CM decoction could effectively treat opioid-induced constipation and improve patients ' QOL at the same time .


It is safe and does n't affect the analgesic effect of opioids when treating constipation .


To compare safety and efficacy of pantoprazol , metoclopramide , ondansetron , as compared to placebo , in controlling gastrointestinal ( GI ) complaints of thyroid cancer patients treated with I-@these patients .


Four-armed , parallel group , single blind , randomized controlled clinical trial , setting : A university hospital , registration : database for clinical trials IRCT@N@ .


@ patients with differentiated thyroid cancer who received @I .


Postradioiodine nausea and vomiting within three days of therapy ( primary endpoint ) ; occurrence of adverse reaction .


The patients ' characteristics were similar within the study groups .


Among the study variables , age , sex , administered dosage , history of previous GI complaints , and history of hyperemesis gravidarum in female patients were not statistically different among the groups ( p > @ ) .


The results revealed that only ondansetron shows a therapeutic benefit over the placebo in controlling nausea ( p < @ ) ; however , it does not prevent vomiting ( p > @ ) .


The other two drugs , pantoprazole and metoclopramide , did not control nausea ( p > @ ) or vomiting ( p > @ ) .


This study may demonstrate that the therapeutic dose of ondansetron could be an effective prophylactic agent in controlling GI complaints in differential thyroid carcinoma ( DTC ) patients following RAI therapy ; however , these preliminary findings should be validated in larger studies .


To conduct a process and impact evaluation of a multifaceted education-based pilot program targeting correct use of age-appropriate restraints in a regional setting with a high proportion of Aboriginal and Torres Strait Islander families .


The program was delivered in @ in @ early learning centers where @ percent of the children were of Aboriginal and Torres Strait Islander descent .


Each component of the program was assessed for message consistency and uptake .


To measure program effectiveness , participating children were matched @:@ by age , language spoken at home , and annual household income with @ children from the control arm of a contemporaneous trial .


The outcome measure in the control and program centers ( a @-category ordinal scale of restraint use ) was compared using ordinal logistic regression accounting for age of the parent .


Process evaluation found that though program components were delivered with a consistency of message , uptake was affected by turnover of all staff at one center and by parents experiencing difficulty in paying for subsidized restraints at each of the centers .


Impact evaluation found that children from the centers receiving the program had nearly twice the odds of being in a better restraint category than children matched from the control group ( adjusted odds ratio -LSB- ORadj -RSB- = @ , @ % confidence interval -LSB- CI -RSB- , @-@ @ ) .


This was a pragmatic study reflecting the real-life issues of implementing a program in preschools where @ percent of families had a low income and turnover of staff was high .


Despite these issues , impact evaluation showed that the integrated educational program showed promise in increasing correct use of age-appropriate restraints .


The findings from this pilot study support the use of an integrated educational program that includes access to subsidized restraints to promote best practice child restraint use among communities that include a high proportion of Aboriginal and Torres Strait Islander families in New South Wales .


Future trials in similar settings should consider offering more support in centers with high turnover of staff and offering alternative methods of payment when families experience financial difficulties in purchasing the subsidized restraints .


If proven in larger trials , this approach could reduce death and injuries in child passengers in this vulnerable group .


To evaluate the anginal attack-relieving efficacy and safety of Kuanxiong Aerosol ( KA ) in patients with coronary heart disease ( CHD ) .


A total of @ patients confirmatively diagnosed as CHD angina from November @ to December @ in @ medical centers in the mainland area were assigned to @ groups by blocked randomization , the treatment group ( @ cases ) and the control group ( @ cases ) .


When the angina attacked , patients in the treatment group received sublingual spray three times , @ mL each time , while those in the control group sublingually dissolved Nitroglycerin Tablet ( NT ) , @ mg each tablet .


The effective rate of angina relief , efficacy of electrocardiogram ( ECG ) , and the incidence of adverse reactions were observed .


The @ min and @ min remission rates of angina attack were @ % ( @/@ ) and @ % ( @/@ ) in the treatment group , and @ % ( @/@ ) and @ % ( @/@ ) in the control group .


The @ % confidence interval ( CI ) of the difference between the @ groups of @ min and @ min remission rates of angina attacks were -LSB- ( -@ % , @ % ) and ( -@ % , @ % ) respectively , P > @ -RSB- .


The total improvement rates of ST-T changes in the treatment group and the control group after treatment were @ % and @ % respectively ( P > @ ) .


The adverse reaction rate was @ ( @/@ cases ) in the treatment group and @ % ( @/@ cases ) in the control group ( P < @ ) .


KA was not inferior to NT in relieving anginal attacks and improving ischemic ECG changes , and had obviously less adverse reaction .


Research directed to optimizing maternal nutrition commencing prior to conception remains very limited , despite suggestive evidence of its importance in addition to ensuring an optimal nutrition environment in the periconceptional period and throughout the first trimester of pregnancy .


This is an individually randomized controlled trial of the impact on birth length ( primary outcome ) of the time at which a maternal nutrition intervention is commenced : Arm @ : @ mo preconception vs. Arm @ : @-@ wk gestation vs. Arm @ : none @ ( derived from @ ) randomized mothers and living offspring in each arm in each of four research sites ( Guatemala , India , Pakistan , Democratic Republic of the Congo ) .


The intervention is a daily @ g lipid-based ( @ kcal ) multi-micronutient ( MMN ) supplement .


Women randomized to receive this intervention with body mass index ( BMI ) < @ or whose gestational weight gain is low will receive an additional @ kcal/d as a balanced energy-protein supplement .


Researchers will visit homes biweekly to deliver intervention and monitor compliance , pregnancy status and morbidity ; ensure prenatal and delivery care ; and promote breast feeding .


The primary outcome is birth length .


Secondary outcomes include : fetal length at @ and @ wk ; incidence of low birth weight ( LBW ) ; neonatal/infant anthropometry @-@ mo of age ; infectious disease morbidity ; maternal , fetal , newborn , and infant epigenetics ; maternal and infant nutritional status ; maternal and infant microbiome ; gut inflammatory biomarkers and bioactive and nutritive compounds in breast milk .


The primary analysis will compare birth Length-for-Age Z-score ( LAZ ) among trial arms ( independently for each site , estimated effect size : @ ) .


Additional statistical analyses will examine the secondary outcomes and a pooled analysis of data from all sites .


Positive results of this trial will support a paradigm shift in attention to nutrition of all females of child-bearing age .


The objective of the study was to evaluate objective and subjective outcomes of MiniArc and Monarc ( American Medical Systems , Minnetonka , MN ) midurethral sling ( MUS ) in women with stress incontinence at @ months .


A total of @ women were randomized to receive MiniArc or Monarc .


Women with intrinsic sphincter deficiency , previous MUS , or untreated detrusor overactivity were excluded .


Objective cure was defined as negative cough stress test with a comfortably full bladder .


Subjective cure was defined as no report of leakage with coughing or exercise on questionnaire .


Validated questionnaires , together with urodynamic and clinical cough stress test , were used to evaluate the objective and subjective outcomes following surgery .


Participants and clinicians were not masked to treatment allocation .


Outcomes were compared with exact binomial tests ( eg , Fisher exact test for dichotomous data ) for categorical data and Student t tests or exact versions of Wilcoxon tests for numerical data as appropriate .


There was no statistically significant difference in the subjective ( @ % vs @ % ; P = @ ; difference , @ % ; @ % confidence interval , -@ % to +@ % ) or objective ( @ % vs @ % ; P = @ ; difference , @ % ; @ % confidence interval , -@ % to +@ % ) cure rates between MiniArc and Monarc at @ m , respectively , with a significant improvement in overactive bladder outcomes and incontinence impact from baseline in both arms .


MiniArc outcomes are not inferior to Monarc MUS outcomes at @ months ' follow-up in women without intrinsic sphincter deficiency .


Examine the efficacy of a parent-augmented One-Session Treatment ( A-OST ) in treating specific phobias ( SP ) in youth by comparing this novel treatment to child-focused OST , a well-established treatment .


A total of @ youth ( ages @-@ , @ % female , @ % White ) who fulfilled diagnostic criteria for SP were randomized to either A-OST or OST .


SPs were assessed with semistructured diagnostic interviews , clinician improvement ratings , and parent and child improvement ratings .


In addition , measures of treatment satisfaction and parental self-efficacy were obtained .


Blind assessments were completed pretreatment , posttreatment , and @month and @months following treatment .


Analyses were undertaken using mixed models .


In addition , gender , age , internalizing/externalizing problems , parent overprotection , and parent anxiety were examined as potential predictors and moderators of treatment outcome .


Both treatment conditions produced similar outcomes with approximately @ % of youth in both treatments diagnosis free and judged to be much or very much improved at posttreatment and @-month follow-up .


At @-month follow-up , however , the treatments diverged with OST resulting in marginally superior outcomes to A-OST , contrary to predictions .


Only age of child predicted treatment outcome across the two treatments ( older children did better ) ; unexpectedly , none of the variables moderated treatment outcomes .


Parent augmentation of OST produced no appreciable gains in treatment outcomes .


Directions for future research are highlighted .


In northern Vietnam the Neonatal health - Knowledge Into Practice ( NeoKIP , Current Controlled Trials ISRCTN@ ) trial has evaluated facilitation as a knowledge translation intervention to improve neonatal survival .


The results demonstrated that intervention sites , each having an assigned group including local stakeholders supported by a facilitator , lowered the neonatal mortality rate by @ % during the last intervention year compared with control sites .


This process evaluation was conducted to identify and describe mechanisms of the NeoKIP intervention based on experiences of facilitators and intervention group members .


Four focus group discussions ( FGDs ) were conducted with all facilitators at different occasions and @ FGDs with @ intervention groups at @ occasions .


Fifteen FGDs were audio recorded , transcribed verbatim , translated into English , and analysed using thematic analysis .


Four themes and @ sub-themes emerged from the @ FGDs with facilitators , and @ themes and @ sub-themes were identified from the @ FGDs with the intervention groups mirroring the process of , and the barriers to , the intervention .


Facilitators and intervention group members concurred that having groups representing various organisations was beneficial .


Facilitators were considered important in assembling the groups .


The facilitators functioned best if coming from the same geographical area as the groups and if they were able to come to terms with the chair of the groups .


However , the facilitators ' lack of health knowledge was regarded as a deficit for assisting the groups ' assignments .


FGD participants experienced the NeoKIP intervention to have impact on the knowledge and behaviour of both intervention group members and the general public , however , they found that the intervention was a slow and time-consuming process .


Perceived facilitation barriers were lack of money , inadequate support , and the function of the intervention groups .


This qualitative process evaluation contributes to explain the improved neonatal survival and why this occurred after a latent period in the NeoKIP project .


