Anesthesia was induced and maintained by a remifentanil hydrochloride TCI combined with etomidate or propofol .


The depth of anesthesia and other relevant indicators were recorded through intraoperative electroencephalogram monitoring using a Narcotrend monitor .


No statistically significant differences were observed between the drug withdrawal times , eye opening requirements , or orientation recoveries of the two groups ( P > @ ) .


The cortisol and aldosterone levels in group E were significantly lower than those in group P @h post operation ( P < @ ) .


No significant differences between the number of operations , hospitalization duration , mean arterial pressure , heart rate , and postoperative adverse reaction incidence of the two groups were observed at each time point ( P > @ ) .


The application of a composite remifentanil hydrochloride combined with etomidate TCI is feasible for the early eschar excision in patients with severe burns .


Uric acid ( UA ) could act as a natural peroxynitrite scavenger with antioxidant properties .


It has been proposed that hyperuricemia might protect against multiple sclerosis ( MS ) .


Patients with relapsing-remitting MS starting treatment with interferon beta-@a @ g sc @/week were randomly assigned to receive either inosine @ g/day or placebo in a double-blind manner .


Follow-up was @ months .


Outcome measures were adverse events and UA laboratory results .


Secondary end point was clinical and radiological activity of MS. Relapse rates , percentage of patients without relapses , and progression to secondary MS ( SPMS ) were assessed .


Thirty six patients were included .


Two patients in the inosine group showed UA serum level above @ mg/ml , and symptoms derived from renal colic not leading to hospital admission .


Ten additional patients had asymptomatic hyperuricemia ( > @ mg ) .


Efficacy parameters ( clinical and radiological ) were similar between groups .


No patient progressed to SPMS CONCLUSIONS : Inosine administration was associated with hyperuricemia and renal colic with no additional effect on MS. We can not conclude inosine is a safe and well-tolerated drug .


Doses of around @ g/day may be more appropriate for future trials .


This study aimed to compare the efficacy of a peel-off facial mask based on polyvinyl alcohol ( PVA ) with an oil-in-water ( o/w ) emulsion and the effect of a soybean extract fermented by Bifidobacterium animale incorporated in those formulations ( @ % w/w ) .


The formulations were submitted to randomized clinical studies in volunteers to evaluate the measurement effects as ( a ) tensor by Cutometer , ( b ) moisturizing by Corneometer and transepidermal water loss ( TEWL ) by Tewameter .


These effects were determined in a short-term study ( @ h ) in a controlled-temperature room .


The tensor effect and TEWL values indicated no significant difference between the use of facial mask and emulsion .


On the other hand , the moisturizing effect of the facial mask on the stratum corneum was more significant than that of the emulsion according to Corneometer measurements .


Biometric cutaneous evaluation of peel-off facial masks ( short-term study ) showed that the masks promoted moisturizing effect of the stratum corneum more effectively than the oil-in-water emulsions .


Thus , the facial masks were more efficient than emulsions in relation to moisturizing effects , but this efficiency is not related to the presence of fermented soybean extract .


The results indicated that peel-off facial masks increase skin hydration in a process related to the occlusive effect .


The possibility and likelihood of a postoperative medical complication after spine surgery undoubtedly play a major role in the decision making of the surgeon and patient alike .


Although prior study has determined relative risk and odds ratio values to quantify risk factors , these values may be difficult to translate to the patient during counseling of surgical options .


Ideally , a model that predicts absolute risk of medical complication , rather than relative risk or odds ratio values , would greatly enhance the discussion of safety of spine surgery .


To date , there is no risk stratification model that specifically predicts the risk of medical complication .


The purpose of this study was to create and validate a predictive model for the risk of medical complication during and after spine surgery .


Statistical analysis using a prospective surgical spine registry that recorded extensive demographic , surgical , and complication data .


Outcomes examined are medical complications that were specifically defined a priori .


This analysis is a continuation of statistical analysis of our previously published report .


Using a prospectively collected surgical registry of more than @,@ patients with extensive demographic , comorbidity , surgical , and complication detail recorded for @ years after surgery , we previously identified several risk factor for medical complications .


Using the beta coefficients from those log binomial regression analyses , we created a model to predict the occurrence of medical complication after spine surgery .


We split our data into two subsets for internal and cross-validation of our model .


We created two predictive models : one predicting the occurrence of any medical complication and the other predicting the occurrence of a major medical complication .


The final predictive model for any medical complications had a receiver operator curve characteristic of @ , considered to be a fair measure .


The final predictive model for any major medical complications had receiver operator curve characteristic of @ , considered to be a good measure .


The final model has been uploaded for use on SpineSage.com .


We present a validated model for predicting medical complications after spine surgery .


The value in this model is that it gives the user an absolute percent likelihood of complication after spine surgery based on the patient 's comorbidity profile and invasiveness of surgery .


Patients are far more likely to understand an absolute percentage , rather than relative risk and confidence interval values .


A model such as this is of paramount importance in counseling patients and enhancing the safety of spine surgery .


In addition , a tool such as this can be of great use particularly as health care trends toward pay-for-performance , quality metrics , and risk adjustment .


To facilitate the use of this model , we have created a website ( SpineSage.com ) where users can enter in patient data to determine likelihood of medical complications after spine surgery .


To determine whether a single trial of interferential current therapy ( ICT ) can immediately alleviate spasticity and improve balance and gait performance in patients with chronic stroke .


Randomized , placebo-controlled clinical trial .


Inpatient rehabilitation in a local center .


A total of @ adult patients with chronic stroke with plantar flexor spasticity of the lower limb .


The ICT group received a single @-minute ICT stimulation of the gastrocnemius in conjunction with air-pump massage .


In the placebo-ICT group , electrodes were placed and air-pump massage performed without electrical stimulation .


After a single ICT application , spasticity was measured immediately using the Modified Ashworth Scale ( MAS ) , and balance and functional gait performance were assessed using the following clinical tools : Functional Reach Test ( FRT ) , Berg Balance Scale ( BBS ) , Timed Up and Go Test ( TUG ) , and @-m Walk Test ( @MWT ) .


Gastrocnemius spasticity significantly decreased in the ICT group than in the placebo-ICT group ( MAS : ICT vs placebo-ICT : @ vs @ ) .


The ICT group showed significantly greater improvement in balance and gait abilities than the placebo-ICT group ( FRT : @ vs @ , BBS : @ vs @ , TUG : @ vs @ , @MWT : @ vs @ ) .


Spasticity correlated significantly with balance and gait abilities ( P < @ ) .


A single trial of ICT is a useful intervention for immediately improving spasticity , balance , and gait abilities in chronic stroke patients , but not for long-term effects .


Further study on the effects of repeated ICT is needed .


Pretreatment with intravenous @ mg or @ mg/kg lidocaine with venous occlusion is recommended to prevent pain following injection of lipid emulsion propofol .


This approach is not sufficient to prevent pain from the injection of microemulsion propofol .


The present study investigated whether a higher dose of lidocaine pretreatment with venous occlusion would be more effective for reducing pain following injection of microemulsion propofol compared with @ mg lidocaine .


Patients undergoing elective surgery were randomly assigned to one of three groups : pretreatment with @ mg ( group L@ ) , @ mg ( group L@ ) or @ mg ( group L@ ) lidocaine intravenously with venous occlusion , followed by injection with microemulsion propofol @ min later .


Pain was assessed on a four-point scale ( severe , moderate , mild , none ) based on physical responses to the injection .


A total of @ patients were included in the final analysis .


Pain severity and incidence were significantly lower in patients in group L@ and L@ compared with patients in group L@ .


There were no statistically significant differences in pain incidence or severity between group L@ and group L@ .


Pretreatment with @ mg lidocaine intravenously with venous occlusion may be the most effective minimum dose for reducing injection pain following microemulsion propofol administration for induction of anaesthesia .


Depressive symptoms are common among adults with diabetes .


Depression and social support may influence diabetes self-management .


This study aimed to examine change in depressive symptoms and the role of depression and support on clinical and dietary outcomes among Latinos with type @ diabetes participating in a diabetes self-management intervention .


Participants ( N = @ ) were randomized to the intervention or usual care .


Mixed effects models were used to examine interaction effects between intervention status and depressive symptoms ( Centers for Epidemiologic Studies Depression ( CES-D ) score ) and support for diabetes self-management behaviors at baseline .


Outcomes were measured at baseline and @ and @months and included dietary quality , physical activity , depressive symptoms , and hemoglobin A@c levels .


Intervention participants had lower CES-D scores at follow-up than control participants .


An interaction effect between intervention status and CES-D scores predicted diet quality .


Latinos with depressive symptoms may derive the greatest benefits from diabetes self-management interventions .


Additional research on support during diabetes self-management interventions is warranted .


To assess the long-term ( up to @ months ) safety profile of a @-month regimen of NeuroAiD for acute ischemic stroke .


A total of @ patients with acute ischemic stroke were identified for eligibility in a randomized , double-blind , placebo-controlled clinical trial , of which @ patients allocated to either receiving NeuroAiD ( @ cases ) or placebo ( @ cases ) were analyzed after dropouts due to absence of baseline data , early death , or noncompliance .


Both groups received treatment for three months and followed up for another three months after the completion of the treatment .


Occurrence of clinical adverse events and laboratory parameters were assessed at @ month , @ months ( while under treatment ) and @ months ( @ months after the completion of treatment ) .


Statistical comparisons between groups were performed using chi-square test or t-test whenever appropriate .


The two groups had comparable baseline characteristics .


Mild nausea was more commonly reported in patients taking NeuroAid compared with placebo ( P = @ ) , of which @ out of @ were observed only during the first month of treatment .


However , none of the adverse events reported were considered severe or required discontinuation of the study drug .


There was no significant change observed in mean arterial blood pressure , haemoglobin , renal and liver laboratory parameters during treatment with NeuroAid and up to @ months after completion of a @-month regimen .


NeuroAiD is safe and does not affect hematologic , hepatic , and renal functions during and long after completion of treatment .


The pre-drinking mood state has been indicated to be an important factor in the mood effects of alcohol .


However , for moderate alcohol consumption there are no controlled studies showing this association .


Also , the mood effects of consuming alcohol combined with food are largely unknown .


The aim of this study was to investigate the effects of moderate alcohol combined with a meal on ambiance-induced mood states .


Furthermore effects on autonomic nervous system activity were measured to explore physiological mechanisms that may be involved in changes of mood state .


