For diagnosis of pelvic recurrence from CRC , both DWI and gadolinium-enhanced MRI significantly increase diagnostic performances compared with `` T@ '' MRI for residents .


DWI may be helpful in patients with contra-indications to intravenous administration of gadolinium .


Upper lip wounds that lie perpendicular to the relaxed skin tension lines are subjected to repetitive dynamic tension caused by the orbicularis oris muscle and are susceptible to unsatisfactory scarring .


In this double-blind , randomized , vehicle-controlled , prospective trial , @ consecutive patients with unilateral cleft lip undergoing primary cheiloplasties between August of @ and June of @ were randomized to receive botulinum toxin type A or vehicle injections into the subjacent orbicularis oris muscle immediately after wound closure .


Scars were assessed after @ months using the Vancouver Scar Scale , photographic visual analogue scale , and photographic scar width measurements .


Fifty-nine patients completed the trial .


Measurements of scar widths at two defined points revealed significantly better visual analogue scale scores and narrower scars in the experimental group .


However , Vancouver Scar Scale assessments were similar between groups .


Botulinum toxin injections into the subjacent orbicularis oris muscle produced better appearing and narrower cheiloplasty scars , but provided no additional benefits in terms of scar pigmentation , vascularity , pliability , or height .


Therapeutic , II .


To investigate the efficacy of tandospirone in patients with irritable bowel syndrome-diarrhea ( IBS-D ) and anxiety in a prospective , randomized , controlled study .


Two hundred patients with IBS-D and moderate anxiety were randomized to receive pinaverium and tandospirone ( arm A ) or pinaverium and placebo ( arm B ) .


Tandospirone or placebo was given thrice daily at a fixed dose of @ mg and pinaverium was given thrice daily at a fixed dose of @ mg .


The duration of treatment was @ wk .


Patients were assessed for abdominal pain and diarrhea .


Anxiety was evaluated using the Hamilton Rating Scale for Anxiety ( HAM-A ) .


The primary study endpoints were response rates for abdominal pain and diarrhea .


The secondary study endpoints were response rates for anxiety .


Adverse events were also evaluated .


One hundred and seventy of @ patients ( @ patients in arm A and @ patients in arm B ) completed the study .


Demographic and baseline characteristics of the @ participants were comparable in the two arms .


At week @ , the overall response rate for abdominal pain and diarrhea was @ % for arm A and @ % for arm B ( P < @ ) .


The HAM-A score showed that the response rate was @ % for arm A and @ % for arm B ( P < @ ) .


The treatments were well tolerated and no significant adverse events were reported .


Tandospirone is effective and can be combined with pinaverium in IBS-D patients with anxiety .


Provision of essential newborn care ( ENC ) can save many newborn lives in poor resource settings but coverage is far from universal and varies by country and place of delivery .


Understanding gaps in current coverage and where coverage is good , in different contexts and places of delivery , could make a valuable contribution to the future design of interventions to reduce neonatal mortality .


We sought to describe the coverage of essential newborn care practices for births in institutions , at home with a skilled birth attendant , and at home without a skilled birth attendant ( SBA ) in rural areas of Bangladesh , Nepal , and India .


We used data from the control arms of four cluster randomised controlled trials in Bangladesh , Eastern India and from Makwanpur and Dhanusha districts in Nepal , covering periods from @ to @ .


We used these data to identify essential newborn care practices as defined by the World Health Organization .


Each birth was allocated to one of three delivery types : home birth without an SBA , home birth with an SBA , or institutional delivery .


For each study , we calculated the observed proportion of births that received each care practice by delivery type with @ % confidence intervals , adjusted for clustering and , where appropriate , stratification .


After exclusions , we analysed data for @ births from Eastern India , @ @ births from Bangladesh , @ births from Makwanpur and @ @ births from Dhanusha .


Across all study areas , coverage of essential newborn care practices was highest in institutional deliveries , and lowest in home non-SBA deliveries .


However , institutional deliveries did not provide universal coverage of the recommended practices , with relatively low coverage ( @ % -@ % ) across all study areas for immediate breastfeeding and thermal care .


Institutions in Bangladesh had the highest coverage for almost all care practices except thermal care .


Across all areas , fewer than @ % of home non-SBA deliveries used a clean delivery kit , the use of plastic gloves was very low and coverage of recommended thermal care was relatively poor .


There were large differences between study areas in handwashing , immediate breastfeeding and delayed bathing .


There remains substantial scope for health facilities to improve thermal care for the newborn and to encourage immediate and exclusive breastfeeding .


For unattended home deliveries , increased handwashing , use of clean delivery kits and basic thermal care offer great scope for improvement .


To evaluate the safety , tolerability , and pharmacokinetics ( PK ) of pregabalin as adjunctive therapy in children with refractory partial seizures .


This was a phase @ , randomized , placebo-controlled , parallel-group , escalating-dose , multiple-dose study comprising a @-day , double-blind treatment period and a single-blind , single dose of pregabalin administered to all children on day @ .


Children in four age cohorts ( @-@ months , @-@ , @-@ , and @-@ years ) received one of four doses of pregabalin ( @ , @ , @ , or @ mg/kg/day ) or placebo .


Safety and tolerability were assessed throughout the study .


Steady-state and single-dose PK parameters on day @ were analyzed using standard noncompartmental procedures .


Sixty-five children received at least one dose of treatment .


Four pregabalin-treated children discontinued treatment , three of whom received @ mg/kg/day .


Two children experienced serious adverse events , one of whom received pregabalin @ mg/kg/day .


During double-blind treatment , the most common adverse events reported in the pregabalin-treated population were somnolence ( @ % ) and dizziness ( @ % ) .


Steady-state pregabalin peak and total exposure in each age cohort appeared to increase linearly with dose .


Apparent oral clearance ( CL/F ) was directly related to creatinine clearance , consistent with adults .


CL/F normalized for body weight was @ % higher in patients weighing < @ kg .


Steady-state and single-dose PK were consistent .


Pregabalin at doses up to @ mg/kg/day in children aged @ month to @ years , and at doses up to @ mg/kg/day in those aged < @ years , demonstrated acceptable safety and tolerability .


For children weighing < @ kg , a dose increase of @ % ( mg/kg dosing ) is required to achieve comparable exposure with adults or children weighing @ kg .


These data will inform dose selection in phase @ trials of the efficacy and safety of adjunctive pregabalin in children with refractory partial seizures .


Intraoperative radiotherapy with electrons allows the substitution of conventional postoperative whole breast irradiation with one session of radiotherapy with the same equivalent dose during surgery .


However , its ability to control for recurrence of local disease required confirmation in a randomised controlled trial .


This study was done at the European Institute of Oncology ( Milan , Italy ) .


Women aged @-@ years with early breast cancer , a maximum tumour diameter of up to @ cm , and suitable for breast-conserving surgery were randomly assigned in a @:@ ratio ( using a random permuted block design , stratified for clinical tumour size -LSB- < @ cm vs @-@ cm vs @ cm -RSB- ) to receive either whole-breast external radiotherapy or intraoperative radiotherapy with electrons .


Study coordinators , clinicians , and patients were aware of the assignment .


Patients in the intraoperative radiotherapy group received one dose of @ Gy to the tumour bed during surgery .


Those in the external radiotherapy group received @ Gy in @ fractions of @ Gy , followed by a boost of @ Gy in five fractions .


This was an equivalence trial ; the prespecified equivalence margin was local recurrence of @ % in the intraoperative radiotherapy group .


The primary endpoint was occurrence of ipsilateral breast tumour recurrences ( IBTR ) ; overall survival was a secondary outcome .


The main analysis was by intention to treat .


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


@ patients were randomised ( @ to external radiotherapy and @ to intraoperative radiotherapy ) between Nov @ , @ , and Dec @ , @ .


After a medium follow-up of @ years ( IQR @-@ ) , @ patients in the intraoperative radiotherapy group and four patients in the external radiotherapy group had had an IBTR ( p < @ ) .


The @-year event rate for IBRT was @ % ( @ % CI @-@ ) in the intraoperative radiotherapy group and @ % ( @-@ ) in the external radiotherapy group ( hazard ratio @ -LSB- @ % CI @-@ -RSB- ) .


During the same period , @ women allocated to intraoperative radiotherapy and @ to external radiotherapy died ( p = @ ) .


@-year overall survival was @ % ( @ % CI @-@ ) in the intraoperative radiotherapy group and @ % ( @-@ ) in the external radiotherapy group .


In patients with data available ( n = @ for intraoperative radiotherapy ; n = @ for external radiotherapy ) we noted significantly fewer skin side-effects in women in the intraoperative radiotherapy group than in those in the external radiotherapy group ( p = @ ) .


Although the rate of IBTR in the intraoperative radiotherapy group was within the prespecified equivalence margin , the rate was significantly greater than with external radiotherapy , and overall survival did not differ between groups .


Improved selection of patients could reduce the rate of IBTR with intraoperative radiotherapy with electrons .


We aimed to evaluate the effect of a decision aid ( DA ) with information only compared to a DA with values clarification exercise ( VCE ) , and to study the role of personality and information seeking style in DA-use , decisional conflict ( DC ) and knowledge .


Two scenario-based experiments were conducted with two different groups of healthy female participants .


Dependent measures were : DC , knowledge , and DA-use ( time spent , pages viewed , VCE used ) .


Respondents were randomized between a DA with information only ( VCE - ) and a DA with information plus a VCE ( VCE + ) ( experiment @ ) , or between information only ( VCE - ) , information plus VCE without referral to VCE ( VCE + ) , and information plus a VCE with specific referral to the VCE , requesting participants to use the VCE ( VCE + + ) ( experiment @ ) .


In experiment @ we additionally measured personality ( neuroticism/conscientiousness ) and information seeking style ( monitoring/blunting ) .


Experiment @ .


There were no differences in DC , knowledge or DA-use between VCE - ( n = @ ) and VCE + ( n = @ ) .


Both DAs lead to a mean gain in knowledge from @ % at baseline to @ % after viewing the DA .


Within VCE + , VCE-users ( n = @ , @ % ) reported less DC compared to non-users .


Since there was no difference in DC between VCE - and VCE + , this is likely an effect of VCE-use in a self-selected group , and not of the VCE per se .


There were no differences in DC or knowledge between VCE - ( n = @ ) , VCE + ( n = @ ) , VCE + + ( n = @ ) .


In all groups , knowledge increased on average from @ % at baseline to @ % after viewing the DA .


Blunters viewed fewer DA-pages ( R = @ , p < @ ) .


More neurotic women were less certain ( R = @ , p < @ ) and felt less supported in decision making ( R = @ , p < @ ) ; conscientious women felt more certain ( R = -@ , p < @ ) and had more knowledge after viewing the DA ( R = @ , p < @ ) .