The used knowledge translation intervention , where facilitators supported multi-stakeholder coalitions with the mandate to impact upon attitudes and behaviour in the communes , has low costs and potential for being scaled-up within existing healthcare systems .


To compare normal saline ( NS ) vs. NS + budesonide irrigations in post - functional endoscopic sinus surgery ( FESS ) patients with chronic rhinosinusitis with polyposis ( CRSwNP ) .


Currently , no evidence exists for NS + budesonide irrigation over NS irrigation alone .


Prospective , single-blind , randomized controlled trial .


Subjects were prospectively enrolled to NS or NS + budesonide arms .


Patients were evaluated at pre-operative and three post-operative visits ( POV ) : POV@ ( @-@ weeks post-op ) , POV@ ( @-@ weeks post-op ) , and POV@ ( @-@ months post-op ) .


Patients were evaluated by three quality of life ( QOL ) questionnaires ( SNOT-@ , RSOM-@ , and RSDI ) and two olfaction scores ( UPSIT and the PEA test ) .


Fifty patients were randomized , with @ patients in the NS arm and @ patients in the NS + budesonide arm .


Two patients had unexpected pathology and were excluded from the study .


By POV@ and POV@ , patients experienced a significant improvement in all three QOL surveys , although the degree of improvement between arms was not significant up through POV@ .


Neither arm experienced significant olfactory improvement up through POV@ .


While both NS and NS + budesonide treatments improve QOL for post-FESS patients , neither intervention significantly increases QOL as compared to the other .


Olfaction was not significantly improved in either treatment group .


The aim of this study was to evaluate the effectiveness of Quetiapine versus Risperidone in control of acute psychotic signs and symptoms in hospitalized patients during four weeks .


In this double-blind , randomized controlled study , a total of @ patients with a confirmed diagnosis acute psychosis and were hospitalized in Zare Hospital , Sari , Iran , and they were treated with Quetiapine ( mean @ mg/day ) or Risperidone ( mean @ mg/day ) , in a @ week period .


The positive and negative symptoms scale ( PANSS ) and Clinical Global Impression-Severity scale ( CGI-s ) were used to assess psychotic symptoms and severity of illness in first and the last day of the study .


No significant difference found between two groups in decreasing positive and negative sub-scores in the PANSS .


Risperidone was superior to Quetiapine in decreasing the PANSS general psychopathology sub-scores and total score ( p < @ ) .


No significant difference found between two groups in decreasing CGI-s score .


This study aimed to investigate the feasibility and effects of intramuscular injections of autologous bone marrow cells ( BMC ) combined with off-pump coronary artery bypass grafts ( OPCAB ) on improving cardiac function in chronic myocardial infarction patients .


Ninety patients with chronic myocardial infarction were prospectively enrolled and randomized to an OPCAB with saline or an OPCAB with BMC-treatment group .


After finishing CABG , patients received injections of BMC or saline into the marginal area of the infarct .


The primary endpoint was incidence of emergent adverse events within @ months .


There were no differences between the control and BMC-treated groups in baseline ejection fractions ( EF ) or wall motion score indices ( WMSI ) in the affected segments .


At the @-month follow-up , the ejection fraction was significantly increased in the BMC-treated group compared to controls ( @ @ vs. @ @ ; p < @ ) , whereas the WMSI were significantly decreased ( @ @ vs. @ @ ; p < @ ) , with no occurrences of life-threatening arrhythmias or death .


The addition of BMC injections to OPCAB treatment increased regional perfusion to the marginal infarct area .


These results demonstrate that BMC transplant is beneficial to the cardiac function with no adverse effects , and therefore a safe and feasible adjunct therapy providing beneficial effects in clinical practice .


To evaluate the influence of topographic profiles ( i.e. , inner directional angle and angular width ) of localized retinal nerve fiber layer ( RNFL ) defects on the diagnostic performance of macular ganglion cell-inner plexiform layer ( GCIPL ) thickness in discriminating preperimetric glaucoma ( PPG ) eyes from normal control eyes .


The ganglion cell analysis algorithm in Cirrus OCT was performed to determine the macular GCIPL thickness .


Areas under the receiver operating characteristic curves ( AUROCs ) and the sensitivities/specificities based on an internal normative database were evaluated .


The effect of the inner directional angle and the angular width of localized RNFL defects on the diagnostic performance of macular GCIPL parameters were evaluated by using linear-by-linear association analysis and logistic regression analysis .


Ninety-two patients with PPG and @ age-matched healthy control subjects were enrolled in this study .


The AUROC of the best parameters in macular GCIPL was @ ( inferotemporal sector ) , which showed no significant difference in comparison to the best parameters of peripapillary RNFL ( @ o'clock sector , @ ) and optic nerve head ( rim area , @ ) ( for all comparisons , P > @ ) .


A significant linear association was observed between the inner directional angle of RNFL defects and the sensitivity of macular GCIPL parameters for detecting RNFL defects .


The angular width of RNFL defects was not significantly associated with the sensitivity of macular GCIPL parameters .


The diagnostic ability of macular GCIPL parameters was comparable to that of peripapillary RNFL and ONH parameters in PPG .


The inner directional angle of RNFL defects , but not the angular width , affects the diagnostic sensitivity of macular GCIPL parameters .


To evaluate the effectiveness of group education , led by health promoters using a guiding style , for people with type @ diabetes in public sector community health centres in Cape Town .


This was a pragmatic clustered randomized controlled trial with @ randomly selected intervention and @ control sites .


A total of @ patients with type @ diabetes , regardless of therapy used , were recruited from the control sites and @ were recruited from the intervention sites .


The control sites offered usual care , while the intervention sites offered a total of four monthly sessions of group diabetes education led by a health promoter .


Participants were measured at baseline and @ months later .


Primary outcomes were diabetes self-care activities , @ % weight loss and a @ % reduction in HbA ( @c ) levels .


Secondary outcomes were self-efficacy , locus of control , mean blood pressure , mean weight loss , mean waist circumference , mean HbA@c and mean total cholesterol levels and quality of life .


A total of @ ( @ % ) participants in the intervention group did not attend any education sessions .


No significant improvement was found in any of the primary or secondary outcomes , apart from a significant reduction in mean systolic ( -@ mmHg , @ % CI @ to -@ ; P = @ ) and diastolic blood pressure ( -@ mmHg , @ % CI -@ to -@ ; P = @ ) .


Process evaluation suggested that there were problems with finding suitable space for group education in these under-resourced settings , with patient attendance and with full adoption of a guiding style by the health promoters .


The reported effectiveness of group diabetes education offered by more highly trained professionals , in well-resourced settings , was not replicated in the present study , although the reduction in participants ' mean blood pressure is likely to be of clinical significance .


In the EXIST-@ trial , initiated on Aug @ , @ , more than @ % of patients with subependymal giant cell astrocytoma ( SEGA ) associated with tuberous sclerosis complex had at least @ % reduction in SEGA volume after @ months of treatment with everolimus .


In this Article , we report interim data ( up to Jan @ , @ ) to support longer-term tolerability and efficacy of everolimus from the continuing @-year extension phase of EXIST-@ .


We assessed data from a prospective , open-label extension of a multicentre , phase @ , randomised , double-blind , placebo-controlled study in patients with tuberous sclerosis complex who had SEGA that was growing and needed treatment .


In this extension study , we included all patients who had been assigned everolimus during the double-blind , randomised phase of the trial and those patients who crossed over from the placebo group to receive everolimus during the randomised phase or at the start of the extension phase .


All patients received oral everolimus at a starting dose of @ mg/m ( @ ) per day .


Everolimus dose was subsequently adjusted subject to tolerability to attain blood trough concentrations of @-@ ng/mL .


An independent central radiology review team assessed SEGA response ( at least a @ % reduction from baseline in total volume of all target SEGAs ; the primary endpoint ) by MRI at @ , @ , and @ weeks , then every year thereafter in all patients who received at least one dose of everolimus .


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


Of the original @ randomly assigned patients , @ were given everolimus between Aug @ , @ , and Jan @ , @ ( date of data cutoff ) ; we included these patients in our longer-term analysis .


Median duration of everolimus exposure was @ months ( IQR @-@ ) .


Median follow-up was @ months ( IQR @-@ ) .


@ ( @ % ) patients had a response of @ % or greater reduction in SEGA volume ( @ % CI @-@ ) , and duration of response was between @ and @ months ( median not reached ) .


SEGA volume was reduced by @ % or more in @ ( @ % ) of @ patients at @ weeks , @ ( @ % ) of @ patients at @ weeks , @ ( @ % ) of @ patients at @ weeks , and @ ( @ % ) of @ patients at @ weeks .


Stomatitis ( @ -LSB- @ % -RSB- patients ) and mouth ulceration ( @ -LSB- @ % -RSB- patients ) were the most frequent treatment-related adverse events ; infections were the most commonly reported treatment-related serious adverse event , occurring in @ ( @ % ) patients .


@ ( @ % ) patients reported treatment-related grade @ or @ adverse events , the most common of which were stomatitis ( nine -LSB- @ % -RSB- ) and pneumonia ( nine -LSB- @ % -RSB- ) .


@ ( @ % ) patients had treatment-related serious adverse events .


Six ( @ % ) patients withdrew because of adverse events .


These results support the longer-term use of everolimus in patients who have few treatment options and who need continued treatment for tuberous sclerosis complex and its varied manifestations .


Reduction or stabilisation of tumour volume with everolimus will hopefully provide long-term clinical benefit in patients with SEGA .


Noncontrast computed tomography ( NCCT ) has high sensitivity , specificity , and is able to predict stone composition using Hounsfield units ( HU ) but is associated with high radiation exposure .


In an attempt to reduce radiation exposure , low-dose stone protocols have been developed that provide excellent detection of stones .


It is not known , however , whether these protocols are equally effective in determining HU stone density .


The purpose of this study is to compare stone HU attenuation between low - and conventional-dose NCCT .


In this prospective randomized , single blinded study , @-mm calcium oxalate stones were placed randomly into nine intact urinary systems and scanned in three different cadaveric vehicles .


Holding other parameters constant , NCCT was performed at varying mAs levels ranging from @ to @ .


Identical magnified images at each mAs setting were reviewed in a blinded fashion to determine HU attenuation .


Statistical analyses were performed using a Kruskal-Wallis test and the Levene test , with P < @ considered significant .


In @ different stone configurations with @ stones , median attenuation levels were @ , @ , @ , @ , @ , @ , and @ HU at @ , @ , @ , @ , @ , @ , and @ mAs , respectively .


The differences in median attenuation levels were not significantly different ( P = @ ) .


An increasing trend of attenuation variability was noticed as the radiation dose decreased ; however , this was not significant ( P = @ ) .


Low-dose NCCT results in similar HU attenuation compared with conventional-dose NCCT .


Although there is a slight increase in variability , low-dose NCCT provides similar information to assist in determining stone composition as conventional-dose NCCT .