In a crossover design @ women ( age @-@ y , BMI @-@ kg/m@ ) were randomly allocated to @ conditions in which they received @ glasses of sparkling white wine ( @ g alcohol ) or alcohol-free sparkling white wine while having dinner in a room with either a pleasant or unpleasant created ambiance .


Subjects filled out questionnaires ( B-BAES , POMS and postprandial wellness questionnaire ) at different times .


Skin conductance and heart rate variability were measured continuously .


Moderate alcohol consumption increased happiness scores in the unpleasant , but not in the pleasant ambiance .


Alcohol consumption increased happiness and stimulation feelings within @ hour and increased sedative feelings and sleepiness for @ hour .


Skin conductance was increased after alcohol within @ hour and was related to happiness and stimulation scores .


Heart rate variability was decreased after alcohol for @ hours and was related to mental alertness .


Mood inductions and autonomic nervous system parameters may be useful to evaluate mood changes by nutritional interventions .


Moderate alcohol consumption elevates happiness scores in an unpleasant ambiance .


However , drinking alcohol during a pleasant mood results in an equally positive mood state .


Remotely monitored patients may be at risk for a delayed response to critical arrhythmias if the telemetry watchers who monitor them are subject to an excessive patient load .


There are no guidelines or studies regarding the appropriate number of patients that a single watcher may safely and effectively monitor .


Our objective was to determine the impact of increasing the number of patients monitored on response time to simulated cardiac arrest .


Randomized trial .


Laboratory-based experiment .


Forty-two remote telemetry technicians and nurses from cardiac units .


Number of patients monitored in a simulation of cardiac telemetry monitoring work .


We carried out a study to compare response times to ventricular fibrillation across five patient loads : @ , @ , @ , @ , and @ patients .


The simulation replicated the work of telemetry watchers using a combination of real recorded patient electrocardiogram signals and a simulated patient experiencing ventricular fibrillation .


Study participants were assigned to one of the five patient loads and completed a @-hour monitoring session , during which they performed tasks-including event documentation and phone calls to report events-similar to real monitoring work .


When the simulated patient sustained ventricular fibrillation , the time required to report this arrhythmia was recorded .


As patient loads increased , there was a statistically significant increase in response times to the ventricular fibrillation .


In addition , frequency of failure to meet a response time goal of less than @ seconds was significantly higher in the @-patient condition than in all other conditions .


Task performance decreased as patient load increased .


As participants monitored more patients in a laboratory setting , their performance with respect to recognizing critical and noncritical events declined .


This study has implications for the design of remote telemetry work and other patient monitoring tasks in critical and intermediate care units .


We conducted a nested randomised trial to evaluate the effect of an educational DVD , providing information about healthy food choices and exercise during pregnancy , on diet and physical activity , among pregnant women who were overweight or obese .


We conducted a nested randomised trial within the context of the LIMIT randomised trial .


Women were eligible with a singleton pregnancy between @ and @weeks gestation , and body mass index at the time of their first antenatal appointment of @kg/m ( @ ) .


All women who were randomised to the Lifestyle Advice Group of the LIMIT trial received a series of consultations with both research dieticians and research assistants , in addition to standard written dietary and exercise materials ( Standard Materials Group ) .


Women randomised to the DVD Group received the same consultations and written materials , and additionally received an educational DVD ( DVD Group ) .


The primary study outcome was the Healthy Eating Index .


Other study outcomes included physical activity , and gestational weight gain .


Women completed a qualitative evaluation of all the materials provided .


@,@ women in the LIMIT Lifestyle Advice Group participated in the nested trial , with @ women randomised to the DVD Group , and @ women to the Standard Materials Group .


Women who received the DVD compared with those who did not , had a higher mean Healthy Eating Index at @weeks gestation ( @ vs @ ; adjusted mean difference @ ; @ % CI @ to @ ; p = @ ) , but not at @weeks gestation ( @ vs @ ; adjusted mean difference -@ ; @ % CI -@ to @ ; p = @ ) .


There were no statistically significant differences in physical activity or total gestational weight gain .


While most women evaluated the materials positively , frequency of utilisation was poor .


Ongoing attention to the delivery of information is required , particularly with the increased use and availability of digital and multi-media interactive technologies .


This study sought to investigate whether the beneficial impact of high-dose rosuvastatin against contrast-induced acute kidney injury ( CI-AKI ) in acute coronary syndrome ( ACS ) patients varied in relation to baseline high-sensitivity C-reactive protein ( hs-CRP ) levels .


High-dose rosuvastatin administered on admission has been shown to prevent CI-AKI and improve short - and mid-term clinical outcome in ACS patients .


All @ statin-nave ACS patients enrolled in the PRATO-ACS ( Protective Effect of Rosuvastatin and Antiplatelet Therapy on Contrast-Induced Acute Kidney Injury and Myocardial Damage in ACS Patients ) study were stratified into baseline hs-CRP tertiles : < @ mg/l , @ to < @ mg/l , and @ mg/l .


The primary endpoint was CI-AKI occurrence ( creatinine @ mg/dl or @ % above baseline within @ h ) .


Logistic regression models were used to evaluate the relationship between hs-CRP levels and effects of rosuvastatin .


Patients with higher baseline hs-CRP values presented a significantly higher incidence of CI-AKI ( @ % , @ % , and @ % in the first , second , and third tertiles , respectively ; p = @ ) .


The beneficial effect of rosuvastatin was markedly significant in the third hs-CRP tertile ( odds ratio : @ ; @ % confidence interval : @ to @ ; p = @ ) .


Statin-treated patients in the third tertile presented a significantly lower rate of adverse events at @ days ( @ % vs. @ % , p = @ ) with a trend toward better outcome at @ months ( @ % vs. @ % , p = @ ) .


High-dose rosuvastatin administered on admission appears to exert more effective kidney protection in ACS subjects with higher baseline hs-CRP levels resulting in better short - and mid-term clinical outcome .


( Protective Effect of Rosuvastatin and Antiplatelet Therapy on Contrast-Induced Nephropathy and Myocardial Damage in Patients With Acute Coronary Syndrome Undergoing Coronary Intervention -LSB- PRATO-ACS -RSB- ; NCT@ ) .


Patients with melanoma that progresses on ipilimumab and , if BRAF ( V@ ) mutant-positive , a BRAF or MEK inhibitor or both , have few treatment options .


We assessed the efficacy and safety of two pembrolizumab doses versus investigator-choice chemotherapy in patients with ipilimumab-refractory melanoma .


We carried out a randomised phase @ trial of patients aged @ years or older from @ hospitals , clinics , and academic medical centres in @ countries who had confirmed progressive disease within @ weeks after two or more ipilimumab doses and , if BRAF ( V@ ) mutant-positive , previous treatment with a BRAF or MEK inhibitor or both .


Patients had to have resolution of all ipilimumab-related adverse events to grade @-@ and prednisone @ mg/day or less for at least @ weeks , an Eastern Cooperative Oncology Group ( ECOG ) performance status of @ or @ , and at least one measurable lesion to be eligible .


Using a centralised interactive voice response system , we randomly assigned ( @:@:@ ) patients in a block size of six to receive intravenous pembrolizumab @ mg/kg or @ mg/kg every @ weeks or investigator-choice chemotherapy ( paclitaxel plus carboplatin , paclitaxel , carboplatin , dacarbazine , or oral temozolomide ) .


Randomisation was stratified by ECOG performance status , lactate dehydrogenase concentration , and BRAF ( V@ ) mutation status .


Individual treatment assignment between pembrolizumab and chemotherapy was open label , but investigators and patients were masked to assignment of the dose of pembrolizumab .


We present the primary endpoint at the prespecified second interim analysis of progression-free survival in the intention-to-treat population .


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


The study is closed to enrolment but continues to follow up and treat patients .


Between Nov @ , @ , and Nov @ , @ , we enrolled @ patients : @ patients were randomly assigned to receive pembrolizumab @ mg/kg , @ to receive pembrolizumab @ mg/kg , and @ to receive chemotherapy .


Based on @ progression-free survival events , progression-free survival was improved in patients assigned to pembrolizumab @ mg/kg ( HR @ , @ % CI @-@ ; p < @ ) and those assigned to pembrolizumab @ mg/kg ( @ , @-@ ; p < @ ) compared with those assigned to chemotherapy .


@-month progression-free survival was @ % ( @ % CI @-@ ) in the pembrolizumab @ mg/kg group , @ % ( @-@ ) in the @ mg/kg group , and @ % ( @-@ ) in the chemotherapy group .


Treatment-related grade @-@ adverse events occurred in @ ( @ % ) patients in the pembrolizumab @ mg/kg group , @ ( @ % ) in the pembrolizumab @ mg/kg group , and @ ( @ % ) in the chemotherapy group .


The most common treatment-related grade @-@ adverse event in the pembrolizumab groups was fatigue ( two -LSB- @ % -RSB- of @ patients in the @ mg/kg group and one -LSB- < @ % -RSB- of @ patients in the @ mg/kg group , compared with eight -LSB- @ % -RSB- of @ in the chemotherapy group ) .


Other treatment-related grade @-@ adverse events include generalised oedema and myalgia ( each in two -LSB- @ % -RSB- patients ) in those given pembrolizumab @ mg/kg ; hypopituitarism , colitis , diarrhoea , decreased appetite , hyponatremia , and pneumonitis ( each in two -LSB- @ % -RSB- ) in those given pembrolizumab @ mg/kg ; and anaemia ( nine -LSB- @ % -RSB- ) , fatigue ( eight -LSB- @ % -RSB- ) , neutropenia ( six -LSB- @ % -RSB- ) , and leucopenia ( six -LSB- @ % -RSB- ) in those assigned to chemotherapy .


These findings establish pembrolizumab as a new standard of care for the treatment of ipilimumab-refractory melanoma .


Febuxostat is a selective inhibitor of xanthine oxidase , which is used to manage hyperuricemia in patients with gout .


The objective of the study was to compare the pharmacokinetics of two different strength of febuxostat formulations ( @ mg and @ mg ) .


A randomized , single-dose , open-label , two-period , two-sequence crossover study with a @-day washout period was conducted in @ healthy male subjects .


Participants received either reference ( @ @ mg ) or test ( @ @ mg ) formulations during the first period and the alternative formulation during the second period .


Plasma samples for the drug analysis were collected up to @ hours after treatment .


All pharmacokinetic parameters were comparable between the two formulations The observed mean Cmax , AUC ( last ) , and AUC ( ) values for the reference formulation were @,@ ng/mL , @,@ ng x h/mL , and @,@ ng x h/mL , respectively .