Both DAs lead to increased knowledge in healthy populations making hypothetical decisions , and use of the VCE did not improve knowledge or DC .


Personality characteristics were associated to some extent with DA-use , information seeking styles with aspects of DC .


More research is needed to make clear recommendations regarding the need for tailoring of information provision to personality characteristics , and to assess the effect of VCE use in actual patients .


Acute viral tonsillitis is an upper respiratory tract infection prevalent in school-aged children .


Because this condition is self-limiting , conventional treatment options are usually palliative .


Homeopathic remedies are a useful alternative to conventional medications in acute uncomplicated upper respiratory tract infections in children , offering earlier symptom resolution , cost-effectiveness , and fewer adverse effects .


This study aimed to determine the efficacy of a homeopathic complex on the symptoms of acute viral tonsillitis in African children in South Africa .


This was a randomized , double-blind , placebo-controlled , @-day pilot study .


Thirty children , age @ to @ years , with acute viral tonsillitis were recruited from a primary school in Gauteng , South Africa .


Participants took two tablets of the medication four times daily .


The treatment group received lactose tablets medicated with the homeopathic complex ( Atropa belladonna D@ , Calcarea phosphoricum D@ , Hepar sulphuris D@ , Kalium bichromat D@ , Kalium muriaticum D@ , Mercurius protoiodid D@ , and Mercurius biniodid D@ ) .


The placebo consisted of the unmedicated vehicle only .


The Wong-Baker FACES Pain Rating Scale measured pain intensity , and a Symptom Grading Scale assessed changes in tonsillitis signs and symptoms .


The treatment group had a statistically significant improvement in the following symptoms compared with the placebo group : pain associated with tonsillitis , pain on swallowing , erythema and inflammation of the pharynx , and tonsil size .


The homeopathic complex used in this study exhibited significant anti-inflammatory and pain-relieving qualities in children with acute viral tonsillitis .


No patients reported any adverse effects .


These preliminary findings are promising ; however , the sample size was small and therefore a definitive conclusion can not be reached .


A larger , more inclusive research study should be undertaken to verify the findings of this study .


Endovascular stenting is a safe , effective treatment of hepatic artery stenosis after liver transplant , but no detailed evaluation has been completed of changes in ultrasound monitoring parameters after stenting .


This study aims to improve poststenting surveillance by delineating the expected postoperative findings .


Thirty-one stent procedures were performed at our institution for hepatic artery stenosis after liver transplant between October @ and October @ .


Of these , @ ( @ % ) were technically successful , of which @ met the minimum follow-up time ( @ days , defined by the earliest diagnosed restenosis ) .


These patients were followed with serial ultrasound , per the following schedule : within @ week of stenting , @ months after stenting , @ months after stenting , and every @ months thereafter ; additional , unscheduled examinations were frequently performed when indicated on the basis of deterioration of clinical and laboratory status .


Follow-up examinations ( mean , @ days total follow-up ) were compared with prestenting examinations to evaluate changes in peak systolic velocity ( PSV ) , resistive index ( RI ) , and tardus-parvus waveforms .


Data were analyzed to determine a normal range for postprocedure values and time course of change in values .


Of the @ patients , six experienced restenosis .


In all patients , mean PSV decreased by @ cm/s , and mean RI increased by @ within @ hours after stenting .


PSV differed between patency and restenosis groups only at more than @ days after stenting ( mean PSV , @ and @ cm/s , respectively ) , with PSV above @ cm/s serving as a high-sensitivity threshold for the determination of restenosis .


Prestenting RI of below @ had a strong correlation with restenosis .


Poststenting RI differed between patency and restenosis groups only at more than @ hours after stenting , with RI of below @ having a strong correlation with restenosis .


Tardus-parvus waveform resolution was often delayed well beyond @ hours after stenting , and time to tardus-parvus waveform resolution had no correlation with patency or restenosis .


Ultrasound is convenient and useful to follow stents in hepatic artery stenosis after liver transplant .


Prestenting hemodynamics can have value in predicting restenosis .


Diagnosis of restenosis can be made with RI and PSV , whereas resolution time of tardus-parvus waveform is of less concern .


These parameters can guide which patients require closer monitoring and aggressive treatment .


Cardiac surgery is associated with excessive bleeding that is as a result of coagulopathy caused by cardiopulmonary bypass .


We evaluated the effect of two different modalities for administering similar doses of tranexamic acid on bleeding following primary elective coronary artery bypass grafting ( CABG ) .


In the randomized control trial .


@ patients scheduled for CABG were randomized to two groups applying different modalities of tranexamic acid administration ( bolus injection of @ mg/kg vs. continuous infusion ) .


Blood loss until removal of chest tubes was the primary outcome measure ; we also recorded and assessed blood products transfused , and length of ICU stay .


Both the groups were comparable at baseline .


Trends toward transfusion differences between groups were not statistically significant .


No differences in length of ICU stay , morbidity or mortality were found .


In CABG surgery , the use of either method for administering similar doses of tranexamic acid leads to a similarl reduction in postoperative mediastinal bleeding .


This study was conducted to evaluate the efficacy of extracorporeal shock wave therapy ( ESWT ) on the healing rate , wound surface area and wound bed preparation in chronic diabetic foot ulcers ( DFU ) .


Thirty eight patients with @ chronic DFU were randomly assigned into ; the ESWT-group ( @ patients/@ ulcers ) and the control-group ( @ patients/@ ulcers ) .


Blinded therapist measured wound surface area ( WSA ) , the percentage of reduction in the WSA , rate of healing and wound bed preparation at baseline , after the end of the interventions ( W@ ) , and at @-week follow-up ( W@ ) .


The ESWT group received shock wave therapy twice per week for a total of eight treatments .


Each ulcer was received ESWT at a frequency of @ pulse/cm ( @ ) , and energy flux density of @ mJ/cm ( @ ) .


All patients received standardized wound care consisting of debridement , blood-glucose control agents , and footwear modification for pressure reduction .


The overall clinical results showed completely healed ulcers in @ % and @ % in ESWT-groups and @ % and @ % in the control group after intervention ( W@ ) , and at follow-up ( W@ ) respectively .


The average healing time was significantly lower ( @ @ days vs @ @ days , p < @ ) in the ESWT-group compared with the control group .


ESWT-treated ulcers had a significant reduction in wound size and median time required for ulcer healing , with no adverse reactions .


So , the ESWT is advocated as an adjunctive therapy in chronic diabetic wound .


Many African infants fail to receive their diagnostic HIV molecular test results and subsequently , antiretroviral therapy ( ART ) .


To determine whether a point-of-care molecular HIV test increases ART access for hospitalized Malawian infants , we simulated a point-of-care test using rapid HIV RNA polymerase chain reaction ( Rapid PCR ) and compared patient outcomes with an optimized standard care that included assessment with the World Health Organization clinical algorithm for HIV infection plus a DNA PCR with a turnaround time of several weeks ( standard care ) .


Randomized controlled trial .


Hospitalized HIV-exposed Malawian infants aged < @ months were randomized into Rapid PCR or standard care .


Rapid PCR infants obtained molecular test results within @ hours to facilitate immediate ART , similar to a point-of-care test .


Standard care infants meeting clinical criteria were also offered inpatient ART .


The primary outcome was appropriate in-hospital ART for DNA or RNA PCR-confirmed HIV-infected infants .


Three hundred infants were enrolled .


A greater proportion of HIV-infected infants receiving Rapid PCR , versus standard care , started inpatient ART ( @ % vs @ % , P = @ ) .


Among molecular test-negative infants , @ % receiving standard care unnecessarily initiated inpatient ART , versus @ % receiving Rapid PCR ( P < @ ) .


Rapid PCR modestly reduced the median days to ART ( @ vs @ , P = @ ) but did not influence outpatient follow-up for HIV-infected infants ( @ % vs @ % , P = @ ) .


Rapid PCR , versus an optimized standard care , increased the proportion of hospitalized HIV-infected infants initiating ART and reduced ART exposure in molecular test-negative infants , without meaningfully impacting time to ART initiation or follow-up rates .


A psychological disorder called ` Internet addiction ' has newly emerged along with a dramatic increase of worldwide Internet use .


However , few studies have used population-level samples nor taken into account contextual factors on Internet addiction .


We identified @,@ middle and high school students ( @-@ year olds ) from a Korean nationally representative survey , which was surveyed in @ .


To identify associated factors with addictive Internet use , two-level multilevel regression models were fitted with individual-level responses ( @st level ) nested within schools ( @nd level ) to estimate associations of individual and school characteristics simultaneously .


Gender differences of addictive Internet use were estimated with the regression model stratified by gender .


Significant associations were found between addictive Internet use and school grade , parental education , alcohol use , tobacco use , and substance use .


Female students in girls ' schools were more likely to use Internet addictively than those in coeducational schools .


Our results also revealed significant gender differences of addictive Internet use in its associated individual - and school-level factors .


Our results suggest that multilevel risk factors along with gender differences should be considered to protect adolescents from addictive Internet use .


Adherence to prescribed exercise is a challenge for cancer patients undergoing treatment .


The changing pattern of exercise adherence over time can not be fully understood by an overall measure of adherence .


This study was aimed to identify the trajectory of exercise adherence and its predictors for women with breast cancer during their chemotherapy .


Participants were @ women with breast cancer assigned to the exercise arm of a randomized control trial .


Based on the weekly adherence rates in time and intensity , patients were classified as good ( > @ % ) , acceptable ( @-@ % ) , and poor ( < @ % ) adherents .


Data were analyzed using ordinal logistic hierarchical linear modeling .


The trajectories for both time and intensity adherence declined significantly .


The decline in exercise-time adherence was significantly slower in women who reported higher interest in exercise .


Women with higher perceived importance of exercise , early disease stage , and employed were more likely to be classified as good intensity adherents .


Poorer weekly adherence for both exercise time and intensity was associated with higher fatigue level for that week .


Adherence to exercise adherence in breast cancer patients declined as the dose of exercise prescription increased .


Factors influencing overall adherence and adherence trend were identified .


Efavirenz is widely prescribed for HIV-@ infection .


Three polymorphisms in CYP@B@ define plasma efavirenz trough concentration strata that vary across an @-fold range .


We characterized associations between human genetic polymorphisms and virologic response among participants who received efavirenz-containing regimens in a prospective clinical trial .


We genotyped @ polymorphisms in CYP@B@ ( including those that define efavirenz concentration strata ) , CYP@A@ , CYP@A@ , CYP@A@ and ABCB@ and week @ virologic responses in @ Haitians who initiated efavirenz-containing regimens in protocol HT @ .


Associations were characterized by logistic regression analysis and Fisher 's exact test .


Proportions with HIV-@ RNA < @ or < @ copies/mL did not differ across @ CYP@B@ metabolizer strata .