Rapid eye movement ( REM ) sleep is considered critical to the consolidation of procedural memory - the memory of skills and habits .


Many antidepressants strongly suppress REM sleep , however , and procedural memory consolidation has been shown to be impaired in depressed patients on antidepressant therapy .


As a result , it is important to determine whether antidepressive therapy can lead to amnestic impairment .


We thus investigated the effects of the anticholinergic antidepressant amitriptyline on sleep-dependent memory consolidation .


Double-blind , placebo-controlled , randomized , parallel-group study .


Sleep laboratory .


Twenty-five healthy men ( mean age : @ @ y ) .


@ mg amitriptyline versus placebo .


To test memory consolidation , a visual discrimination task , a finger-tapping task , the Rey-Osterrieth Complex Figure Test , and the Rey Auditory-Verbal Learning Test were performed .


Sleep was measured using polysomnography .


Our findings show that amitriptyline profoundly suppressed REM sleep and impaired perceptual skill learning , but not motor skill or declarative learning .


Our study is the first to demonstrate that an antidepressant can affect procedural memory consolidation in healthy subjects .


Moreover , considering the results of a recent study , in which selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors were shown not to impair procedural memory consolidation , our findings suggest that procedural memory consolidation is not facilitated by the characteristics of REM sleep captured by visual sleep scoring , but rather by the high cholinergic tone associated with REM sleep .


Our study contributes to the understanding of potentially undesirable behavioral effects of amitriptyline .


Risk factors for first stroke are well established , but less is known about risk factors for recurrent stroke .


In the present analysis , we aimed to assess the effect of heart rate and other possible predictors of stroke in a hypertensive population with previous stroke or transient ischemic attack ( TIA ) .


The Valsartan Antihypertensive Long-Term Use Evaluation trial was a multicentre , double-masked , randomized controlled , parallel group trial comparing the effects of an angiotensin receptor blocker ( valsartan ) and a calcium channel blocker ( amlodipine ) in patients with hypertension and high cardiovascular risk .


We used Cox proportional hazard models to investigate the effect of baseline variables on the risk of stroke .


Quadratic terms of the continuous variables were entered in the models to test for linearity .


Of @,@ patients included in the trial , @ had a previous stroke or TIA at baseline and were included in the present analysis .


Stroke recurrence occurred in @ patients ( @ % ) during a median of @ years of follow-up .


Resting heart rate ( per @ beats per minute ; hazard ratio -LSB- HR -RSB- , @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ) and diabetes mellitus at baseline ( HR , @ ; @ % CI , @-@ @ ) were significantly associated with an increased risk of stroke recurrence in the multivariable analysis .


In high-risk , hypertensive patients with previous stroke or TIA , resting heart rate was the strongest predictor of recurrent stroke .


Arthrocentesis ( AC ) is an acceptable treatment modality in the treatment of internal derangement ( ID ) pain .


This study evaluated outcomes of AC on pain relief of ID pain with or without corticosteroids .


This single-blind clinical trial was conducted on @ patients with ID pain who were randomly assigned to @ groups ( @ in each group ) for AC .


The AC of the upper joint space was then performed by using Ringer lactate under local anesthesia in both groups .


In the second group , the procedure was followed by the administration of a single-dose intra-articular dexamethasone ( @ mg ) .


Assessments were made at baseline ( T@ ) , @ month ( T@ ) , and @ months ( T@ ) after AC ; pain , maximum mouth opening , and joint sounds before and after treatment up to @ months were evaluated .


Pain severity was documented according to Visual Analogue Scale .


Age , sex , and skeletal maxillomandibular relationship were considered as variable factors , and irrigation with or without corticosteroids was a predictive factor of the study .


Pain , click , and maximum mouth opening were other assessment outcomes of the study .


Comparison of age , sex , and skeletal relationship did not show any significant differences between the @ groups .


Results did not demonstrate any difference for click between the @ groups .


Comparison of pain severity in T@ , T@ , and T@ between the @ groups did not show any significant differences ( P < @ ) .


The repeat measure test revealed a significant change in T@ , T@ , and T@ for both groups ( P < @ ) .


MMO significantly changed between T@ and T@ and T@ and T@ in the @ groups without any significant differences between them .


The AC is an effective procedure for a short-term reduction of pain in temporomandibular disorder cases .


It seems that AC using Ringer solution with or without corticosteroids may have the same effect on pain relief .


Cytogenetically normal ( CN ) acute myeloid leukemia ( AML ) is the largest and most heterogeneous cytogenetic AML subgroup .


For the practicing clinician , it is difficult to summarize the prognostic information of the growing number of clinical and molecular markers .


Our purpose was to develop a widely applicable prognostic model by combining well-established pretreatment patient and disease characteristics .


Two prognostic indices for CN-AML ( PINA ) , one regarding overall survival ( OS ; PINAOS ) and the other regarding relapse-free survival ( RFS ; PINARFS ) , were derived from data of @ patients with CN-AML treated within the AML Cooperative Group @ study ( www.aml-score.org ) .


On the basis of age ( median , @ years ; range , @ to @ years ) , performance status , WBC count , and mutation status of NPM@ , CEBPA , and FLT@-internal tandem duplication , patients were classified into the following three risk groups according to PINAOS and PINARFS : @ % of all patients and @ % of @ responding patients had low-risk disease ( @-year OS , @ % ; @-year RFS , @ % ) ; @ % of all patients and @ % of responding patients had intermediate-risk disease ( @-year OS , @ % ; @-year RFS , @ % ) , and @ % of all patients and @ % of responding patients had high-risk disease ( @-year OS , @ % ; @-year RFS , @ % ) , respectively .


PINAOS and PINARFS stratified outcome within European LeukemiaNet genetic groups .


Both indices were confirmed on independent data from Cancer and Leukemia Group B/Alliance trials .


We have developed and validated , to our knowledge , the first prognostic indices specifically designed for adult patients of all ages with CN-AML that combine well-established molecular and clinical variables and that are easily applicable in routine clinical care .


The integration of both clinical and molecular markers could provide a basis for individualized patient care through risk-adapted therapy of CN-AML .


Postoperative apnea is a complication in young infants .


Awake regional anesthesia ( RA ) may reduce the risk ; however , the evidence is weak .


The General Anesthesia compared to Spinal anesthesia study is a randomized , controlled trial designed to assess the influence of general anesthesia ( GA ) on neurodevelopment .


A secondary aim is to compare rates of apnea after anesthesia .


Infants aged @ weeks or younger , postmenstrual age scheduled for inguinal herniorrhaphy , were randomized to RA or GA. .


Exclusion criteria included risk factors for adverse neurodevelopmental outcome and infants born less than @ weeks gestation .


The primary outcome of this analysis was any observed apnea up to @ h postoperatively .


Apnea assessment was unblinded .


Three hundred sixty-three patients were assigned to RA and @ to GA. .


Overall , the incidence of apnea ( @ to @ h ) was similar between arms ( @ % in RA and @ % in GA arms ; odds ratio -LSB- OR -RSB- , @ ; @ % CI , @ to @ , P = @ ) ; however , the incidence of early apnea ( @ to @ min ) was lower in the RA arm ( @ vs. @ % ; OR , @ ; @ % CI , @ to @ ; P = @ ) .


The incidence of late apnea ( @ min to @ h ) was @ % in both RA and GA arms ( OR , @ ; @ % CI , @ to @ ; P = @ ) .


The strongest predictor of apnea was prematurity ( OR , @ ; @ % CI , @ to @ ) , and @ % of infants with apnea were premature .


RA in infants undergoing inguinal herniorrhaphy reduces apnea in the early postoperative period .


Cardiorespiratory monitoring should be used for all ex-premature infants .


This randomized clinical trial compared endovenous laser ablation ( EVLA ) and surgical ligation with attempted stripping in the treatment of small saphenous vein ( SSV ) insufficiency .


The early results demonstrated that EVLA was more likely to eradicate axial reflux and was also associated with a faster recovery , lower periprocedural pain , and fewer sensory complications .


The aim of this @-year follow-up was to establish whether these benefits remained stable over time and whether these improved technical outcomes were associated with less clinical recurrence .


Patients with primary saphenopopliteal junction and SSV reflux were randomized to EVLA or saphenopopliteal junction ligation and attempted stripping/excision .


Outcomes assessed at @ years included the presence of residual or recurrent reflux , clinical recurrence , sensory complications , the need for secondary intervention , and patient-reported quality of life on the Aberdeen Varicose Veins Questionnaire , SF-@ , and EuroQol .


Of @ patients who were equally randomized and successfully treated according to the protocol , @ ( @ % ) were successfully assessed at @ years .


The groups were comparable at baseline .


At @ years , EVLA remained superior to surgery in eradicating axial reflux in @ patients ( @ % ) compared with @ ( @ % ) in the surgery group ( P = @ ) .


There was no significant difference in clinical recurrence ( EVLA : seven of @ -LSB- @ % -RSB- vs surgery : @ of @ -LSB- @ % -RSB- ; P = @ ) , sensory disturbance ( EVLA : one -LSB- @ % -RSB- vs surgery vs three -LSB- @ % -RSB- ; P = @ ) or any quality of life domain .


The results of treatment of SSV insufficiency with EVLA appear durable up until @ years .


The study does not appear to suggest that the improved abolition of reflux after EVLA compared with surgery is associated with superior outcomes than those seen after surgery by this time point , because equal effect was shown in both groups .


The sensory disturbance associated with surgery appears to settle over this time frame .


EVLA is therefore superior in the short-term and not inferior by @ years .


Neutralizing antibodies in breast milk may adversely influence the immune response to live oral vaccines .


Withholding breastfeeding around the time of vaccine administration has been suggested for improving vaccine performance .


However , we do not know whether mothers find withholding breastfeeding around the time of vaccination acceptable and how they perceive this recommendation .


In a clinical study designed to examine predictors of poor immune response to rotavirus vaccine in infants in India , Rotarix was administered to infants at @ and @ weeks with other childhood vaccines .


For the study , @ mother-infant pairs were randomized into two groups in a @:@ ratio .


Mothers were either recommended to withhold breastfeeding or were encouraged to breastfeed half an hour before and after administration of Rotarix .


The mother-infant pairs were observed and the breastfeeding intervals were recorded during this period .


Mothers were administered a questionnaire about their perception of the intervention after the infants received the second dose of Rotarix .


Almost @ % ( @/@ ) of the infants received both doses of Rotarix .


Adherence to the recommendations was high in both groups .


All mothers in the group who were asked to withhold breastfeeding did so , except one who breastfed her infant before the recommended time after the first dose of Rotarix .


Of the mothers , @ % ( @/@ ) reported that the recommendation to withhold breastfeeding was difficult to follow .


