In May @ , a double-blind , placebo-controlled study was conducted in @ patients with allergic rhinitis due to grass pollen ( @-@ years of age ) .


SMS on mobile phones were used as reminders of treatment and reporting of symptom scores .


We found significant reductions in severity scores for sneezing , runny nose , stuffy nose and symptoms from eyes and lower airways , both separately and together ( all p < @ ) .


Reflective opinion of effect and guess on treatment at follow-up visits ( both p < @ ) confirmed a high efficacy .


No clinically significant adverse effects were reported .


The product provided significant protection against all seasonal allergic rhinitis symptoms from both upper and lower airways during the grass pollen season in an adult population .


The magnitude and scope of efficacy support the use of the product as an early choice in the treatment of allergic rhinitis .


To evaluate the value of angiography in clarifying the origin of the feeding arteries of primary retroperitoneal tumors and to explore the application of embolization therapy in the treating of primary retroperitoneal tumor .


@ patients with primary retroperitoneal tumor were randomized into conventional tumor resection group ( n = @ ) and the preoperative embolization group ( n = @ ) .


Some clinical data were compared between the preoperative embolization group and the routine operation group , including blood loss , blood transfusion , operation time and adverse reactions after embolization .


All the diagnoses were pathologically confirmed .


The origins of the tumor-feeding arteries were analyzed .


The clinical value of embolization in assisting the surgery as well as in making prognosis was assessed .


According to their location and size , primary retroperitoneal tumors had feeding arteries from different origins .


In this series of cases the tumor blood supply originated from the lumbar artery ( @ % ) , internal iliac artery ( @ % ) and adrenal artery ( @ % ) .


In the preoperative embolization group and conventional surgery group , the blood loss was @ ml vs. @ @ ml ( P < @ ) , the blood transfusion was @ @ ml vs. @ @ ml ( P < @ ) , the operation time was @ h vs. @ h ( P < @ ) , and the length of hospital stay was @ d vs. @ d ( P < @ ) .


The origins of the feeding arteries in primary retroperitoneal tumors are very complex .


Preoperative embolization therapy may effectively reduce the intraoperative blood loss , postoperative adverse events , length of hospital stay , and facilitate the patients ' recovery .


To study potential exposures to crystalline silica and the number of work-related cases of silicosis occurring in Alberta .


Exposure data comprising @ occupational samples were collected at @ worksites across @ industries .


To assess silicosis reporting , cases reported to the Alberta government , claims accepted by the Workers ' Compensation Board for work-related silicosis , and billings to Alberta Health for medical services with a diagnostic code for silicosis during a similar time period were compared .


Workers potentially over-exposed to airborne respirable crystalline silica were identified at most of the worksites evaluated .


There were large discrepancies in the number of silicosis cases found .


Many Alberta workers may be over-exposed to airborne respirable crystalline silica , and the incidence of work-related silicosis in Alberta may not be adequately represented by the official statistics .


Despite the use of embolic protection devices , no-reflow can still occur during saphenous vein grafts ( SVGs ) intervention .


High-dose intracoronary adenosine infusion preconditions the myocardium , improves coronary flow , and prevents no-reflow .


The role of high-dose intragraft adenosine infusion on protection of microvascular function and prevention of no-reflow has not been investigated


We investigated the cardioprotective effect of high-dose intragraft adenosine infusion , compared with placebo , on microvascular function and prevention of no-reflow during SVGs intervention .


We randomized @ patients with SVGs stenoses to receive either a @-min intragraft adenosine infusion ( @ g/min ; total dose = @,@ g ) or normal saline prior to stenting .


Average peak velocity ( APV ) , coronary flow velocity reserve ( CVR ) , thrombolysis in myocardial infarction ( TIMI ) frame count ( TFC ) , TIMI myocardial perfusion grade ( TMPG ) , and the rate of no-reflow were compared between the two groups before adenosine or saline infusions and after stenting


After stenting , hyperemic APV , CVR , and TMPG were significantly higher in the adenosine-treated group than in the control group ( @ @ vs. @ @ cm/sec ; @ @ vs. @ @ ; and @ @ vs. @ @ , respectively ; P < @ .


TFC was significantly lower in the adenosine-treated group than in the control group ( @ @ vs. @ @ ; P < @ ) .


In the control group , four patients ( @ % ) developed no-reflow compared to none in the adenosine-treated patient ; P < @ CONCLUSIONS : This study provides the first evidence that high-dose intragraft adenosine infusion compared with placebo protects microvascular function and prevents no-reflow during SVGs intervention .


Among surgical oncology patients , incisional surgical site infection is associated with substantially increased morbidity , mortality and healthcare costs .


Moreover , while adults undergoing pancreaticoduodenectomy with preoperative placement of an intrabiliary stent have a high risk of this type of infection , and wound protectors may significantly reduce its risk , no relevant studies of wound protectors yet exist involving this patient population .


This study will evaluate the efficacy of a dual-ring wound protector for prevention of incisional surgical site infection among adults undergoing pancreaticoduodenectomy with preoperatively-placed intrabiliary stents .


This study will be a parallel , dual-arm , randomised controlled trial that will utilise a more explanatory than pragmatic attitude .


All adults ( @years ) undergoing a pancreaticoduodenectomy at the Foothills Medical Centre in Calgary , Alberta , Canada with preoperative placement of an intrabiliary stent will be considered eligible .


Exclusion criteria will include patient age < @years and those receiving long-term glucocorticoids .


The trial will employ block randomisation to allocate patients to a commercial dual-ring wound protector ( the Alexis Wound Protector ) or no wound protector and the current standard of care .


The main outcome measure will be the rate of surgical site infection as defined by the Centers for Disease Control and Prevention criteria within @days of the index operation date as determined by a research assistant blinded to treatment allocation .


Outcomes will be analysed by a statistician blinded to allocation status by calculating risk ratios and @ % CIs and compared using Fisher 's exact test .


Examine the relationship of demographics and health conditions , alone and in combination , on objective measures of cognitive function in a large sample of community-dwelling older adults .


Baseline data from @,@ participants in the Advanced Cognitive Training in Independent and Vital Elderly ( ACTIVE ) study were used to examine relationships of demographics and health conditions with composite scores of memory , reasoning , and speed of processing .


Younger age , increased education , and White race were independently associated with better performance in each cognitive domain after adjusting for gender and health conditions .


Male gender , diabetes , and suspected clinical depression were associated with poorer cognitive functioning ; suspected clinical depression was associated with lower reasoning and diabetes and history of stroke with slower speed of processing .


Age , education , and race are consistently associated with cognitive performance in this sample of older community-dwelling adults .


Diabetes , stroke , and suspected clinical depression had independent but weaker effects on cognition .


Functional constipation ( FC ) is a common functional gastrointestinal disorders ( FGIDs ) which has a major impact on the quality of life .


Acupuncture is widely used as an alternative and complementary medicine ( CAM ) for FC , but the available evidence of its effectiveness is scarce .


Therefore , we will perform a randomized controlled trial to determine whether acupuncture improves symptom and quality of life in FC patients more effectively than sham acupuncture or gastrointestinal prokinetic agent .


This article will report the protocol of the trial .


The current trial is a multicenter , randomized , three-arm controlled study undergoing in China .


About @ people who aged from @ to @years with FC will be recruited in this study .


These participants will be randomly allocated into three treatment groups , including electro-acupuncture ( EA ) , Mosapride ( M ) and Mosapride & Sham Electro-acupuncture ( MS ) groups in a @:@:@ ratio .


Both the EA and sham EA receives @ sessions of needling at Quchi ( LI@ ) and Shangjuxu ( ST@ ) during @weeks of treatment , and a follow-up period of @weeks .


These groups will be compared on the primary outcomes of the number of times of defecation at baseline and @ , @ , @weeks after randomization .


The secondary outcome measures include : stool consistency , intensity of defecating difficulty , MOS item Short Form health survey ( SF-@ ) , Self-Rating Anxiety Scale ( SAS ) , Self-rating Depression Scale ( SDS ) , and the validated Patient Assessment of Constipation Quality of Life ( PAC-QOL ) .


These outcomes are measured at baseline and @ , @weeks after randomization , but SF-@ is measured at baseline and @weeks after randomization .


This study will supply significant evidence for using acupuncture to treat FC , and will help us to observe whether it is a therapeutic effect rather than a placebo effect .


The Intercollegiate Surgical Curriculum now recommends that cardiac surgical trainees should be able to understand and interpret transesophageal echocardiography images .


However , cardiac surgical trainees receive limited formal transesophageal echocardiography training .


The objective of this study was to assess the impact of simulation-based teaching versus more traditional operating room teaching on transesophageal echocardiography knowledge in cardiac surgical trainees .


A total of @ cardiac surgical trainees with no formal transesophageal echocardiography learning experience were randomly assigned by computer to a study group receiving simulation-based transesophageal echocardiography teaching via the Heartworks ( Inventive Medical , London , UK ) simulator ( n = @ ) or a control group receiving transesophageal echocardiography teaching during elective cardiac surgery ( n = @ ) .


Each subject undertook a video-based test composed of @ multiple choice questions on standard transesophageal echocardiography views before and after teaching .


There was no significant difference in the pretest scores between the @ groups ( P = @ ) .


After transesophageal echocardiography teaching , subjects within each group demonstrated a statistically significant improvement in transesophageal echocardiography knowledge .


Although the subjects within the simulation group outperformed their counterparts in the operating room teaching group in the post-test scores , this difference was not significant ( P = @ ) .


Despite the familiarity with transesophageal echocardiography images during surgery , subjects in the simulation group performed at least as well as those in the operating room group .


Surgical trainees will benefit from formal transesophageal echocardiography teaching incorporated into their training via either learning method .


The purpose of this study is to explore the applicability of a psychosocial intervention in childhood cancer patients .


This individualized structured psychosocial program to enhance social-emotional functioning and coping with disease-related effects includes six sessions for children and two sessions for parents .


This program was part of a combined intervention with physical exercise .


Questionnaires are used to evaluate completion of the psychosocial intervention , coping and satisfaction with the psychosocial intervention by patients and psychologists , and ranking of the individual topics by patients , parents , and psychologists .


Of the @ patients ( mean age @ ( SD @ ) ; @ % male ; @ % still on treatment ) who participated in the psychosocial intervention , two dropped out due to medical complications and one due to lack of time ; @ % completed the psychosocial intervention .


Overall , patients liked participation in the intervention ( @ on a @-point scale ; SD @ ) and were positive about the psychologists ( @ on a @-point scale ; SD @ ) .


Psychologists rated the intervention on several points ( e.g. , clarity of the manual and content of the intervention ) , and mean scores ranged from @ ( SD @ ) to @ ( SD @ ) on @-point scales .


Minor adaptations were suggested by patients and psychologists , including customizing according to age and a more patient-tailored approach .