In analyses that combined strata into three metabolizer levels ( extensive , intermediate and slow ) , the respective proportions were @ , @ and @ ( < @ copies/mL cut-off ) and @ , @ and @ ( < @ copies/mL cut-off ) .


Genetic associations were not identified after controlling for baseline variables or with other polymorphisms after adjusting for multiple comparisons .


Virologic failures in HT @ were not explained by genetic polymorphisms known to define the lowest plasma efavirenz concentration stratum .


the aim of this study was to compare the effects of a functional tasks exercise programme to a cognitive training programme in older adults with mild cognitive impairment .


a single-blind randomised control trial with the intervention group compared with an active control group .


out-patient clinic .


older adults with mild cognitive impairment ( n = @ ) aged @ and older living in the community .


participants were randomised to either a functional task exercise group ( n = @ ) or an active cognitive training group ( n = @ ) for @ weeks .


All outcome measures were undertaken at baseline , post-intervention and @-month follow-up using Neurobehavioral Cognitive Status Examination , Trail Making Test , Chinese Version Verbal Learning Test , Category Verbal Learning Test , Lawton Instrumental Activities of Daily Living Scale and Problems in Everyday Living Test .


the functional task exercise group showed significant between-group differences in general cognitive functions , memory , executive function , functional status and everyday problem solving ability .


The improvements were sustained over time at @-month follow-up .


a functional tasks exercise programme is feasible for improving cognitive functions and functional status of older adults with mild cognitive impairment .


This may serve as a cost-effective adjunct to the existing interventions for populations with mild cognitive impairment .


The effect of proton pump inhibitors ( PPIs ) on the pharmacokinetics and pharmacodynamics of clopidogrel was assessed in two healthy volunteer crossover studies .


Study @ : subjects received clopidogrel alone ( @-mg loading dose , then @ mg/day for @ days ) and two of three PPIs ( omeprazole @ mg , esomeprazole @ mg or lansoprazole @ mg ) plus clopidogrel for @ days in three treatment periods ( randomized treatment sequence assignment ) .


Study @ : subjects received clopidogrel alone ( @ mg/day for @ days ) and clopidogrel alone for @ days followed by clopidogrel plus fixed-combination esomeprazole @ mg/low-dose acetylsalicylic acid ( ASA ) @ mg for @ days in two treatment periods ( randomized treatment sequence assignment ) .


Pharmacokinetic effects were estimated by measuring active metabolite of clopidogrel , and pharmacodynamic effects by inhibition of adenosine diphosphate ( ADP ) - induced platelet aggregation .


There was a relative decrease of up to @ % in exposure to the active metabolite of clopidogrel with the different PPIs ( study @ ) , and close to @ % with esomeprazole/low-dose ASA ( study @ ) , compared with clopidogrel alone .


There was an absolute decrease of up to @ % in inhibition of ADP-induced platelet aggregation with co-administration of different PPIs , compared with clopidogrel alone ; however , no differences in platelet inhibition were observed during co-administration with the esomeprazole/low-dose ASA fixed-dose combination .


Omeprazole , esomeprazole and lansoprazole decreased systemic exposure to the active metabolite of clopidogrel in healthy volunteers , leading to modest decreases in its antiplatelet effect .


However , no apparent differences in platelet inhibition were observed when esomeprazole was co-administered with low-dose ASA as a fixed-dose combination .


Despite their high rates of depression , homebound older adults have limited access to evidence-based psychotherapy .


The purpose of this paper was to report both depression and disability outcomes of telehealth problem-solving therapy ( tele-PST via Skype video call ) for low-income homebound older adults over @ months postintervention .


A @-arm randomized controlled trial compared the efficacy of tele-PST to in-person PST and telephone care calls with @ homebound individuals who were aged @ + and scored @ + on the @-item Hamilton Rating Scale for Depression ( HAMD ) .


Treatment effects on depression severity ( HAMD score ) and disability ( score on the WHO Disability Assessment Schedule -LSB- WHODAS -RSB- ) were analyzed using mixed-effects regression with random intercept models .


Possible reciprocal relationships between depression and disability were examined with a parallel-process latent growth curve model .


Both tele-PST and in-person PST were efficacious treatments for low-income homebound older adults ; however the effects of tele-PST on both depression and disability outcomes were sustained significantly longer than those of in-person PST .


Effect sizes ( dGMA-raw ) for HAMD score changes at @ weeks were @ for tele-PST and @ for in-person PST .


Effect sizes for WHODAS score changes at @ weeks were @ for tele-PST and @ for in-person PST .


The results also supported reciprocal and indirect effects between depression and disability outcomes .


The efficacy and potential low cost of tele-delivered psychotherapy show its potential for easy replication and sustainability to reach a large number of underserved older adults and improve their access to mental health services .


Steroids may improve outcomes in high-risk patients undergoing cardiac surgery with the use of cardiopulmonary bypass ( CBP ) .


There is a need \ for a large randomized controlled trial to clarify the effect of steroids in such patients .


We plan to randomize @,@ patients with elevated European System for Cardiac Operative Risk Evaluation who are undergoing cardiac surgery with the use of CBP to methylprednisolone or placebo .


The first coprimary outcome is @-day all-cause mortality , and the most second coprimary outcome is a composite of death , MI , stroke , renal failure , or respiratory failure within @ days .


Other outcomes include a composite of MI or mortality at @ days , new onset atrial fibrillation , bleeding and transfusion requirements , length of intensive care unit stay and hospital stay , infection , stroke , wound complications , gastrointestinal complications , delirium , postoperative insulin use and peak blood glucose , and all-cause mortality at @ months .


As of October @ , @ , @,@ patients have been recruited into SIRS in @ centers from @ countries .


Patient 's mean age is @ years , and @ % are male .


The average European System for Cardiac Operative Risk Evaluation is @ with @ % having an isolated coronary artery bypass graft procedure , and @ % having a valve procedure .


SIRS will lead to a better understanding of the safety and efficacy of prophylactic steroids for cardiac surgery requiring CBP .


Although multiple studies have suggested that repetitive transcranial magnetic stimulation ( rTMS ) may facilitate recovery after stroke , the efficacy of synchronous speech therapy integrated with an rTMS protocol has yet to be determined .


We investigated language responses to this strategy and determined the longevity of the resulting therapeutic outcomes .


Forty-five patients with stroke who presented with nonfluent aphasia were randomly assigned to the TMSsyn group and underwent synchronous picture-naming training together with contralesional @ Hz-rTMS for @ daily sessions .


The TMSsub group underwent subsequent picture-naming activity after the primed @ Hz-rTMS , and the TMSsham group received concurrent naming task along with the sham @ Hz-rTMS .


The Concise Chinese Aphasia test and the picture-naming test were performed before , immediately , and after @ months of the intervention .


TMSsyn showed significantly superior results in Concise Chinese Aphasia test score ( P < @ ) , expression and description subtests ( P < @ ) , and action ( P = @ ) and object naming activity ( P = @ ) ; the superior results lasted for @ months ( P = @ ) , in comparison with the TMSsub and TMSsham groups .


We established a real-time model that involved implementing verbal tasks together with the rTMS protocol .


Our results confirmed that the strategy yielded favorable outcomes that were of considerable longevity .


The results also indicated that the rTMS protocol and language training can be combined to achieve outcomes superior to those obtained when used separately .


Traditional training of electroconvulsive therapy ( ECT ) consists of a combination of didactic and hands-on demonstrations using ECT equipment .


Our goal was to explore the potential of a high-fidelity patient simulator ( HPS ) to train these skills .


To our knowledge , this is the first time an HPS has been used for skills training in psychiatry .


Nineteen psychiatry residents participated in this randomized controlled trial to compare traditional training ( n = @ ) versus training using an HPS ( n = @ ) .


Two blinded raters assessed performance using a newly developed checklist and global rating scale for this task ( ECT-OSATS ) ( Objective Structured Assessment of Technical Skills ) .


Residents also completed a pretest-posttest knowledge test and confidence survey .


Residents in the HPS group performed significantly better in terms of ECT-OSATS when compared with the control group ( P < @ ) .


All @ of the HPS group received a `` pass '' rating following training , whereas only @ of the @ control group received a `` pass '' rating .


There were no significant group differences in posttest confidence ( P = @ ) or total knowledge gain scores from pretest to posttest ( P = @ ) .


The level of clinical skill acquired by trainees in psychiatry for performing ECT is significantly superior using HPS - based training , in contrast to the domains of knowledge and confidence , which appear to be equally imparted using either training modality .


The acquisition of skills in administering ECT seems to be an independent variable in relation to a clinician 's level of knowledge and confidence in performing ECT .


To compare the advantages of prolotherapy in the treatment of first carpometacarpal osteoarthritis ( OA ) with those of corticosteroid local injection in the short and long term .


We performed a randomized controlled trial from March @ to March @ in an outpatient clinic at a university hospital .


Sixty participants ( @ hands ) with OA of the first carpometacarpal joint were assigned equally to two groups .


For the corticosteroid group , after @ monthly saline placebo injections , a single dose of @ mg methylprednisolone acetate ( @ ml ) mixed with @ ml of @ % lidocaine was injected .


For the dextrose ( DX ) group , @ ml of @ % DX was mixed with @ ml of @ % lidocaine and the injection was repeated monthly for @ months .


Pain intensity , hand function and the strength of lateral pinch grip were measured at the baseline and at @ , @ , and @ months after the treatment .


Mean age ( STD ) was @ ( @ ) years , and mean ( STD ) visual analog scale ( VAS ) was @ ( @ ) .


The two groups were comparable at @ months , but significantly different at @ month , with better results for corticosteroid , and at @ months with apparently more favorable outcome for DX -LSB- mean difference ( @ % CI ) in VAS = @ ( @ , @ ) , p = @ -RSB- .


After @ months of treatment , both DX and corticosteroid injection increased functional level , but DX seemed to be more effective -LSB- mean difference ( @ % CI ) in total function score = @ ( @ , @ ) , p = @ -RSB- .


For the long term , DX seems to be more advantageous , while the two treatments were comparable in the short term .


Because of the satisfactory pain relief and restoring of function , we would prefer DX prolotherapy for the treatment of patients with OA .


Therapeutic studies -- investigating the results of treatment ; level I.


QT assessment of oncology drugs is generally challenging because they are genotoxic and , of necessity , they require multisite evaluation in cancer patients .


Lenvatinib is not genotoxic , therefore , this thorough QT ( TQT ) study with lenvatinib , a multityrosine kinase inhibitor , was undertaken utilizing healthy volunteers and concentration effect modeling to project the TQT effect at high plasma levels .


Fifty-two healthy subjects randomly received single doses of lenvatinib @ mg , placebo , or moxifloxacin @ mg in a three-way crossover study .


