randomly assigned to receive HSCT ( n = @ ) or cyclophosphamide ( n = @ ) .


During a median follow-up of @ years , @ events occurred : @ in the HSCT group ( @ deaths and @ irreversible organ failures ) and @ in the control group ( @ deaths and @ irreversible organ failures ) .


During the first year , there were more events in the HSCT group ( @ events -LSB- @ % -RSB- , including @ treatment-related deaths ) than in the control group ( @ events -LSB- @ % -RSB- , with no treatment-related deaths ) .


At @ years , @ events ( @ % ) had occurred cumulatively in the HSCT group vs @ events ( @ % ) in the control group ; at @ years , @ events ( @ % ) had occurred cumulatively in the HSCT group vs @ events ( @ % ) in the control group .


Time-varying hazard ratios ( modeled with treatmenttime interaction ) for event-free survival were @ ( @ % CI , @-@ @ ) at @ years and @ ( @ % CI , @-@ @ ) at @ years .


Among patients with early diffuse cutaneous systemic sclerosis , HSCT was associated with increased treatment-related mortality in the first year after treatment .


However , HCST conferred a significant long-term event-free survival benefit .


To analyse if predictors of radiographic progression differ between patients treated with or without prednisolone in early rheumatoid arthritis ( RA ) .


Radiographs of hands and feet were assessed using the modified Sharp/van der Heijde score and radiographic progression was defined as an increase in the total Sharp score above @ ( the smallest detectable change ) .


Prospective , randomised study of patients with early RA .


Secondary level of care ; six participating centres from southern Sweden ; both urban and rural populations .


In all , @ patients , @ % women , with a diagnosis of RA according to the American College of Rheumatology criteria , were included if they were between @ and @years of age and had a disease duration of less than @year .


The patients were randomised to @ mg prednisolone daily for @years ( P-group ; n = @ ) or no prednisolone ( NoP-group ; n = @ ) when they started with their first disease-modifying anti-rheumatic drug and were prospectively followed for @years .


The frequency of patients with radiographic progression after @years was @ % in the P-group and @ % in the NoP-group ( p = @ ) .


Relevant interactions between treatment and rheumatoid factor ( RF ) ( p = @ ) and between treatment and anti-cyclic citrullinated peptide @ ( anti-CCP ) ( p = @ ) were found .


RF and anti-CCP independently predicted radiographic progression only in the NoP-group , OR ( @ % CI ) @ ( @ to @ ) , p = @ and OR ( @ % CI ) @ ( @ to @ ) , p = @ , respectively .


The presence of RF and anti-CCP predicted radiographic progression in patients not treated with prednisolone but failed to predict progression in patients treated with this drug .


The data suggest that early treatment with prednisolone may modulate not only inflammation but also autoimmunity-associated pathogenetic mechanisms .


Black individuals with lung cancer ( LC ) experience higher mortality because they present with more advanced disease and are less likely to undergo curative resection for early-stage disease .


The National Lung Screening Trial ( NLST ) demonstrated improved LC mortality by screening high-risk patients with low-dose computed tomography ( LDCT ) .


The benefit of LDCT screening in black individuals is unknown .


Examine results of the NLST by race .


This was a secondary analysis of a randomized trial ( NCT@ ) performed in @ U.S. centers .


Overall and lung cancer-specific mortality were measured .


Screening with LDCT reduced LC mortality in all racial groups but more so in black individuals ( hazard ratio -LSB- HR -RSB- , @ vs. @ ) .


Smoking increased the likelihood of death from LC , and when stratified by race black smokers were twice as likely to die as white smokers ( HR , @ vs. @ ) .


Adjusting for sociodemographic and behavioral characteristics , black individuals experienced higher all-cause mortality than white individuals ( HR , @ ; @ % confidence interval , @-@ @ ) ; however , black individuals screened with LDCT had a reduction in all-cause mortality .


Black individuals were younger , were more likely to be current smokers , had more comorbidities , and had fewer years of formal education than white individuals ( P < @ ) .


Black individuals screened with LDCT had decreased mortality from lung cancer .


However , the demographics associated with improved LC survival were less commonly found in black individuals .