Corresponding values for the test formulation were @,@ ng/mL , @,@ ng x h/mL , and @,@ ng x h/mL , respectively .


The geometric mean ratios ( @ % CI ) between the two formulations were @ ( @ - @ ) for Cmax , @ ( @ - @ ) for AUC ( last ) , and @ ( @ - @ ) for AUC ( ) .


The changes of serum uric acid at @ hours after reference and test formations were comparable ( -@ mg/dL for reference and -@ mg/dL for test ; p = @ ) .


The results of the present study indicated that the reference and test formulations have comparable pharmacokinetics and that these two formulations meet the regulatory criteria for bioequivalence .


In addition , the reduction of serum UA levels in the reference formulation was similar to that of the test formulation after a single dose .


The aim of this study was to determine whether massage therapy can be used as an adjunct intervention to induce sleep in infants born preterm .


Thirty infants born at a minimum of @ weeks gestational age , who were at the time of the study between @ and @ weeks adjusted gestational age , were randomly assigned to receive massage therapy on @ day and not receive massage on an alternate day .


The Motionlogger Micro Sleep Watch Actigraph recorded lower extremity activity on the morning of each day .


No significant difference was found between groups for sleep efficiency ( P = @ ) during the time period evaluated .


Groups differed significantly during the time period after the massage ended with more infants sleeping on the nonmassage day ( = @ , P = @ ) .


Massage is well tolerated in infants born preterm and infants do not fall asleep faster after massage than without massage .


Circulating levels of cardiac troponin I ( cTnI ) after ST-segment elevation myocardial infarction ( STEMI ) are associated with infarct size and chronic left ventricular dysfunction , but the relation to clinical end points and biochemical measures of global cardiac function remains less well defined .


One thousand sixty-six patients receiving primary percutaneous coronary intervention ( PCI ) in the PROTECTION AMI trial were studied in a post hoc analysis .


Cardiac troponin I was measured at several time points during the index hospitalization , and patients were followed up for @ months before reassessment including N-terminal pro-B-type natriuretic peptide ( NT-proBNP ) and left ventricular ejection fraction ( LVEF ) measurements .


The median ( quartile @-@ ) cTnI levels were @ ( @-@ @ ) g/L at admission , @ ( @-@ @ ) g/L after @ to @ hours , and @ ( @-@ @ ) g/L after @ to @ hours .


In adjusted models , all post-PCI single points , peak , and area under curve were found to be independently associated with clinical events , NT-proBNP > @ pmol/L , or LVEF < @ % ( P for all < @ ) .


When cTnI was added to a baseline risk model for prediction of clinical events , the C statistic improved from @ to @ ( @-@ hours ) and @ ( @-@ hours ) .


Quantified by integrated discrimination improvement , the addition of cTnI significantly augmented prediction ability ( relative integrated discrimination improvement @ % -@ % ; P for all @ ) .


Consistent improvements in discrimination of NT-proBNP > @ pmol/L and LVEF < @ % were observed .


Cardiac troponin I measured after primary PCI for STEMI is independently associated with clinical outcomes and cardiac function through @-month follow-up .


These results suggest that cTnI levels are a useful risk stratification tool in STEMI patients .


Published studies of triptans in acute migraine have shown relatively disappointing @-hour pain-free rates , ranging from @ % to @ % , with @ - to @-hour sustained pain-free rates from @ % to @ % .


A major flaw in the design of previous studies may have contributed to disappointing results : many subjects are not truly episodic in the nature of their headaches-they discount days with mild headache and ignore days with migraine-related neck pain .


Believing that neck pain is integrally related to migraine , we sought to ascertain whether early treatment with sumatriptan @/naproxen sodium @ ( sumatriptan/naproxen ) in truly episodic migraineurs is more robust than results when neck pain has not been considered .


Successfully screened adult migraineurs who returned baseline diaries showing @ to @ migraine attacks monthly and < @ headache and/or neck pain days/month received blister packs containing @ sumatriptan/naproxen/@ placebo for treatment of @ migraines .


Instructions were to treat within the first @ minutes of mild headache or neck discomfort-but only if the preceding day was completely free of both headache and neck pain .


In our study , @ % of patient attacks treated with sumatriptan/naproxen achieved @-hour pain freedom compared with @ % of those with placebo ( P < @ ) .


Sustained pain freedom ( @-@ hours ) was achieved in @ % of sumatriptan/naproxen-treated attacks , compared with @ % with placebo ( P < @ ) .


More subjects using sumatriptan/naproxen achieved sustained pain freedom ( than @-hour pain freedom ) , due to @ time points when the subject was sleeping/napping @-hours post dose ( @ sumatriptan/naproxen , @ placebo ) , yet attested to no discomfort between @ and @ hours post dose .


Had the attacks been scored as pain-free at @ hours , the @-hour pain-free and sustained pain-free rates with sumatriptan/naproxen would have been identical at @ % ( vs @ % with placebo ) .


With truly episodic migraineurs , pain freedom was significant as soon as @ minutes following treatment with sumatriptan/naproxen ( @ % vs @ % with placebo ; P < @ ) .


Our study results support a fundamental re-evaluation of the role of neck pain in migraine .


Endobronchial valve ( EBV ) therapy is an innovative treatment that has been shown to be safe and effective in selected subgroups of patients with severe emphysema .


The objective of our study was to assess the cost-effectiveness of EBV therapy compared to the medical management of patients with high heterogeneity , complete fissures and lobar exclusion in the context of the German health-care system .


Clinical data from a subset of VENT ( Endobronchial Valve for Emphysema Palliation Trial ) provided information about clinical events , health-related quality of life , and disease staging for @ months .


This information was subsequently used to project long-term disease progression , mortality , and health resource utilization .


We computed the @ - and @-year incremental cost-effectiveness ratio ( ICER ) in euros per quality-adjusted life year ( QALY ) .


Costs and effects were discounted at @ % per year .


EBV therapy led to clinically meaningful disease restaging at @ months ( @ % of the cohort improved staging , compared to @ % in the controls ) .


Over @ years , EBV therapy was projected to increase survival from @ to @ % , and to add @ QALYs .


Costs were estimated to increase by EUR @,@ , resulting in an ICER of EUR @,@ per QALY .


Over @ years , @ QALYs were gained at an additional cost of EUR @,@ , yielding an ICER of EUR @,@ per QALY .


Our model-based analysis suggests that EBV therapy leads to clinically meaningful changes in disease staging and progression when compared to medical management , with resulting gains in unadjusted and quality-adjusted life expectancy .


Our results indicate that EBV therapy is cost-effective in the German health-care system .


Burns remain disproportionately prevalent in developing countries .


This study aims to describe the epidemiology of burns in Sierra Leone to serve as a baseline for future programs .


A cluster randomized , cross-sectional , countrywide survey was conducted in @ in Sierra Leone .


With a standardized questionnaire demographics and deaths during the previous @ months of household members were assessed with the household representative .


Thereafter , @ randomly selected household members were interviewed , elucidating whether participants had ever had a burn in six body regions and determining burn mechanisms and patterns of health care seeking behavior .


This study included @ households and @ individuals .


@ % ( @/@ ) of individuals reported at least one burn-injury .


The highest proportions of burns were reported in the age groups @-@ years old ( @/@ , @ % ) and @-@ years old ( @/@ , @ % ) .


The majority of burns ( @/@ , @ % ) were caused by a hot liquid/object and the upper , extremities were the most commonly burned body regions , with @ % ( @/@ ) of cases .


@ % ( @/@ ) of individuals with burns sought care from a traditional healer .


Burns are highly prevalent in Sierra Leone .


Further research and resources should be allocated to the care and prevention of thermal injuries .


We investigated whether micronutrients given acutely following the Christchurch earthquakes continued to confer benefit @ year following the treatment .


Sixty-four adults from the original @ participants experiencing heightened anxiety or stress @-@ months following the @nd February @ earthquake and who had been randomized to receive three different doses of micronutrients completed on-line questionnaires assessing mood , anxiety , stress , and symptoms associated with post-traumatic stress disorder @ year after completing the initial study .


Twenty-one out of @ nonrandomized controls who did not receive the treatment also completed the questionnaires .


Both the treated and control groups experienced significant improvement in psychological functioning compared with end-of-trial .


However , treated participants had better long-term outcomes on most measures compared with controls ( ES = @-@ @ ) .


Those who stayed on micronutrients through to follow-up or stopped all treatment reported better psychological functioning than those who switched to other treatments including medications .


About @ % of the sample continued to have post-traumatic stress disorder symptoms .


Disaster survivors improve psychologically over time regardless of receiving intervention ; however , those taking micronutrients during the acute phase following a disaster show better outcomes , identifying micronutrients as a viable treatment for acute stress following a natural disaster with maintenance of benefits @ year later .


ACTRN @


To investigate an infusion of propofol for anesthesia in comparison to tiletamine-zolazepam anesthesia , evaluating physiological variables and recovery in squirrel monkeys .


Prospective non-blinded randomized study .


Eight healthy squirrel monkeys ( Saimiri sciureus ) , aged @years and weighing @-@ @ kg .


Premedication was intramuscular midazolam ( @ mg ) and meperidine ( @mg ) .


Anesthesia was induced with intravenous ( IV ) propofol ( @mgkg ( -@ ) minute ( -@ ) ) and maintained with propofol starting at @ mgkg ( -@ ) minute ( -@ ) ( PRO , n = @ ) or IV tiletamine-zolazepam ( @mgkg ( -@ ) ) and maintained with supplementary doses of TZ ( TZ , n = @ ) .


Cardiopulmonary variables were measured continuously .


Arterial blood gases and lactate concentration were measured at the end of anesthesia .


Quality and times of recovery were determined .


Repeatedly measured data for significant differences were tested between groups with t-test and within groups by anova .


Median time for induction of anesthesia in PRO was @seconds .


Mean maintenance infusion rate of propofol was @ mgkg ( -@ ) minute ( -@ ) , varying during the @hour period .


One monkey died after administration of TZ ; others required @ , @ , or @ supplemental doses .


Cardiopulmonary variables were similar between groups , but hypotension was recorded .


Recovery times to ventral recumbency in PRO ( @minutes ) and TZ ( @minutes ) and normal ambulation in PRO ( @minutes ) and TZ ( @minutes ) were significantly different ( p < @ ) .


Recovery quality was superior in PRO , with less ataxia and fewer unsuccessful attempts to stand .