Serial electrocardiograms were recorded , and the effect on placebo corrected change-from-baseline QTcF ( QTcF ) was evaluated .


The relationship between lenvatinib plasma concentrations and QTcF was analyzed with linear mixed effects modeling .


L envatinib mildly lowered the heart rate by @ bpm during the first @ h after dosing .


QTcF was shortened with a peak effect of @ ms ( @ % confidence interval ( @ % CI ) @ to @ ms ) at @ h postdosing.The upper bound of mean QTcF did not exceed @ ms at any time point postdosing .


A concentration-dependent effect of lenvatinib on QTcF was identified with an estimated population intercept of @ ms ( @ % CI @ to@ @ ms ; P = @ ) and a negative slope of @ ( @ % CI @ to @ ) ms per ng/mL , respectively .


The safety profile after a single dose of lenvatinib was acceptable , with adverse events ( AEs ) of mild-to-moderate severity and no serious AEs .


L envatinib had no clinically relevant effect on the QTc interval .


Concentration-effect modeling supports the lack of QTc prolongation at high plasma concentrations .


Low @-hydroxyvitamin D levels are common in patients with primary hyperparathyroidism ( PHPT ) and associated with higher PTH levels and hungry bone syndrome after parathyroidectomy ( PTX ) .


However , concerns have been raised about the safety of vitamin D supplementation in PHPT .


We aimed to assess safety and effects on calcium homeostasis and bone metabolism of supplementation with high doses of vitamin D in PHPT patients .


This was an investigator-initiated double-blind , randomized , placebo-controlled , parallel-group trial from a single center .


Forty-six PHPT patients were recruited , with a mean age of @ ( range @-@ ) years , and @ ( @ % ) were women .


Intervention included daily supplementation with @ g ( @ IU ) cholecalciferol or identical placebo for @ weeks .


Treatment was administered @ weeks before PTX and continued for @ weeks after PTX .


PTH , calcium homeostasis , and bone metabolism were evaluated .


Preoperatively , @-hydroxyvitamin D increased from @ to @ nmol/L in the treatment group and decreased from @ to @ nmol/L in the placebo group ( P < @ ) .


Compared with placebo , vitamin D decreased PTH significantly by @ % before PTX ( P = @ ) , increased lumbar spine bone mineral density by @ % ( P = @ ) , and decreased C-terminal - CrossLaps by @ % ( P < @ ) .


The trabecular bone score did not change in response to treatment , but improved after PTX .


Postoperatively , PTH remained lower in the cholecalciferol group compared with the placebo group ( P = @ ) .


Plasma creatinine and plasma and urinary calcium did not differ between groups .


Daily supplementation with a high vitamin D dose safely improves vitamin D status and decreases PTH in PHPT patients .


The vitamin D treatment is accompanied by reduced bone resorption and improved bone mineral density before operation .


In line with a rapidly ageing global population , the rise in the frequency of falls will lead to increased healthcare and social care costs .


This study will be one of the few randomized controlled trials evaluating a multifaceted falls intervention in a low-middle income , culturally-diverse older Asian community .


The primary objective of our paper is to evaluate whether individually tailored multifactorial interventions will successfully reduce the number of falls among older adults .


Three hundred community-dwelling older Malaysian adults with a history of ( i ) two or more falls , or ( ii ) one injurious fall in the past @ months will be recruited .


Baseline assessment will include cardiovascular , frailty , fracture risk , psychological factors , gait and balance , activities of daily living and visual assessments .


Fallers will be randomized into @ groups : to receive tailored multifactorial interventions ( intervention group ) ; or given lifestyle advice with continued conventional care ( control group ) .


Multifactorial interventions will target @ specific risk factors .


All participants will be re-assessed after @ months .


The primary outcome measure will be fall recurrence , measured with monthly falls diaries .


Secondary outcomes include falls risk factors ; and psychological measures including fear of falling , and quality of life .


Previous studies evaluating multifactorial interventions in falls have reported variable outcomes .


Given likely cultural , personal , lifestyle and health service differences in Asian countries , it is vital that individually-tailored multifaceted interventions are evaluated in an Asian population to determine applicability of these interventions in our setting .


If successful , these approaches have the potential for widespread application in geriatric healthcare services , will reduce the projected escalation of falls and fall-related injuries , and improve the quality of life of our older community .


The purpose of the present study was to compare the effects of equal-volume resistance training ( RT ) performed once or twice a week on muscle mass and strength of the elbow flexors in untrained young men .


Thirty men ( @ @ years ) without previous resistance training experience were divided into two groups : Group @ ( G@ ) trained each muscle group only once a week and group @ ( G@ ) trained each muscle twice a week during @ weeks .


Baseline and @ weeks post-test elbow flexors muscle thickness ( MT ) were measured using a B-Mode ultrasound .


Peak torque ( PT ) was assessed by an isokinetic dynamometer before and after the training program .


Elbow flexors MT increased significantly ( P < @ ) from @ @ to @ @ mm in G@ , and from @ @ to @ @ mm in G@ .


Elbow flexors PT also increased ( P < @ ) from @ @ to @ @ N.m in G@ , and from @ @ to @ @ N.m in G@ .


The results of ANOVA did not reveal group by time interactions for any variable , indicating no difference between groups for the changes in MT or PT .


The results from the present study suggest that untrained men experience similar gains in muscle mass and strength with equal volume RT performed one or two days per week .


The introduction of new medical devices may be accompanied by a learning curve .


To evaluate the impact of the device learning curve on the outcomes of PROTECT II trial , comparing Impella @ versus the intra-aortic balloon pump ( IABP ) during high-risk percutaneous coronary intervention , we report on a prespecified analysis , excluding the first Impella @ and IABP patients at each site .


A total of @ patients were enrolled at @ sites .


Among these , @ patients were the first to receive Impella @ at their site , @ were the first to receive IABP .


A trend toward higher major adverse events ( MAEs ) at @ days was observed for the subgroup of first versus remaining Impella @ patients : @ % versus @ % , P = @ .


MAE rates for the first and remaining IABP patients were similar at @ days .


After exclusion of the first patient in each group , MAE rates for Impella @ and IABP were @ % versus @ % ( P = @ ) at @ days and @ % versus @ % ( P = @ ) at @ days .


Significantly lower @-day MAE rates were observed with the use of Impella @ compared to the use of IABP after excluding the first patient per group at each site .


This prespecified analysis suggests a learning curve associated with initial introduction of the Impella @ .


Clinical trials should better address the training aspect of new devices , especially when compared with more established devices .


One-lung ventilation ( OLV ) is accomplished with a double-lumen tube ( DLT ) or a bronchial blocker ( BB ) .


The authors compared the effectiveness of lung collapse using DLT , BB , and BB with the disconnection technique .


Prospective , randomized , blind trial .


A university hospital .


Fifty-two patients undergoing elective pneumothorax surgery .


Patients were assigned randomly to @ of @ groups : The DLT group ( group @ ) , the BB group ( group @ ) , and the BB with the disconnection technique group ( group @ ) .


The authors modified the disconnection technique in group @ as follows : ( @ ) turned off the ventilator and opened the adjustable pressure-limiting valve , allowing both lungs to collapse and ( @ ) after loss of the CO@ trace on the capnograph , inflated the blocker cuff and turned on the ventilator , allowing only dependent-lung ventilation .


Five and ten minutes after OLV , the degree of lung collapse was assessed by the surgeon , who was blinded to the isolation technique .


The quality of lung collapse at @ and @ minutes was significantly better in groups @ and @ than in group @ .


No significant differences were observed for the degree of lung collapse at any time point between groups @ and @ .


The average time for loss of the CO@ trace on the capnograph was @ seconds in group @ .


A BB with spontaneous collapse took longer to deflate and did not provide equivalent surgical exposure to the DLT .


The disconnection technique could be helpful to accelerate lung collapse with a BB .


To compare levels of diabetes distress in people with Type @ diabetes treated in primary and secondary care and to examine demographic and clinical correlates that may explain potential differences in levels of distress between care settings .


People with Type @ diabetes from @ primary care practices ( n = @ ) and three secondary care clinics ( n = @ ) completed the Problem Areas In Diabetes questionnaire .


Data on HbA@c levels and diabetes complications were derived from medical charts .


Hierarchical ordinal regression analysis was used to investigate which correlates could explain the potential differences in level of diabetes distress between care settings .


Diabetes distress levels and the prevalence of elevated diabetes distress were considerably lower in the participants treated in primary care ( mean ( SD ) total diabetes distress score @ ( @ ) ; @ % of participants with a Problem Areas In Diabetes score @ ) than in secondary care ( mean ( SD ) total diabetes distress score @ ( @ ) ; @ % of participants with a Problem Areas In Diabetes score @ , P < @ ) .


In addition to care setting , the following variables were also independently related to diabetes distress : younger age , ethnic minority status , using insulin , having a higher HbA@c level , having a higher BMI and the presence of neuropathy .


Other diabetes complications were not independently associated with diabetes distress .


In primary care , lower levels of diabetes distress were reported than in secondary care .


The difference in diabetes distress between care settings can be largely , but not fully , explained by specific demographic and clinical characteristics .


These results need to be interpreted with caution as they are based on two separate studies , but do call into question the need to screen for diabetes distress in people with Type @ diabetes in primary care .


This randomized , double-blind , parallel-group clinical trial aims to assess the equivalence of intra-articular polynucleotides compared to standard hyaluronic acid ( HA ) viscosupplementation in the treatment of knee osteoarthritis ( OA ) .


@ patients affected by knee OA were assessed for eligibility and @ were enrolled and randomized to receive either intra-articular polynucleotides ( Condrotide-@ patients ) or hyaluronic acid ( Hyalubrix-@ patients ) at the Orthopedic Institute `` Gaetano Pini '' ( Milan ) .


All patients underwent three intra-articular injections of Condrotide or Hyalubrix with an interval of @week .


Participants , care givers , and investigators responsible for outcome assessment were all blinded to group assignment .


Primary outcome measurements ( KOOS and pain level ( @ ) at rest , ( @ ) at weight-bearing and ( @ ) during physical activity ) were evaluated at baseline ( T@ ) and after one ( T@ ) , two ( T@ ) , six ( T@ ) , ten ( T@ ) , and @ ( T@ ) weeks .


Secondary measurements included the determination of COMP serum levels at T@ , T@ and T@ .


The reduction of pain and the increase of KOOS values from baseline were statistically significant for both treatments ; nevertheless , for parameter KOOS `` symptoms '' the treatment with Condrotide showed significant results already after twoweeks ( at T@ p = @ ) while the results obtained with Hyalubrix became significant only after @ weeks ( at T@ p = @ ) .


No significant adverse events were reported .