This psychosocial intervention for childhood cancer patients appears to be applicable .


Future studies need to establish whether this intervention combined with a physical exercise intervention actually improves psychosocial functioning of childhood cancer patients .


When proven effective , this combined intervention can be offered to childhood cancer patients and may enhance their physical health and quality of life .


The objective of our study was to evaluate image quality and overall adequacy of low-dose CT angiography ( CTA ) with model-based iterative reconstruction ( MBIR ) in patients who had undergone endovascular aneurysm repair ( EVAR ) of a thoracic or abdominal aortic aneurysm .


Thirty patients , all of whom had undergone standard-dose CTA performed previously with adaptive statistical iterative reconstruction ( ASIR ) , underwent low-dose CTA for surveillance after EVAR .


Two radiologists randomly evaluated both studies , and quality parameters were assessed .


The maximal aneurysm diameter was measured , and the images were evaluated to see whether an endoleak was present .


The image noise and contrast-to-noise ratio ( CNR ) were measured .


The volume CT dose index and dose-length product were recorded .


The mean image score for low-dose CTA was acceptable to very good in all categories of assessment .


There was no significant difference between low-dose CTA and standard-dose CTA in the evaluation of the stent lumen .


Subjective assessments of stent configuration , aneurysm outline , aortic branch vessel outline , overall adequacy of vascular imaging , and overall adequacy of solid organ imaging were superior on standard-dose CTA .


Interobserver agreement for endoleak detection was higher for low-dose CTA .


There was no significant difference in the mean aneurysm diameter between the two readers on low-dose CTA and standard-dose CTA .


The effective radiation dose for low-dose CTA was lower than standard-dose CTA during both the arterial ( mean , @ vs @ mSv , respectively ) and the delayed ( @ vs @ mSv ) phase acquisitions .


The measured image noise was lower ( @ vs @ HU ) and CNR was higher ( @ vs @ ) on the low-dose CTA studies than on the standard-dose CTA studies .


Low-dose CTA with MBIR enables up to @ % dose reduction as compared with CTA performed with ASIR while maintaining diagnostic adequacy for CTA surveillance of patients who have undergone EVAR of a thoracic or abdominal aortic aneurysm .


To assess the long-term glycaemic durability , safety and tolerability of dapagliflozin versus glipizide as add-on therapies in patients with type @ diabetes inadequately controlled by metformin alone .


This was a @-week , randomised , double-blind study of dapagliflozin ( n = @ ) versus glipizide ( n = @ ) , uptitrated over @ weeks according to tolerability and glycaemic response to a maximum of @ and @ mg/day , respectively , as add-on therapies to metformin ( @ mg/day ) with a @-week double-blind extension period .


Data over @ weeks are reported here .


In total , @ % of patients completed @ weeks of treatment .


After the greater initial decrease ( @-@ weeks ) in glycated haemoglobin ( HbA@c ) with glipizide , the @-@-week HbA@c coefficient of failure ( CoF ) was lower with dapagliflozin ( @ % / year ) than with glipizide ( @ % / year ) , resulting in significant dapagliflozin versus glipizide differences of -@ % / year ( @ % CI -@ , -@ ; p = @ ) for CoF and -@ % ( -@ mmol/mol ) -LSB- @ % CI -@ ( -@ ) , -@ ( -@ ) ; p = @ -RSB- for @-week HbA@c .


Dapagliflozin produced sustained reductions in weight and systolic blood pressure , whereas glipizide increased weight and systolic blood pressure , giving @-week dapagliflozin versus glipizide differences of -@ kg ( @ % CI : -@ , -@ ) and -@ mmHg ( @ % CI : -@ , -@ ) , respectively .


Over @ weeks , the hypoglycaemia rate was @-fold lower with dapagliflozin than with glipizide ( @ vs. @ % ) , whereas patient proportions with events suggestive of genital infection and of urinary tract infection ( UTI ) were greater with dapagliflozin ( @ and @ % , respectively ) than with glipizide ( @ and @ % , respectively ) .


Over @ years , compared with glipizide , dapagliflozin demonstrated greater glycaemic durability , sustained reductions in weight and systolic blood pressure and a low hypoglycaemia rate ; however , genital infections and UTIs occurred more frequently .


Nitrous oxide is commonly used in general anaesthesia but concerns exist that it might increase perioperative cardiovascular risk .


We aimed to gather evidence to establish whether nitrous oxide affects perioperative cardiovascular risk .


We did an international , randomised , assessor-blinded trial in patients aged at least @ years with known or suspected coronary artery disease having major non-cardiac surgery .


Patients were randomly assigned via automated telephone service , stratified by site , to receive a general anaesthetic with or without nitrous oxide .


Attending anaesthetists were aware of patients ' group assignments , but patients and assessors were not .


The primary outcome measure was a composite of death and cardiovascular complications ( non-fatal myocardial infarction , stroke , pulmonary embolism , or cardiac arrest ) within @ days of surgery .


Our modified intention-to-treat population included all patients randomly assigned to groups and undergoing induction of general anaesthesia for surgery .


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


Of @,@ eligible patients , we enrolled @ patients between May @ , @ , and Sept @ , @ were assigned to receive nitrous oxide and @ were assigned not to receive nitrous oxide .


@ patients receiving nitrous oxide and @ not receiving nitrous oxide were assessed for the primary outcome .


The primary outcome occurred in @ ( @ % ) patients receiving nitrous oxide and in @ ( @ % ) patients not receiving nitrous oxide ( relative risk @ , @ % CI @ ; p = @ ) .


Surgical site infection occurred in @ ( @ % ) patients assigned to nitrous oxide , and in @ ( @ % ) patients in the no-nitrous oxide group ( p = @ ) , and severe nausea and vomiting occurred in @ patients ( @ % ) assigned to nitrous oxide and @ patients ( @ % ) not assigned to nitrous oxide ( p < @ ) .


Our findings support the safety profile of nitrous oxide use in major non-cardiac surgery .


Nitrous oxide did not increase the risk of death and cardiovascular complications or surgical-site infection , the emetogenic effect of nitrous oxide can be controlled with antiemetic prophylaxis , and a desired effect of reduced volatile agent use was shown .


Weight reduction programs are not generally designed or adapted for people with physical disabilities .


This study examined the effect of a @-months remote , telephone-based weight management program for people with physical disabilities using a Web-based system ( Personalized Online Weight and Exercise Response System -LSB- POWERS -RSB- ) .


A total of @ participants ( mean SD age , @ @ yrs ; body mass index , @ @ kg/m ( @ ) ) with a physical disability ( spinal cord injury , multiple sclerosis , spina bifida , cerebral palsy , stroke , or lupus ) were randomized to one of three conditions : physical activity only ( POWERS ) , physical activity plus nutrition ( POWERS ( plus ) ) , and control .


The POWERS group received a physical activity tool kit and regular coaching telephone calls .


The POWERS ( plus ) group received an intervention identical to that of the POWERS group plus nutritional information .


The control group received the physical activity tool kit and self-guided health promotion resources at the completion of the trial but no coaching .


Postintervention differences in body weight were found between the groups .


There was a significant group time interaction ( P < @ ) in postintervention body weight , with both the POWERS and POWERS ( plus ) groups demonstrating greater reduction in body weight compared with the control group ( POWERS : -@ @ kg , -@ -@ % ; POWERS ( plus ) : -@ @ kg , -@ @ % ; control : +@ @ kg , @ @ % ) .


A low-cost telephone intervention supported with a Web-based remote coaching tool ( POWERS ) can be an effective strategy for assisting overweight adults with physical disabilities in maintaining or reducing their body weight .


During the development of a vaccine , identification of the correlates of protection is of paramount importance for establishing an objective criterion for the protective performance of the vaccine .


However , the ascertainment of correlates of immunity conferred by any vaccine is a difficult task .


While conducting a phase three double-blind , cluster-randomized , placebo-controlled trial of a bivalent killed whole-cell oral cholera vaccine in Kolkata , we evaluated the immunogenicity of the vaccine in a subset of participants .


Randomly chosen participants ( recipients of vaccine or placebo ) were invited to provide blood samples at baseline , @ days after the second dose and one year after the first dose .


At these time points , serum geometric mean titers ( GMT ) of vibriocidal antibodies and seroconversion rates for vaccine and placebo arms were calculated and compared across the age strata ( @ to @ years , @ to @ years and more than @ years ) as well as for all age groups .


Out of @ subjects included in analysis , @ were vaccinees and @ received placebo .


There were @ and @ geometric mean fold ( GMF ) rises in titers to Vibrio cholerae Inaba and Ogawa , respectively at @ days after the second dose , with @ % and @ % of vaccinees showing a four-fold or greater titer rise , respectively .


After one year , the titers to Inaba and Ogawa remained @ and @ fold higher , respectively , compared to baseline .


Serum vibriocidal antibody response to V. cholerae O@ was much lower than that to Inaba or Ogawa .


No significant differences in the GMF-rises were observed among the age groups .


The reformulated oral cholera vaccine induced a statistically significant anti-O@ Inaba and O@ Ogawa vibriocidal antibody response @ days after vaccination , which although declined after one year remained significantly higher than baseline .


Despite this decline , the vaccine remained protective five years after vaccination .


GS-@ is a recombinant , heat-killed , yeast-based immunotherapy engineered to express hepatitis B virus ( HBV ) - specific antigens .


GS-@ is being developed as a therapeutic vaccine for chronic HBV infection .


The aim of this study was to assess the safety , tolerability and immunogenicity of GS-@ in healthy subjects .


This was a randomized , open-label , dose-ascending study .


Subjects were allocated to one of three dose groups ( n = @ per group ) to receive @ , @ or @ yeast units ( YU ; @YU = @ ( @ ) yeast ) of GS-@ in two immunization regimens ( five subcutaneous injections at weekly intervals with one monthly booster or three subcutaneous injections at monthly intervals ) .


T-cell-mediated responses were determined by interferon ( IFN ) - enzyme-linked immunospot ( ELISpot ) assay and lymphocyte-proliferation assay ( LPA ) .


Adverse events were reported by @ of @ ( @ % ) subjects ; all were mild or moderate and none was serious .


Adverse events occurred most frequently in the highest dose group , @YU , and the number of individual events was higher after weekly immunization than monthly .


The most common adverse events were injection-site reactions .


Most ( @ % ) subjects responded to GS-@ by at least one of the T-cell assays .


Following immunization with GS-@ , IFN -- producing T-cells specific for HBV antigens were detectable in @ ( @ % ) subjects .


The ELISpot response was observed at all doses , with the highest frequency of responders occurring at the highest dose ( @YU : @ % ; @YU : @ % ; @YU : @ % ) .


Proliferative responses to HBV recombinant antigens were observed in @ % subjects ; responses were mainly independent of GS-@ dose and immunization regimen .