All mothers in this group reported that they would withhold breastfeeding at the time of vaccination if they were asked to by a health-care provider .


Only one mother responded that withholding breastfeeding would be a reason for not giving rotavirus vaccine to her infant .


Withholding breastfeeding half an hour before and after vaccination appears to be acceptable to mothers in this setting .


If withholding breastfeeding produces an improvement in the performance of the vaccine , it could be used to increase the public health impact of rotavirus immunization .


The aim of the study was to determine whether individualized coaching improved surgical technical skill in the operating room to a higher degree than current residency training .


Clinical training in the operating room is a valuable opportunity for surgeons to acquire skill and knowledge ; however , it often remains underutilized .


Coaching has been successfully used in various industries to enhance performance , but its role in surgery has been insufficiently investigated .


This randomized controlled trial was conducted at one surgical training program .


Trainees undergoing a minimally invasive surgery rotation were randomized to either conventional training ( CT ) or comprehensive surgical coaching ( CSC ) .


CT included ward and operating room duties , and regular departmental teaching sessions .


CSC comprised performance analysis , debriefing , feedback , and behavior modeling .


Primary outcome measures were technical performance as measured on global and procedure-specific rating scales , and surgical safety parameters , measured by error count .


Operative performance was assessed by blinded video analysis of the first and last cases recorded by the participants during their rotation .


Twenty residents were randomized and @ completed the study .


At posttraining the CSC group ( n = @ ) scored significantly higher on a procedure-specific skill scale compared with the CT group ( n = @ ) -LSB- median , @ ( interquartile range , @-@ @ ) vs @ ( @-@ @ ) , P = @ -RSB- , and made fewer technical errors -LSB- @ ( @-@ ) vs @ ( @-@ ) , P = @ -RSB- .


Significant within-group improvements for all skill metrics were only noted in the CSC group .


Comprehensive surgical coaching enhances surgical training and results in skill acquisition superior to conventional training .


To compare and contrast three different training modalities for fit testing N-@ respirator face masks .


Block randomized interventional study .


Urban university .


Two hundred eighty-nine medical students .


Students were randomly assigned to video , lecture , or slide show to evaluate the effectiveness of the methods for fit testing large groups of people .


Ease of fit and success of fit for each instructional technique .


Mask @ was a Kimberly-Clark duckbill N-@ respirator mask , and mask @ was a @M carpenters N-@ respirator mask .


`` Ease of fit '' was defined as the ability to successfully don a mask in less than @ seconds .


`` Success of fit '' was defined as the ability to correctly don a mask in one try .


There were no statistical differences by training modality for either mask regarding ease of fit or success of fit .


There were no differences among video presentation , small group demonstration , and self-directed slide show just-in-time training modalities for ease of fit or success of fit N-@ respirator mask fitting .


Further study is needed to explore more effective fit training modalities .


In TRITON-TIMI @ , patients with acute coronary syndromes were treated with prasugrel or clopidogrel , with aspirin , for a median of @ ( maximum of @ ) months .


Based on this trial , the EU label for prasugrel recommends treatment for up to @ months and excludes patients with prior stroke/transient ischemic attack ( TIA ) .


Furthermore , the EU label recommends the @mg maintenance dose ( MD ) for patients with body weight @kg and age < @ years .


A lower MD of @mg is recommended for those with body weight < @kg ; although generally not recommended , @mg can be prescribed to patients @ years after individual risk-benefit evaluation .


This paper presents the one-year outcome data for this ' @mg indicated cohort ' .


From the overall cohort of @,@ patients in TRITON-TIMI @ , @,@ fulfilled inclusion criteria for the @mg indicated cohort , of whom @ % had a history of diabetes , @ % an index diagnosis of unstable angina/non-ST-segment - elevation myocardial infarction ( UA/NSTEMI ) , and @ % an index diagnosis of ST-segment-elevation myocardial infarction ( STEMI ) .


In this cohort at @ months , those given prasugrel experienced significantly fewer ischemic events ( cardiovascular death , non-fatal myocardial infarction , or non-fatal stroke , @ % vs @ % , hazard ratio ( HR ) = @ , p < @ , than those given clopidogrel , with a non-significant increase in non-coronary artery bypass graft ( CABG ) TIMI major bleeding , @ % vs @ % , HR = @ , p = @ ; similarly , in the overall cohort these frequencies were @ % vs @ % , HR = @ , p < @ , for cardiovascular death , non-fatal myocardial infarction , or non-fatal stroke , and @ % vs @ % , HR = @ , p = @ , for non-CABG TIMI major bleeding .


There was a significant reduction in stent thrombosis in the prasugrel group , with similar mortality rates and no excess of strokes .


Treatment with prasugrel according to EU label recommendations results in a significant @ % and @ % relative risk reduction ( absolute risk reductions of @ % and @ % ) in ischemic events and stent thromboses respectively compared with clopidogrel , with a @ % relative risk increase ( absolute risk increase of @ % ) for major bleeds ( p = @ ) , and no excess of strokes .


Although restricted to @ days of follow-up , this analysis encapsulates @ of @ ( @ % ) of all primary endpoint events and @ of @ ( @ % ) of all first non-CABG TIMI major bleeds reported in the pivotal manuscript .


Furthermore , the @mg indicated cohort was not a pre-specified subgroup in the study protocol , but due to European labeling restrictions , results for all outcomes in this cohort are presented through @ months .


The aim of this study was to evaluate the usefulness of the APACHE II ( Acute Physiology and Chronic Health Evaluation II ) , SAPS II ( Simplified Acute Physiology Score II ) and SOFA ( Sequential Organ Failure Assessment ) scores compared to simpler models based on age and Glasgow Coma Scale ( GCS ) in predicting long-term outcome of patients with moderate-to-severe traumatic brain injury ( TBI ) treated in the intensive care unit ( ICU ) .


A national ICU database was screened for eligible TBI patients ( age over @ years , GCS @-@ ) admitted in @-@ .


Logistic regression was used for customization of APACHE II , SAPS II and SOFA score-based models for six-month mortality prediction .


These models were compared to an adjusted SOFA-based model ( including age ) and a reference model ( age and GCS ) .


Internal validation was performed by a randomized split-sample technique .


Prognostic performance was determined by assessing discrimination , calibration and precision .


In total , @,@ patients were included .


The overall six-month mortality was @ % .


The APACHE II and SAPS II-based models showed good discrimination ( area under the curve ( AUC ) @ , @ % confidence interval ( CI ) @ to @ ; and @ , @ % CI @ to @ , respectively ) , calibration ( P > @ ) and precision ( Brier score @ to @ ) .


The SOFA-based model showed poor discrimination ( AUC @ , @ % CI @ to @ ) and precision ( Brier score @ ) but good calibration ( P > @ ) .


The AUC of the SOFA-based model was significantly improved after the insertion of age and GCS ( AUC +@ , P < @ ) .


The performance of the reference model was comparable to the APACHE II and SAPS II in terms of discrimination ( AUC @ ; compared to APACHE II , AUC -@ , P = @ ; compared to SAPS II , AUC -@ , P = @ ) , calibration ( P > @ ) and precision ( Brier score @ ) .


A simple prognostic model , based only on age and GCS , displayed a fairly good prognostic performance in predicting six-month mortality of ICU-treated patients with TBI .


The use of the more complex scoring systems APACHE II , SAPS II and SOFA added little to the prognostic performance .


Pomaglumetad methionil ( LY@ monohydrate ) is a potent and highly selective agonist for the metabotropic glutamate mGluR@ and mGluR@ receptors .


We present results of a pivotal clinical study H@Y-MC-HBBM assessing the efficacy of LY@ in improving symptoms as a monotherapy in patients with an acute exacerbation of schizophrenia .


Enrolled adult patients ( ages @-@ ) with schizophrenia who had experienced an exacerbation of symptoms within @ weeks prior to study entry .


Patients ( N = @ ) were randomized @:@:@:@ to treatment with placebo , LY@ mg twice daily ( BID ) , LY@ mg BID , or risperidone ( RIS ) @ mg BID for @ weeks after a one-week blinded placebo lead-in .


The primary outcome assessed change from baseline in the Positive and Negative Syndrome Scale ( PANSS ) total score in an overall schizophrenia population and a predefined subpopulation which excluded non-Hispanic white patients with the A/A genotype at the HTR@A SNP rs@ .


Neither LY@ dose showed significant improvement compared to placebo on PANSS total in either population ( @-sided p-value -LSB- significance level -RSB- , overall : LY@ , p = @ -LSB- @ -RSB- ; LY@ , p = @ -LSB- @ -RSB- , subpopulation : LY@ , p = @ -LSB- @ -RSB- ; LY@ , p = @ -LSB- @ -RSB- , MMRM analysis ) .


RIS statistically separated from placebo in both populations ( p < @ -LSB- @ -RSB- ) .


There were no statistically significant differences in the incidence of serious adverse events , and no seizures on LY@ .


LY@ treatment did not demonstrate efficacy in populations studied .


Overall , LY@ treatment was generally well tolerated with no new adverse safety findings compared to previous trials .


Further understanding of the role of glutamate as a therapeutic target in schizophrenia is needed .


The aim of the present study was to investigate the effects of mindfulness-based cognitive therapy ( MBCT ) on suicidal ideation in an open-label randomised controlled trial of patients with residual depressive symptoms .


Furthermore , this study aimed at examining whether an effect of MBCT on suicidal ideation was dependent on a reduction in depression severity , worry and rumination , or an increase in mindfulness .


One hundred and thirty participants were randomised to a treatment arm ( treatment as usual plus MBCT ) or a wait list arm .


Change in depression , change in worry , change in rumination and change in mindfulness were entered as covariates in a repeated measures ANOVA in order to assess to what degree MBCT-induced changes in suicidal ideation were independent from changes in these parameters .


There was a significant grouptime ( pre vs. post ) interaction on suicidal ideation indicating a significant reduction of suicidal ideation in the MBCT group , but not in the control group .


The interaction remained significant after addition of the above covariates .


Change in worry was the only covariate associated with change in suicidal ideation , causing a moderate reduction in the interaction effect size .


The results suggest that MBCT may affect suicidal ideation in patients with residual depressive symptoms and that this effect may be mediated , in part , by participants ' enhanced capacity to distance themselves from worrying thoughts .


The aim of this study was to show the preliminary outcomes of transplantation in patients treated with the generic formulation of mycophenolate mofetil ( Myfenax , Teva ) .


Over the past @ years , @ patients received generic mycophenolate mofetil ( Myfenax ) after renal transplantation at the Gdansk Transplantology Center .


During the same time period , another @ kidney transplantations were performed in our department , and these patients were treated with other formulations of mycophenolate ( CellCept -LSB- Roche -RSB- , Myfortic , or mycophenolate mofetil-Apotex ) as a part of the immunosuppressive plan .