Lactate concentration was not different between treatments .


Cardiopulmonary variables were similar between protocols , aside from the higher incidence of hypotension in PRO , indicating that further studies with a larger number of animals are required .


Compared to tiletamine-zolazepam , propofol anesthesia provided faster and superior anesthetic recovery in these animals .


The objectives of this study were to evaluate the effects of medication education and behavioral intervention on Chinese patients with epilepsy and to compare the difference between them .


A total of @ patients with epilepsy who did not to take their antiepileptic drugs ( AEDs ) more than once were randomly assigned to two intervention groups : the medication education group ( group I ) and the medication education with behavioral intervention group ( group II ) .


Group I was initially provided with medication education in the form of oral education and written materials , and this education was reinforced by monthly calls from the pharmacist over the next six months .


The behavioral intervention provided to group II consisted of a modified medication schedule which was based on cue-dose training therapy .


The outcomes that were evaluated both in the beginning and in the end of the study included adherence , which was measured using the four-item Morisky Medication Adherence Scale ( MMAS-@ ) , the number of seizures , knowledge of AEDs , and the number of patients who missed a dose of their AEDs .


Differences within and between the groups were analyzed .


After intervention , the adherence and knowledge of AEDs increased greatly in all patients , and the number of patients who had seizures or missed AEDs decreased .


However , no significant differences were observed between groups I and II .


The observed changes were ( group I vs group II , p value ) increased adherence : @ % vs @ % , @ ; increased knowledge of AEDs : @ % vs @ % , @ ; and improved seizure control : @ % vs @ % , @ .


In addition , the percentage of patients who forgot to take their AEDs decreased to @ % from more than @ % , and @ % of these patients took the missed AEDs as soon as they remembered .


These findings clearly demonstrate that medication education and reinforced telephone calls from pharmacists can help to increase adherence to AEDs , the knowledge of patients regarding AEDs , and seizure control .


However , the inclusion of a behavioral strategy that was easy to administer and use in this program did not lead to any significant effects on improving adherence .


The results indicate that pharmacists can play an important role in improving the effects of medication regimens , but further research is required to identify strategies for improving adherence to behavioral theory .


To compare between the effects of cold and warm ischemia on the risk of deterioration of renal insufficiency in patients with T@ renal tumor managed by partial nephrectomy .


This prospective randomized study was performed on @ patients with chronic kidney disease , all having T@ renal tumors .


Renal function was estimated by estimated glomerular filtration rate ( eGFR ) , using the Modification of Diet in Renal Disease formula .


Patients were randomly divided into @ groups : in group A , warm ischemia was used , and in group B , cold ischemia was used .


All patients were treated by open partial nephrectomy .


Patients were followed up for @years .


The primary outcome of the study was eGFR at @years .


Secondary outcomes were tumor recurrence , loss of follow-up , or patient death .


Mean age of patients was @ @ years .


Associated chronic disease ( diabetes and/or hypertension ) was present in @ patients .


Worsening of renal insufficiency occurred within @month of surgery in @ patients ( @ in group A and @ in group B ) .


At @months follow-up , @ of these @ patients returned to their baseline eGFR .


Warm ischemia rendered patients more prone to a decrease in eGFR after partial nephrectomy , with relative risk of @ and @ times at @months and @years of follow-up , respectively .


Warm ischemia increases the risk of deterioration of renal functions in patients with renal insufficiency undergoing open partial nephrectomy for renal tumors .


Impaired nitric oxide-mediated pulmonary vascular tone is commonly found in heart failure with reduced ejection fraction ( HFrEF ) , and is associated with derangement of left ventricular ( LV ) hemodynamics and decreased exercise capacity , which may be reversed by PDE@ inhibitor .


This study investigated the effects of a new , long-acting PDE@ inhibitor on LV hemodynamics and exercise capacity in HFrEF .


Patients with chronic HFrEF on optimal medical therapy for > @ days before enrollment were randomly assigned to placebo or udenafil at a dose of @mg @x/day for the first @ weeks followed by @mg @x/day for the next @ weeks .


All patients underwent cardiopulmonary exercise echocardiography before and after the @-week treatment .


Improvement of subjective functional capacity was more frequently reported in the udenafil group ( P = @ ) .


Also , a higher increase in peak VO@ ( peak VO@ , @ % ( @ ~ @ % ) vs @ % ( -@ ~ @ % ) in the placebo group , P = @ ) and a larger decrease in ventilatory efficiency were observed in the udenafil group ( -@ @ vs @ @ in the placebo group , P = @ ) .


Regarding LV systolic function , the extent of increment in LV ejection fraction was significantly greater in the udenafil group ( @ @ % vs @ @ % in the placebo group , P = @ ) .


In the udenafil group , an echocardiographic surrogate of LV filling pressure was more prominently decreased ( P = @ ) along with a significant reverse remodeling of left atrial volume index ( @ @mL at baseline to @ @ at @th week , P = @ ) and a progressive fall in B-type natriuretic peptide level ( @ @pg/mL at baseline to @ @pg/mL at @th week , P < @ ) , indicating LV diastolic function improvement .


Udenafil was well tolerated without excess of adverse events compared to placebo .


Udenafil improves LV systolic/diastolic functions and exercise capacity in conjunction with established conventional pharmacotherapy , without significant adverse events in HFrEF .


Two studies assessing ticagrelor pharmacokinetics , pharmacodynamics , and tolerability in healthy Japanese and Caucasian volunteers .


Single-ascending dose ( SAD ) study : Japanese ( n = @ ) and Caucasians ( n = @ ) received single doses of ticagrelor ( @ , @ , @ , @ , @ , and @ mg ) or placebo .


Multiple-ascending dose ( MAD ) study : Japanese ( n = @ ) and Caucasians ( n = @ ) received single doses of @ mg or @ mg ticagrelor ( day @ ) , twice-daily @ mg or @ mg ticagrelor , or placebo ( days @ @ ) , and single doses of @ mg or @ mg ticagrelor ( day @ ) .


Exposure to ticagrelor and its active metabolite , AR-C@XX , was generally higher in Japanese vs. Caucasians .


In the SAD study , area under the plasma concentration-time curve ( AUC ) values were @ % ( ticagrelor ) and @ % ( AR-C@XX ) greater in Japanese vs. Caucasians following @ mg ticagrelor .


In the MAD study , AUC values of ticagrelor and AR-C@XX following multiple doses of ticagrelor @ mg and @ mg were statistically significantly greater ( @ - @ % ) in Japanese vs. Caucasians .


In both groups , mean peak inhibition of platelet aggregation was > @ % after single doses ( > = @ mg ticagrelor ) and > @ % after multiple doses .


Bleeding times were > = @ minutes in more Japanese than Caucasians with multiple dosing of @ mg and @ mg ticagrelor Adverse events were similar between groups ( mild-to-moderate intensity ) .


The pharmacokinetics and tolerability of ticagrelor were broadly similar in Japanese and Caucasians , although exposure was slightly greater in Japanese volunteers .


Ticagrelor was generally well tolerated .


The use of procinticos in the critical patient with nutrition enteral , they have as aim reduce the increase of the gastric residue ( RG ) .


We evaluate his efficiency in the improvement of the intake enteral and on the reduction in the incident gastrointestinal complications ( CGI ) and pneumonia , in critical patients , with neurological injury Aims : To evaluate the effects in the administration metoclopramide ( MCG ) , during the first five days with enteral nutrition , versus control ( GC ) , on the volume of administered diet , gastrointestinal complications and the incidence of mechanical ventilation associated pneumonia ( NAVM ) , in neuro-critically patients ( NC ) of traumatic and vascular aetiology .


Prospective , closed-label , randomized study performed in an intensive Care Unit .


Methords : @ adult neuro-critical patients ( NC ) were admitted of consecutive form and @ were randomly and two groups @ MCG y @ GC .


The primary outcomes was the nutritional : the volume of administered diet ( VAD ) ; mean efficacious volume ( MEV ) measured in three consecutive periods of time ; the gastrointestinal complications ( GIC ) , and the rate of partial and definitive suspension of the diet .


Infecction : incidence of ventilator associated pneumonia NAVM ; and of secondary outcomes were : the duration of mechanical ventilation , length of ICU and hospital stay , and incidence the serious sequelae , and @ days mortality .


Differences were not observed in the severity variables between groups on admission .


A significant increase was observed in the global values and in the first five days of ( p < @ ) of the VEM in the group of MCG .


The values of the global VDA and during three phases of study , the number CGI , the rate of partial and definitive suspensions of the diet , and number of NAVM , were similar in both not significant groups .


Neither differences were observed in the overall analysis secondary variables .


The metoclopramida in the NC , it is not effective in the decrease of the CGI , in the doses and time of treatment reflected in the study .


Whereas in the U.S. and Canada the Individual Placement and Support ( IPS ) model has proven to be highly effective in enhancing employment perspectives for persons with severe mental illnesses , the evidence base is less abundant in countries with a different socioeconomic climate .


The aim of this study was to examine the effectiveness of IPS in the Dutch socioeconomic context .


A multisite randomized controlled trial was performed following @ persons with severe mental illnesses expressing an explicit wish for regular employment , comparing IPS with traditional vocational rehabilitation ( TVR ) .


Primary outcome was the proportion of persons who were competitively employed over a period of @ months .


Secondary outcomes were self-reported quality of life , self-esteem and mental health .


Additionally , the impact of being engaged in competitive employment on these secondary outcomes was examined .


In @ months , @ % of IPS participants found competitive work , compared with @ % of participants supported by TVR .


No direct effect of IPS on mental health , self-esteem or quality of life was found .


Being competitively employed before follow-up measurements was significantly associated with an increase in mental health , self-esteem and quality of life .


This study strongly confirms that IPS is an effective method in helping people with severe mental illnesses find competitive work also in countries characterized by a relatively protective socioeconomic climate putting up unintended barriers to employment .


The implementation of IPS on a larger scale seems warranted , and new studies are needed on the mechanisms through which IPS works .


The incidence of venous thromboembolism in children has increased significantly over the past @ years .


Over the same period of time , there was an increase in the prevalence of obesity in the pediatric population .


Obesity is a known risk factor for VTE in adults , but little information is available in children .


This study evaluates the relation between obesity and VTE using a retrospective , case-control design , comparing the body mass index ( BMI ) of patients admitted with a diagnosis of VTE versus patients admitted with other diagnoses , at a single institution , between @ and @ .