GS-@ was safe and well-tolerated in healthy subjects with injection-site reactions being the most frequently reported adverse events .


With both weekly and monthly regimens , GS-@ provided HBV-specific immune responses at all doses evaluated .


Further evaluation of GS-@ is ongoing in patients with chronic HBV infection .


Insulin resistance is commonly observed in uremic patients .


Angiotensin II receptor blockers ( ARB ) are reported to act as insulin sensitizers in the animal model of hypertension and hypertensive patients .


The authors investigated the effects of valsartan on insulin resistance and glucose metabolism in patients with long-term hemodialysis in the prospective , randomized controlled study .


Thirty-three hemodialysis patients were randomized into two treatment groups , valsartan @ to @ mg/day ( n = @ ) or non-renin-angiotensin-aldosterone-system blocking antihypertensive agents ( control , n = @ ) , treated for @ weeks .


Insulin resistance determined by homeostasis model assessment ( HOMA-IR ) , fasting plasma glucose ( FPG ) , fasting plasma insulin , and blood pressure monitoring were measured during the study .


At baseline , metabolic profiles did not significantly differ between the treatment and the control groups .


After @ weeks of treatment , the valsartan group significantly improved HOMA-IR from @ + / - @ to @ + / - @ ( p = @ ) and significantly decreased FPG from @ + / - @ to @ + / - @ mg/dL ( p = @ ) .


In contrast , the control group was not associated with any significant changes in HOMA-IR , FPG , and fasting insulin levels .


At the end of @-week treatment , HOMA-IR , FPG , and fasting insulin levels were not significantly different between the two groups .


These results indicate that the antihypertensive action of valsartan improves glucose metabolism by improving the peripheral insulin sensitivity in subjects with long-term dialysis .


Recently there has been great concern about the quality of life and health of liver transplant patients ( LTP ) .


These patients often present with metabolic disorders , which can improve with regular physical exercise .


The aim of this study was to investigate the effect of a physical exercise program on the functional capacity of LTP .


The distance walked in the @-minute walk test and the resting energy expenditure ( REE ) were evaluated in @ subjects who regularly attend the outpatient Bias Fortes Clinic at Universidade Federal de Minas Gerais .


The patients were divided into @ groups , the Exercise Group ( EG ) ( @ men and @ women ; @ @ years old , BMI @ @ kg/m ) performed @ sessions of continuous @min treadmill exercise .


Intensity of exercise was increased from @ % -@ % of the maximum heart rate over the training period .


A group of @ men and @ women ( @ @ years , BMI @ @ kg/m ) served as controls ( CG ) .


After undergoing exercise training , patients in the EG showed a @ % increase in the distance walked ( pre = @ @ m and post = @ @ m ) .


Also , there was an increase in their REE ( pre = @,@ @ kcal and post = @,@ @ kcal ) ( P < @ ) indicating an increase in their exercise capacity and metabolic improvements .


There were no differences in the distance walked ( pre = @ @ m and post = @ @ m ) and REE ( pre = @,@ @ kcal to post = @,@ @ kcal ) ( P > @ ) for CG .


Our results are in agreement with previous studies .


We conclude that the exercise program promoted significant improvements in functional capacity .


These findings have positive implications for the control of metabolic diseases , which are common in patients after liver transplantation .


To evaluate the effects of combined administration of gonadotropin-releasing hormone ( GnRH ) agonist with human chorionic gonadotropin ( hCG ) for final oocyte maturation in GnRH antagonist cycles for in vitro fertilization ( IVF ) .


A total of @ infertile women undergoing GnRH antagonist multiple-dose protocol for controlled ovarian stimulation were recruited and randomized into @ groups : a study group ( n = @ ) and a control group ( n = @ ) .


For the study group , both GnRH agonist and recombinant hCG ( rhCG ) were injected concomitantly for final oocyte maturation when @ or more follicles reached a mean diameter of @ mm .


For the control group , rhCG alone was administered for final oocyte maturation .


There were no significant differences in patient characteristics .


The @ groups were also similar with respect to the number of oocytes retrieved , fertilized oocytes and good-quality embryos .


Embryo implantation rate ( @ % vs. @ % ) , clinical pregnancy rate per cycle ( @ % vs. @ % ) , and live birth rate ( @ % vs. @ % ) were significantly higher in the study group than in the control group ( p = @ , p = @ , and p = @ , respectively ) .


Combined administration of GnRH agonist with rhCG may be beneficial in improving endometrial receptivity and pregnancy rate in GnRH antagonist cycles for IVF .


Stress affects flow-experience , but the mediating psychobiological mechanisms remain unknown .


Previous studies showed an association between flow-experience and endogenous cortisol levels , suggesting an inverted , u-shaped relation between flow-experience and cortisol .


However , these studies could not exclude effects of other stress factors .


The aim of this experiment was , therefore , to test the isolated effect of cortisol on flow-experience , independent of concomitant physiological and psychological stress responses , via controlled administration of exogenous cortisol .


Sixty-four young healthy subjects ( @ males , @ females ) participated in the experiment .


According to a double-blind , randomized , placebo-controlled , cross-over design , they received @ mg oral cortisol on @ day and placebo on the other day , respectively , with a time distance of @ week between the experimental days .


One hour after cortisol administration , participants engaged in the computer game Pacman .


Pacman was delivered in five blocks of randomly differing difficulty levels .


One block lasted @ min .


At the end of each block , participants rated flow-experience by the Flow Short Scale .


Data was analyzed with hierarchical linear modeling .


Subjects were not able to predict whether the pill they received contained cortisol or placebo .


Overall , results revealed a negative effect of oral @ mg cortisol on flow-experience , with no differences between males and females .


This study is the first to show that exogenous cortisol in a dose corresponding to a severe stressor impairs flow-experience .


The observed negative effect of high cortisol dosage on experienced flow underlines recent findings of an inverted u-shaped relationship between cortisol and flow .


GH action is attenuated by estrogens and selective estrogen receptor modulators ( SERMs ) administered orally .


During GH therapy in hypopituitary women , co-treatment with raloxifene , a SERM , induced a smaller gain in lean body mass ( LBM ) compared with estrogen , despite an equal reduction in IGF@ .


As a higher IGF-binding protein-@ ( IGFBP@ ) level was observed with raloxifene co-treatment , we hypothesize that an increase in IGFBP@ reduced IGF@ bioactivity causing the attenuated anabolic effect .


To assess the effects of @-estradiol ( E ) and raloxifene on bioactive IGF@ .


In study @ , @ GH-deficient ( GHD ) women were randomized to raloxifene @ mg/day or E @ mg/day for @ month .


In study @ , @ GHD women were randomized to @ month GH treatment alone ( @ mg/day ) and in combination with raloxifene ( @ mg/day ) or E ( @ mg/day ) .


We measured bioactive IGF@ , immunoreactive IGF@ and IGF@ , and IGFBP@ immunoreactivity and fragmentation .


Raloxifene and estrogen suppressed ( P < @ ) total IGF@ equally in GHD and GH-replaced hypopituitary women .


In GHD patients , neither raloxifene nor estrogen affected bioactive IGF@ .


GH significantly increased IGF@ bioactivity , an effect attenuated by co-treatment with raloxifene ( -@ @ % , P < @ ) and estrogen ( -@ @ % , P = @ ) .


Total IGF@ correlated ( r ( @ ) = @ , P < @ ) with bioactive IGF@ , which represented @ @ % of the total IGF@ , irrespective of the treatments .


Total IGF@ was unchanged by raloxifene and estrogen treatment .


IGFBP@ was significantly higher during raloxifene administration , whereas no differences in IGFBP@ fragmentation were observed .


Raloxifene effect on bioactive IGF@ is similar to that of estrogen despite higher IGFBP@ levels during raloxifene administration .


We conclude that the observed different effects on LBM between raloxifene and estrogen treatments can not be explained by differences in IGF@ bioactivity .


The purpose of this study was to determine the safety and effectiveness , as assessed by risk of bleeding and incidence of deep venous thrombosis ( DVT ) , of administering delayed low-molecular-weight heparin ( LMWH ) after total knee arthroplasty .


A prospective study of @ consecutive patients undergoing primary unilateral total knee arthroplasty was undertaken .


The patients were randomized into two groups : one of which was managed according to a standard LMWH program ( LMWH-s group ) and the other with delayed LMWH ( LMWH-p ) .


LMWH was initiated @h after wound closure in the LMWH-s group , and @h after wound closure in the LMWH-p group .


The total blood loss in the first three postoperative days was calculated and all complications were recorded .


The mean total blood loss was @ and @mL in the LMWH-s group and LMWH-p group , respectively ( p < @ ) .


No significant difference in the incidence of symptomatic DVT was observed .


The mean length of hospital stay was @ days in the LMWH-s group and @ days in the LMWH-p group ( p < @ ) .


After total knee arthroplasty , LMWH-p is safer for bleeding than LMWH-s and equally effective concerning prevention of DVT .


Parenting programs could provide effective routes to increasing children 's physical activity and reducing screen-viewing .


Many studies have reported difficulties in recruiting and retaining families in group parenting interventions .


This paper uses qualitative data from the Teamplay feasibility trial to examine parents ' views on recruitment , attendance and course refinement .


Semi-structured interviews were conducted with @ intervention and @ control group parents of @-@ year old children .


Topics discussed with the intervention group included parents ' views on the recruitment , structure , content and delivery of the course .


Topics discussed with the control group included recruitment and randomization .


Interviews were digitally recorded , transcribed and thematically analyzed .


Many parents in both the intervention and control group reported that they joined the study because they had been thinking about ways to improve their parenting skills , getting ideas on how to change behavior , or had been actively looking for a parenting course but with little success in enrolling on one .


Both intervention and control group parents reported that the initial promotional materials and indicative course topics resonated with their experiences and represented a possible solution to parenting challenges .


Participants reported that the course leaders played an important role in helping them to feel comfortable during the first session , engaging anxious parents and putting parents at ease .


The most commonly reported reason for parents returning to the course after an absence was because they wanted to learn new information .


The majority of parents reported that they formed good relationships with the other parents in the group .


An empathetic interaction style in which leaders accommodated parent 's busy lives appeared to impact positively on course attendance .


The data presented indicate that a face-to-face recruitment campaign which built trust and emphasized how the program was relevant to families positively affected recruitment in Teamplay .


Parents found the parenting component of the intervention attractive and , once recruited , attendance was facilitated by enjoyable sessions , empathetic leaders and support from fellow participants .


Overall , data suggest that the Teamplay recruitment and retention approaches were successful and with small refinements could be effectively used in a larger trial .


This study evaluated whether adding a preoperative single thoracic paravertebral block ( TPVB ) to intravenous patient-controlled analgesia ( IV PCA ) would improve postoperative analgesia compared with using IV PCA alone in patients undergoing nephrectomy .