Thirty of the Myfenax patients received a pair of kidneys from the same donor and received original mycophenolate mofetil CellCept with observation for at least @ months .


The outcomes of the renal transplantations in both groups ( Myfenax vs pair ) were good , with satisfactory function of grafts .


One case of graft loss was reported in the Myfenax group ( renal vein thrombosis , graftectomy @ days after transplantation ) .


There was no difference in the incidence of acute renal graft rejection in either group .


Moderate adverse reactions to immunosuppression were observed in both groups .


On the other hand , a comparison between the @ patients with Myfenax and the @ other patients with other formulations of mycophenolate revealed no differences in the incidence of acute renal graft rejection , delayed graft function , graft loss , and death .


There were no differences in the incidence of acute renal graft rejection , delayed graft function , graft loss , and death in patients with Myfenax vs original CellCept and other formulations of mycophenolate .


To confirm its complete biological and pharmacokinetic equivalence with the reference medicine , long-term , randomized observations carried out on larger renal transplant patients groups are needed .


To determine whether children with calcium-deficiency rickets have a better response to treatment with vitamin D and calcium than with calcium alone .


Randomised controlled trial .


Jos University Teaching Hospital , Jos , Nigeria .


Nigerian children with active rickets treated with calcium carbonate as limestone ( approximately @ mg elemental calcium twice daily ) were , in addition , randomised to receive either oral vitamin D@ @,@ IU ( Ca + D , n = @ ) or placebo ( Ca , n = @ ) monthly for @weeks .


Achievement of a @-point radiographic severity score @ and serum alkaline phosphatase @U/L .


The median ( range ) age of enrolled children was @ ( @-@ ) months , and baseline characteristics were similar in the two groups .


Mean ( SD ) @-hydroxyvitamin D ( @ ( OH ) D ) was @ nmol/L at baseline , and @ ( @ % ) had values < @nmol/L .


Baseline alkaline phosphatase and radiographic scores were unrelated to vitamin D status .


Of the @ children ( @ % of original cohort ) who completed @weeks of treatment , @ ( @ % ) in the Ca + D group and @ ( @ % ) in the Ca group achieved the primary outcome ( p = @ ) .


Baseline @ ( OH ) D did not alter treatment group effects ( p = @ for interaction ) .


At the end of @weeks , @ ( OH ) D values were @ nmol/L and @ nmol/L in the Ca + D and Ca groups , respectively , ( p < @ ) .


In the Ca + D and Ca groups , the final @ ( OH ) D concentration was greater in those who achieved the primary outcome ( @ nmol/L ) than in those who did not ( @ nmol/L , p < @ ) .


In children with calcium-deficiency rickets , there is a trend for vitamin D to improve the response to treatment with calcium carbonate as limestone , independent of baseline @ ( OH ) D concentrations .


Patient-reported outcomes are increasingly incorporated in drug evaluation trials .


Whether new immunosuppressive drugs result in an improved health-related quality of life ( HRQoL ) and a reduced side effect experiences remains unknown .


Moreover , the relationship between HRQoL and kidney function has never been investigated in kidney transplant recipients .


Using the BENEFIT and BENEFIT-EXT trials , we investigated the following : ( a ) evolution of HRQoL , assessed by the Medical Outcomes Short Form Health Survey ( SF-@ ) in the first @ years ( baseline , @ , @ , and @ months ) after kidney transplantation ; ( b ) association among kidney function ( chronic kidney disease stage ) , HRQoL , and patient-reported side effects ( Modified Transplant Symptom Occurrence and Symptom Distress Scale-@R ; BENEFIT trial only ) ; and ( c ) impact of belatacept and cyclosporine on side effect experience and HRQoL .


In the BENEFIT trial , all subjects reported clinically meaningful improvements compared with baseline and returned to general population scores , both for physical composite score ( PCS ) and mental composite score Short Form ( @ ) Health Survey at @ to @ months after transplantation .


In the BENEFIT-EXT trial , this was observed for PCS only .


Belatacept-treated patients reported better absolute PCSs compared with cyclosporine-treated patients .


The differences were small but statistically significant at all times .


Belatacept-treated patients tended to experience less side effects compared with cyclosporine-treated patients , except for dry skin .


Worsening kidney function was associated with a significant decrease in HRQoL .


Worsening in kidney function was associated with lower HRQoL .


Compared with cyclosporine , belatacept was associated with improved HRQoL , suggesting that use of non-nephrotoxic immunosuppressants may affect the patient 's side effect experience and improve their HRQoL .


To examine the impact of prescription on predicted speech intelligibility and loudness for children .


A between-group comparison of speech intelligibility index ( SII ) and loudness , based on hearing aids fitted according to NAL-NL@ , DSL v@ @ , or DSL m -LSB- i/o -RSB- prescriptions .


A within-group comparison of gains prescribed by DSL m -LSB- i/o -RSB- and NAL-NL@ for children in terms of SII and loudness .


Participants were @ children , who were randomly assigned to first hearing-aid fitting with either NAL-NL@ , DSL v@ @ , or DSL m -LSB- i/o -RSB- .


Audiometric data and hearing-aid data at @ years of age were used .


On average , SII calculated on the basis of hearing-aid gains were higher for DSL than for NAL-NL@ at low input level , equivalent at medium input level , and higher for NAL-NL@ than DSL at high input level .


Greater loudness was associated with DSL than with NAL-NL@ , across a range of input levels .


Comparing NAL-NL@ and DSL m -LSB- i/o -RSB- target gains revealed higher SII for the latter at low input level .


SII was higher for NAL-NL@ than for DSL m -LSB- i/o -RSB- at medium - and high-input levels despite greater loudness for gains prescribed by DSL m -LSB- i/o -RSB- than by NAL-NL@ .


The choice of prescription has minimal effects on speech intelligibility predictions but marked effects on loudness predictions .


Femorotibial knee osteoarthritis is associated with muscle weakness in the lower limbs , particularly in the quadriceps , which results in disease progression .


The interest of having muscular strengthening as part of the therapeutic arsenal for the medical treatment of knee osteoarthritis is now well established.The functional disability induced by knee osteoarthritis manifests itself principally when walking , notably downhill , during which the muscles are called upon to contract eccentrically.We can therefore think that eccentric muscular strengthening could bring a functional benefit that is superior to concentric muscular strengthening .


This is a prospective , randomized , bicenter , parallel-group , international study .


Eighty patients aged from @ to @ years old , suffering from medical-stage knee osteoarthritis , will undertake @ weeks of isokinetic muscular strengthening .


Randomization determines the mode of muscular strengthening : either exclusively eccentric or exclusively concentric.The principal objective is to demonstrate the superiority of the improvement in the quadriceps isokinetic torque after isokinetic muscular strengthening by the eccentric mode compared to the concentric mode.The following parameters are also evaluated : the variations in the level of pain , the parameters of walking ( maximum speed over @ and @ meters , analysis on a computerized Gaitrite treadmill ) , static equilibrium ( on a FUSYO force platform ) , and the functional status of the patient using the Western Ontario and MacMaster Universities osteoarthritis index ( WOMAC ) questionnaire after the strengthening period and at @ months .


A better knowledge of the most effective mode of muscular strengthening is needed to optimize the functional benefits to the patients .


In case of superiority in terms of efficacy of the eccentric mode , the latter could be given priority in the rehabilitation treatment of knee osteoarthritis patients .


We developed the iTrainer ( iT ) as a portable laparoscopic trainer , which incorporates the iPad tablet .


We then compared the iT with a standard pelvic trainer ( SPT ) to assess surgical skills as well as its image quality , resolution , brightness , comfort , and overall performance .


We designed and constructed the iT to be compatible with the Apple iPad @ and standard laparoscopic instruments .


Participants were assigned to perform the thread-the-loops task on both trainers and were prospectively randomized to start on either the iT or the SPT .


Each participant was allowed a @-minute warm-up before the @-minute testing period .


We scored participants using the product of skill quality ( @-@ scale ) and quantity of loops threaded ( @-@ scale ) .


Participants then rated each trainer on image quality , resolution , brightness , comfort , and overall performance on a @-point Likert scale .


A total of @ subjects including @ undergraduates , @ medical students , @ general surgery and urology residents , and @ experts ( fellows and attending surgeons ) participated in this study .


There was no significant difference between thread-the-loops task scores completed on the iT when compared with the SPT for all groups tested ( p > @ ) with the exception of the medical student group , who performed better on the SPT ( p < @ ) .


On evaluation of each trainer , participants rated the iT as having superior image quality and resolution when compared with the SPT ( p < @ ) but rated the SPT higher in overall performance ( p < @ ) .


Brightness and comfort were rated similarly for both trainers .


We have demonstrated face validity and criterion validity for the thread-the-loops task on the iT .


The iT rated superior in image quality and resolution but inferior in overall performance compared with the SPT .


The iT provides trainees a unique advantage over SPT as an additional resource to laparoscopic training as it is inexpensive , portable , and can be readily available for training .


Simulator sickness causes vestibulo-autonomic responses that increase sympathetic activity and decrease parasympathetic activity .


The purpose of the study was to quantify these responses through electrogastrography and cardiac interbeat intervals during flight simulation .


There were @ subjects that were randomly assigned to @ parallel arms : ( @ ) oculovestibular recoupling , where galvanic vestibular stimulation was synchronous with the visual field ; and ( @ ) control .


Electrogastrography and interbeat interval data were collected during baseline , simulation , and post-simulation periods .


A simulator sickness questionnaire was administered .


Statistically significant differences were observed in percentage of recording time with the dominant frequency of electrogastrography in normogastric and bradygastric domains between the oculovestibular recoupling and control groups .


Normogastria was dominant during simulation in the oculovestibular recoupling group .


In the control group , the percentage of recording time with the dominant frequency decreased by @ % in normogastria and increased by @ % in bradygastria .


The percentage change of the dominant power instability coefficient from baseline to simulation was @ % in the oculovestibular recoupling group vs. @ % in the control group .


The power of high-frequency components for interbeat intervals did not change significantly in the oculovestibular recoupling group and was decreased during simulation in the control group .


Electrogastrography and interbeat intervals are sensitive indices of autonomic changes in subjects undergoing flight simulation .


These data demonstrate the potential of oculovestibular recoupling to stabilize gastric activity and cardiac autonomic changes altered during simulator and motion sickness .


The inability of current vaccines to provide effective protection against porcine reproductive and respiratory syndrome virus ( PRRSV ) infection is not fully understood .


One of the reasons might be the presence of anti-idiotypic antibodies ( Ab@s ) to the envelope glycoprotein GP@ induced by PRRSV infection since our previous studies demonstrated the presence of auto-Ab@s ( aAb@s ) in pigs infected with PRRSV .