The overall mortality in the NLST was higher for black individuals than white individuals , but improved in black individuals screened , suggesting that this subgroup may have had improved access to care .


To realize the reductions in mortality from LC screening , dissemination efforts need to be tailored to meet the needs of this community .


Vasopressor administration is recommended to prevent hypotension during spinal anaesthesia ( SA ) for elective Caesarean delivery .


We aimed to test the superior efficacy and ensure safety of a hydroxyethyl starch ( HES ) vs a Ringer 's lactate ( RL ) preloading , when combined with a phenylephrine-based prophylaxis .


A total of @ healthy parturients undergoing elective Caesarean delivery under SA were included in this multicentre , randomized , double-blind study .


Patients received @ ml of @ % HES ( @/@ @ ) +@ ml of RL ( HES group ) or @ ml of RL ( RL group ) i.v. before SA .


After SA , i.v. phenylephrine boluses were titrated when systolic arterial pressure ( SAP ) was below @ % of baseline .


The primary outcome was the incidence of maternal hypotension ( SAP < @ % of baseline ) .


The incidence of both hypotension and symptomatic hypotension ( i.e. with dizziness , nausea/vomiting , or both ) was significantly lower in the HES group vs the RL group : @ % vs @ % ( one-sided P = @ ) and @ % vs @ % .


There was no significant difference in total phenylephrine requirements -LSB- median ( range ) : @ ( @-@ ) vs @ ( @-@ ) g -RSB- .


The decrease in maternal haemoglobin value the day after surgery was similar in the two groups -LSB- @ ( @ ) vs @ ( @ ) g dl ( -@ ) -RSB- .


There was no detectable placental transfer of HES in six umbilical cord blood samples analysed in the HES group .


Neonatal outcomes were comparable between the groups .


Compared with a pure RL preloading , a mixed HES-RL preloading significantly improved prevention of both hypotension and symptomatic hypotension based on early phenylephrine bolus administration and did not induce adverse effects .


The aim of this study was to compare the efficacy of HES @/@ @ coloading compared to normal saline solution for prevention of hypotension during spinal anesthesia for elective caesarean section .


Prospective , randomized .


One hundred and twenty ASA I and II patients scheduled for elective caesarean section were recruited .


Patients were randomized to receive either @mL of HES @/@ @ ( Voluven ( ) ) coloading ( GroupV ) or @mL of normal saline solution coloading ( GroupC ) .


Spinal anesthesia technique and ephedrine administration were standardized in both groups .


The primary endpoint was the incidence of maternal hypotension during spinal anesthesia for elective caesarean section .


Hypotension occurred in @ patients in group C and @ patients in group V ( p = @ ) .


Ephedrine consumption was significantly lower in group V ( P = @ ) .


Nausea , vomiting and headache incidence was higher in group C ( p = @ ) .


Apgar scores and umbilical blood gazes were comparable between groups .


HES @/@ @ coload was more effective than normal saline solution to prevent hypotension following spinal anesthesia for elective cesarean section .


HES @/@ @ coload reduced the incidence , the duration of longest hypotension , the need for ephedrine and the adverse maternal effects .


Newer approaches for understanding suicidal behavior suggest the assessment of suicide-specific beliefs and cognitions may improve the detection and prediction of suicidal thoughts and behaviors .


The Suicide Cognitions Scale ( SCS ) was developed to measure suicide-specific beliefs , but it has not been tested in a military setting .


Data were analyzed from two separate studies conducted at three military mental health clinics ( one U.S. Army , two U.S. Air Force ) .


Participants included @ active duty Army personnel with acute suicidal ideation and/or a recent suicide attempt referred for a treatment study ( Sample @ ) and @ active duty Air Force personnel receiving routine outpatient mental health care ( Sample @ ) .


In both samples , participants completed self-report measures and clinician-administered interviews .


Follow-up suicide attempts were assessed via clinician-administered interview for Sample @ .


Statistical analyses included confirmatory factor analysis , between-group comparisons by history of suicidality , and generalized regression modeling .


Two latent factors were confirmed for the SCS : Unloveability and Unbearability .