We studied @ inpatients diagnosed with deep venous thrombosis or pulmonary embolism and a control group of @ age and gender matched patients admitted with other diagnoses .


We found obese patients ( BMI > @th percentile ) to have significantly higher risk of VTE ( odds ratio @ , with @ % CI @-@ @ ) than patients of normal weight ( BMI < @th percentile ) .


Overweight patients ( BMI @th-@th percentile ) did not demonstrate a significant change in risk .


Most of the VTE patients were adolescents and the majority of them had other identifiable risk factors for thrombosis .


This study establishes a correlation between obesity and VTE in a group of hospitalized children , showing a risk for VTE in obese children similar to the one described in much larger adult cohorts .


To evaluate the feasibility of low radiation exposure and low contrast medium volume for coronary CT angiography with High - pitch spiral acquisition mode of dual source CT. .


@ patients whose BMI < @ kg/m and heart rates < @ bpm selected from @ patients diagnosed of suspected CHD at our institution from September @ to February @ were randomly divided into @ groups before CCTA , and there were @ patients in each group .


@ kV , Iodixanol ( @ mgI/ml ) and sinogram affirmed iterative reconstruction ( SAFIRE ) were used in A group .


@ kV , Iopamidol ( @ mgI/ml ) and SAFIRE were used in B group .


@ kV , Iodixanol and filtered back projection ( FBP ) were used in C group .


Two radiologists assessed image quality with @-piont scale subjectively and double-blind .


Independent-Sample Test was used to analyze statistical significance of image quality including signal to noise ratio ( SNR ) and contrast to noise ratio ( CNR ) between A and B group or between A and C group .


At the same time , Contrast medium dose statistical significance between A and B group and mean effective Radiation dose ( ED ) statistical significance between A and C were analyzed by the same way .


There were no significant difference of image quality including SNR and CNR of aortic root ( AO ) , left main coronary artery ( LM ) , left anterior descending artery ( LAD ) , circumflex coronary artery ( CX ) and right coronary artery ( RCA ) Between A and B group ( P = non-significant for all comparison ) , whereas Iodine in taken of A group decreased @ % ( @ @ mg vs @ @ mg ) .


There were no significant difference of image quality including SNR and CNR of AO , LM , LAD , CX and RCA Between A and C group ( P = non-significant for all comparison ) , whereas mean ED of A group decreased @ % ( @ @ mSv vs @ @ mSv ) .


The double low dose application which use High-pitch spiral mode , @ kV , SAFIRE , and Iodixanol ( @ mgI/ml ) can be used in those patients whose BMI < @ kg/m and heart rates < @ bpm to reduce the burden of radiation and contrast medium significantly , without compromising the image quality .


The Fundamentals of Laparoscopic Surgery ( FLS ) trainer is currently the standard for training and evaluating basic laparoscopic skills .


However , its manual scoring system is time-consuming and subjective .


The Virtual Basic Laparoscopic Skill Trainer ( VBLaST ) is the virtual version of the FLS trainer which allows automatic and real time assessment of skill performance , as well as force feedback .


In this study , the VBLaST pattern cutting ( VBLaST-PC ) and ligating loop ( VBLaST-LL ) tasks were evaluated as part of a validation study .


We hypothesized that performance would be similar on the FLS and VBLaST trainers , and that subjects with more experience would perform better than those with less experience on both trainers .


Fifty-five subjects with varying surgical experience were recruited at the Learning Center during the @ SAGES annual meeting and were divided into two groups : experts ( PGY @ , surgical fellows and surgical attendings ) and novices ( PGY @-@ ) .


They were asked to perform the PC or the ligating loop task on the FLS and the VBLaST trainers .


Their performance scores for each trainer were calculated and compared .


There were no significant differences between the FLS and VBLaST scores for either the PC or the ligating loop task .


Experts ' scores were significantly higher than the scores for novices on both trainers .


This study showed that the subjects ' performance on the VBLaST trainer was similar to the FLS performance for both tasks .


Both the VBLaST-PC and the VBLaST-LL tasks permitted discrimination between the novice and expert groups .


Although concurrent and discriminant validity has been established , further studies to establish convergent and predictive validity are needed .


Once validated as a training system for laparoscopic skills , the system is expected to overcome the current limitations of the FLS trainer .


Patients with major depressive disorder ( MDD ) often suffer from impaired declarative , episodic and working memory .


Further , MDD is associated with alterations in the noradrenergic system .


There is evidence that presynaptic @ receptors that inhibit release of noradrenaline are upregulated in MDD .


Results from our recent study demonstrated that increasing noradrenergic activity by blocking the @ receptor with yohimbine leads to stronger memory consolidation in MDD patients .


In the current study , we further examined the role of noradrenaline on memory in MDD by administering clonidine that activates presynaptic @ receptors and thereby globally suppresses the noradrenergic output .


In a placebo-controlled , within-subject crossover design , @ patients with MDD and @ healthy controls received either @ mg of clonidine or placebo orally before memory testing .


A word list paradigm ( memory consolidation ) , an autobiographical memory test ( retrieval ) and a working memory test were applied .


Salivary alpha-amylase and blood pressure were measured .


Across groups , clonidine decreased blood pressure and alpha-amylase .


Clonidine impaired memory consolidation ( word list learning ) in depressed patients and controls .


Memory retrieval and working memory were not affected by clonidine .


Reducing noradrenergic activity had a specific effect on memory consolidation in patients with MDD and healthy controls .


The underlying mechanisms need further scrutiny .


Enterovirus @ ( EV@ ) is a major cause of hand , foot , and mouth disease in children and may be fatal .


A vaccine against EV@ is needed .


We conducted a randomized , double-blind , placebo-controlled phase @ trial involving healthy children @ to @ months of age in Guangxi Zhuang Autonomous Region , China .


Two doses of an inactivated EV@ vaccine or placebo were administered intramuscularly , with a @-week interval between doses , and children were monitored for up to @ months .


The primary end point was protection against hand , foot , and mouth disease caused by EV@ .


A total of @,@ children were randomly assigned to receive vaccine or placebo .


Serum neutralizing antibodies were assessed in @ children who received the vaccine .


The seroconversion rate was @ % @ weeks after the two vaccinations , with a geometric mean titer of @ .


Over the course of two epidemic seasons , the vaccine efficacy was @ % ( @ % confidence interval -LSB- CI -RSB- , @ to @ ) according to the intention-to-treat analysis and @ % ( @ % CI , @ to @ ) according to the per-protocol analysis .


Adverse events , such as fever ( which occurred in @ % of the participants who received vaccine vs. @ % of those who received placebo ) , were significantly more common in the week after vaccination among children who received the vaccine than among those who received placebo .


The inactivated EV@ vaccine elicited EV@-specific immune responses and protection against EV@-associated hand , foot , and mouth disease .


( Funded by the National Basic Research Program and others ; ClinicalTrials.gov number , NCT@ . )


Olfactory dysfunction is deemed to be a significant contributor to poor quality of life in chronic rhinosinusitis ( CRS ) .


To assess and to compare the effectiveness of three modalities of corticosteroids administration in patients with CRS .


A prospective randomized controlled study


Thirty patients with CRS were randomized in three groups depending on the route of corticosteroids administration : @ days by oral route ( Medrol ( Pfizer , Belgique ) , @ mg/@ days -@ mg/@ days-@ mg/@ days ) ; nasal spray ( Rhinocort ( AstraZeneca , Belgique ) , @ @ @ g/nostril ) ; or sonic nebulization ( Pulmicort ( AstraZeneca , Belgique ) , @ @ mg/@ mL ) ( Sonic nebulizer , AOHBOX-NL@SN , DTF , France ) .


Olfactory function was assessed using orthonasal threshold discrimination identification and retronasal psychophysical olfactory tests ( RNT ) before and after the treatment .


Same intranasal modalities were previously tested for in vitro airways scintigraphic deposition .


In vitro differences in drug deposition pattern between both intranasal modalities were demonstrated .


Threshold discrimination identification and RNT were similar between three groups at baseline .


Threshold discrimination identification improved by @ , @ , and -@ for sonic nebulization , oral , and nasal spray groups , respectively ( P = @ ) .


This improvement was clinically relevant for oral and nebulized administration .


It was similar between oral and nebulized administration but significantly higher than nasal spray administration .


Retronasal psychophysical olfactory tests improved similarly for the three groups ( P = @ ) CONCLUSION : Effectiveness of sonic nebulized and oral administration is demonstrated on orthonasal olfactory .


The clinical benefit is better than with nasal spray .


Patients with moderately to severely active ulcerative colitis occasionally do not respond to or lose initial response to maintenance dosing of anti-TNF therapy .


To report the efficacy of escalation from every other week ( EOW ) to weekly adalimumab dosing in patients from the clinical trial ULTRA @ ( NCT@ ) , by week @ response ( i.e. response after adalimumab induction therapy ) .


Week @ remission , response , and mucosal healing rates were assessed in ULTRA @ adalimumab-randomised patients who escalated to weekly dosing .


Patients were stratified by week @ response per partial Mayo score .


Kaplan-Meier and logistic regression analyses estimated time to weekly dosing and defined predictors of escalation to weekly dosing , respectively .


Adverse events were reported for patients receiving open-label adalimumab .


The rate of escalation to weekly dosing was @ % ( @/@ ) for week @ responders and @ % ( @/@ ) for week @ nonresponders .


Week @ remission , response and mucosal healing rates with weekly dosing were @ % , @ % , and @ % for week @ responders and @ % , @ % and @ % for nonresponders , respectively ( NRI ) .


The median time to weekly dosing was @days for week @ nonresponders and not estimable for responders .


Prior anti-TNF use was a significant predictor of escalation to weekly dosing .


Treatment-emergent adverse event rates were similar for patients receiving open-label EOW or weekly adalimumab .


Escalation to weekly adalimumab dosing demonstrated clinical benefits for patients who lost response to therapy and may be beneficial for patients not initially responding to induction therapy .


No new safety risks were identified with weekly dosing .


Implementation intentions are effective for enhancing physical activity , but it is unknown how well these effects extend to older adults and/or are modified by cognitive variables .


Our objective is to examine ( @ ) the efficacy of an implementation intentions intervention for physical activity in older adult women and ( @ ) to examine the moderating effects of executive function .


Participants ( N = @ , M age = @ ) completed measures of executive function and were randomly assigned to weekly implementation intentions for physical activity ( experimental condition ) , implementation intentions for an unrelated behavior ( control condition ) , or no treatment .


Baseline activity was measured by accelerometer and self-report ; follow-up activity was measured by weekly self-report .