To test this hypothesis , PRRSV negative piglets were injected with a monoclonal Ab@ ( Mab@-@G@ ) and aAb@s that are specific for anti-GP@ antibody , vaccinated with the attenuated PRRSV vaccine CH-@R and then challenged with the highly pathogenic PRRSV HuN@ strain .


The animals were evaluated for clinical signs , pathological changes of the thymus and lungs , viremia , levels of serum antibodies and cytokines .


The piglets injected with Mab@-@G@ or aAb@ , and who received the attenuated PRRSV vaccine CH-@R before challenge , produced high levels of anti-N antibodies , IL-@ and IL-@ , but low levels of neutralizing antibodies .


After PRRSV HuN@ challenge , the animals showed obvious clinical signs , including lung lesions , severe thymus atrophy and decreased production of IL-@ and higher level of viremia .


When anti-GP@ Ab@s are present , the use of attenuated PRRSV vaccine CH-@R against HP-PRRSV infection is not recommended .


It can result in poor health status with pneumonia and thymus atrophy .


Problems associated with lifelong antiretroviral therapy , such as need for strict adherence , drug-related toxic effects , difficulties with treatment schedules , and cost , mean that simplification strategies should be sought .


We aimed to explore the efficacy and safety of dual treatment with atazanavir-ritonavir plus lamivudine as an option to switch to from standard combination antiretroviral therapy in patients with an HIV-@ infection who are virologically suppressed .


In this randomised , open-label , non-inferiority trial , we recruited patients aged @ years and older with chronic HIV-@ infection and no previous treatment failure or resistance , and with HIV-@ RNA of less than @ copies per mL for at least @ months , negative hepatitis B virus surface antigen , and good general health , from @ hospitals in Spain .


Exclusion criteria were switch in antiretroviral therapy during the previous @ months , previous virological failure , pregnancy or breastfeeding , Gilbert 's syndrome , use of contraindicated drugs , grade @ laboratory abnormalities , and previous intolerance to any of the study drugs .


We randomly assigned patients ( @:@ ; stratified by active hepatitis C virus infection and previous treatment ; computer-generated random number sequence ) to dual treatment with oral atazanavir ( @ mg once daily ) and ritonavir ( @ mg once daily ) plus lamivudine ( @ mg once daily ) or triple treatment with oral atazanavir ( @ mg once daily ) and ritonavir ( @ mg once daily ) plus two nucleos ( t ) ide reverse transcriptase inhibitors at the discretion of the investigators .


The primary endpoint was virological response , defined as HIV-@ RNA of less than @ copies per mL at week @ , in the per-protocol population , with a non-inferiority margin of @ % .


We included patients who received at least one dose of the study drug in the safety analysis .


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


Between Sept @ , @ , and May @ , @ , we randomly assigned @ patients ( @ -LSB- @ % -RSB- to each group ) .


At week @ in the per-protocol population , @ ( @ % ) of @ patients had virological response in the dual-treatment group versus @ ( @ % ) of @ in the triple-treatment group ( difference @ % -LSB- @ % CI -@ to @ % ) , showing non-inferiority at the prespecified level .


@ ( @ % ) patients developed severe adverse events ( dual treatment six -LSB- @ % -RSB- ; triple treatment eight -LSB- @ % -RSB- ) , none of which we deemed related to the study drug .


Grade @-@ adverse events were similar between groups ( dual treatment @ -LSB- @ % -RSB- of @ ; triple treatment @ -LSB- @ % -RSB- of @ ) .


Treatment discontinuations were less frequent in the dual-treatment group ( three -LSB- @ % -RSB- ) than in the triple-treatment group ( ten -LSB- @ % -RSB- ; p = @ ) .


In our trial , dual treatment was effective , safe , and non-inferior to triple treatment in patients with an HIV-@ infection who are virologically suppressed who switch antiretroviral therapy because of toxic effects , intolerance , or simplification .


This combination has the potential to suppress some of the long-term toxic effects associated with nucleos ( t ) ide reverse transcriptase inhibitors , preserve future treatment options , and reduce the cost of antiretroviral therapy .


To observe the efficacy of Jinghuaweikang gelatin pearls plus proton pump inhibitor ( PPI ) - based triple regimen in the treatment of chronic atrophic gastritis ( CAG ) patients with Helicobacter pylori ( H.pylori ) infection .


For this multicenter , randomized , controlled clinical study , @ patients of endoscopically confirmed CAG with positive H.pylori ( ( @ ) C or ( @ ) C-urea breath test ( UBT ) or rapid urease test ) were enrolled .


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


None of them had H.pylori eradication background .


They were randomly divided into @ groups , Group LACJ ( n = @ ) received lansoprazole @ mg + amoxicillin @ mg + clarithromycin @ mg + jinghuaweikang gelatin pearls @ mg , twice daily , for @ days ( d@-@ ) plus another @ days ( d@-@ ) only with jinghuaweikang gelatin pearls @ mg , twice daily .


Group LACB ( n = @ ) had standard quadruple regimen treatment : lansoprazole @ mg + amoxicillin @ mg + clarithromycin @ mg + bismuth potassium citrate @ mg , twice daily for @ days ( d@-@ ) .


The status of H.pylori was detected by ( @ ) C-UBT at least @ days after therapy .


The eradication rates in Groups LACJ and LACB were as follows : per-protocol ( PP ) : @ % ( @/@ ) and @ % ( @/@ ) , intention-to-treat ( ITT ) : @ % ( @/@ ) and @ % ( @/@ ) ( both P > @ ) .


The symptomatic improvements of bloating in upper abdomen , belching and epigastric pain after treatment in both groups .


And those in Group LACJ was higher than those of Group LACB , but no statistical difference existed between two groups ( all P > @ ) .


The efficacy of LACJ for the treatment of CAG patients with H.pylori infection is similar to LACB .


And the symptomatic improvement of patients is better than LACB .


To determine the independent and combined effects of pain and opioids on the activation of an early marker of inflammation , nuclear factor-B ( NF-B ) .


NF-B activation was compared within-subjects following four randomly ordered experimental sessions of opioid-only ( intravenous fentanyl @ g/kg ) , painonly ( cold-pressor ) , opioid + pain , and a resting condition .


University General Clinical Research Center .


Twenty-one ( @ female ) healthy controls .


Following exposure to treatment ( fentanyl administration and/or cold-pressor pain ) , blood samples for NF-B analysis were obtained .


Intracellular levels of activated NF-B , in unstimulated and stimulated peripheral blood mononuclear cells at @ and @ minutes .


Neither pain nor opioid administration alone effected NF-B levels in cell populations ; however , the combination of treatments induced significant increases of NF-B in stimulated peripheral blood mononuclear cell , lymphocytes , and monocytes .


The combination of acute pain with opioids , as occurs in clinical situations , activates a key transcription factor involved in proinflammatory responses .


Hemodynamic disturbances are common during continuous epidural anesthesia in elderly patients undergoing total hip arthroplasty .


This study aimed to investigate the effects of methoxamine on the intraoperative hemodynamics in elderly patients undergoing total hip arthroplasty under epidural anesthesia .


This prospective study included @ elderly patients undergoing elective total hip arthroplasty under epidural anesthesia .


Patients were randomly assigned into @ groups ( n = @ per group ) : a control group receiving saline ( Group C ) , a dopamine group receiving @ g/kg/min dopamine ( Group D ) , and methoxamine groups receiving @ , @ , or @ g/kg/min methoxamine ( Groups M@ , M@ , and M@ , respectively ) .


Hemodynamic parameters were assessed @ min before anesthesia ( T@ ) ; @ min ( T@ ) , @ min , ( T@ ) , @ min ( T@ ) , and @ min ( T@ ) after anesthesia ; and at the conclusion of surgery ( T@ ) .


At T@-T@ , the mean arterial pressure , central venous pressure , cardiac output , stroke volume , stroke volume ratio , and pulmonary vascular resistance were higher in Groups D , M@ , and M@ compared to Group C ( p < @ ) .


Compared to Group D , the heart rate and rate pressure product were significantly lower in Groups M@-M@ .


Infusion volume , ephedrine dose , and postoperative @-h urine volume were significantly lower and intraoperative urine volume was significantly greater in Groups D , M@ , and M@ compared with Group C. Hypertension occurred more frequently in Group M@ than in any other group .


Continuous intravenous infusion of @ g/kg/min methoxamine is safe and effective in maintaining hemodynamic stability in elderly patients undergoing total hip arthroplasty .


This study aimed at evaluating the safety and efficacy of an improved dosage regimen of sertraline in patients with premature ejaculation ( PE ) and to examine whether the premature ejaculation diagnostic tool ( PEDT ) can be used as a measure of treatment response in these patients .


A total of @ PE patients were randomized into control ( n = @ ) and treatment ( n = @ ) groups to receive mycelium of cordyceps sinensis C@ and sertraline @mg daily for @weeks , respectively .


Following this blinded stage , sixty-three patients chose to take sertraline @mg daily for an additional @-week period , and @ other patients continued treatment with sertraline @mg .


Main outcome measures include intravaginal ejaculatory latency time ( IELT ) , PEDT score and Clinical Global Impression of Change ( CGIC ) score .


At weeks @ and @ , mean IELT of patients who subsequently chose to take @mg of sertraline was significantly lower than that of patients who continued taking @mg of sertraline , although the IELT value was comparable between the two groups of patients at baseline .


However , with an additional @-week treatment , the mean IELT increased significantly more in the @-mg group than in the @-mg continuation group .


Similar results were also obtained in the analyses of the PEDT and CGIC scores .


Both regimens were well tolerated , and relapse rate did not differ significantly between the two groups .


These findings suggest that PE patients not responding to an @-week treatment with sertraline @mg can benefit from an additional @-week treatment with sertraline @mg and that the PEDT may be a valid measure of treatment response in PE patients .


The long-acting muscarinic antagonist ( LAMA ) umeclidinium ( UMEC ) and the combination of UMEC with the long-acting @-agonist ( LABA ) vilanterol ( UMEC/VI ) are approved maintenance treatments for chronic obstructive pulmonary disease ( COPD ) in the US and EU .


They are not indicated for the treatment of asthma .


In this @-week , double-blind , placebo-controlled , parallel-group safety study ( GSK study DB@ ; NCT@ ) , patients were randomized @:@:@ to UMEC/VI @/@ mcg , UMEC @ mcg , or placebo .


Study endpoints included adverse events ( AEs ) , clinical chemistry and hematology parameters , vital signs , @-lead , and @-hour Holter electrocardiograms .


COPD exacerbations and rescue medication use were assessed as safety parameters ; lung function was also evaluated .


The incidence of on-treatment AEs , serious AEs ( SAEs ) , and drug-related AEs was similar between treatment groups ( AEs : @-@ % ; SAEs : @-@ % ; drug-related AEs : @-@ % ) .


Headache was the most common AE in each treatment group ( @-@ % ) .