Each demonstrated good internal consistency , convergent validity , and divergent validity .


Both scales significantly predicted current suicidal ideation ( s > @ , ps < @ ) and significantly differentiated suicide attempts from nonsuicidal self-injury and control groups ( F ( @ , @ ) = @ , p < @ ) .


Both scales significantly predicted future suicide attempts ( AORs > @ , ps < @ ) better than other risk factors .


Self-report methodology , small sample sizes , predominantly male samples .


The SCS is a reliable and valid measure that predicts suicidal ideation and suicide attempts among military personnel better than other well-established risk factors .


Standard clips do not consistently prevent the migration of covered self-expanding metal stents ( SEMS ) .


The aims of this study were to assess the efficacy and safety of the over-the-scope clip ( OTSC ) system for anchoring SEMS to the esophagus , and to evaluate a novel OTSC removal technique .


This was a single-center , retrospective , cohort study of consecutive patients undergoing SEMS anchoring with OTSC .


Removal of the OTSC was accomplished using an inject-and-resect technique .


A total of @ patients were included .


The indications for endoscopic stenting were : tracheo-esophageal fistula ( n = @ ) , postoperative leak or fistula ( n = @ ) , perforation ( n = @ ) .


Successful application of the OTSC system was accomplished in all patients ( @ % ) .


Stent migration during follow-up ( mean @ weeks , range @-@ weeks ) occurred in two patients ( @ % ) .


After healing of the underlying condition , the stent was removed in six patients ( @ % ) .


In four patients ( @ % ) , the anchored stent was left indefinitely in order to treat the underlying condition .


There were no complications associated with deployment of the OTSC or SEMS removal .


Although endoscopic anchoring of fully covered SEMS with the OTSC was feasible , easy to accomplish , safe , and prevented stent migration in most cases , larger studies are needed to confirm these encouraging early findings .


The inject-and-resect technique was safe and efficient for OTSC and stent removal in all cases in which it was attempted .


Botulinum toxin type A ( BTX-A ) is widely used for the clinical treatment of masseteric hypertrophy .


Until now , few reports have discussed how to prolong the duration of its effectiveness .


This study evaluated that purposely adjusting the masticatory movements is possible of postponing the masseter muscle rehypertrophy .


Ninety-eight patients were randomly and equally divided into @ groups , and @ U BTX-A per side was injected into the masseters .


The thickness and volume of the masticatory muscles were measured by ultrasound and computerized tomography , respectively .


Patients in Group @ were instructed to strengthen their masticatory effort during the denervated atrophic stage of the masseter ( the interval was evaluated by real-time ultrasound monitoring ) , whereas patients in Group @ were not given this instruction .


When the masseter muscle began to recover , patients in both groups were instructed to reduce their chewing .


The duration of the masseter muscle rehypertrophy was significantly prolonged in Group @ patients .


The thickness and the volume of the other masticatory muscles were significantly increased in Group @ but were either slightly decreased or insignificantly different in Group @ .


Purposely strengthening masticatory muscle movement during the denervated atrophic stage of the masseter can prolong the duration of masseter rehypertrophy .


The aim of this prospective randomized study was to evaluate the efficacy of estrogen in preventing intrauterine adhesions following hysteroscopic septal resection and to investigate its effect on reproductive outcome .


After hysteroscopic septal resection , @ women received either estrogen or placebo ( n = @ per group ) for @ days .


A second-look hysteroscopy was performed after @ months .


All pregnancies occurring during the study period were recorded .


Adhesions developed in three of @ ( @ % ) patients in the control group compared to none in the estrogen group .


This difference was not statistically significant ( P = @ ) .


Regarding reproductive outcome , the differences between the two groups were also not significant .


Estrogen treatment was not found to prevent intrauterine adhesions or improve reproductive outcome after hysteroscopic septal resection .


A preliminary report showed that autologous blood is an effective and easily applicable technique that can control actively bleeding gastroduodenal ulcers .


The aim of this study was to test whether an endoscopic injection of autologous blood is comparable to an endoscopic injection of diluted epinephrine in controlling bleeding from gastroduodenal ulcers .