Prospective , randomized , controlled , observer-blinded trial .


University hospital .


Thirty-four adult patients undergoing elective open nephrectomy .


The patients were randomized to receive a TPVB plus IV PCA ( group T ) or IV PCA alone ( group C ) .


A single @-mL injection of @ % ropivacaine was administered preoperatively under ultrasound guidance ; fentanyl was used for IV PCA .


Each patient 's postoperative pain score based on a verbal numerical rating scale , postoperative fentanyl consumption , inspiratory volume by incentive spirometry , and complications were evaluated at @ , @ , @ , @ , and @ hours after surgery .


Changes in heart rate ( HR ) , systolic arterial pressure ( SAP ) , and mean arterial pressure ( MAP ) were evaluated following skin incision .


The postoperative pain score and fentanyl consumption were significantly lower in group T than in group C at all time points up to @ hours after surgery .


The postoperative inspiratory volumes were not significantly different .


The changes in HR were similar , while the increases in SAP and MAP after skin incision were lower in group T than in group C.


A preoperative single TPVB improved postoperative analgesia by reducing the postoperative pain score and fentanyl consumption in patients undergoing nephrectomy .


Undamaged medical gloves protect medical personnel from contact with physiological fluids of the patient .


Thus they protect the assistance provider from hand skin contamination with potentially infectious biological materials .


The aim of the study was to evaluate the occurrence of pierce , perforations or damage of medical gloves during cannulation of blood vessels .


In the prospective randomized study @ pairs of gloves , used during cannulation of blood vessels under simulated resuscitation , were analyzed .


Gloves were tested by the water leak test .


The water test revealed @ cases of damage to the gloves used during cannulation of blood vessels .


Significant differences were noted in the frequency of damage to both the outer and single pairs of gloves and the inner pair of gloves .


The study showed that the use of double gloves provides a higher level of security for a paramedic than the use of a single pair of gloves , however , double gloves reduce the manual dexterity of a paramedic .


A large number of damages to gloves are not noticed by medical personnel during surgery .


In this study we aimed to investigate the effects of dexmedetomidine on early stage renal function in pediatric patients undergoing cardiac angiography .


@ pediatric patients between @ and @ months of age undergoing cardiac angiography were included in the study .


Patients were divided into two groups .


The patients in both groups were administered @ mg kg ( -@ ) ketamine , @ mg kg ( -@ ) propofol as bolus and followed by @ mg kg ( -@ ) h ( -@ ) ketamine and @ g kg ( -@ ) min ( -@ ) propofol infusion .


Additionally , a loading dose of @ g kg ( -@ ) dexmedetomidine given over @ min followed by @ g kg ( -@ ) h ( -@ ) dexmedetomidine infusion to patients in group D.


The patients were evaluated for NGAL , creatinine , renin , endothelin-@ , TAS and TOS blood levels before the procedure and @th and @th h after the procedure .


pRIFLE criteria were used to define CIN and its incidence in the study .


According to pRIFLE criteria contrast-induced acute kidney injury developed in @ ( @ % ) of the patients in group D and @ ( @ % ) of the patients in group C ( P = @ , risk ratio = @ ; @ % CI : @-@ @ ) .


In patients who developed CIN , Endothelin-@ levels in groups C and D were significantly higher than baseline levels at @th , @th and @th h , respectively .


Renin levels were significantly increased at @th and @ th ( ) h in patients with CIN in both groups .


Dexmedetomidine may be beneficial in protecting against contrast-induced nephropathy during pediatric angiography by preventing the elevation of vasoconstrictor agents such as plasma endothelin-@ and renin .


To evaluate whether daily administration of Lactobacillus reuteri DSM @ reduces the frequency and duration of diarrheal episodes and other health outcomes in day school children in Mexico .


Healthy children ( born at term , aged @-@ months ) attending day care centers were enrolled in this randomized , double-blind , placebo-controlled trial .


They received L reuteri DSM @ ( dose @ ( @ ) colony-forming unit ; n = @ ) or identical placebo ( n = @ ) by mouth , daily for @ months , after which they were followed-up after a further @ months without supplementation .


Data from all children were included in the final analysis .


L reuteri DSM @ significantly reduced the frequency and duration of episodes of diarrhea and respiratory tract infection at both @ and @ months ( P < @ ) .


Additionally , the number of doctor visits , antibiotic use , absenteeism from day school and parental absenteeism from work were significantly reduced in the L reuteri group ( P < @ ) .


A cost-benefit analysis revealed significant reductions in costs in the L reuteri-treated children .


No adverse events related to the study product were reported .


In healthy children attending day care centers , daily administration of L reuteri DSM @ had a significant effect in reducing episodes and duration of diarrhea and respiratory tract infection , with consequent cost savings for the community .


To observe the clinical effect on type @ diabetes mellitus ( T@DM ) complicated with pulmonary tuberculosis ( TB ) of insulin , isoniazid , rifampicin , pyrazinamide and ethambutol ( conventional medication ) administered together with Qi-boosting and Yin-nourishing decoction derived from Traditional Chinese Medicine ( TCM ) .


A total of @ patients with T@DM complicated with pulmonary TB were randomly and equally divided into positive control group and treatment group .


The control group was treated with Western conventional regiment ( WCR ) : insulin , isoniazid , rifampicin , pyrazinamide , and ethambutol , whereas the treatment group was given both WCR and Qi-boosting and Yin-nourishing decoction prepared from TCM .


After the treatment , @ ( @ % ) and @ ( @ % ) cases showed sputum bacteria negative conversion in the WCR plus TCM group and WCM group respectively ( P < @ ) .


A total of @ ( @ % ) and @ ( @ % ) cases showed improvement in lung lesion in the WCR plus TCM group and WCM group respectively ( P < @ ) .


Compared with WCR group , fasting plasma glucose and @-hour postprandial blood glucose levels in the WCR plus TCM group significantly decreased ( P < @ and P < @ , respectively ) .


Qi-boosting and Yin-nourishing decoction combined with the Western medication showed better curative effect in treating T@DM complicated with pulmonary TB compared with the group using the conventional Western Medicine alone .


To explore the effect of Chinese drugs for Pi strengthening Shen benefiting ( CDPSSB ) on the immunity function of HIV/AIDS patients ' specific T cells .


Totally @ patients were randomly recruited from the treated group -LSB- treated by CDPSSB combined highly active anti-retroviral therapy ( HAART ) -RSB- and @ patients were randomly recruited from the control group ( treated by HAART alone ) .


All patients were follow-up infected persons form You'an Hospital between from June @ to June @ .


CD@ + T absolute counts and HIV viral load were detected .


Meanwhile , HIV whole gene overlapping peptides were used as stimulating antigen .


The response intensity of HIV specific T cells was detected in the two groups .


There was no statistical difference in CD@ T absolute counts or HIV viral load between the two groups ( P > @ ) .


The response intensity of HIV specific T cells was significantly enhanced in the treated group , when compared with the control group ( P < @ ) .


Along with elongation of treatment time ( @ , @ , @ , and @ months ) in the treated group , the response intensity of HIV specific T cells showed enhancing tendency , but there was no statistical difference among these time points ( P > @ ) .


CDPSSB could enhance improve the immunity function of HIV specific T cells , which might be one of its mechanisms .


To evaluate the effectiveness of topical eutectic mixture of local anaesthetics ( EMLA ) cream in reducing the pain associated with vaccination injections .


This was a randomized , double-blind , placebo-controlled study that included children who presented for routine immunization .


Eligible children were randomly assigned to receive either EMLA or placebo cream .


The Modified Behavioural Pain Scale ( MBPS ) was used to assess baseline and postvaccination pain scores , while a visual analogue scale ( VAS ) was used to assess pain at the time of the needle prick and at the end of the injection .


A total of @ children were enrolled in the EMLA group and @ children in the placebo group .


The difference between the pre - and postvaccination MBPS scores was significantly lower in the EMLA group than in the placebo group ( @ @ versus @ @ , respectively ) .


The VAS scores at the time of the needle prick and after the injection were significantly lower in the EMLA group compared with the placebo group ( @ @ versus @ @ ; @ @ versus @ @ ; respectively ) .


Application of EMLA cream can be effectively incorporated as a routine pain-relieving intervention within routine vaccination appointments .


Few data regarding viral replication in patients receiving belatacept are available .


The aim of this single-center study was to compare the incidence of viral infections ( cytomegalovirus , Epstein Barr virus , BK virus , and JC virus ) , in @ de novo kidney transplant patients enrolled in the BENEFIT studies , receiving either belatacept ( n = @ ) or cyclosporine ( n = @ ) .


By means of polymerase chain reaction , belatacept-treated patients were tested for cytomegalovirus , Epstein-Barr virus , BK virus , and JC virus infections monthly for @ months , monthly for the first @ months , and then quarterly for @ months in cyclosporine-treated patients .


Additional samples were obtained when a viral infection was suspected .


The number of positive cytomegalovirus , BK virus , or JC virus viremias over the number of polymerase chain reactions performed through all @ years was similar in both groups .


Conversely , over the @-year study , the number of positive Epstein-Barr virus viremias over the number of Epstein-Barr virus polymerase chain reactions performed was significantly higher in the belatacept group ( @ % vs @ % ; P = @ ) .


The number of Epstein-Barr virus primary infection was similar in both groups , while the number of Epstein-Barr virus reactivation was higher in the belatacept group .


Epstein-Barr virus replication occurs more often in patients receiving belatacept , than it does in those receiving cyclosporine .


A subset of HIV-@ infected patients starting highly active antiretroviral treatment ( HAART ) experience suboptimal CD@ response ( SCR ) despite virologic suppression .


We studied the rate of and risk factors for SCR among women starting HAART in the ACTG A@ study conducted in @ African countries .


@ HAART-naive women with screening CD@ count < @ cells/L were randomized to start HAART with Tenofovir/Emtricitabine plus either Nevirapine or Lopinavir/Ritonavir .


This analysis includes the @ women who remained on-study through @ weeks without experiencing protocol-defined virologic failure .


We defined SCR as < @ CD@ cells/L increase from baseline and absolute CD@ cell count < @ cells/L , both at @ weeks after HAART initiation .


The baseline characteristics for the @ women prior to HAART initiation were : median age @ years , screening CD@ count @ cells/L , and HIV-@ RNA @ log@ copies/mL ; @ ( @ % ) were WHO Stage @ or @ .


Seventy one ( @ % ) of these @ women experienced SCR .


Baseline factors independently associated with increased odds of SCR included older age , lower HIV-@ RNA , positive Hepatitis B surface antigen , and site location .


At @ weeks , only @ % of the SCR group had CD@ @ cells/L compared with @ % in the non SCR group .


After starting HAART , @ % of women with virologic suppression through @ weeks experienced SCR .


These patients were also less likely to achieve CD@ @ cells/L by @ weeks .