Findings indicated a significant treatment effect for the experimental condition and a treatment by executive function interaction .


Specifically , participants with relatively stronger executive function benefited most from the experimental intervention .


Implementation intentions are effective for enhancing physical activity among older adult women , and the effects may be especially pronounced for those with relatively stronger executive function .


Vitamin D ( D ) status is reported to correlate negatively with insulin production and insulin sensitivity in patients with type @ diabetes mellitus ( T@DM ) .


However , few placebo-controlled intervention data are available .


We aimed to assess the effect of large doses of parenteral D@ on glycosylated haemoglobin ( HbA ( c ) ) and estimates of insulin action ( homeostasis model assessment insulin resistance : HOMA-IR ) in patients with stable T@DM .


We performed a prospective , randomised , double-blind , placebo-controlled pilot study at a single university care setting in Switzerland .


Fifty-five patients of both genders with T@DM of more than @ years were enrolled and randomised to either @,@ IU D or placebo , intramuscularly .


The primary endpoint was the intergroup difference in HbA ( c ) levels .


Secondary endpoints were : changes in insulin sensitivity , albuminuria , calcium/phosphate metabolism , activity of the renin-aldosterone axis and changes in @-hour ambulatory blood pressure values .


After @ months of D supply , there was a significant intergroup difference in the change in HbA ( c ) levels ( relative change -LSB- mean standard deviation -RSB- +@ % @ % in the D group vs +@ % @ % the in placebo group , p = @ ) as HOMA-IR decreased by @ % @ % in the D group and increased by @ % @ % in the placebo group ( intergroup difference , p = @ ) .


Twenty-four-hour urinary albumin excretion decreased in the D group from @ @ to @ @ , p = @ ) .


There was no significant intergroup difference for the other secondary endpoints .


D improved insulin sensitivity ( based on HOMA-IR ) and affected the course of HbA ( c ) positively compared with placebo in patients with T@DM .


To investigate the effect of atorvastatin on exercise tolerance in patients with diastolic dysfunction and exercise-induced hypertension .


A randomized , double-blind , placebo-controlled prospective study was performed .


Sixty patients with diastolic dysfunction ( mitral flow velocity E/A < @ ) and exercise-induced hypertension ( SBP > @ mm Hg ) treated with atorvastatin ( @ mg q.d ) or placebo for @ year .


Cardiopulmonary exercise test and exercise blood pressure measurement were performed .


Plasma B-natriuretic peptide ( BNP ) concentration at rest and at peak exercise , plasma high sensitive-C reaction protein ( hs-CRP ) and endothelin ( ET ) concentration were determined at baseline and after treatment .


After treatment by atorvastatin , the resting SBP , pulse pressure , the peak exercise SBP and BNP were significantly decreased ; and the exercise time , metabolic equivalent , maximal oxygen uptake and anaerobic threshold were increased .


All of these parameters had significant differences with baseline levels ( P < @ ) and the rest pulse pressure , the peak exercise SBP and BNP , and the exercise time had significant differences compared with placebo treatment ( P < @ ) .


Plasma concentrations of hs-CRP and ET were markedly reduced by atorvastatin treatment compared with baseline and placebo ( P < @ ) .


No difference in above parameters was found before and after placebo treatment ( P > @ ) .


In patients with diastolic dysfunction at rest and exercise-induced hypertension , atorvastatin can effectively reduce plasma hs-CRP and ET level , lower blood pressure and peak exercise SBP , decrease peak exercise plasma BNP concentration , and ultimately improve exercise tolerance .


The inequity of randomising participants to control groups in randomised controlled trials ( RCTs ) is often considered inappropriate , especially for research trials that include vulnerable populations such as Indigenous peoples .


The Aboriginal and Torres Strait Islander Women 's Fitness Program conducted a trial that randomly assigned participants to ` active ' and ` waitlisted ' groups .


This paper reports on participant views of the randomisation protocol .


A pragmatic RCT was conducted in an urban setting to assess the effectiveness of the @-week Aboriginal and Torres Strait Islander Women 's Fitness Program on metabolic health outcomes and waist circumference .


Qualitative interviews were conducted at follow-up , one of the objectives was to explore participant perspectives on the research protocol , including participant randomisation to ` Active ' and ` Waitlisted ' groups .


A total of @ interviews were conducted ( @ Active and @ Waitlisted participants ) .


Two key factors influenced participant views on the protocol : @ ) group assignment ; and @ ) how well they understood the research design , including the justification for randomisation .


` Active ' participants were concerned about the inequity of the randomisation process but overall supported the study protocol .


Although most Waitlisted participants were disappointed about having to wait @-months for the program , some participants derived motivation from being waitlisted , whilst others lost motivation .


Well-informed participants were more likely to express both support for the randomisation process and an understanding of the research benefits than participants not attending an information session prior to registration .


Participants were more accepting of the research protocol if it was clearly explained to them , if they understood the randomisation process and felt the randomisation was justified in terms of the potential for the results to benefit other Aboriginal and Torres Strait Islander women .


Our study suggests that the time and resources required to adequately explain the research protocol in research trials should not be undervalued .


The authors studied the interaction between sevoflurane and remifentanil on bispectral index ( BIS ) , state entropy ( SE ) , response entropy ( RE ) , Composite Variability Index , and Surgical Pleth Index , by using a response surface methodology .


The authors also studied the influence of stimulation on this interaction .


Forty patients received combined concentrations of remifentanil ( @ to @ ng/ml ) and sevoflurane ( @ to @ vol % ) according to a crisscross design ( @ concentration pairs ) .


During pseudo-steady-state anesthesia , the pharmacodynamic measures were obtained before and after a series of noxious and nonnoxious stimulations .


For the `` prestimulation '' and `` poststimulation '' BIS , SE , RE , Composite Variability Index , and Surgical Pleth Index , interaction models were applied to find the best fit , by using NONMEM @ .


( Icon Development Solutions , Hanover , MD ) .


The authors found an additive interaction between sevoflurane and remifentanil on BIS , SE , and RE .


For Composite Variability Index , a moderate synergism was found .


The comparison of pre - and poststimulation data revealed a shift of C@SEVO for BIS , SE , and RE , with a consistent increase of @ vol % .


The Surgical Pleth Index data did not result in plausible parameter estimates , neither before nor after stimulation .


By combining pre - and poststimulation data , interaction models for BIS , SE , and RE demonstrate a consistent influence of `` stimulation '' on the pharmacodynamic relationship between sevoflurane and remifentanil .


Significant population variability exists for Composite Variability Index and Surgical Pleth Index .


Abdominal aortic aneurysm ( AAA ) is thought to develop as a result of inflammatory processes in the aortic wall .


In particular , mast cells are believed to play a central role .


The AORTA trial was undertaken to investigate whether the mast cell inhibitor , pemirolast , could retard the growth of medium-sized AAAs .


In preclinical and clinical trials , pemirolast has been shown to inhibit antigen-induced allergic reactions .


Inclusion criteria for the trial were patients with an AAA of @-@mm in diameter on ultrasound imaging .


Among exclusion criteria were previous aortic surgery , diabetes mellitus , and severe concomitant disease with a life expectancy of less than @years .


Included patients were treated with @ , @ or @mg pemirolast , or matching placebo for @weeks .


The primary endpoint was change in aortic diameter as measured from leading edge adventitia at the anterior wall to leading edge adventitia at the posterior wall in systole .


All ultrasound scans were read in a central imaging laboratory .


Some @ patients ( mean age @years ; @ per cent men ) were included in the trial .


The overall mean growth rate was @mm during the @-month study .


There was no statistically significant difference in growth between patients receiving placebo and those in the three dose groups of pemirolast .


Similarly , there were no differences in adverse events .


Treatment with pemirolast did not retard the growth of medium-sized AAAs .


Little is known about how U.S. physicians political affiliations , specialties , or sense of social responsibility relate to their reactions to health care reform legislation .


To assess U.S. physicians impressions about the direction of U.S. health care under the Affordable Care Act ( ACA ) , whether that legislation will make reimbursement more or less fair , and examine how those judgments relate to political affiliation and perceived social responsibility .


A cross-sectional , mailed , self-reported survey .


Simple random sample of @,@ U.S.physicians .


Views on the ACA in general , reimbursement under the ACA in particular , and perceived social responsibility .


Among @,@ physicians who responded ( RR@ : @ % ) , approximately two out of five ( @ % ) believed that the ACA will turn U.S. health care in the right direction and make physician reimbursement less fair ( @ % ) .


Seventy-two percent of physicians endorsed a general professional obligation to address societal health policy issues , @ % agreed that every physician is professionally obligated to care for the uninsured or underinsured , and half ( @ % ) were willing to accept limits on coverage for expensive drugs and procedures for the sake of expanding access to basic health care .


In multivariable analyses , liberals and independents were both substantially more likely to endorse the ACA ( OR @ -LSB- @ % CI , @ -RSB- ; OR @ -LSB- @ % CI , @ -RSB- , respectively ) , as were physicians reporting a salary ( OR @ -LSB- @ % CI , @ -RSB- ) or salary plus bonus ( OR @ -LSB- @ % CI , @ ) compensation type .


In the same multivariate models , those who agreed that addressing societal health policy issues are within the scope of their professional obligations ( OR @ -LSB- @ % CI , @ -RSB- ) , who believe physicians are professionally obligated to care for the uninsured / under-insured ( OR @ -LSB- @ % CI ,@ -RSB- ) , and who agreed with limiting coverage for expensive drugs and procedures to expand insurance coverage ( OR @ -LSB- @ % CI , @ -RSB- ) , were all significantly more likely to endorse the ACA .


Surgeons and procedural specialists were less likely to endorse it ( OR @ -LSB- @ % CI , @ -RSB- , OR @ -LSB- @ % CI , @ -RSB- , respectively ) .


Significant subsets of U.S. physicians express concerns about the direction of U.S. health care under recent health care reform legislation .


Those opinions appear intertwined with political affiliation , type of medical specialty , as well as perceived social responsibility .


To evaluate the influence of different alveolar bone heights on fracture resistance and pattern of post and core restored maxillary premolars .


Forty-eight maxillary premolars were randomly divided into @ groups ( @ teeth in each group ) for different alveolar bone heights and different post and core materials .


Group A : fiber post and core and normal alveolar bone height .


Group B : Ni-Cr cast post and core and normal alveolar bone height .


Group C : fiber post and core with @ mm alveolar bone height reduction .