A total of @ patients with actively bleeding gastroduodenal ulcers were assigned randomly to either an autologous blood injection ( group A , n = @ ) or a diluted epinephrine injection ( group B , n = @ ) along the edges of the ulcers .


Groups were compared for rates of initial hemostasis , rebleeding , and complications .


All patients initially achieved hemostasis ( @ % ) .


Rebleeding occurred in four patients from group A ( @ % ) and five patients from group B ( @ % ) .


Two patients in group B developed cardiovascular complications ( arrhythmia and ischemic heart attack ) , whereas none in group A developed complications .


Autologous blood is effective , comparable to diluted epinephrine in achieving initial hemostasis from actively bleeding gastroduodenal ulcers , associated with an @ % rebleeding rate , and led to no complications .


The objective of this study was to determine the effects of the N-methyl-d-aspartate ( NMDA ) receptor antagonist , memantine ( @ , @ , @mg/d ) , upon alcohol drinking and craving in heavy drinkers with or without a family history ( FH ) of alcoholism , and to explore the modulatory influence of the presence of impulsivity on these outcomes .


Ninety-two , nontreatment-seeking , heavy drinkers received memantine or placebo for @days .


On the eighth day , they received a priming dose of alcohol followed by a @-hour period of alcohol access .


Memantine at a dose of @mg reduced alcohol craving but did not influence alcohol drinking .


No effects of FH were observed .


In participants with higher baseline levels of impulsivity , @mg of memantine reduced alcohol craving but increased alcohol drinking and alcohol-induced stimulation .


NMDA receptor signaling may play divergent roles in mediating alcohol cue-induced craving and alcohol drinking in heavy drinkers .


The potential efficacy of memantine as monotherapy for alcohol use disorders may be limited by its tendency to disinhibit drinking in some individuals .


To explore the surgical techniques in posterolateral mini-incision total hip arthroplasty and clinical efficacy .


A total of @ patients ( @ hips ) had posterolateral mini-incision total hip arthroplasty , from December @ to December @ , and were randomly divided into a posterolateral miniincision total hip arthroplasty group ( Group A ) and a conventional group of posterolateral incision for total hip arthroplasty ( Group B ) .


Forty-nine patients ( @ hips ) in Group A had posterolateral small incision total hip arthroplasty -LSB- @ males , @ females , between @ and @ years ( average @ years ) , body mass index ( BMI ) between @ and @ ( average BMI @ ) -RSB- .


Forty-five patients ( @ hips ) in Group B had the conventional posterolateral incision -LSB- @ males , @ females , between @ and @ years ( average @ years ) , BMI between @ and @ ( average BMI @ ) -RSB- .


The incision length , blood loss , drainage , operation time , and postoperative Harris scores were compared between the @ groups .


The incision length was @ ~ @ ( average length @ ) cm , average blood loss was @ ( @ ~ @ ) mL , average drainage was @ ( @ ~ @ ) mL , average blood transfusion was @ ( @ ~ @ ) mL , average operation time was @ ( @ ~ @ ) min , and vitalock abduction angle imaging after the operation was @ ( averagely @ ~ @ ) in Group A.


The incision length was @ ~ @ ( average length @ ) cm , average blood loss was @ ( @ ~ @ ) mL , average drainage was @ ( @ ~ @ ) mL , average blood transfusion was @ ( @ ~ @ ) mL , average operation time was @ ( @ ~ @ ) min , and postoperative radiographic acetabular cup abduction angle was @ ( @ ~ @ ) in Group B.


The follow-up showed that the prosthesis of the @ groups was in a good position , Harris score was significantly improved with no complications after total hip arthroplasty in the @ groups .


With the correct selection of indications and adept operation skills and other circumstances , posterolateral mini-incision total hip arthroplasty may do little damage to the soft tissue with a small scar on the skin .


The imaging evaluation after the operation and the Harris score show no difference between the @ groups .


Patients are satisfied with their joint function and postoperative recovery .


In randomised trials of medical interventions , the most reliable analysis follows the intention-to-treat ( ITT ) principle .


However , the ITT analysis requires that missing outcome data have to be imputed .


Different imputation techniques may give different results and some may lead to bias .