The underlying causes and long term clinical implications of SCR deserve further investigation .


To investigate the effect on glycaemic control of adding glimepiride to on-going treatment with metformin and insulin in patients with known diabetes more than @ years .


Glimepiride @ mg or placebo was added in randomised order for three months with a washout period of @ weeks .


All insulin regimens were allowed .


Insulin doses were reduced if considered necessary .


Continuous glucose monitoring was performed at the end of each period .


Forty-three patients , median age @ years ( @-@ ) , diabetes duration @ ( @-@ ) , BMI @ kg/m ( @ ) ( @-@ ) and mean HbA@c @ % NGSP , ( @ mmol/mol IFCC ) were randomised .


With placebo there was no change in HbA@c while a decrease of @ % , ( @ mmol/mol IFCC ) ( P < @ ) , was observed with glimepiride even though insulin doses had to be reduced in @ patients ( median change @ % , range @-@ % ) .


Minor hypoglycaemia was reported but no severe hypoglycaemic event was observed .


The ratio between C-peptide/glucose increased significantly ( P < @ ) with glimepiride , both fasting and postprandially and , in a stepwise multiple regression analysis of possible predictive factors for response , a more pronounced decrease in HbA@c was associated with the magnitude of the increment in C-peptide/glucose .


Older age was associated with a smaller response .


Twenty-nine patients ( @ % ) were defined as responders if this was defined as an HbA@c decrease @ % ( @ mmol/mol IFCC ) or an insulin dose reduction @ % .


Even after long duration of diabetes , addition of glimepiride to insulin and metformin can be effective in lowering HbA@c and/or reducing the need for exogenous insulin .


Rectal cancer predominantly affects the elderly .


Unfortunately , this age category is under-represented in clinical trials because clinicians are loath to include patients with a high risk of comorbidity .


An exploratory analysis of the ACCORD@/PRODIGE @ phase III trial was carried out to retrospectively compare the benefit of neoadjuvant chemotherapy between the elderly ( @ years ; n = @ ) and younger patients ( < @ years ; n = @ ) , this analysis was not preplanned in the study protocol .


Patients with histologically confirmed resectable stage T@ or T@ rectal adenocarcinoma were eligible with an age limit of @ years .


Overall , the two age categories did not statistically differ in terms of patient 's clinical and tumor baseline characteristics .


Preoperative chemoradiotherapy leads to more severe grade @/@ toxicities ( @ % vs. @ % , p = @ ) and more permanent stomas ( @ % vs. @ % , p = @ ) in elderly patients who were less often operated on than younger patients ( @ % vs. @ % , p = @ ) .


The relative number of interventions per surgery type ( p = @ ) , treatment efficacy in terms of R@ resection rate ( @ % vs. @ % ; p = @ ) and complete pathological response ( @ % vs. @ % ; p = @ ) were nearly identical between the two categories .


Altogether these results warrant the development of specific optimal therapeutic strategies for the elderly .


Chronic hand and wrist pain is a common clinical issue for orthopaedic surgeons and rheumatologists .


The purpose of this study was @ .


To analyze the interobserver agreement of SPECT/CT , MRI , CT , bone scan and plain radiographs in patients with non-specific pain of the hand and wrist , and @ .


to assess the diagnostic accuracy of these imaging methods in this selected patient population .


Thirty-two consecutive patients with non-specific pain of the hand or wrist were evaluated retrospectively .


All patients had been imaged by plain radiographs , planar early-phase imaging ( bone scan ) , late-phase imaging ( SPECT/CT including bone scan and CT ) , and MRI .


Two experienced and two inexperienced readers analyzed the images with a standardized read-out protocol .


Reading criteria were lesion detection and localisation , type and etiology of the underlying pathology .


Diagnostic accuracy and interobserver agreement were determined for all readers and imaging modalities .


The most accurate modality for experienced readers was SPECT/CT ( accuracy @ % ) , followed by MRI ( @ % ) .


The best performing , though little accurate modality for inexperienced readers was also SPECT/CT ( @ % ) , followed by MRI and bone scan ( @ % each ) .


The interobserver agreement of experienced readers was generally high in SPECT/CT concerning lesion detection ( kappa @ , MRI @ ) , localisation ( kappa @ , MRI @ ) and etiology ( kappa @ , MRI @ ) , while MRI yielded better results on typification of lesions ( kappa @ , SPECT/CT @ ) .


There was poor agreement between experienced and inexperienced readers in SPECT/CT and MRI .


SPECT/CT proved to be the most helpful imaging modality in patients with non-specific wrist pain .


The method was found reliable , providing high interobserver agreement , being outperformed by MRI only concerning the typification of lesions .


We believe it is beneficial to integrate SPECT/CT into the diagnostic imaging algorithm of chronic wrist pain .


TREATMENT of patients with chronic low back pain ( CLBP ) aims to reduce disability , improve functional capacity , and participation .


Time contingent prescription of analgesics is a treatment modality in CLBP .


The impact of analgesics on functional capacity is unknown .


Aim of the study was to explore the effect of analgesics on functioning measured by functional capacity evaluation , and self-reported disability in patients with CLBP .


Explorative Randomized Placebo-Controlled Clinical Trial was performed in an outpatient pain rehabilitation setting on patients waiting for rehabilitation .


Included patients had low back pain lasting > @ months , visual analogue scale worst pain @ cm , and age > @ years .


Outcome measures before ( T@ ) and after treatment ( T@ ) : functional capacity , pain intensity , Roland Morris Disability Questionnaire .


T@ : global perceived pain relief .


Patient characteristics and psychological questionnaires were assessed .


Fifty patients were included in this study and were randomly assigned to @ weeks treatment or placebo .


acetaminophen/tramadol @ mg/@ @ mg per capsule .


Dose : maximum acetaminophen @,@ mg and tramadol @ mg per day ; treatment and placebo titrated identically .


Compliance and side-effects were monitored .


TREATMENT effects between groups over time were compared .


One patient ( treatment group ) was lost to follow-up .


Forty-nine patients remained in the study .


TREATMENT effects in primary outcomes did not differ significantly between groups .


A subgroup of @ ( @ % ) patients ( treatment group ) reported global pain relief ( responders ) who reduced self-reported disability ( p < @ ) .


Responders had significantly lower catastrophizing scores .


Overall treatment effects were small and non-significant .


A subgroup , however , reported improved functioning as a result of treatment .


Responders had lower catastrophizing scores .


Circadian variation in bodily functions has been shown to impact health in acute and chronic medical conditions .


Little is known about the relationship between circadian rhythm and sepsis in humans .


We aimed to investigate circadian variations in the host response in a human endotoxaemia model .


A cross-over study , where @ healthy young men received E. coli endotoxin ( lipopolysaccharide , LPS ) @ ng/kg at @ noon and , on another day , at @ midnight .


Blood samples were analysed for pro- and anti-inflammatory cytokines : tumour-necrosis factor ( TNF ) - alpha , soluble TNF receptors ( sTNF-R ) -@ and -@ , interleukin ( IL ) -@ beta , IL-@ receptor antagonist ( IL-@Ra ) , IL-@ , and IL-@ as well as YKL-@ and the oxidative stress markers malondialdehyde ( MDA ) , ascorbic acid ( AA ) and dehydroascorbic acid ( DHA ) before and at @ , @ , @ and @ hours after LPS administration .


The levels of MDA and IL-@ where significantly higher during the day time ( P < @ ) whereas levels of TNF-alpha , sTNF-RI , sTNF-RII , IL-@Ra , IL-@ , and YKL-@ were higher ( P < @ for all comparisons ) during the night time .


No significant differences were seen in the levels of AA and DHA .


A day-night difference in the acute phase response to endotoxaemia exists in healthy volunteers with a more pronounced inflammatory response during the night time .


This circadian difference in the response to endotoxaemia may play an important role in the clinical setting and should be investigated further .


The study aimed to establish the benefits of using chest tubes with negative pleural suction against trapped water in patients with penetrating or blunt chest trauma who underwent tube thoracostomy , in terms of the incidence of complications , such as persistent air leak , clotted hemothorax , empyema , and duration of stay .


Patients who underwent tube thoracostomy because of traumatic pneumothorax , hemothorax , or hemopneumothorax were randomly assigned into one of two groups : in Group @ , the three-bottle drainage system was connected to a negative suction ; in Group @ , no suction was given .


Patients who required mechanical ventilation or emergency surgery ( thoracotomy or thoracoscopy ) either at the time of admission to the institution or immediately after the tube thoracostomy , patients who had histories of thoracic procedures or chronic pulmonary diseases ( chronic obstructive pulmonary disease , diffuse interstitial lung disease ) , and patients with multiple injuries with severe traumatic brain injury and a Glasgow Coma Scale ( GCS ) score less than @ of @ were excluded from the study .


Hospital stay , duration of tube thoracostomy , prolonged fistula , and other clinical variables were compared .


One hundred ten patients were included , @ in the group with suction and @ in the group without suction .


There were no differences in the demographic characteristics of each group .


There were no differences between the groups in terms of hospital stay ( p = @ ) , duration of tube thoracostomy ( p = @ ) ( @ days in each group ) , or complications .


However , the probability of air leak presence in time was greater for the Group @ patients with negative suction versus the Group @ patients ( p = @ ) .


The use of negative pleural suction did not demonstrate advantages over the three-bottle chest drainage system without suction in patients with uncomplicated traumatic pneumothorax , hemothorax , or hemopneumothorax .


Therapeutic study , level II .


The ability of apolipoprotein A-I ( apoA-I ) to transport cholesterol from atherosclerotic plaque is thought to underlie its inverse correlation with cardiovascular risk .


To gauge the potential of infused apoA-I to transport cholesterol , we quantified cholesterol transport markers in human subjects infused with a novel formulation of apoA-I ( CSL@ ) .


CSL@ was infused into human subjects in single ( @ subjects ) and multiple ( @ subjects ) ascending dose trials .


Pharmacokinetic and biomarker assessments were conducted before and after infusions .


CSL@ caused an immediate , up to @-fold elevation of apoA-I and subsequent movement of tissue cholesterol into plasma .


Cholesterol appeared first as unesterified cholesterol in the high-density lipoprotein ( HDL ) fraction and was promptly esterified by lecithin cholesterol acyltransferase .


HDL cholesterol increased up to @ % .


Underlying this movement of cholesterol was an immediate and strong rise in the ability of plasma to promote cholesterol efflux from cells ex vivo .


CSL@ had its greatest impact on the fraction of efflux mediated by ATP-binding cassette transporter A@ ( ABCA@ ) , a cholesterol transporter induced in cholesterol-loaded tissues such as plaque .


ABCA@-dependent efflux capacity increased @ % and total efflux capacity by @ % .


In keeping with this finding , we observed a profound rise in very small HDL , also known as pre@-HDL , the preferred substrate for ABCA@ .