AEs associated with the LAMA and LABA pharmacologic classes occurred at a low incidence across treatment groups .


No clinically meaningful effects on vital signs or laboratory assessments were reported for active treatments versus placebo .


The incidences of atrial arrhythmias with UMEC/VI @/@ mcg were similar to placebo ; for UMEC @ mcg , the incidences of ectopic supraventricular beats , sustained supraventricular tachycardia , and ectopic supraventricular rhythm were @ % greater than placebo .


With active treatments , COPD exacerbations were fewer ( @-@ % of patients reporting @ exacerbation ) and on average less rescue medication was required ( @-@ @ puffs/day ) versus placebo ( @ % reporting @ exacerbation , @ puffs/day ) .


Both active treatments improved lung function versus placebo .


UMEC/VI @/@ mcg and UMEC @ mcg were well tolerated over @months in patients with COPD .


Retinoblastoma is a rare malignant intraocular neoplasm .


About @ % of cases feature a germline mutation in the RB@ gene and these will develop retinoblastoma during their early childhood .


An association between mutations in germline cells and aging has been demonstrated .


This suggests a higher incidence of childhood cancer including retinoblastoma among children of older parents .


In the present study we aimed to determine the association of paternal and maternal age with an increased risk of retinoblastoma in a case-control study in Iranian population .


The study was carried out on @ persons who were born during @-@ in Mahak and Mofid hospitals in Tehran , Iran .


The statistical analysis included studying the mean age of parents and in order to know whether parental age of patients is different from parental age of control group , ( t-test ) compare averages test is used perfectly .


By binary logistic regression , odds ratios ( ORs ) and @ % confidence intervals ( CIs ) were calculated .


The results of statistical analysis including the study of mean parental age by the use of ( t-test ) compare averages test showed a significant difference between parental ages of patients and controls .


Logistic regression showed that coefficients were significant for maternal but not paternal age .


Our findings indicate that advanced maternal age can increase the risk of retinoblastoma in offspring , but the paternal age has no significant effect .


To observe the curative effect of acupoint-injection and intramuscular-injection of Bacillus Calmette-Guerin ( BCG ) Polysaccharide Nucleic Acid for bronchial asthma .


Sixty patients with bronchial asthma were equally randomized into acupoint-injection group and intramuscular-injection group .


For patients of the acupoint-injection group , @ mL of BCG was injected into bilateral Feishu ( BL @ , @ mL for one side ) once per day in the first @ days , and once every other day in the rest @ months except weekends .


Intramuscular-injection was conducted at the lateral sites of the left or right buttock , @ mL/time for each site , and the injection frequency was the same to that of the acupoint-injection .


The therapeutic effect was assessed according to the standards of Guide Principles for Clinical Research of New Chinese Herbal Drugs ( @ ) and Asthma Group of Breathing Diseases of China Medical Association ( @ ) .


Changes of FEV @ ( forced expiratory volume in the first second ) / FVC ( forced vital capacity ) and PEF % ( peak expiratory flow ) were detected using a pulmonary function detector .


Serum IgA , IgM , IgG and IgE contents were assayed by using an autonomic biochemical analyzer .


After @ months ' treatment , the scores of patients ' symptoms and signs and serum IgE and IgG levels were significantly decreased in both muscular-injection and acupoint-injection groups ( P < @ ) , while asthma controlled test ( ACT ) scores FEV @/FVC % and PEF % values were considerably increased in both groups compared to pre-treatment in the same one group ( P < @ ) .


The effects of acupoint-injection were markedly superior to those of the intramuscular-injection in reducing clinical symptom-sign score , and serum IgE content , and in up-regulating ACT score , FEV @/FVC % and PEF % levels ( P < @ , P < @ ) .


There were no significant differences in serum IgG , IgA and IgM levels between the two groups @ months following the treatment ( P > @ ) .


Acupoint-injection of BCG polysaccharide nucleic acid can effectively improve bronchial asthma patients ' clinical symptoms and sings and pulmonary function , which may be closely associated with its function in down-regulating serum IgE and IgG levels .


Omega-@ fatty acids supplements lower triglyceride ( TG ) levels in adults ; little pediatric information is available .


We evaluated their effect in hypertriglyceridemic adolescents .


Twenty-five patients aged @ to @ years with TG levels @ to @ mg/dL were randomized to @ months double-blind trial of Lovaza ( ~ @ mg docosahexaenoic acid + eicosapentaenoic acid per day ) versus placebo .


Baseline mean TG levels were @ mg/dL ( standard deviation = @ ) .


TG levels declined at @ months in the Lovaza group by @ @ mg/dL ( mean standard error ; P = @ ) and by @ @ mg/dL ( P = @ ) in the placebo group .


The difference in TG lowering between groups was not significant ( P = @ ) .


There were no between-group differences in endothelial function , blood pressure , body mass index , C-reactive protein , or side effects .


High-dose omega-@ fatty acid supplements are well tolerated in adolescents .


However , declines in TG levels did not differ significantly from Placebo in this small study .


The objective of this study was to ascertain whether clinicians can reliably distinguish between spasmodic dysphonia ( SD ) / vocal tremor and other voice disorders by telephone , despite this modality 's limited frequency response .


Randomized , single-blinded , and prospective study .


Voice-disordered patients with ( n = @ ) and without ( n = @ ) SD and/or vocal tremor recorded standardized utterances via landline telephone .


A laryngologist and two speech-language pathologists blinded to the diagnoses rated each recording as `` yes '' or `` no '' to `` SD or tremor present ?


, '' and if `` yes '' categorized into adductor , abductor , tremor only , or adductor with tremor subtypes .


Twenty-one recordings were presented twice at random so intrarater reliability could be assessed .


All ratings were compared with gold standard diagnosis by a second laryngologist who performed a full examination , including videostroboscopy , on each patient .


For the comparison `` SD or tremor '' yes versus no , sensitivity , specificity , positive predictive value , and negative predictive value are @ % , @ % , @ % , and @ % , respectively .


Interrater reliability ( Cohen kappa ) compared with the gold standard ranged from @ to @ ( substantial to almost perfect agreement ) .


Cronbach alpha among three raters was @ for this comparison .


Intrarater reliability ( number matched/number inspected ) was very high , ranging from@ @ to @ .


Comparing gold standard and telephone rating of SD/tremor subtypes , kappa ranged from @ to @ ( moderate agreement ) .


Intrarater reliability ranged from @ to @ .


SD and tremor can be reliably distinguished from other voice disorders over the telephone .


Contrast-induced nephropathy ( CIN ) , an acute kidney injury resulting from the administration of intravascular iodinated contrast media , is an important cause of morbidity/mortality following coronary angiographic procedures in high-risk patients .


Despite preventative measures intended to mitigate the risk of CIN , there remains a need for an effective intervention .


Remote ischaemic conditioning ( RIC ) , where non-injurious ischaemia is applied to an arm prior to the administration of contrast , has shown promise in attenuating CIN but its effectiveness in preserving long-term renal function is unknown , which will be studied as part of the effect of remote ischaemic conditioning against contrast-induced nephropathy ( ERICCIN ) trial .


( http://Controlled-trials.com Identifier : ISRCTN@ . )


The ERICCIN trial is a single-centre , randomised double-blinded placebo-controlled trial which plans to recruit @ patients who are at risk of CIN , defined by pre-existent renal impairment ( estimated glomerular filtration rate < @ ml/min/@ @ m@ ) , over a period of @ years .


Patients will be randomised to either control or RIC consisting of @ , @ min @ mmHg balloon-cuff inflation/deflations , to the upper arm .


The primary endpoint will be the development of CIN ( > @ % of eGFR , or rise of creatinine of > @ mol/l ) at @ h.


A key secondary endpoint will be whether RIC impacts upon persistent renal impairment over the @-month follow-up period .


Additional secondary endpoints include the measurement of serum neutrophil gelatinase-associated lipocalin and urinary albumin at @ , @ h and @ months following administration of contrast .


Findings from ERICCIN trial will potentially demonstrate that RIC attenuates contrast-induced acute and chronic kidney injury and influence future clinical practice guidelines in at-risk patients undergoing coronary angiographic procedures .


To investigate the effects of sitagliptin therapy on the kinetics of triglyceride-rich lipoprotein ( TRL ) apolipoprotein ( apo ) B-@ , VLDL apoB-@ , apoE and apoC-III in patients with type @ diabetes .


Twenty-two subjects with type @ diabetes were recruited in this double-blind crossover study , during which the subjects received sitagliptin ( @ mg/day ) or placebo for a @-week period each .


At the end of each phase of treatment , the in vivo kinetics of the different apolipoproteins were assessed using a primed-constant infusion of l - -LSB- @,@,@-D@ -RSB- leucine for @ h , with the participants in a constantly fed state .


Sitagliptin therapy significantly reduced fasting plasma triglyceride ( -@ % , p = @ ) , apoB-@ ( -@ % , p = @ ) and free fatty acid concentrations ( -@ % , p = @ ) , as well as plasma HbA@c ( placebo : @ % @ vs. sitagliptin : @ % @ , p < @ ) and plasma glucose levels ( -@ % , p = @ ) , without any significant effect on insulin levels .


Kinetic results showed that treatment with sitagliptin significantly reduced the pool size of TRL apoB-@ by -@ % ( p = @ ) , paralleled by a reduction in the production rate of these particles ( -@ % , p = @ ) .


The VLDL apoB-@ pool size was also significantly decreased by sitagliptin therapy ( -@ % , p = @ ) , mainly because of a reduction in the hepatic secretion of these lipoproteins , although this difference did not reach statistical significance ( -@ % , p = @ ) .


Treatment with sitagliptin for @ weeks reduced triglyceride-rich apoB-containing lipoprotein levels by reducing the synthesis of these particles .


It has previously been reported that increased level of serum heat shock proteins ( Hsps ) antibody in patients with metabolic syndrome .


It is possible that the expression of Hsp and inflammatory markers can be affected by cupping and traditional Chinese medicine .


There is a little data investigating the effects of cupping on markers of inflammation and Hsp proteins , hence , the objective of this study was evaluation of the effects of wet cupping on serum high-sensitivity C-reactive protein ( hs-CRP ) and Hsp@ antibody titers in patients with metabolic syndrome .


Serum Hs-CRP and Hsp@ antibody titers were assessed in samples from @ patients with metabolic syndrome ( @-@ years of age ) at baseline , and after @ and @ weeks after treatment .


One hundred and twenty-six patients were randomly divided into the experimental group treated with wet cupping combined with dietary advice , and the control group treated with dietary advice alone using a random number table .


Eight patients in case group and five subjects in control groups were excluded from the study .


Data were analyzed using SPSS @ software and a repeated measure ANCOVA .


Serum hs-CRP titers did not change significantly between groups ( p > @ ) and times ( p = @ ) .