In anti-obesity drug trials , many data are usually missing , and the most used imputation method is last observation carried forward ( LOCF ) .


LOCF is generally considered conservative , but there are more reliable methods such as multiple imputation ( MI ) .


To compare four different methods of handling missing data in a @-week placebo controlled anti-obesity drug trial on topiramate .


We compared an analysis of complete cases with datasets where missing body weight measurements had been replaced using three different imputation methods : LOCF , baseline carried forward ( BOCF ) and MI .


@ participants were randomised .


Compared to placebo , there was a significantly greater weight loss with topiramate in all analyses : @ kg ( SE @ ) in the complete case analysis ( N = @ ) , @ kg ( SE @ ) using LOCF ( N = @ ) , @ kg ( SE @ ) using MI ( N = @ ) and @ kg ( SE @ ) using BOCF ( N = @ ) .


The different imputation methods gave very different results .


Contrary to widely stated claims , LOCF did not produce a conservative ( i.e. , lower ) efficacy estimate compared to MI .


Also , LOCF had a lower SE than MI .


To investigate the effects of @-kilovoltage ( kV ) tube voltage coronary computed tomographic angiography ( CCTA ) with a reduced amount of contrast agent on qualitative and quantitative image quality parameters and on radiation dose in patients with a body mass index ( BMI ) < @ kg/m ( @ ) .


One hundred and twenty consecutive patients with a BMI < @ kg/m ( @ ) and a low calcium load undergoing retrospective electrocardiogram ( ECG ) - gated dual-source CCTA were randomized into two groups -LSB- standard-tube voltage ( @-kV ) vs. low-tube voltage ( @-kV ) -RSB- .


The injection flow rate of contrast agent ( @ mg I/mL ) was adjusted to body weight of each patient ( @-@ @ mL/s in the @-kV group and @-@ @ mL/s in the @-kV group ) .


Radiation and contrast agent doses were evaluated .


Quantitative image quality parameters and figure of merit ( FOM ) of coronary artery were evaluated .


Each coronary segment was evaluated for image quality on a @-point scale .


Compared with the @-kV group , effective dose and amount of contrast agent in the @-kV group were decreased by @ % and @ % ( effective dose :@ @ vs. @ @ mSv ; amount of contrast agent :@ @ vs. @ @ mL ; both p < @ ) , respectively .


Image noise was @ @ HU for @-kV images and @ @ HU for @-kV images ( p < @ ) .


Signal-to-noise ratio ( SNR ) and contrast-to-noise ratio ( CNR ) in the proximal right coronary artery ( RCA ) and left main coronary artery ( LMA ) were all lower in @-kV than @-kV images ( SNR in the proximal RCA : @ @ vs. @ @ ; SNR in the LMA : @ @ vs. @ @ ; CNR in the proximal RCA : @ @ vs. @ @ ; CNR in the LMA : @ @ vs. @ @ ; all p < @ ) .


FOM were all significantly higher in @-kV than @-kV images ( proximal RCA : @ @ vs. @ @ ; LMA : @ @ vs. @ @ ; all p < @ ) .


There was no significant difference in image quality score between the two groups ( @ @ vs. @ @ , p = @ ) despite decreased SNR and CNR of coronary artery in the @-kV group .


The @-kV protocol significantly reduces radiation and contrast agent doses in CCTA in patients with a low BMI < @ kg/m ( @ ) and a low calcium load while maintaining image quality .


GVAX pancreas , granulocyte-macrophage colony-stimulating factor-secreting allogeneic pancreatic tumor cells , induces T-cell immunity to cancer antigens , including mesothelin .


GVAX is administered with low-dose cyclophosphamide ( Cy ) to inhibit regulatory T cells .


CRS-@ , live-attenuated Listeria monocytogenes-expressing mesothelin , induces innate and adaptive immunity .


On the basis of preclinical synergy , we tested prime/boost vaccination with GVAX and CRS-@ in pancreatic adenocarcinoma .


Previously treated patients with metastatic pancreatic adenocarcinoma were randomly assigned at a ratio of @:@ to two doses of Cy/GVAX followed by four doses of CRS-@ ( arm A ) or six doses of Cy/GVAX ( arm B ) every @ weeks .