Very small HDL increased @ % .


Elevations in apoA-I , cholesterol efflux , and very small HDL were dose-proportional over a wide range .


No significant changes in atherogenic lipids were observed at any dose .


Infusion of CSL@ elevates the ability of plasma to withdraw cholesterol from cells .


Preferential elevation of ABCA@-dependent efflux may target atherosclerotic plaque for cholesterol removal , making CSL@ a promising candidate therapy for acute coronary syndrome .


We assessed the impact of using an automated bolus advisor integrated into a blood glucose meter on the timing and frequency of adjusting insulin therapy parameter settings and whether the availability of this technology would increase blood glucose test strip utilization in diabetes patients treated with multiple daily insulin injection ( MDI ) therapy .


The Automated Bolus Advisor Control and Usability Study ( ABACUS ) trial , a @-week , prospective , randomized , controlled , multinational study that enrolled @ type @ and type @ diabetes patients , demonstrated that use of an automated insulin bolus advisor helps improve glycemic control in suboptimally controlled , MDI-treated patients .


Patient data were assessed to determine when and how often changes in insulin parameter settings occurred during the study .


Patient meters were downloaded to determine blood glucose monitoring frequency .


One hundred ninety-three patients completed the study : @ control arm ( CNL ) and @ intervention ( experimental ) arm ( EXP ) .


Significantly more EXP ( @ % ) than CNL ( @ % ) patients received one or more changes in their insulin sensitivity factor ( ISF ) settings during the study ( P = @ ) .


Changes in ISF settings occurred earlier and more frequently in EXP than CNL patients throughout the study .


A similar trend was seen in changes in insulin-to-carbohydrate ratios .


There were no differences in daily self-monitoring of blood glucose frequency -LSB- mean ( SD ) -RSB- between CNL and EXP patients : @ ( @ ) versus @ ( @ ) ( P = @ ) .


Use of an automated bolus advisor was associated with earlier , more frequent changes in key insulin parameters , which may have contributed to subsequent improvements in glycemic control but without increased glucose test strip utilization .


This study was designed to describe and evaluate the use of a vascularized marginal periosteal barrier membrane ( MPM ) harvested by a semilunar incision , alone or combined with a bone graft , in treatment of class II furcation defects in mandibular molars , compared to open flap debridement ( OFD ) .


Thirty class II furcation defects in mandibular molars were randomly assigned into three equal groups : Group I included OFD , Group II included defects treated with MPM , and Group III consisted of defects treated with MPM after applying demineralized freeze-dried bone allograft ( DFDBA ) .


At baseline and @-month follow-up , vertical probing depth ( VPD ) , clinical attachment level ( CAL ) measurements , along with a radiographic measurement of bone height ( BH ) , were obtained for each defect .


Transmission electron microscopy ( TEM ) was used for further evaluation of the histological changes associated with gingival samples related to each line of treatment .


Both Groups II and III reflected significant favorable outcomes in all the assessed parameters compared to OFD .


A non-significant difference was found between both groups regarding VPD , while significant improvement in CAL and BH were detected in Group III ( p @ ) .


Favorable histological findings were also noticed in the test groups , with more improvement in Group III .


Placement of a vascularized MPM as a barrier membrane , using a semilunar incision , demonstrated a significant improvement in both clinical and histological outcomes of class II furcation defects in lower molars .


When it was combined with DFDBA , a meaningful difference was found with regard to early wound healing and gain in CAL and BH .


Capnography enables the measurement of end-tidal CO@ and thereby the early detection of apnea , prompting immediate intervention to restore ventilation .


Studies have shown that capnographic monitoring is associated with a reduction of hypoxemia during sedation for endoscopy and early detection of apnea during sedation for colonoscopy .


The primary aim of this prospective randomized study was to evaluate whether capnographic monitoring without tracheal intubation reduces hypoxemia during propofol-based sedation in patients undergoing colonoscopy .


A total of @ patients presenting for colonoscopy at two study sites were randomized to either standard monitoring ( n = @ ) or to standard monitoring with capnography ( n = @ ) .


The incidence of hypoxemia ( SO@ < @ % ) and severe hypoxemia ( SO@ < @ % ) were compared between the groups .


Furthermore , risk factors for hypoxemia were evaluated , and sedation performed by anesthesiologists was compared with nurse-administered propofol sedation ( NAPS ) or endoscopist-directed sedation ( EDS ) .


The incidence of hypoxemia was significantly lower in patients with capnography monitoring compared with those receiving standard monitoring ( @ % vs. @ % ; P = @ ) .


Independent risk factors for hypoxemia were age ( P = @ ) , high body mass index ( P = @ ) , history of sleep apnea ( P = @ ) , standard monitoring group ( P = @ ) , total dose of propofol ( P = @ ) , and dose of ketamine ( P < @ ) .


Patients receiving anesthesiologist-administered sedation developed hypoxemic events more often than those receiving NAPS or EDS.In patients with anesthesiologist-administered sedation , sedation was deeper , a combination of sedative medication ( propofol , midazolam and/or ketamine ) was administered significantly more often , and sedative doses were significantly higher compared with patients receiving NAPS or EDS .


In patients undergoing colonoscopy during propofol-based sedation capnography monitoring with a simple and inexpensive device reduced the incidence of hypoxemia .


Serum N-terminal pro-C-natriuretic peptide ( NT-proCNP ) concentration at hospital admission has sufficient sensitivity and specificity to differentiate naturally occurring sepsis from nonseptic systemic inflammatory response syndrome ( SIRS ) .


However , little is known about serum NT-proCNP concentrations in dogs during the course of sepsis .


To determine serum NT-proCNP and cytokine kinetics in dogs with endotoxemia , a model of canine sepsis .


Eighty canine serum samples .


Eight healthy adult Beagles were randomized to receive Escherichia coli lipopolysaccharide ( LPS , @ g/kg ) or placebo ( @ % NaCl ) as a single IV dose in a randomized crossover study .


Serum collected at @ , @ , @ , @ , and @ hours was stored at -@ C for batch analysis .


Serum NT-proCNP was measured by ELISA and @ cytokines and chemokines by multiplex magnetic bead-based assay .


Serum NT-proCNP concentrations did not differ significantly between LPS - and placebo-treated dogs at any time .


When comparing serum cytokine concentrations , LPS-treated dogs had higher interleukin-@ ( IL-@ ) , IL-@ , TNF - and KC-like at @ , @ , and @ hours ; higher CCL@ at @ , @ , @ , and @ hours ; and higher IL-@ and CXCL@ at @ hours compared to placebo-treated dogs .


There were no differences in serum GM-CSF , IFN - , IL-@ , IL-@ , IL-@ or IL-@ between LPS - and placebo-treated dogs .


Serum NT-proCNP concentration does not change significantly in response to LPS administration in healthy dogs .


Certain serum cytokine and chemokine concentrations are significantly increased within @-@ hours after LPS administration and warrant further investigation as tools for the detection and management of sepsis in dogs .


Promotion of healthy pregnancies has gained high priority in the Netherlands because of relatively unfavorable perinatal outcomes .


In response , a nationwide study , ` Healthy Pregnancy @ All ' ( HP@ALL ) , has been initiated .


Part of this study involves systematic and broadened antenatal risk assessment ( the Risk Assessment substudy ) .


Risk selection in current clinical practice is mainly based on medical risk factors .


Despite the increasing evidence for the influence of nonmedical risk factors ( social status , lifestyle or ethnicity ) on perinatal outcomes , these risk factors remain highly unexposed .


Systematic risk selection , combined with customized care pathways to reduce or treat detected risks , and regular and structured consultation between community midwives , gynecologists and other care providers such as social workers , is part of this study .


Neighborhoods in @ municipalities with adverse perinatal outcomes above national and municipal averages are selected for participation .


The study concerns a cluster randomized controlled trial .


Municipalities are randomly allocated to intervention ( n = @,@ pregnant women ) and control groups ( n = @,@ pregnant women ) .


The intervention consists of systematic risk selection with the Rotterdam Reproductive Risk Reduction ( R@U ) score card in pregnant women at the booking visit , and referral to corresponding care pathways .


A risk score , based on weighed risk factors derived from the R@U , above a predefined threshold determines structured multidisciplinary consultation .


Primary outcomes of this trial are dysmaturity ( birth weight < p@ ) , prematurity ( birth < @weeks ) , and efficacy of implementation .


The ` HP@ALL ' study introduces a systematic approach in antenatal health care that may improve perinatal outcomes and , thereby , affect future health status of a new generation in the Netherlands .


To compare the efficacy , tolerance , and safety of manual manipulation at day @ to day @ following collagenase Clostridium histolyticum ( CCH ) injection for Dupuytren contracture .


Eligible patients were randomized to manipulation at day @ versus day @ following CCH injection .


Preinjection , premanipulation , postmanipulation , and @-day follow-up metacarpophalangeal ( MCP ) and proximal interphalangeal ( PIP ) joint contractures were measured .


Pain scores were recorded at each time point .


Data were stratified per cohort based on primary joint treated ( MCP vs PIP ) .


Means were compared using paired and unpaired t-tests .


Forty-three patients with @ digits were eligible and were randomized to @-day ( @ digits ) and @-day ( @ digits ) manipulation .


For MCP joints , there were no significant differences in flexion contractures between @ - and @-day cohorts for initial ( @ vs @ ) , postmanipulation ( @ vs @ ) , or @-day follow-up ( @ vs @ ) measurements .


Premanipulation , the residual contracture was significantly lower in the @-day group ( @ vs @ ) .


For PIP joints , there were no significant differences between @ - and @-day cohorts for initial ( @ vs @ ) , premanipulation ( @ vs @ ) , postmanipulation ( @ vs @ ) , or @-day ( @ vs @ ) measurements .


There were no significant differences in pain or skin tears between the @ groups .


No flexor tendon ruptures were observed .


The effectiveness of CCH in achieving correction of Dupuytren contractures was preserved when manipulation was performed on day @ , with no differences in correction , pain , orskin tears .


These data suggest that manipulation can be scheduled at the convenience ofthe patient and surgeon within the first @ days after injection .


The value of aspirin in primary prevention of cancer and cardiovascular disease ( CVD ) remains unclear .


The aim of this study was to identify women who benefit from alternate-day aspirin with regard to all relevant outcomes , including cancer , CVD and major gastrointestinal bleeding .


Long term follow-up data of @ healthy women with baseline plasma samples in the Women 's Health Study , a randomised trial of @mg alternate-day aspirin versus placebo , were used to develop competing risks models for individualised prediction of absolute risk reduction of the combination of CVD , cancer and major gastrointestinal bleeding by aspirin .


Although aspirin was associated with a modestly decreased @-year risk of colorectal cancer , CVD , and in some women non-colorectal cancer , aspirin treatment resulted in a negative treatment effect in the majority of women if gastrointestinal bleeding was also taken into account .