Condrotide is as effective as Hyalubrix in reducing knee OA symptoms but showed an earlier response on pain reduction and can therefore be considered a valid alternative to the use of HA in the treatment of OA , avoiding the adverse events of NSAIDs and of intra-articular corticosteroids .


To develop a multivariable prognostic model for the risk of preterm delivery in women with multiple pregnancy that includes cervical length measurement at @ to @ weeks ' gestation and other variables .


We used data from a previous randomized trial .


We assessed the association between maternal and pregnancy characteristics including cervical length measurement at @ to @ weeks ' gestation and time to delivery using multivariable Cox regression modelling .


Performance of the final model was assessed for the outcomes of preterm and very preterm delivery using calibration and discrimination measures .


We studied @ women , of whom @ ( @ % ) delivered < @ weeks ( preterm ) and @ ( @ % ) < @ weeks ( very preterm ) .


Women with cervical length < @ mm delivered more often preterm ( hazard ratio @ ; @ % CI @ to @ ) .


Other independently contributing predictors were previous preterm delivery , monochorionicity , smoking , educational level , and triplet pregnancy .


Prediction models for preterm and very preterm delivery had a c-index of @ ( @ % CI @ to @ ) and @ ( @ % CI @ to @ ) , respectively , and showed good calibration .


In women with a multiple pregnancy , the risk of preterm delivery can be assessed with a multivariable model incorporating cervical length and other predictors .


Dietary sodium loading has been shown to adversely impact endothelial function independently of blood pressure ( BP ) .


However , it is unknown whether dietary sodium loading impacts endothelial function differently in men as compared to women .


The aim of this study was to test the hypothesis that endothelial-dependent dilation ( EDD ) would be lower in men as compared to women in response to a high sodium diet .


Thirty subjects ( @F , @y ; @M , @y ) underwent a randomized , crossover , controlled diet study consisting of @ days of low sodium ( LS ; @ mmol/day ) and @ days of high sodium ( HS ; @-@ mmol/day ) .


Salt-resistance was determined by a change in @-hr mean arterial pressure ( MAP ) @ mm Hg between HS and LS as assessed on day @ of each diet .


Blood and @-hr urine were also collected and EDD was assessed by brachial artery flow-mediated dilation ( FMD ) .


By design , MAP was not different between LS and HS conditions and urinary sodium excretion increased on HS diet ( P < @ ) .


FMD did not differ between men and women on the LS diet ( @ @ vs. @ @ ; P > @ ) and declined in both men and women on HS ( P < @ ) .


However , FMD was lower in men as compared to women on HS ( @ @ vs. @ @ ; P < @ ) .


HS reduced FMD in both men and women .


In response to an HS diet , FMD was lower in men compared to women suggesting a greater sensitivity of the vasculature to high sodium in men .


We assessed the efficacy of onabotulinumtoxinA ( BOTOX , Allergan Inc. , Irvine , CA , USA ) in patients with refractory overactive bladder ( OAB ) after treatment for benign prostatic hyperplasia ( BPH ) .


This was a two-center , randomized , double-blinded pilot study conducted in patients with OAB secondary to bladder outlet obstruction ( BOO ) , refractory to anticholinergic medication and persistent for greater than @ months after surgical intervention to relieve obstruction , with an International Prostate Symptom Score ( IPSS ) > @ .


Patients were randomized in @:@ fashion to either @ units of onabotulinumtoxinA versus placebo .


Fifteen patients received onabotulinumtoxinA versus @ who received placebo .


Follow up was performed at @ week and then @ , @ , @ , and @ months .


The primary endpoint was reduction in the frequency of micturition per @ hours by @-day voiding diary .


Secondary endpoints were maximum flow rate ( Qmax ) , post-void residual ( PVR ) , and IPSS scores .


Patients receiving onabotulinumtoxinA demonstrated significantly improved quality of life scores at @ and @ days after treatment ( p = @ and @ , respectively ) as well as significantly lower International Consultation on Incontinence Questionnaire ( ICIQ ) scores ( p < @ ) .


Baseline urinary frequency was @ versus @ voids/day ( p = @ ) .


Frequency episodes improved from @ episodes per day to @ episodes per day in the treatment arm .


The placebo arm did not have a decrease in frequency episodes .


This response was durable up to @ days , although this was not statistically significant .


IPSS , PVR , and urgency were unchanged postoperatively in both groups .


OnabotulinumtoxinA was safe in patients with refractory irritative lower urinary tracts symptoms after surgical treatment of BPH .


There were improvements in daily frequency , although the results were not statistically significant .


Larger trials are needed to help characterize the utility of onabotulinumtoxinA in the treatment of OAB secondary to BPH .


The aim of the study was to assess the hemodynamic and metabolic actions of estrogen plus progestin therapy ( EPT ) in hypertensive , postmenopausal women treated with perindopril ( ACEI ) or hydrochlorothiazide ( HCTZ ) .


A group of normotensive postmenopausal women was also studied .


@ hypertensive and @ normotensive postmenopausal women were recruited for the study .


The hypertensive females were randomly assigned to receive ACEI or HCTZ for @months .


The patients of the ACEI group and the patients of the HCTZ group , as well as normotensives , were further subdivided into two subgroups each .


One subgroup received estrogen plus progestin therapy ( EPT + ) , the other subgroup received no hormone replacement ( EPT - ) .


Combined hormone replacement with transdermal patches releasing @-estradiol and norethisterone was used .


Office and @-hour ambulatory blood pressure was measured at baseline and during follow-up .


Renal plasma flow ( RPF ) was measured using the clearance of -LSB- @I -RSB- - iodohippuran .


Pulse wave velocity ( PWV ) was determined with an automatic device .


In normotensive postmenopausal women , transdermal estrogen plus progestin therapy increases RPF and insulin sensitivity , decreases PWV , decreases total and LDL cholesterol , and decreases uric acid serum levels .


Perindopril ( @mg/day ) and hydrochlorothiazide ( @mg/day ) were equally effective in reducing blood pressure in postmenopausal , hypertensive subjects .


In these females , perindopril increased RPF and decreased PWV and plasma insulin levels .


These effects of the ACEI were not altered by estrogen plus progestin therapy .


Hydrochlorothiazide decreased RPF and increased plasma insulin and uric acid concentrations in hypertensive subjects whom were not receiving estrogen plus progestin therapy .


The unfavorable metabolic and hemodynamic actions of the diuretic were counteracted by estrogen plus progestin therapy .


Concomitant estrogen plus progestin therapy may be a method to avoid unfavorable hemodynamic and metabolic effects of thiazide diuretics in hypertensive , postmenopausal women .


Distal radius fractures in young , working-age patients are frequent and are associated with potential disability in case of inappropriate treatment .


Our hypothesis is that there is no difference between patients treated with a volar plate and those treated with closed reduction and external fixation .


We studied @ patients with complex distal radius fractures .


They were prospectively and randomly assigned to treatment with a volar plate or an external fixator : they were followed-up and assessed at one year using two scales , the Visual Analog Scale ( VAS ) and the McDermid et al. .


Functionality Scale .


Both groups showed good results at one year .


Measurements in the pain Visual Analog Scale and disability measured with the McDermid et al. scale were not statistically significant .


Higher scores mean greater disability .


Scores above @ were considered as failures .


We found @ cases with complications in the F group ; one with material dislodgement and one with malunion , without significant differences .


Both treatments show good results in the medium-term ; no differences were found between both groups regarding pain and residual disability .


Complications were few and they were addressed conservatively ; they were less frequent with open reduction and internal fixation .


When ranges of motion and the complication rate were compared , the volar plate showed a statistically significant difference in a decreased complication risk .


To determine whether Asian and white subjects differ in clinical signs or subjective symptoms in response to the use of different biguanide-preserved contact lens care solutions .


Forty-two subjects ( @ Asian and @ white ) wearing lotrafilcon B silicone hydrogel contact lenses used a preservative-free lens care solution bilaterally for @ weeks , then used two biguanide-preserved solutions ( solution @ : ReNu MPS ; solution @ : AQuify MPS ) contralaterally in randomly assigned eyes for @ weeks .


Comprehensive ocular surface examinations were performed and symptomatology questionnaires were administered every @ weeks .


Investigators were masked as to solution assignment during examinations , whereas subjects were not to avoid potential difficulties in compliance with the protocol .


With solution @ , most Asian and white subjects had grade @ or greater corneal staining after @ weeks ( @ % and @ % , respectively ) and @ weeks ( @ % and @ % , respectively ) .


With solution @ , grade @ or greater corneal staining occurred in @ % of Asians after @ weeks and in @ % after @ weeks , but in only @ % of whites after @ weeks and @ % after @ weeks .


Whites reported significantly better average comfort ( P = @ ) and less dryness ( P < @ ) than did Asians .


Asians and whites differ in both ocular response to the use of contact lens care solutions and in reporting subjective symptoms .


Racial and ethnic differences should be considered when evaluating and treating contact lens patients in a clinical setting .


The purpose of this study was to evaluate the efficacy of periarticular multimodal drug injection after medial opening-wedge high tibial osteotomy regarding the postoperative pain level .


From January @ to January @ , @ patients underwent medial opening-wedge high tibial osteotomy .


Thirty-five patients were randomly assigned to receive no injection ( group I ) , and @ patients were assigned to receive periarticular multimodal drug injection ( group II ) .


These @ groups were compared regarding the postoperative pain level , frequency of additional nonsteroidal anti-inflammatory drug injections , total amount of patient-controlled analgesia , and number of times that patients pushed the patient-controlled analgesia button at each time interval .


Statistical results were based on multivariate analysis of variance and repeated-measures analyses .


Multivariate analysis of variance of mean visual analog scale ( VAS ) scores over the @-week postoperative period showed statistical significance ( P < @ ) .


Repeated-measures analysis yielded a statistically significant difference ( P = @ ) for the time-by-treatment interaction , showing a clear periarticular multimodal drug injection benefit over time based on VAS scores .


In addition , the mean number of times that patients pushed the patient-controlled analgesia button differed significantly between groups over time ( P = @ ) .


The VAS scores , frequency of additional nonsteroidal anti-inflammatory drug injections , mean number of times that patients pushed the patient-controlled analgesia button , and mean total amount of fentanyl consumption differed significantly within each group over time ( P < @ for all variables ) .


However , the frequency of additional nonsteroidal anti-inflammatory drug injections and mean total amount of fentanyl consumption did not differ significantly between groups over time ( P = @ , P = @ , and P = @ ) .


Opioid - and injection-related complications were not found .


This prospective randomized study shows that intraoperative periarticular multimodal drug injections in patients undergoing medial opening-wedge high tibial osteotomy for unicompartmental osteoarthritis of the knee could result in significant reductions in VAS scores at @weeks postoperatively .