Group D : Ni-Cr cast post and core with @ mm alveolar bone height reduction .


Group E : fiber post and core with @ mm alveolar bone height reduction .


Group F : Ni-Cr cast post and core with @ mm alveolar bone height reduction .


All of the teeth were restored with Ni-Cr cast crowns .


Fracture resistances were tested and the failure modes were examined .


The mean fracture resistances were ( @ @ ) N for group A , ( @ @ ) N for group B , ( @ @ ) N for group C , ( @ @ ) N for group D , ( @ @ ) N for group E , and ( @ @ ) N for group F.


The ratios of favorable fractures were @ % for group A , @ % for group B , @ % for group C , @ % for group D , @ % for group E , and @ for group F.


The alveolar bone height has a significant impact on fracture resistance and modes of post and core restored maxillary premolars .


With the reduction of alveolar bone height , the fracture decreases and the fracture mode tends to be unfavorable .


Computed tomography ( CT ) is used to assess for fracture after knee trauma , but identification of ligamentous injuries may also be beneficial .


Our purpose is to assess the potential of dual-energy computed tomography ( DECT ) for the detection of complete anterior cruciate ligament ( ACL ) disruption .


Sixteen patients with unilateral traumatic ACL disruption ( average of @ days following trauma ) confirmed by MRI , and @ control patients without trauma , underwent DECT of both knees .


For each knee , axial , sagittal , and oblique sagittal images ( with DECT bone removal , single-energy ( SE ) bone removal , and DECT tendon-specific color mapping ) were reconstructed .


Four musculoskeletal radiologists randomly evaluated the @ DECT reconstructed series ( @ knees with @ displays ) separately , to assess for ACL disruption using a five-point scale ( @ = definitely not torn , to @ = definitely torn ) .


ROC analysis was used to compare performance across readers and displays .


Sagittal oblique displays ( mixed kV soft tissue , SE bone removal , and DECT bone removal ) demonstrated higher areas under the curve for ACL disruption ( AUC = @ , @ and @ respectively ) without significant differences in performance between readers ( p > @ ) .


Inter-reader agreement was also better for these display methods ( ICC range @-@ @ ) compared with other techniques ( ICC range @-@ @ ) .


Mean sensitivity for ACL disruption was worst for DECT tendon-specific color map and axial images ( @ % and @ % respectively ) .


DECT knee images with oblique sagittal reconstructions using either mixedkV or bone removal displays ( either DECT or SE ) depict ACL disruption in the subacute or chronic setting with reliable identification by musculoskeletal radiologists .


A treatment-as-usual randomized wait-list controlled trial was conducted to investigate the feasibility and impact of an online synchronous Mindfulness-Based Cancer Recovery ( MBCR ) group program for underserved distressed cancer survivors .


Sixty-two men and women exhibiting moderate to high distress within @ years of completing primary cancer treatment without access to in-person MBCR were randomized to either immediate online MBCR ( n = @ ) or to wait for the next available program ( n = @ ) .


Participants completed questionnaires preintervention and postintervention or wait period online .


Program evaluations were completed after MBCR .


Feasibility was tracked through monitoring eligibility and participation through the protocol .


Intent-to-treat mixed-model analyses for repeated measures were conducted .


Feasibility targets for recruitment and retention were achieved , and participants were satisfied and would recommend online MBCR .


There were significant improvements and moderate Cohen d effect sizes in the online MBCR group relative to controls after MBCR for total scores of mood disturbance ( d = @ , p = @ ) , stress symptoms ( d = @ , p = @ ) , spirituality ( d = @ , p = @ ) , and mindfully acting with awareness ( d = @ , p = @ ) .


Main effects of time were observed for posttraumatic growth and remaining mindfulness facets .


Results provide evidence for the feasibility and efficacy of an online adaptation of MBCR for the reduction of mood disturbance and stress symptoms , as well as an increase in spirituality and mindfully acting with awareness compared with a treatment-as-usual wait-list .


Future study using larger active control RCT designs is warranted .


Lemongrass oil ( LG ) has been reported as being effective against bacteria embedded within the biofilm .


The aims of this study were to investigate antimicrobial activity against common odourigenic micro-organisms , the safety and efficacy of LG mouthrinse on oral malodour in healthy volunteers .


Antimicrobial activity of LG mouthrinse was examined against common odourigenic micro-organisms using broth microdilution assay and the disc diffusion method .


A randomised double-blind clinical study was performed in @ healthy volunteers .


Volatile sulphur compounds ( VSCs ) level was measured using a Halimeter on day @ and day @ in each volunteer .


The results showed that LG mouthrinse was effective against Aggregatibacter actinomycetemcomitans ATCC@ and Porphyromonas gingivalis W@ but less effective against Streptococcus mutans ATCC @ .


In addition , the mouthrinse significantly reduced VSCs on day @ .


LG mouthrinse was able to reduce oral malodour and appeared to be safe .


The overall satisfaction of the mouthrinse was acceptable .


However , the spiciness and taste of the mouthrinse need to be improved .


This study demonstrated that the LG mouthrinse significantly reduced oral malodour .


This mouthrinse would be another alternative mouthrinse choice for prevention of malodour , plaque and gingivitis .


The goal of aneurysm treatment is occlusion of an aneurysm without morbidity or mortality .


Using well-established , traditional endovascular techniques , this is generally achievable with a high level of safety and efficacy .


These techniques involve either constructive treatment of the aneurysm ( coils with or without an intravascular stent ) or deconstruction ( coil occlusion ) of the aneurysm and the parent artery .


While established as safe and efficacious , the constructive treatment of large and giant aneurysms with coils has typically been associated with relatively lower rates of complete occlusion and higher rates of recurrence .


Parent artery deconstruction , though immediately efficacious in achieving complete and durable occlusion , does require occlusion of a major intracranial blood vessel and is associated with risk of stroke .


Flow diversion represents a new technology that can be used to constructively treat large and giant aneurysms .


Once excluded successfully , the vessel reconstruction and aneurysm occlusion appears durable .


The ability to definitively reconstruct cerebral blood vessels is an attractive approach to these large and giant complex aneurysms and allows the treatment of some aneurysms which were previously not amenable to other therapies .


By comparison , conventional coiling techniques have traditionally been used for endovascular treatment of large aneurysms .


Large and giant aneurysms that are amenable to either flow diversion or traditional endovascular treatment will be randomized to either therapy with FDA ( or appropriate regulatory body ) approved devices .


The trial is currently enrolling and results of the data are pending the completion of enrollment and follow-up .


This paper details the trial design of the LARGE trial , a blinded , prospective randomized trial of large anterior circulation aneurysms amenable to either traditional endovascular treatments using coils or reconstruction with flow diverters .


Sixty percent of cancer survivors are @years of age or older .


Cancer and its treatments lead to cancer-related fatigue and many other side effects , in turn , creating substantial global side-effect burden ( total burden from all side effects ) which , ultimately , compromises functional independence and quality of life .


Various modes of exercise , such as yoga , reduce cancer-related fatigue and global side-effect burden in younger cancer survivors , but no studies have specifically examined the effects of yoga on older cancer survivors .


The purpose of this study was to assess the effects of a @-week yoga intervention ( Yoga for Cancer Survivors : YOCAS ) on overall cancer-related fatigue , and due to its multidimensional nature , the subdomains of cancer-related fatigue ( general , physical , emotional , and mental ) and global side-effect burden in older cancer survivors .


We conducted a secondary analysis on data from a multicenter phase III randomized controlled clinical trial with @ arms ( standard care and standard care plus a @-week YOCAS intervention ) .


The sample for this secondary analysis was @ older cancer survivors ( @years of age ) , between @months and @years post-treatment , who participated in the original trial .


Participants in the YOCAS intervention arm reported significantly lower cancer-related fatigue , physical fatigue , mental fatigue , and global side-effect burden than participants in the standard care arm following the @-week intervention period ( p < @ ) .


YOCAS is an effective standardized yoga intervention for reducing cancer-related fatigue , physical fatigue , mental fatigue , and global side-effect burden among older cancer survivors .


To observe the clinical effect of acupuncture therapy combined with Lipitor in the treatment of primary hyperlipidemia ( spleen deficiency and food stagnation type ) .


Sixty primary hyperlipidemia patients ( spleen deficiency and food stagnation type ) were equally randomized into medication group and acupuncture plus medication group .


Patients of both groups were treated by oral administration of Lipitor ( @ mg/tablet , one tablet per day ) for @ weeks .


Manual acupuncture stimulation was applied to Baihui ( GV @ ) , Zhongwan ( CV @ ) , and bilateral Zusanli ( ST @ ) , Sanyinjiao ( SP @ ) , Yin-lingquan ( SP @ ) and Fenglong ( ST @ ) for @ min , twice daily for @ weeks except the weekends .


Serum total cholesterol ( TC ) , triglyceride ( TG ) , high density lipoprotein-cholesterol ( HDL-C ) , low density lipoprotein-cholesterol ( LDL-C ) were detected by using a full-automatic biochemistry analyzer before and after the treatment .


The therapeutic effect was assessed according to the standards described in `` Guide Principles for Clinical Researches of New Chinese Herbal Drugs '' .


After the treatment , the levels of serum TC , TG of the two groups were significantly decreased in comparison with pre-treatment in the same one group ( P < @ ) , and the therapeutic effect of the acupuncture + medication group was significantly superior to that of simple medication group in lowering serum TC , TG and LDL-C levels and heightening HDL-C levels ( P < @ ) .


Of the two @ cases in the medication and acupuncture + medication groups , @ ( @ % ) and @ ( @ % ) were basically controlled in their blood-lipid levels , @ ( @ % ) and @ ( @ % ) had a marked improvement , @ ( @ % ) and @ ( @ % ) were improved , and @ ( @ % ) and @ ( @ % ) were invalid , with the effective rates being @ % and @ % , respectively .


Acupuncture combined with administration of Lipitor is effective in improving primary hyperlipidemia in patients , which is superior to administration of simple Lipitor .


To evaluate the feasibility of using a reduced radiation dose and reduced iodine intake ( i.e. , `` double low '' : low tube voltage/low iodine dose contrast agent ) scanning protocol and the adaptive iterative dose reduction ( AIDR ) reconstruction algorithm in coronary heart disease ( CHD ) patients with a BMI of @-@kg / m ( @ ) .


One-hundred and seventy-nine consecutive CHD patients with a body mass index > @kg/m but < @kg/m were randomly assigned to two groups ( group A : @ men , @ women , average age @ years , and group B : @ men , @ women , average age @ years ) based on tube voltage , contrast agent , and algorithm used .