The excess risk of major gastrointestinal bleeding by aspirin increased with age , but the benefits for colorectal cancer and CVD risk were also greater at higher age .


Decision curves indicated that selective treatment of women @years may improve net benefit compared to treating all , none and prediction-based treatment .


The observed @-year number needed to treat to prevent one event among women @years was @ ( @ % CI @ to @ ) .


Concurrent evaluation of the absolute effects on cancer , CVD and major gastrointestinal bleeding showed that alternate-day use of low-dose aspirin is ineffective or harmful in the majority of women in primary prevention .


Selective treatment of women @years with aspirin may improve net benefit .


Although good progress has been achieved in expanding immunization of children in China , disparities exist across different provinces .


Information gaps both from the service supply and demand sides hinder timely vaccination of children in rural areas .


The rapid development of mobile health technology ( mHealth ) provides unprecedented opportunities for improving health services and reaching underserved populations .


However , there is a lack of literature that rigorously evaluates the impact of mHealth interventions on immunization coverage as well as the usability and feasibility of smart phone applications ( apps ) .


This study aims to assess the effectiveness of a smart phone-based app ( Expanded Program on Immunization app , or EPI app ) on improving the coverage of children 's immunization .


This cluster randomized trial will take place in Xuanhan County , Sichuan Province , China .


Functionalities of the app include the following : to make appointments automatically , record and update children 's immunization information , generate a list of children who missed their vaccination appointments , and send health education information to village doctors .


After pairing , @ villages will be randomly allocated to the intervention arm ( n = @ ) and control arm ( n = @ ) .


The village doctors in the intervention arm will use the app while the village doctors in the control arm will record and manage immunization in the usual way in their catchment areas .


A household survey will be used at baseline and at endline ( @ months of implementation ) .


The primary outcome is full-dose coverage and the secondary outcome is immunization coverage of the five vaccines that are included in the national Expanded Program on Immunization program as well as Hib vaccine , Rotavirus vaccine and Pneumococcal conjugate vaccine .


Multidimensional evaluation of the app will also be conducted to assess usability and feasibility .


This study is the first to evaluate the effectiveness of a smart phone app for child immunization in rural China .


This study will contribute to the knowledge about the usability and feasibility of a smart phone app for managing immunization in rural China and to similar populations in different settings .


We aimed to decrease the postseptoplasty morbidities depending on nasal packing by using Merocel within glove finger moistened with tetracaine @ % solution .


The study was designed as a randomized prospective study .


A university hospital in Turkey .


Our study consisted of @ patients who underwent septoplasty .


The Merocel nasal tampon within glove finger was inserted after surgery in the study group and removed after @ or @ hours .


Merocel was moistened with tetracaine @ % solution after insertion into the nasal cavity and just before removal .


The morbidities and normal breathing time were recorded and compared with those of the control group .


The postseptoplasty morbidities were significantly decreased in the study group compared with those in the control group .


The morbidities were also improved after removal of tampons after @ hours compared with @ hours .


However , the normal breathing time was prolonged when the nasal tampons were removed after @ hours .


The glove finger provides comfortable removal of nasal packing .


The Merocel tampons might be safely removed just after @ hours postoperatively without any complication .


Insulin resistance ( IR ) affects sustained virological response ( SVR ) to peginterferon alfa plus ribavirin ( PR ) in patients with chronic hepatitis C ( CHC ) .


Whether add-on oral hypoglycemic agents ( OHAs ) to PR improve SVR remains unclear ; therefore , we conducted a prospective , randomized pilot trial on @ consecutive patients with genotype @ CHC and IR in Taiwan .


Patients were randomized to receive acarbose ( Arm A ; n = @ ) or metformin ( Arm B ; n = @ ) or pioglitazone ( Arm C ; n = @ ) in addition to peginterferon alfa-@b ( @ g/kg/week ) plus ribavirin ( @-@ mg/day ) or just PR ( Arm D ; n = @ ) .


The primary end point was SVR , and secondary end points were viral clearance at Weeks @ , @ , and @ .


There were no differences among all arms at baseline .


Using intent-to-treat analysis , SVR was observed in @ % ( @/@ ) , @ % ( @/@ ) , @ % ( @/@ ) , and @ % ( @/@ ) in Arms A , B , C , and D , respectively .


SVR was higher in female patients receiving OHA -LSB- @ % ( @/@ ) -RSB- than in male patients -LSB- @ % ( @/@ ) -RSB- .


Results of per protocol analysis showed that SVR was @ % ( @/@ ) in Arm A , @ % ( @/@ ) in Arm B , @ % ( @/@ ) in Arm C , and @ % ( @/@ ) in Arm D. Patients receiving OHA had a higher rapid virologic response : @/@ ( @ % ) versus @/@ ( @ % ) .


Complete early virologic response was comparable between patients receiving OHA and PR -LSB- @/@ ( @ % ) vs. @/@ ( @ % ) -RSB- .


Our preliminary data show add-on OHAs to PR might achieve better early viral kinetics and SVR .


However , further larger studies are needed to confirm these findings .


Delayed hair re-growth , pruritus and urinary retention are known complications after epidural anaesthesia in dogs .


The aim of this study was to prospectively evaluate the effect of epidurally administered drugs on the occurrence of these complications in dogs .


Ninety dogs were included in this study .


Eighty client-owned dogs undergoing surgery were randomly assigned to one of three epidural treatment groups : either morphine and bupivacaine ( MB ) , bupivacaine ( B ) , or saline solution @ % ( S ) was administered epidurally to these patients .


Ten dogs were only clipped in the lumbosacral area ( C ) .


Follow-up started @ weeks after clipping and was performed every @-@ weeks in cases of delayed hair re-growth or pruritus .


Hair re-growth in the lumbosacral area was observed and compared to hair re-growth in the surgical field and the fentanyl patch area .


Cytological analysis and a trichogram were performed if hair re-growth was delayed after @ months .


Time interval to first urination postoperatively was recorded ( n = @ ) .


Hair re-growth was delayed in @ dogs ( @ % ; B : n = @ , S : n = @ , MB : n = @ , C : n = @ ) with no differences between groups .


Pruritus was evident in two dogs ( @ % ; MB : n = @ , S : n = @ ) .


After @ months , hair had started to re-grow in all but one dog ( B ) .


After @ months the coat of this dog had re-grown .


Time to first urination did not differ between groups .


No direct correlation between the particular drugs injected epidurally and delayed hair re-growth , pruritus and urinary retention could be shown .


Dog owners should be informed that hair re-growth after epidural anaesthesia could be markedly delayed .


A period of nonsurgical management is advocated before surgical treatment for most patients with lumbar spinal stenosis .


Currently , little evidence is available to define optimal nonsurgical management .


Physical therapy is often used , however its use and effectiveness relative to other nonsurgical strategies has not been adequately explored .


Describe the use of physical therapy and other nonsurgical interventions by patients with lumbar spinal stenosis and examine the relationship between physical therapy and long-term prognosis .


Secondary analysis of the Spine Patient Outcomes Research Trial ( SPORT ) combining data from randomized and observational studies .


Thirteen spine clinics in @ states in the United States .


Patients with lumbar spinal stenosis receiving nonsurgical management including those who did or did not receive physical therapy within @ weeks of enrollment .


Primary outcome measures included crossover to surgery , the bodily pain and physical function scales changes from the Survey Short Form @ ( SF-@ ) , and the modified Oswestry Disability Index .


Secondary outcome measures were patient satisfaction and the Sciatica Bothersomeness Index .


Baseline characteristics and rates of crossover to surgery were compared between patients who did or did not receive physical therapy .


Baseline factors predictive of receiving physical therapy were examined with logistic regression .


Mixed effects models were used to compare outcomes between groups at @ and @ months and @ year after enrollment adjusted for baseline severity and patient characteristics .


Physical therapy was used in the first @ weeks by @ of @ patients ( @ % ) and was predicted by the absence of radiating pain and being single instead of married .


Physical therapy was associated with a reduced likelihood of crossover to surgery after @ year ( @ % vs. @ % , p = @ ) , and greater reductions on the Short Form @ physical functioning scale after @ months ( mean difference = @ , @ % confidence interval : @-@ @ ) and @ year ( mean difference = @ , @ % confidence interval : @-@ @ ) .


There were no differences in bodily pain or Oswestry scores across time .


Many patients with lumbar spinal stenosis pursuing conservative management receive physical therapy .


Using physical therapy was associated with reduced likelihood of patients receiving surgery within @ year .


Results for other outcomes were mixed with no differences in several measures .


Further research is needed to examine the effectiveness of physical therapy relative to other nonsurgical management strategies for patients with lumbar spinal stenosis .


Although promising results have emerged regarding oral immunotherapy ( OIT ) and sublingual immunotherapy ( SLIT ) for the treatment of peanut allergy ( PA ) , direct comparisons of these approaches are limited .


This study was conducted to compare the safety , efficacy , and mechanistic correlates of peanut OIT and SLIT .


In this double-blind study children with PA were randomized to receive active SLIT/placebo OIT or active OIT/placebo SLIT .


Doses were escalated to @ mg/d ( SLIT ) or @ mg/d ( OIT ) , and subjects were rechallenged after @ and @ months of maintenance .


After unblinding , therapy was modified per protocol to offer an additional @ months of therapy .


Subjects who passed challenges at @ or @ months were taken off treatment for @ weeks and rechallenged .


Twenty-one subjects aged @ to @ years were randomized .


Five discontinued therapy during the blinded phase .


Of the remaining @ , all had a greater than @-fold increase in challenge threshold after @ months .


The increased threshold was significantly greater in the active OIT group ( @ - vs @-fold , P = @ ) .


Significant within-group changes in skin test results and peanut-specific IgE and IgG@ levels were found , with overall greater effects with OIT .


Adverse reactions were generally mild but more common with OIT ( P < @ ) , including moderate reactions and doses requiring medication .


Four subjects had sustained unresponsiveness at study completion .


OIT appeared far more effective than SLIT for the treatment of PA but was also associated with significantly more adverse reactions and early study withdrawal .


Sustained unresponsiveness after @ weeks of avoidance was seen in only a small minority of subjects .


Laser Doppler flowmetry ( LDF ) is widely used for estimating cerebral blood flow changes during intraluminal middle cerebral artery occlusion ( MCAO ) .


No investigation has systematically examined LDF efficacy in standardizing outcome .


We examined MCAO histologic and behavioral outcome as a function of LDF measurement .


Rats were subjected to @min MCAO by @ surgeons having different levels of MCAO surgical experience .


LDF was measured in all rats during ischemia .


By random assignment , LDF values were ( Assisted ) or were not ( Blinded ) made available to each surgeon during MCAO ( n = @-@ per group ) .