Level I , high-quality randomized controlled trial with statistically significant differences .


Desflurane is the least soluble and most expensive inhalation agent .


Hence , low flow technique is suitable for anesthesia with desflurane .


However , one of the disadvantages of low flow technique is the discrepancy among the end-tidal concentration , inspired concentration , and vaporizer setting .


To measure the concentrations of desflurane at different sites of the anesthesia circuit by varying fresh gas flow ( FGF ) rates but fixing expired concentration .


Thirty ASA PS I-II adult patients were enrolled in this crossover study .


After induction of anesthesia and ten minutes of wash-in period , the flow meters of oxygen and air were then adjusted to maintain FiO@ at @ with the random sequences of FGF rates at @ , @ and @ L x min ( -@ ) .


Desflurane vaporizer was adjusted to obtain @ % end-tidal desflurane concentration ( FeDES ) throughout the study period .


After FeDES reached the target and was stable for @ minutes , inspired concentration ofdesflurane ( FiDES ) and delivered desflurane concentration at fresh gas outlet ( FdDES ) were measured .


Lastly , the consumption of desflurane was calculated .


FdDES was higher than FiDES in every FGF rates .


FdDES at FGF @ L x min ( -@ ) ( @ + / - @ ) was significantly higher than FdDES at @ and @ L x min ( -@ ) ( @ + / - @ , @ + / - @ , respectively ) , but not significantly different between FGF @ and @ L x min ( -@ ) .


FeDES/FdDES at FGF @ , @ and @ L.min ( -@ ) were @ + / - @ , @ + / - @ and @ + / - @ , respectively .


There was no significant difference of FeDES/FdDES between FGF @ and @ L x min ( -@ ) , but there was significant difference between FGF @ and @ L x min ( -@ ) with the p-value < @ .


The calculated liquid desflurane consumption per hour at FGF rate of @ , @ and @ L x min ( -@ ) were @ + / - @ , @ + / - @ and @ + / - @ mL x hr ( -@ ) .


Using FGF @ L x min ( -@ ) has no advantage over FGF @ L x min ( -@ ) , because they both have the similar FdDES .


Regarding at FGF @ and @ L x min ( -@ ) , the delivered concentration has to be increased to obtain the desired expired concentration with more intense at FGF @ L x min ( -@ ) because there are more discrepancies between FdDES and FeDES .


Increased oxidative stress and inflammation has a role in the pathogenesis of chronic obstructive pulmonary disease ( COPD ) .


Drugs with antioxidant and anti-inflammatory properties , such as N-acetylcysteine , might provide a useful therapeutic approach for COPD .


We aimed to assess whether N-acetylcysteine could reduce the rate of exacerbations in patients with COPD .


In our prospective , randomised , double-blind , placebo-controlled , parallel-group study , we enrolled patients aged @-@ years with moderate-to-severe COPD ( post-bronchodilator forced expiratory volume in @ s -LSB- FEV@ -RSB- / forced vital capacity < @ and FEV@ of @-@ % of predicted ) at @ hospitals in China .


We stratified patients according to use of inhaled corticosteroids ( regular use or not ) at baseline and randomly allocated them to receive N-acetylcysteine ( one @ mg tablet , twice daily ) or matched placebo for @ year .


The primary endpoint was the annual exacerbation rate in patients who received at least one dose of study drug and had at least one assessment visit after randomisation .


This study is registered with the Chinese Clinical Trials Registry , ChiCTR-TRC-@ .


Between June @ , @ , and Dec @ , @ , we screened @ patients , of whom @ were eligible for randomisation ( @ to N-acetylcysteine and @ to placebo ) .


After @ year , we noted @ acute exacerbations in @ patients in the N-acetylcysteine group who received at least one dose and had at least one assessment visit ( @ exacerbations per patient-year ) and @ acute exacerbations in @ patients in the placebo group ( @ exacerbations per patient-year ; risk ratio @ , @ % CI @-@ ; p = @ ) .


N-acetylcysteine was well tolerated : @ ( @ % ) of @ patients who received at least one dose of N-acetylcysteine had adverse events ( @ serious ) , as did @ ( @ % ) of @ patients who received at least one dose of placebo ( @ serious ) .


The most common serious adverse event was acute exacerbation of COPD , occurring in @ ( @ % ) of @ patients in the N-acetylcysteine group and @ ( @ % ) of @ patients in the placebo group .


Our findings show that in Chinese patients with moderate-to-severe COPD , long-term use of N-acetylcysteine @ mg twice daily can prevent exacerbations , especially in disease of moderate severity .


Future studies are needed to explore efficacy in patients with mild COPD ( GOLD I ) .


Optimal positioning of orthodontic mini-implants is essential for a successful treatment with skeletal anchorage .


This study aims to compare the accuracy of two-dimensional radiographs with a cone beam computed tomography ( CBCT ) for mini-implant placement .


An ideal site for mini-implant placement at the buccal interradicular space between the second premolar and the first molar was determined for @ sites ( in @ patients aged @ to @ years ) by using CBCT data .


The mini-implant placement procedure was then divided into two groups .


In CBCT group , mini-implants were placed at the sites determined from CBCT data .


In RVG group , mini-implants were placed with the help of two-dimensional digital radiographs and a custom made guide .


Postplacement CBCT scans were obtained to determine the accuracy of the mini-implant placement .


The results were statistically analyzed with a Mann-Whitney test .


A statistically significant difference ( p value = @ ) was observed between the two groups for deviation from an ideal height of placement of the mini-implants .


Deviations in mesiodistal positioning and angular deviation showed a statistically non-significant difference .


Three out of twenty mini-implants in the RVG group showed root contact in the mandibular arch that may be attributed to the narrower interradicular space and reduced accessibility in the mandibular posterior region .


Although CBCT provides an accurate three-dimensional visualization of the interradicular space , the two-dimensional intraoral radiograph of the interradicular area provides sufficient information for mini-implant placement .


Considering the amount of radiation exposure and cost with the two techniques , it is recommended to use two-dimensional radiographs with a surgical guide for a routine mini-implant placement .


The amount of epicardial adipose tissue ( EAT ) around the heart has been identified as an independent predictor of coronary artery disease ( CAD ) , potentially through local release of inflammatory cytokines .


Ethnic differences have been observed , but no studies have investigated this relationship in the Mexican population .


The objective of the present study was to evaluate whether a relationship exist between EAT thickness assessed via echocardiography with CAD and adiponectin levels in a Mexican population .


We studied @ consecutive patients who underwent coronary angiography and transthoracic echocardiography ( TTE ) .


EAT thickness on the free wall of the right ventricle was measured at the end of systole from parasternal long and short axis views of three consecutive cardiac cycles .


Coronary angiograms were analyzed for the presence , extent and severity of CAD .


Serum adiponectin , lipids , glucose , C-reactive protein and fibrinogen were determined .


EAT thickness was greater in patients with CAD than in those without CAD from both parasternal long ( @ @ mm vs @ @ mm p < @ ) and short-axis views ( @ @ vs @ @ , p = @ ) .


EAT thickness measured from parasternal long and short-axis showed a statistically significant positive correlation with age ( r = @ , p < @ ; r = @ , p < @ respectively ) , and waist circumference ( r = @ , p = @ ; r = @ , p = @ respectively ) .


A significant negative correlation between EAT thickness from the parasternal long axis with cholesterol-HDL was observed ( r = -@ , p = @ ) .


No significant correlation was found between epicardial fat thickness and serum adiponectin or with the severity of CAD .


EAT thickness was greater in patients with CAD .


However , no correlation was observed with the severity of the disease or with serum adiponectin levels .


EAT thickness measured by echocardiography might provide additional information for risk assessment and prediction of CAD .


To compare the level of sedation , cardiorespiratory changes , and quality of recovery in cats receiving methadone plus either low dose tiletamine-zolazepam or acepromazine for premedication prior to general anaesthesia for neutering .


Prospective , randomized , blinded clinical study .


Twenty cats @ @ years-old ( mean SD ) , weighing @ @ kg ( @ male and @ female ) .


Cats were allocated randomly to receive intramuscularly either @ mg kg ( -@ ) acepromazine ( ACE ) or @ mg kg ( -@ ) tiletamine-zolazepam ( TZ ) , both regimens combined with @ mg kg ( -@ ) methadone for premedication .


Sedation was assessed @ minutes after premedication using a visual analogue scale ( VAS ) and a simple descriptive scale ( SDS ) .


Anaesthesia was induced with alfaxalone and maintained with isoflurane .


Physiological parameters were recorded at @ , @ and @ minutes post-endotracheal intubation .


Recovery from cessation of isoflurane was timed and quality assessed using a SDS and a VAS .


Data was analysed with Mann-Whitney U-test , students t-test , anova or ordinal logistic regression as relevant .


Significance was taken as p < @ .


Sedation was more pronounced in TZ than ACE as indicated by higher VAS ( @ @ versus @ @ ) and SDS scores -LSB- @ ( @-@ ) versus @ ( @-@ ) -RSB- .


Following sedation , Heart ( HR ) and respiratory ( fR ) rates did not differ between groups .


After anaesthetic induction , at times @ , @ and @ HR , systolic arterial pressure and end tidal carbon dioxide were significantly higher and fR was significantly lower in TZ than ACE .


Recovery quality was similar between groups .


In both groups , times to extubation , head lift and sternal recumbency were similar , but time ( minutes ) until standing was significantly longer in TZ ( @ @ ) than ACE ( @ @ ) .


Low dose tiletamine-zolazepam combined with methadone provided superior sedation to ACE .


Recovery quality was similar , although time to standing was longer .


We describe the safety and efficacy of the Altis ( ) Single Incision Sling System for the treatment of female stress urinary incontinence through @months .


In this study we collected a variety of safety and efficacy measures relevant to the assessment of urinary incontinence .


The primary efficacy end point was improvement in @-hour pad weight test .


Other efficacy measures included the cough stress test , Urogenital Distress Inventory-Short Form , Incontinence Impact Questionnaire-Short Form , Patient Global Impression of Improvement and @-day voiding diary .


Safety was evaluated through assessment of device and procedure related adverse events .


Of @ surgical attempts @ subjects were implanted with the Altis sling .


Of these patients @ had primary efficacy data at baseline and @ months , and @ had efficacy data at baseline and @ months .


Consequently @ ( @ % ) subjects at @ months and @ ( @ % ) at @ months achieved a @ % or greater reduction in pad weight .


The cough stress test was negative for @ ( @ % ) subjects at @ months and @ ( @ % ) at @ months .


A decrease in median leaks per day was observed at @ months and improvements in all patient reported measures were observed through @ months .


A majority of subjects reported feeling much better or very much better at @ and @ months , respectively .


There were no reports of mesh erosion or migration and no unanticipated adverse events through @ months .