The same result was found for Hsp@ titers ( p > @ ) .


Wet-cupping on the interscapular region has no effect on serum hs-CRP and Hsp@ patients with metabolic syndrome .


The aim of this study was to ascertain if a modified carotid sinus massage ( CSM ) using ultrasonography is superior to the conventional CSM for vagal tone generation .


This was a prospective , crossover , clinical trial including @ subjects with sinus rhythm .


Participants were paired , and they performed @ types of CSM to each other .


To perform the conventional technique , pressure was exerted at the point where the maximal impulse of the carotid pulse was palpated .


In the modified technique , participants localized the point of maximal diameter just above the bifurcation of the common carotid artery using ultrasonography and applied pressure to that point .


Mean differences between premaneuver and postmaneuver R-R intervals and heart rates were compared .


The distance from the midline of the neck ( x distance ) to the angle of the mandible ( y distance ) was measured , and the mean distance between the @ techniques was compared .


The baseline mean premaneuver R-R interval and heart rate did not differ significantly between the @ techniques .


The postmaneuver R-R interval and heart rate as well as the mean R-R interval and heart rate differences were significantly greater in the modified CSM .


The mean location determined using the modified CSM was located @ cm lateral and @ cm superior to the mean location of the conventional CSM .


The modified CSM using ultrasonography might be more useful than the conventional CSM in reverting episodes of paroxysmal supraventricular tachycardia and may be a suitable alternative for treating the same in the emergency department .


Flumazenil was administered after the completion of endoscopy under sedation to reduce recovery time and increase patient safety .


We evaluated patient satisfaction after endoscopy under sedation according to the timing of a postprocedural flumazenil injection .


In total , @ subjects undergoing concurrent colonoscopy and upper endoscopy while sedated with midazolam and meperidine were enrolled in our investigation .


We randomly administered @ mg of flumazenil either immediately or @ minutes after the endoscopic procedure .


A postprocedural questionnaire and next day telephone interview were conducted to assess patient satisfaction .


Flumazenil injection timing did not affect the time spent in the recovery room when comparing the two groups of patients .


However , the subjects in the @ minutes injection group were more satisfied with undergoing endoscopy under sedation than the patients in the immediate injection group according to the postprocedural survey ( p = @ ) .


However , no difference in overall satisfaction , memory , or willingness to undergo a future endoscopy was observed between the two groups when the telephone survey was conducted on the following day .


This study demonstrated that a delayed flumazenil injection after endoscopic sedation increased patient satisfaction without prolonging recovery time , even though the benefit of the delayed flumazenil injection did not persist into the following day .


The degree of glycemic control in patients with type @ diabetes mellitus ( T@DM ) may alter lipid levels and may alter the efficacy of lipid-modifying agents .


Evaluate the lipid-modifying efficacy of extended-release niacin/laropiprant ( ERN/LRPT ) in subgroups of patients with T@DM with better or poorer glycemic control .


Post hoc analysis of clinical trial data from patients with T@DM who were randomized @:@ to double-blind ERN/LRPT or placebo ( n = @ ) , examining the lipid-modifying effects of ERN/LRPT in patients with glycosylated hemoglobin or fasting plasma glucose levels above and below median baseline levels .


At Week @ of treatment , ERN/LRPT significantly improved low-density lipoprotein cholesterol , high-density lipoprotein cholesterol ( HDL-C ) , non-high-density lipoprotein cholesterol , triglycerides , and lipoprotein ( a ) , compared with placebo , with equal efficacy in patients above or below median baseline glycemic control .


Compared with placebo , over @ weeks of treatment more patients treated with ERN/LRPT had worsening of their diabetes and required intensification of antihyperglycemic medication , irrespective of baseline glycemic control .


Incidences of other adverse experiences were generally low in all treatment groups .


The lipid-modifying effects of ERN/LRPT are independent of the degree of baseline glycemic control in patients with T@DM ( NCT@ ) .


A combination of scintigraphy and a lymphotropic dye ( patent blue dye ( BD ) ) is the recommended technique to detect the sentinel lymph node ( SLN ) in early breast cancer .


This study determined the effect of clinical factors on SLN identification in the sentinel node biopsy versus axillary clearance ( SNAC ) trial .


A total of @ women were registered .


Lymphatic mapping was performed using preoperative lymphoscintigraphy ( LSG ) and gamma probe ( GP ) combined with peritumoural injection of patent BD ( @ patients ) or BD alone ( @ patients ) .


SLNs were identified in @ women ( @ % ) , localized with LSG in @ ( @ % ) , and were identified by GP in @ ( @ % ) .


The BD identified SLNs in @ of @ ( @ % ) women .


Three patients had allergic reactions .


BD detected the SLNs in @ of @ women with negative LSG mapping and in @ of @ women with no hot SLNs detected intraoperatively .


Age , body mass index ( BMI ) and tumour presentation ( screen detected versus symptomatic ) were significantly related to the identification of the SLN .


For BD , the primary tumour location was significantly related to identification rate .


The detection of blue SLN was significantly lower in women with inner quadrant tumours .


The combined technique resulted in a high identification rate .


BD contributed to the identification of the SLNs in patients where LSG and GP failed to identify the sentinel node .


Special attention to these techniques is needed in particular groups of patients such as those with high BMI , screen-detected primary tumours and tumour located in the inner quadrants .


To compare the clinical , analytical and graft maturation effects of two different platelet-rich plasma ( PRP ) preparations applied during anterior cruciate ligament ( ACL ) reconstruction .


A total of @ patients with ACL disruption were included in the study .


Arthroscopic ACL reconstruction with patellar tendon allograft was conducted on all knees using the same protocol .


One hundred patients were prospectively randomised to either a group to receive double-spinning platelet-enriched gel ( PRP ) with leukocytes ( n = @ ) or to a non-gel group ( n = @ ) .


Finally , we included @ patients treated with a platelet-rich preparation from a single-spinning procedure ( PRGF Endoret ( ) Technology ) without leukocytes .


Inflammatory parameters , including C-reactive protein ( CRP ) and knee perimeters ( PER ) , were measured @ hours and @ days after surgery .


Postoperative pain score ( visual analogue score -LSB- VAS -RSB- ) was recorded the day after surgery .


Follow-up visits occurred postoperatively at @ , @ , and @ months .


The International Knee Documentation Committee scale ( IKDC ) was included to compare functional state , and MRI was conducted @ months after surgery .


The PRGF group showed a statistically significant improvement in swelling and inflammatory parameters compared with the other two groups at @ hours after surgery ( p < @ ) .


The results did not show any significant differences between groups for MRI and clinical scores .


PRGF used in ACL allograft reconstruction was associated with reduced swelling ; however , the intensity and uniformity of the graft on MRI were similar in the three groups , and there was no clinical or pain improvement compared with the control group .


Despite calls to expand measurement of acute myocardial infarction ( AMI ) outcomes to include symptom burden , little has been done to describe hospital-level variation in this patient-centered outcome , or its association with mortality .


Understanding the relationship between symptoms and longer-term mortality could inform the importance of these outcomes for monitoring quality of care .


Among @ patients with AMI treated at @ hospitals participating in the Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients ' Health Status ( TRIUMPH ) study , we assessed risk-standardized @-year symptom burden as measured by the Seattle Angina Questionnaire Angina Frequency Score and mortality attributed to the hospital that provided AMI care .


Median odds ratios were used to assess outcome variation and reflect the relative odds of an outcome for @ patients with identical covariates at different , randomly selected , hospitals .


We then evaluated the correlation between hospital-level mortality and angina .


Finally , we determined the extent to which variation in mortality and angina was explained by achievement of AMI performance measures .


We observed hospital variation in risk-adjusted @-year mortality ( range , @ % -@ % ; median odds ratio , @ ; P = @ ) and angina ( range , @ % -@ % ; median odds ratio , @ ; P < @ ) .


At the hospital level , mortality and angina at @ year were weakly correlated ( r = @ ; @ % confidence interval , @-@ @ ; P = @ ) .


Accounting for the quality of AMI care did not attenuate variation in risk-adjusted @-year mortality or angina .


Symptom burden and mortality vary at the hospital level after AMI and are only weakly correlated .


These findings suggest that symptom burden should be considered a separate quality domain that is not well captured by current quality metrics .


Forty to sixty percent of MS patients suffer from cognitive impairments .


Cognitive deficits are a great burden for patients affected .


In particular they may lead to a reduced quality of life , loss of work and problems with the social environment .


The aim of this study was to evaluate a specific neuropsychological rehabilitation program for MS patients according to the ICF to be able to meet more properly individual requirements on the therapy level of function as well as of activities and participation .


Forty patients with MS were randomised in an intervention ( IG ) - and a control group ( CG ) .


The outcome measure of the IG , who started an intensive computer based home training of attention and attended psychological counselling was compared to the untrained CG .


In specific domains of attention ( simple and cued alertness and divided attention ) significant group differences between CG and IG could be found .


The IG reported an improvement of mental fatigue and retardation .


These findings support the idea that a neuropsychological rehabilitation program , which based on the model of ICF , could improve cognitive impairment and could also have a positive influence of activities and participation .


The results of weight maintenance after initial weight loss are reported infrequently , although , when they have been reported , the outcomes are generally poor and weight regain is common .


After an initial @-week randomised intervention comparing all meal provision against a self-directed energy restriction , participants re-consented to participate in a follow-on study .


Participants were given the option to choose to continue with the same dietary intervention ( either all meal provision ( provided free of charge ) or self-directed diet ) or change to the other diet for a further @ weeks .


Participants were followed up at @-weekly intervals during both intervention periods ( a total of @ weeks ) , with a final follow up at @ months .


Eighty-five out of @ individuals who completed the original @-week randomised phase chose to continue on to the follow-up study .


No significant differences in further weight loss between groups ( P = @ ) -LSB- mean ( SEM ) : -@ % ( @ % ) for all meal provision only ; -@ % ( @ % ) self-directed then all meal provision ; -@ % ( @ % ) all meal provision then self-directed -RSB- were seen after a further @ weeks .


Meal provision for a total of @ weeks resulted in @ % of individuals losing at least @ % body weight .


The groups switching from self-directed dieting to meal provision ( or vice versa ) were the only groups to have a lower mean weight at @ months than at the start of the follow-on study .


Structured support for @ weeks followed by @ weeks of self-care can result in weight maintenance , with initial weight loss maintained at @ months from enrolling on a @-week weight loss intervention , with a @-week follow-on period .


A diagnosis of diabetes mellitus types @ or @ doubles the odds of a comorbid depressive disorder .


The combined diseases have a wide range of adverse outcomes , such as a lower quality of life , poorer diabetes outcomes and increased healthcare utilisation .


Diabetes patients with depression can be treated effectively with psychotherapy , but access to psychological care is limited .