Neurologic and histologic outcomes were measured @ days post-MCAO .


A second study examined LDF effects on @-day post-MCAO outcome .


Pooled across surgeons , intra-ischemic % LDF change ( P = @ ) , neurologic scores ( Assisted vs. Blinded = @ vs. @ , P = @ , meanstandard deviation ) and cerebral infarct volume ( @mm ( @ ) vs. @mm ( @ ) , P = @ ) were not different between groups .


Only for one surgeon ( novice ) did LDF use alter infarct volume ( @mm ( @ ) vs. @mm ( @ ) , P = @ ) .


LDF use decreased infarct volume coefficient of variation ( COV ) by @ % ( P = @ ) , but had no effect on neurologic score COV .


We compared intraluminal MCAO outcome as a function of LDF use .


LDF measurement altered neither neurologic nor histologic MCAO outcome .


LDF did not decrease neurologic deficit COV , but did decrease infarct volume COV .


LDF may allow use of fewer animals if infarct volume is the primary dependent variable , but is unlikely to impact requisite sample sizes if neurologic function is of primary interest .


Dairy food is an important natural source of saturated and trans fatty acids in the human diet .


This study evaluates the effect of dietary advice to change dairy food intake on plasma fatty acid levels known to be present in milk in healthy volunteers .


Twenty one samples of whole fat dairy milk were analyzed for fatty acids levels .


Changes in levels of plasma phospholipid levels were evaluated in @ healthy volunteers randomized to increase , not change or reduce dairy intake for one month .


Fatty acids were measured by gas chromatography-mass spectrometry and levels are normalized to d-@ alanine .


The long chain fatty acids palmitic ( @ % ) , stearic ( @ % ) and myristic ( @ % ) acid were most common saturated fats in milk .


Four trans fatty acids constituted @ % of the total milk fat content .


Increased dairy food intake by @ ( @ ) serves / day for @month was associated with small increases in plasma levels of myristic ( +@ , @ % confidence level-@ @ to @ , p = @ ) , pentadecanoic ( +@ , @ % confidence level -@ to @ , p = @ ) and margaric acid ( +@ , -@ to @ , p = @ ) .


There was no significant change in plasma levels of @ saturated , @ trans and @ unsaturated fatty acids .


Decreasing dairy food intake by @ ( @ ) serves per day was not associated with change in levels of any plasma fatty acid levels .


Dietary advice to change dairy food has a minor effect on plasma fatty acid levels .


To observe the clinical effects of essential hypertension treated with acupuncture at Siguan -LSB- Hegu ( LI @ ) and Taichong ( LR @ ) -RSB- , Quchi ( LI @ ) and Xingjian ( LR @ ) .


Sixty cases of essential hypertension were randomly divided into an acupuncture group and a medication group , @ cases in each group .


Two groups of acupoint , which were ( @ ) Siguan -LSB- Hegu ( LI @ ) and Taichong ( LR @ ) -RSB- and ( @ ) Quchi ( LI @ ) , Xingjian ( LR @ ) , were selected alternatively in the acupuncture group , once everyday .


In the medication group , captopril was prescribed for oral administration @ mg per time , three times per day .


Seven days made one session in both groups and totally three sessions were required .


( @ ) After treatment , the blood pressure were decreased significantly in the two groups ( all P < @ ) .


Compared with the medication group , the diastolic pressure after @ days , @ days of treatment in the acupuncture group was decreased significantly ( both P < @ ) .


( @ ) In the terms of TCM syndrome score , the improvement of dizziness , soreness and weakness of waist and knees , palpitations was significant in the acupuncture group compared with that in the medication group ( all P < @ ) .


( @ ) The acupuncture group had less adverse reactions compared with the control group ( P < @ ) .


Acupuncture at Hegu ( LI@ ) and Taichong ( LR @ ) , Quchi ( LI @ ) and Xingjian ( LR @ ) can effectively decrease blood pressure ; the effect of controlling diastolic pressure is better than captopril .


It can also improve the symptoms of dizziness , soreness and weakness of waist and knees , and palpitations .


Although both researchers and practitioners widely recognize therapeutic alliance 's importance in general psychotherapy , studies specific to alcohol use treatments have produced mixed results and generally do not investigate if and how alliance changes over course of treatment .


Using parallel process latent growth curve modeling , the authors examined if increase in alliance was associated with reduced drinking behaviors and a statistical mediator in the relationship between treatment modality and outcome .


The authors used data from Project MATCH ( J Stud Alcohol .


@ ; @:@ -@ ; Addiction .


@ ; @:@ -@ ) , which investigated client-treatment matching effects for alcohol treatment among outpatient ( n = @ ) and aftercare ( n = @ ) participants randomized to cognitive behavioral treatment ( CBT ) , @-step facilitation ( TSF ) , or motivational enhancement therapy ( MET ) .


Results indicate therapist-rated alliance increased significantly for CBT and TSF participants , but not MET .


Participants across modalities in both samples evidenced the largest decrease in drinking behaviors from baseline to midtreatment and a slight deterioration in treatment gains from midtreatment to @ months posttreatment .


Alliance did not mediate the relationship between treatment modality and outcome , but increase in alliance was significantly related to decrease in drinking frequency .


These findings provide further justification for researchers to specifically design studies to examine change in alliance as a mechanism of change in alcohol treatments .


Although heterogeneity exists in patient outcomes following subarachnoid hemorrhage ( SAH ) across different centers and countries , it is unclear which factors contribute to such disparities .


In this study , the authors performed a post hoc analysis of a large international database to evaluate the association between a country 's socioeconomic indicators and patient outcome following aneurysmal SAH .


An analysis was performed on a database of @ patients enrolled in studies of tirilazad mesylate for aneurysmal SAH from @ to @ , which included @ neurosurgical centers in North and Central America , Australia , Europe , and Africa .


Two primary outcomes were assessed at @ months after SAH : mortality and Glasgow Outcome Scale ( GOS ) score .


The association between these outcomes , nation-level socioeconomic indicators ( percapita gross domestic product -LSB- GDP -RSB- , population-to-neurosurgeon ratio , and health care funding model ) , and patientlevel covariates were assessed using a hierarchical mixed-effects logistic regression analysis .


Multiple previously identified patient-level covariates were significantly associated with increased mortality and worse neurological outcome , including age , intraventricular hemorrhage , and initial neurological grade .


Among national-level covariates , higher per-capita GDP ( p < @ ) was associated with both reduced mortality and improved neurological outcome .


A higher population-to-neurosurgeon ratio ( p < @ ) , as well as fewer neurosurgical centers per population ( p < @ ) , was also associated with better neurological outcome ( p < @ ) .


Health care funding model was not a significant predictor of either primary outcome .


Higher per-capita gross GDP and population-to-neurosurgeon ratio were associated with improved outcome after aneurysmal SAH .


The former result may speak to the availability of resources , while the latter may be a reflection of better outcomes with centralized care .


Although patient clinical and radiographic phenotypes remain the primary predictors of outcome , this study shows that national socioeconomic disparities also explain heterogeneity in outcomes following SAH .


We aimed to compare the success rates of the double hydrodistention implantation technique ( HIT ) and the HIT with a polyacrylate/polyalcohol copolymer ( PPC ) for the treatment of primary vesicoureteral reflux ( VUR ) with a new nonbiodegradable tissue-augmenting substance ( Vantris , Promedon , Cordoba , Argentina ) .


Between January @ and December @ , fifty-two children who underwent subureteric injection for primary VUR are included .


The children were randomly separated into two groups , the HIT and the double HIT groups , according to the type of injection .


Success was defined as no reflux on a follow-up voiding cystourethrogram ( VCUG ) after @ months .


The patients were evaluated according to sex , age , grade of reflux , number of injections , and injected volume , and the radiological success rates were compared .


Fifty-two patients underwent an endoscopic injection for primary grade III-V VUR .


The HIT group consisted of @ patients with @ ureters , and the double HIT group consisted of @ patients with @ ureters .


There were no significant differences in terms of the sex , ages , VUR grades , bilaterality between the two groups .


The mean injected volumes were ml @ ( @-@ @ ) in the HIT group and @ ml ( @ % CI @-@ @ ) in the double HIT group .


The reflux was resolved in @/@ ( @ % ) ureters in the HIT group and in @/@ ( @ % ) ureters in the double HIT group , ( p < @ ) .


We had only one complication .


This patient in the double HIT group , developed bilateral hydronephrosis and oliguric renal failure requiring open reimplantation at the sixth month .


We observed successful results double HIT method with PPC in Grade III-V reflux , but the long-term follow-up of patients is needed for hydronephrosis .


As the double HIT treatment leads to a higher success rate , its use is preferable .


Glaucoma is a chronic eye disease associated with irreversible visual loss .


In Africa , glaucoma patients often present late , with very advanced disease .


One-off procedures , such as laser or surgery , are recommended in Africa because of lack of or poor adherence to medical treatment .


However , acceptance of surgery is usually extremely low .


To prevent blindness , adherence to treatment needs to improve , using acceptable , replicable and cost-effective interventions .


After reviewing the literature and interviewing patients in Bauchi ( Nigeria ) motivational interviewing ( MI ) was selected as the intervention for this trial , with adaptation for glaucoma ( MIG ) .


MI is designed to strengthen personal motivation for , and commitment to a specific goal by eliciting and exploring a person 's reasons for change within an atmosphere of acceptance and compassion .


The aim of this study is to assess whether MIG increases the uptake of laser or surgery amongst glaucoma patients where this is the recommended treatment .


The hypothesis is that MIG increases the uptake of treatment .


This will be the first trial of MI in Africa .


This is a hospital based , single centre , randomized controlled trial of MIG plus an information sheet on glaucoma and its treatment ( the latter being `` standard care '' ) compared with standard care alone for glaucoma patients where the treatment recommended is surgery or laser.Those eligible for the trial are adults aged @years and above who live within @km of Bauchi with advanced glaucoma where the examining ophthalmologist recommends surgery or laser .


After obtaining written informed consent , participants will be randomly allocated to MIG plus standard care , or standard care alone .


Motivational interviewing will be delivered in Hausa or English by one of two MIG trained personnel .


One hundred and fifty participants will be recruited to each arm .


The primary outcome is the proportion of participants undergoing laser or surgery within two months of the date given to re attend for the procedure .


MIG quality will be assessed using the validated MI treatment integrity scale .


Motivational interviewing may be an important tool to increase the acceptance of treatment for glaucoma .


The approach is potentially scalable and may be useful for other chronic conditions in Africa .


To undertake a double-blind , randomized , placebo-controlled trial to examine the efficacy of acamprosate in maintaining complete abstinence in Japanese patients with alcohol dependence .


We enrolled @ patients with ICD-@-defined alcohol dependence and randomly assigned them to treatment with either acamprosate ( @,@ mg/d orally ) or placebo for @ weeks .