The Altis sling appears to be safe and efficacious , and performs asintended in the treatment of stress urinary incontinence through @ months .


Transformation of B-cell chronic lymphocytic leukaemia ( B-CLL ) to diffuse large B cell lymphoma ( DLBCL ) ( Richter 's syndrome ( RS ) ) is a rare ( @-@ % of patients ) but catastrophic complication of B-CLL .


Dose-intense chemotherapy regimens investigated in small single institution trials , but with the exception of bone marrow transplantation for a minority of patients , little has improved the median overall survival of patients with RS beyond eight months .


Patients are often elderly , immunosuppressed , possess co-morbidities and have a deteriorating performance status .


TP@ disruption is a common molecular abnormality noted in RS and contributes to the tumour 's chemotherapy resistance .


Ofatumumab is a fully human anti-CD@ monoclonal IgG@ antibody that targets a unique epitope on B lymphocytes .


It has displayed increased binding affinity and a longer dissociation time when compared to rituximab resulting in improved complement dependent cellular cytotoxicity ( CDCC ) ; a mechanism with the potential to overcome apoptosis-resistance in TP@ disruption .


Given the prevalence of TP@ disruption in RS , Ofatumumab was considered a relatively non-toxic agent with a sound rationale to test in a prospective multicentre trial as an adjunct to CHOP induction and subsequent ofatumumab maintenance therapy in responding patients .


The CHOP-OR study is a prospective phase II study to evaluate the safety , feasibility and activity of a CHOP chemotherapy in combination with ofatumumab in induction and subsequent maintenance for patients with newly diagnosed RS .


The primary objective will be the overall response rate ( ORR ) in patients with RS after six cycles of CHOP-O .


The secondary objectives include feasibility of recruitment , progression free survival ( PFS ) , overall survival ( OS ) and toxicity .


The study will be accompanied by exploratory analysis of the genomic landscape of RS in newly diagnosed patients .


The CHOP-OR trial evaluates the safety , feasibility and activity of CHOP plus Ofatumumab induction and Ofatumumab maintenance in new RS patients .


The study is currently recruiting and has met the interim analysis criteria , with more than @ of the first @ participants achieving a CR or PR after six cycles of CHOP-O .


The study has the potential to identify predictive biomarkers for this treatment modality .


Dinaciclib ( MK-@ , formerly SCH @ ) , a novel , small-molecule inhibitor of cyclin-dependent kinases , has been shown to induce apoptosis in preclinical studies of human tumor cell lines , including non-small cell lung cancer ( NSCLC ) cells .


Erlotinib , an epidermal growth factor receptor inhibitor , is approved for the treatment of advanced NSCLC as second - or third-line therapy .


This phase @ , randomized , multicenter , open-label study compared dinaciclib with erlotinib in patients with previously treated NSCLC .


The study was comprised of @ parts : in part @ , patients were randomized to either intravenous ( IV ) dinaciclib ( @ mg/m@ ) or oral erlotinib ( @ mg ) using an adaptive Bayesian design that adjusted the randomization ratio in favor of the more active arm , and in part @ , patients who had progressed on erlotinib were permitted to cross over to receive dinaciclib at the same dosage as in part @ .


Patients were followed until disease progression or death , initiation of nonstudy cancer treatment , discontinuation , or withdrawal of consent .


The primary efficacy end point was time-to-progression ( TTP ) in part @ and objective response rate ( ORR ) in part @ .


Based on Kaplan-Meier estimates , the median TTP was @ months ( @ % confidence interval -LSB- CI -RSB- : @ , @ ) following initial treatment with dinaciclib , compared with @ months ( @ % CI : @ , @ ) with erlotinib .


No objective responses were observed following initial treatment with dinaciclib .


Common severe ( grade @ or @ ) drug-related adverse effects included neutropenia , leukopenia , vomiting , and diarrhea .


Dinaciclib , administered IV , was well tolerated at the @ mg/m@ dose , but does not have activity as monotherapy in previously treated NSCLC .


Evaluation of dinaciclib in combination with other agents for other indications including breast cancer and multiple myeloma is in progress .


Few studies have investigated objective markers of lipodystrophy in African children .


We compared body circumferences , skin-fold thickness ( SFT ) and lipids in antiretroviral therapy ( ART ) - naive and stavudine ( d@T ) - exposed children with HIV-uninfected controls .


In the CHAPAS-@ trial , HIV-infected children ( ART-naive or on d@T for @ years without clinical lipodystrophy ) were randomized to d@T , abacavir or zidovudine with lamivudine ( @TC ) plus a non-nucleoside reverse transcriptase inhibitor .


Mid-upper-arm circumference ( MUAC ) and calf circumference ( CC ) , SFT ( biceps , triceps , sub-scapular and supra-iliac ) and fasting lipids ( total cholesterol -LSB- TC -RSB- , low-density lipoprotein -LSB- LDL -RSB- , high-density lipoprotein -LSB- HDL -RSB- and triglycerides -LSB- TRIG -RSB- ) were measured at randomization in all HIV-infected children , and in HIV-uninfected controls .


Age - and sex-adjusted z-scores of MUAC , CC , SFT and the sum of SFT ( SSF ) using Dutch reference data were compared across groups using linear regression .


Of @ children , @ % were male , @ ( median age @ years -LSB- IQR @-@ @ -RSB- ) were ART-naive , @ ( median age @ years -LSB- IQR @-@ @ -RSB- ) were ART-experienced and @ ( median age @ years -LSB- IQR @-@ @ -RSB- ) were control children .


Overall , @ % and @ % of ART-experienced children had been on d@T plus @TC and nevirapine , respectively , for a median @ years ( IQR @-@ @ ) .


Mean ( sd ) weight-for-age z-scores and MUAC z-scores were -@ ( @ ) versus -@ ( @ ) versus -@ ( @ ) and -@ ( @ ) versus -@ ( @ ) versus -@ ( @ ) in ART-naive versus - experienced versus controls , respectively ( all P < @ ) .


The mean ( sd ) of SSF was lower in the ART-experienced ( -@ -LSB- @ -RSB- ) than in the ART-naive ( -@ -LSB- @ -RSB- ; P < @ ) children and controls ( -@ -LSB- @ -RSB- ; P < @ ) .


ART-experienced children had higher mean fasting TC , LDL and HDL but lower TRIG compared to ART-naive children ( P-values < @ ) , and higher TC and HDL but lower TRIG compared to controls ( P-values < @ ) .


In ART-experienced children on d@T-containing regimens , we observed lower SFT and higher TC and LDL values compared to ART-naive children and HIV-uninfected controls .


The aim of this trial is to search effectiveness of specifically adapted exercise programs on its own and with low back school on pain , disability , trunk and quadriceps muscle strength , walking performance , spinal mobility , quality of life ( QOL ) , and depression in the patients with chronic low back pain ( CLBP ) .


A total of @ patients with definite CLBP were included in this study .


The patients were randomized into two groups .


Group @ ( n = @ ) was given exercises only and accepted as the control group .


Group @ ( n = @ ) received back school program and exercises .


The exercise treatment was performed @ days a week , for @ months .


The pain ( visual analog scale , VAS ) , disability ( Oswestry Disability Questionnaire , ODQ ) , walking performance ( @ minute walking test , @MWT ) , depression ( Beck Depression Inventory scores , BDI ) , and QOL ( Short Form @ , SF-@ ) of all participants were evaluated .


The trunk and knee muscle strength were measured with a handheld dynamometer .


Patients were assessed at baseline ( BT ) , at the end of treatment ( AT ) , and at the six month follow-up ( F ) .


Statistically significant improvements were found between groups regarding all of the clinical parameters over time .


Pain , disability , muscle strength , endurance , @MWT , mobility , QOL , and depression of both groups also showed improvements AT .


These improvements persisted at @-months follow-ups ( P < @ ) .


There were statistically significant differences between the groups for pain , disability , muscle strength , endurance , @MWT , QOL , and depression regarding the change scores between AT-BT test and F-BT test ( P < @ ) .


Group @ improved more than group @ except for mobility .


Exercise programs can be modified and used successfully in CLBP and this effect can be increased with addition of back school further .


Diagnostic study Level-I-I ( prospective study ) .


To evaluate the value of exhaled nitric oxide in the severity evaluation of asthmatic children with remitting rhinitis .


A total of @ asthmatic children were randomly allocated to a untreated control and a conventional treatment group .


Patients in each of the two subclasses were classified as asthma with concurrent rhinitis and asthma without concurrent rhinitis .


Values of the @ % fall in forced expiratory volume in @ second ( PC@FEV@ ) and fractional exhaled nitric oxide ( FeNO ) were measured .


The PC@FEV@ level was significantly higher in untreated asthma patients without rhinitis than in those with concurrent rhinitis ( P < @ ) , while FeNO was not significantly different between these two groups ( P > @ ) .


There were no significant differences in both FeNO and PC@FEV@ between treated asthma patients with and without concurrent rhinitis ( P > @ ) .


PC@FEV@ was significantly increased ( P < @ ) but FeNO was significantly decreased ( P < @ ) in asthma patients with concurrent rhinitis after conventional treatment .


In asthmatic children without concurrent rhinitis , treatment significantly decreased the level of FeNO ( P < @ ) but had not effect on PC@FEV@ ( P > @ ) .


Exhaled nitric oxide measurement may be useful in the severity evaluation of asthmatic children with remitting rhinitis .


Randomized , within-in participant cross-over study .


The purpose of this study was to determine the effect on comfort and pressure of lying with the shoulders and bed in different positions for people with tetraplegia .


Rehabilitation hospital .


Twenty people with tetraplegia were tested lying supine with the shoulders and bed in seven different positions .


The positions used a combination of three arm and two bed positions .


Six of the positions reflected what is commonly recommended in acute spinal cord injury units including a crucifix-type position .


The seventh position was selected by participants and reflected their preferred sleeping position .


There were five outcomes : general comfort , shoulder comfort , participant choice of preferred position , peak pressure under the shoulders and areal pressure under the shoulders .


Pressure was measured using a pressure mapping system and comfort using a visual analogue scale ( VAS ) .


The participants reported significantly higher ( P < @ ) general comfort and shoulder comfort in their self-selected position compared with all other positions .


There was no statistical difference in peak pressure ( P = @ ) or areal pressure ( P = @ ) under the shoulders between the seven positions .


Most participants indicated that they preferred to lie with their shoulders adducted and internally rotated and the hands either by their sides or on their stomachs .


The position of the shoulders has little effect on pressure but a notable effect on comfort .


Participants preferred to sleep with their arms beside their bodies , not with their arms in a crucifix position as commonly advocated .


To compare the effects of topical nonsteroidal anti-inflammatory drugs on pupil dilation maintenance during phacoemulsification cataract surgery and quantify the relationships between pupil size change and nuclear hardness .