Stable patients were offered additional courses .


The primary end point was overall survival ( OS ) between arms .


Secondary end points were safety and clinical response .


A total of @ patients were treated ( arm A , n = @ ; arm B , n = @ ) ; @ % had received prior chemotherapy ; @ % had received two regimens for metastatic disease .


Mean number of doses ( standard deviation ) administered in arms A and B were @ @ and @ @ , respectively .


The most frequent grade @ to @ related toxicities were transient fevers , lymphopenia , elevated liver enzymes , and fatigue .


OS was @ months in arm A versus @ months in arm B ( hazard ratio -LSB- HR -RSB- , @ ; P = @ ) .


In a prespecified per-protocol analysis of patients who received at least three doses ( two doses of Cy/GVAX plus one of CRS-@ or three of Cy/GVAX ) , OS was @ versus @ months ( arm A v B ; HR , @ ; P = @ ) .


Enhanced mesothelin-specific CD@ T-cell responses were associated with longer OS , regardless of treatment arm .


Heterologous prime/boost with Cy/GVAX and CRS-@ extended survival for patients with pancreatic cancer , with minimal toxicity .


To determine the effects of tai chi training on functional performance and walking with and without the addition of the performance of a cognitive task , in older adults living in supportive housing facilities .


Secondary data analysis comparing a single-blind , randomized controlled trial of tai chi training with an attention-matched educational control intervention with crossover to tai chi .


Two supportive housing facilities .


Sixty-six men and women living in supportive housing facilities entered the study , and @ aged @ completed all study procedures .


Interventions consisted of two @-hour-long instructor-led group sessions per week for @ weeks .


Tai chi training consisted of movements based upon the Yang-style short form .


Educational sessions consisted of lectures and discussions of age-related health topics .


Subjects were tested for physical function ( Short Physical Performance Battery , SPPB ) , balance ( Berg Balance Scale , BBS ) , mobility ( timed up-and-go , TUG ) , and walking speed under normal and cognitive dual-task conditions .


The tai chi group exhibited greater improvement in SPPB scores ( baseline @ , follow-up @ ) than controls ( baseline @ , follow-up @ ) ( P = @ ) .


Tai chi also increased normal and dual-task walking speed ( P < @ ) yet did not affect BBS ( P = @ ) or TUG ( P = @ ) after accounting for multiple comparisons .


The dual-task cost ( percentage change ) to walking speed was unaffected .


After the crossover tai chi intervention , the control group improved performance in the SPPB , BBS , and TUG , and increased walking speed under normal and dual-task conditions ( P = @ ) .


Tai chi training may be a safe and effective therapy to help improve physical function and dual-task walking in very old adults living in supportive housing facilities .


To assess the efficacy and safety of a @-week course of abatacept in the treatment of active lupus nephritis and to assess the potential of abatacept to induce `` clinical tolerance , '' defined as sustained clinical quiescence of lupus nephritis after discontinuation of immunosuppressive therapy .


Patients with active lupus nephritis ( n = @ ) were enrolled in a randomized , double-blind phase II add-on trial in which they received either abatacept or placebo in conjunction with the Euro-Lupus Nephritis Trial regimen of low-dose cyclophosphamide ( CYC ) followed by azathioprine ( AZA ) .


The primary efficacy outcome was the frequency of complete response at week @ .


Thereafter , patients who met either complete or partial response criteria continued blinded treatment through week @ .


During this phase of the study , subjects in the abatacept treatment group in whom a complete response was achieved at week @ discontinued immunosuppressive therapy other than prednisone ( @ mg/day ) .


There were no statistically significant differences between groups with respect to the primary outcome or any of the secondary outcomes , including measures of safety .


A complete response was achieved in @ % of the subjects in the treatment group and in @ % of the subjects in the control group at week @ .


Fifty percent of the subjects in the treatment group who met complete response criteria and therefore discontinued immunosuppressive therapy at week @ maintained their complete response status through week @ .


The addition of abatacept to a regimen of CYC followed by AZA did not improve the outcome of lupus nephritis at either @ or @ weeks .