This prospective randomized clinical observation study was single centered and double-masked .


We studied @ cases undergoing uneventful phacoemulsification cataract surgery in the absence of significant ocular comorbidity .


Cases were randomly assigned to @ of @ groups receiving the following treatments : ( @ ) diclofenac ( @ % ) ; ( @ ) pranoprofen ( @ % ) ; ( @ ) control , physiological normal saline solution ; ( @ ) diclofenac ( @ % ) and epinephrine ; ( @ ) pranoprofen ( @ % ) and epinephrine ; ( @ ) control , physiological normal saline and epinephrine solutions .


Pupil diameter was measured at @ intervals of cataract surgery : before the first incision , at the end of nucleus fragmentation , and at the end of cortex irrigation/aspiration .


Compared with patients who were not treated , there was a significant difference in maintaining pupil dilation throughout the operation when the patients were treated with either diclofenac or pranoprofen , P < @ and P < @ , respectively .


From the first incision to postnucleus fragmentation , the change in pupil size in both diclofenac and control groups was significantly associated with the hardness of the crystalline lens , P = @ and P = @ , respectively .


At the end of irrigation/aspiration , the change in pupil size in only the control groups was significantly associated with the hardness of the crystalline lens , P = @ .


Diclofenac treatment was most effective at inhibiting pupil miosis when the hardness of the nucleus was grade @ , P = @ .


Pupil miosis was not related to the hardness of the nucleus when the patients were treated with epinephrine .


Both diclofenac and pranoprofen treatment inhibit surgical-induced miosis .


There is a negative correlation between the hardness of the crystalline lens and pupil diameter maintenance at the early stage of phacoemulsification .


To assess whether the administration of symbiotic preparations in patients with multi-organ failure ( MOF ) diminishes the evolution of the failure , the inflammatory response generated , the colonization pattern and the Intensive Care Unit ( ICU ) infectious illness .


Randomized and controlled trial .


All patients with MOF were included .


Neutropenia and acute pancreatitis patients were excluded .


A symbiotic ( Simbiotic Drink ) was administered via enteral feeding during the first @ days .


Variables of interest were : Sequential Organ Failure Assessment ( SOFA ) score evolution , systemic concentrations of lactate , fibrinogen and D-dimer ; skin and mucosa colonization and infectious disease register .


Eighty-nine patients were included ; @ in the symbiotic group ( SG ) and @ in the control group ( CG ) .


There were @ % males , with a median age of @ years .


There were no significant differences in the patients ' fundamental characteristics ( medical history , age , reason for admission , severity scores ) , nor in the length of ICU stay or in mortality .


Comparing the SG with the CG , there were lower lactate levels on the second day , more fibrinogen levels on the days @ and @ , and lower D-dimer levels on the day @ .


Eight hundred and ninety-five cultures were performed for colonization assessment , with isolation of @ microorganisms .


No differences in microbiological resistance were found ; there were more colonization in the SG by Candida in mucous membranes after the third day ; this situation resolved after stopping symbiotic administration .


Twenty-two patients suffered an infectious disease in ICU , @ in SG ( @ % ) and @ in CG ( @ % ) .


Although no differences were found in the microbiological pattern , there was a predominance of Candida spp .


over other microorganisms ( @ vs. @ cases ) .


The symbiotic preparation Simbiotic Drink , administered in MOF , results in differences to improve the early lactate levels and late fibrinogen/D-dimer levels as well as mucosa colonization by Candida .


There were no differences in the ICU evolution .


Whole-grain foods have been reported to affect serum levels of inflammatory cytokines .


However , we are aware of no study examining the effect of whole-grain intake on inflammatory biomarkers among children .


The present study aimed to determine the effect of whole-grain intake on serum levels of inflammatory biomarkers in overweight or obese children .


In this randomized crossover clinical trial , @ overweight or obese girls aged @-@ years participated .


After a @-week run-in period , subjects were randomly assigned to either whole-grain or control groups .


Subjects in the whole-grain group were given a list of whole-grain foods and were asked to obtain half of their needed servings of grains from whole-grain foods each day for @ weeks .


Individuals in the control group were also given a list of whole-grain foods and were asked not to consume any of these foods during the intervention phase of the study .


A @-week washout period was applied following which subjects were crossed over to the alternate arm for an additional @ weeks .


Fasting blood samples were taken before and after each phase of the study to quantify markers of systemic inflammation .


Mean age , weight , and BMI of study participants were @ @ years , @ @ kg , and @ @ kg/m ( @ ) , respectively .


No significant effect of whole-grain intake on weight and BMI was seen compared with the control group .


We found a significant effect of whole-grain intake on serum levels of high-sensitive C-reactive protein ( -@ versus +@ % , p = @ ) , soluble intercellular adhesion molecule-@ ( -@ versus +@ % , p = @ ) , serum amyloid A ( -@ versus +@ % , p = @ ) , and leptin ( -@ versus +@ % , p = @ ) after @ weeks .


A trend toward the significant effect of whole-grain intake on serum levels of soluble vascular cell adhesion molecule-@ ( -@ % versus -@ % , p = @ ) was also observed .


This study provides evidence supporting the beneficial effects of whole-grain foods on biomarkers of systemic inflammation in obese children .


This study addresses methods for training respirator users , particularly when occupational health professionals are not immediately available .


A randomized trial compared three training methods-printed brochure , video , and computer-based training-for two respirator types ( filtering facepiece and a dual-cartridge half facemask ) .


Quantitative fit testing ( PortaCount ) measured the effectiveness of training .


The study included @ subjects .


For both respirator types , video was significantly superior to either print or computer-based training methods .


Conclusions were consistent , whether determined by average fit factor ( analysis of variance ) , log-transformed fit factors , or the number of users in the lowest quartile of achieved fit .


Video training for proper respirator use can be effective when direct training from an occupational health professional is unavailable .


These methods are particularly relevant to `` rapid rollout '' situations , such as natural disasters , epidemics , or bioterrorism concerns .


Widening socioeconomic disparities in mortality in the United States are largely explained by slower declines in tobacco use among smokers of low socioeconomic status ( SES ) than among those of higher SES , which points to the need for targeted tobacco cessation interventions .


Documentation of smoking status in electronic health records ( EHRs ) provides the tools for health systems to proactively offer tobacco treatment to socioeconomically disadvantaged smokers .


To evaluate a proactive tobacco cessation strategy that addresses sociocontextual mediators of tobacco use for low-SES smokers .


This prospective , randomized clinical trial included low-SES adult smokers who described their race and/or ethnicity as black , Hispanic , or white and received primary care at @ of @ practices in the greater Boston area ( intervention group , n = @ ; control group , n = @ ) .


We analyzed EHRs to identify potentially eligible participants and then used interactive voice response ( IVR ) techniques to reach out to them .


Consenting patients were randomized to either receive usual care from their own health care team or enter an intervention program that included ( @ ) telephone-based motivational counseling , ( @ ) free nicotine replacement therapy ( NRT ) for @ weeks , ( @ ) access to community-based referrals to address sociocontextual mediators of tobacco use , and ( @ ) integration of all these components into their normal health care through the EHR system .


Self-reported past-@-day tobacco abstinence @ months after randomization ( `` quitting '' ) , assessed by automated caller or blinded study staff .


The intervention group had a higher quit rate than the usual care group ( @ % vs @ % ; odds ratio , @ ; @ % CI , @-@ @ ; number needed to treat , @ ) .


We examined whether use of intervention components was associated with quitting among individuals in the intervention group : individuals who participated in the telephone counseling were more likely to quit than those who did not ( @ % vs @ % ; P < @ ) .


There was no difference in quitting by use of NRT .


Quitting did not differ by a request for a community referral , but individuals who used their referral were more likely to quit than those who did not ( @ % vs @ % ; P < @ ) .


Proactive , IVR-facilitated outreach enables engagement with low-SES smokers .


Providing counseling , NRT , and access to community-based resources to address sociocontextual mediators among smokers reached in this setting is effective .


Sequential therapy is one of the recent answers given to the problem of increasing antibiotic resistance and decreasing eradication rates of Helicobacter pylori infection .


The aim of this study is to compare the ornidazole-based sequentialtherapy with the standard triple therapy in Helicobacter pylori eradication .


Children aged @-@ years diagnosed with Helicobacter pylori infection based on histology and at least one of @ C urea breath test and rapid urease test positivity were included in the study .


Children were randomized to standard triple therapy with amoxicillin , clarithromycin , and lansoprazole for @ days and sequential therapy with amoxicillin and lansoprazole for the first @ days and clarithromycin , ornidazole and lansoprazole for another @ days in @:@ randomization .


At the end of the treatment , families were contacted by phone , and side effects of and the compliance to the treatment were noted .


Patients were requested to do @ C urea breath test @-@ weeks after the treatment .


Sixty-one children were included for the final analysis .


Per-protocol eradication rates were @ % for sequential therapy group and @ % for standard triple therapy group .


Intention to treat eradication rates were @ % and @ % , respectively .


There were no differences between eradication rates in the two study groups .


Side effect rates were also similar between the two groups .


Ornidazole-based sequential therapy did not show any superiority compared to the standard triple treatment in children with Helicobacter pylori infection .


The purpose of this study was to compare illness-related anxiety among participants in the Rituximab Extended Schedule or Retreatment Trial ( RESORT ) randomly assigned to maintenance rituximab ( MR ) versus rituximab re-treatment ( RR ) .


A secondary objective was to examine whether the superiority of MR versus RR on anxiety depended on illness-related coping style .


Patients ( N = @ ) completed patient-reported outcome ( PRO ) measures at random assignment to MR or RR ( baseline ) ; at @ , @ , @ , @ , @ , and @ months after random assignment ; and at rituximab failure .


PRO measures assessed illness-related anxiety and coping style , and secondary end points including general anxiety , worry and interference with emotional well-being , depression , and health-related quality of life ( HRQoL ) .


Patients were classified as using an active or avoidant illness-related coping style .


Independent sample t tests and linear mixed-effects models were used to identify treatment arm differences on PRO end points and differences based on coping style .


Illness-related anxiety was comparable between treatment arms at all time points ( P > @ ) , regardless of coping style ( active or avoidant ) .


Illness-related anxiety and general anxiety significantly decreased over time on both arms .


HRQoL scores were relatively stable and did not change significantly from baseline for both arms .


An avoidant coping style was associated with significantly higher anxiety ( @ % and @ % exceeded clinical cutoff points at baseline and @ months , respectively ) and poorer HRQoL compared with an active coping style ( P < @ ) , regardless of treatment arm assignment .


Surveillance until RR at progression was not associated with increased anxiety compared with MR , regardless of coping style .


Avoidant coping was associated with higher anxiety and poorer HRQoL .