Group A underwent the `` double low '' protocol ( iodixanol at @mg iodine/ml , @kVp tube voltage , and AIDR ) .


Group B received the conventional protocol -LSB- iopamidol at @mg iodine/ml , @kVp tube voltage , and filtered back projection ( FBP ) -RSB- .


The volume CT dose index ( CTDIvol ) , dose-length product ( DLP ) , effective dose ( ED ) , and iodine intake of patients in `` double low '' group A were significantly lower than the `` conventional '' group B ( p < @ ) .


The mean intraluminal attenuation and contrast enhancement in group A were also significantly less than group B ( p < @ ) , whereas the image noise using AIDR in group A was significantly lower than group B using FBP ( p < @ ) .


However , the signal-to - noise ratio ( SNR ) , contrast-to-noise ratio ( CNR ) , and image-quality scores between the two groups were comparable .


Use of @-row CT with a `` double low '' scanning protocol for CCTA in patients with a BMI of @-@kg / m ( @ ) not only provided images of diagnostic quality but also reduced both radiation dose and iodine intake during scanning .


A self-enhancing loop between impaired inhibitory control under alcohol and alcohol consumption has been proposed as a possible mechanism underlying dysfunctional drinking in susceptible people .


However , the neural underpinnings of alcohol-induced impairment of inhibitory control are widely unknown .


We measured inhibitory control in @ young adults with a stop-signal task during functional magnetic resonance imaging .


In a single-blind placebo-controlled cross-over design , all participants performed the stop-signal task once under alcohol with a breath alcohol concentration of @ g/kg and once under placebo .


In addition , alcohol consumption was assessed with a free-access alcohol self-administration paradigm in the same participants .


Inhibitory control was robustly decreased under alcohol compared with placebo , indicated by longer stop-signal reaction times .


On the neural level , impaired inhibitory control under alcohol was associated with attenuated brain responses in the right fronto-temporal portion of the inhibition network that supports the attentional capture of infrequent stop-signals and subsequent updating of action plans from response execution to inhibition .


Furthermore , the extent of alcohol-induced impairment of inhibitory control predicted free-access alcohol consumption .


We suggest that during inhibitory control alcohol affects cognitive processes preceding actual motor inhibition .


Under alcohol , decreased brain responses in right fronto-temporal areas might slow down the attentional capture of infrequent stop-signals and subsequent updating of action plans , which leads to impaired inhibitory control .


In turn , pronounced alcohol-induced impairment of inhibitory control might enhance alcohol consumption in young adults , which might promote future alcohol problems .


Ex vivo evidence suggests that cyclo-oxygenase ( COX ) @-preferential inhibitor nonsteroidal anti-inflammatory drugs ( NSAIDs ) , such as meloxicam , have a less detrimental effect on intestinal healing than flunixin meglumine ( FM ) .


Whether this translates to a beneficial effect in horses with naturally occurring strangulating small intestinal ( SSI ) lesions is unknown .


To compare the clinical outcome of horses with naturally occurring SSI lesions treated with meloxicam or FM .


Randomised prospective study .


Cases presenting to the Royal Veterinary College Equine Referral Hospital and Bell Equine Veterinary Clinic during @ and @ in which an SSI lesion was identified at exploratory laparotomy were eligible for inclusion .


Horses received either @ mg/kg bwt FM or @ mg/kg bwt meloxicam i.v. q. @h .


Clinical outcomes and clinical and laboratory parameters associated with endotoxaemia were compared between groups .


Sixty cases were enrolled , @ horses received FM and @ received meloxicam .


There was no difference in signalment , physical examination or surgical factors between groups .


The overall survival to discharge was @ % ; there was no difference in survival ( P = @ ) or incidence of post operative ileus ( P = @ ) between groups .


There was no significant difference between the plasma lipopolysaccharide ( LPS ) concentrations at @h ( P = @ ) or @h ( P = @ ) ; however , there was a significant difference between neutrophil count at @h ( P < @ ) and at @h ( P < @ ) with significantly greater cell numbers in horses receiving meloxicam compared with FM .


Blinded pain score evaluation showed that more horses receiving meloxicam showed gross signs of pain than those treated with FM ( P = @ ) .


Nonsteroidal anti-inflammatory drug choice did not affect major clinical outcomes in horses with SSI lesions but had some effects on signs of pain .


This study provides no evidence to recommend one NSAID treatment above another based on survival or the incidence of ileus ; however , evaluation of a larger number of cases is required .


Long-term ventilated intensive care patients frequently require tracheostomy .


Although overall risks are low , serious immediate and late complications still arise .


Real-time ultrasound guidance has been proposed to decrease complications and improve the accuracy of the tracheal puncture .


We aimed to compare the procedural safety and efficacy of real-time ultrasound guidance with the traditional landmark approach during percutaneous dilatational tracheostomy ( PDT ) .


A total of @ patients undergoing PDT for clinical indications were randomly assigned , after obtaining informed consent , to have the tracheal puncture procedure carried out using either traditional anatomical landmarks or real-time ultrasound guidance .


Puncture position was recorded via bronchoscopy .


Blinded assessors determined in a standardised fashion the deviation of the puncture off midline and whether appropriate longitudinal position between the first and fourth tracheal rings was achieved .


Procedural safety and efficacy data , including complications and number of puncture attempts required , were collected .


In total , @ data sets were evaluable .


Real-time ultrasound guidance resulted in significantly more accurate tracheal puncture .


Mean deviation from midline was @ versus @ ( P = @ ) .


The proportion of appropriate punctures , defined a priori as @ from midline , was significantly higher : @ ( @ % ) of @ versus @ ( @ % ) of @ ( RR = @ ; @ % CI = @ to @ ; P = @ ) .


First-pass success rate was @ ( @ % ) of @ in the ultrasound group and @ ( @ % ) of @ in the landmark group ( RR = @ ; @ % CI = @ to @ ; P = @ ) .


The observed decrease in procedural complications was not statistically significant : @ ( @ % ) of @ in the ultrasound group versus @ ( @ % ) of @ in the landmark group ( RR = @ ; @ % CI = @ to @ ; P = @ ) .


Ultrasound guidance significantly improved the rate of first-pass puncture and puncture accuracy .


Fewer procedural complications were observed ; however , this did not reach statistical significance .


These results support wider general use of real-time ultrasound guidance as an additional tool to improve PDT .


The United Nations Millennium Development Goals include targets for the health of children under five years old .


Poor health is linked to poverty and microfinance initiatives are economic interventions that may improve health by breaking the cycle of poverty .


However , there is a lack of reliable evidence to support this .


In addition , microfinance schemes may have adverse effects on health , for example due to increased indebtedness .


Rojiroti UK and the Centre for Promoting Sustainable Livelihood run an innovative microfinance scheme that provides microcredit via women 's self-help groups ( SHGs ) .


This pilot study , conducted in rural Bihar ( India ) , will establish whether it is feasible to collect anthropometric and mortality data on children under five years old and to conduct a limited cluster randomized trial of the Rojiroti intervention .


We have designed a cluster randomized trial in which participating tolas ( small communities within villages ) will be randomized to either receive early ( SHGs and microfinance at baseline ) or late intervention ( SHGs and microfinance after @months ) .


Using predesigned questionnaires , demographic , and mortality data for the last year and information about participating mothers and their children will be collected and the weight , height , and mid upper arm circumference ( MUAC ) of children will be measured at baseline and at @months .


The late intervention group will establish SHGs and microfinance support at this point and data collection will be repeated at @months .


The primary outcome measure will be the mean weight for height z-score of children under five years old in the early and late intervention tolas at @months .


Secondary outcome measures will be the mortality rate , mean weight for age , height for age , prevalence of underweight , stunting , and wasting among children under five years of age .


Despite economic progress , marked inequalities in child health persist in India and Bihar is one of the worst affected states .


There is a need to evaluate programs that may alleviate poverty and improve health .


This study will help to inform the design of a definitive trial to determine if the Rojiroti scheme can improve the nutrition and survival of children under five years of age in deprived rural communities .


The potential for small-quantity lipid-based nutrient supplements ( LNS ) to promote growth and development after @ mo of age is currently being investigated .


Because infants self-regulate energy intake , consumption of LNS may reduce breast milk intake and potentially decrease the beneficial effects of breast milk .


The objective was to test the hypothesis that the breast milk intake of @ - to @-mo-old rural Malawian infants receiving LNS would not be lower than that of infants receiving no supplementation .


This was a substudy of the International Lipid-based Nutrient Supplements ( iLiNS ) DOSE trial , in which @-mo-old infants were randomly assigned to receive @ , @ , or @ g LNS/d containing @ , @ , or @ kcal/d , respectively , or no LNS until @ mo of age .


A subset was randomly selected to estimate breast milk intake at @-@ mo of age with the dose-to-mother deuterium oxide dilution method .


The noninferiority margin was < @ % of total energy requirements .


Baseline characteristics ( n = @ ) were similar across groups .


The mean ( SD ) daily breast milk intake of unsupplemented infants was @ @ g.


The differences ( @ % CIs ) in mean intake of infants provided with @ , @ , or @ g LNS/d , compared with controls , were +@ ( -@ , +@ ) , +@ ( -@ , +@ ) , and +@ ( -@ , +@ ) g/d , respectively .


Non-breast milk oral water intake did not differ by group ( P = @ ) and was inversely ( r = -@ , P < @ ) associated with breast milk intake .


In this rural Malawian population , breast milk intake at @-@ mo of age was not reduced by supplementation with complementary foods with @-@ g LNS/d .


In the United States , data from federally funded genomics studies are stored in national databases , which may be accessible to anyone online ( public release ) or only to qualified researchers ( restricted release ) .


The availability of such data exposes participants to privacy risk and limits the ability to withdraw from research .


This exposure is especially challenging for pediatric participants , who are enrolled in studies with parental permission .


The current study examines genomic research participants ' attitudes to explore differences in data sharing ( DS ) preferences between parents of pediatric patients and adult patients .


A total of @ parents of pediatric patients and @ adult participants from @ genomics studies were randomly assigned to @ experimental consent forms .


Participants were invited to a follow-up structured interview exploring DS preferences , study understanding , and attitudes .


Descriptive analyses and regression models were built on responses .


Most parents ( @ % ) and adult participants ( @ % ) ultimately consented to broad public release .


However , parents were significantly more restrictive in their data release decisions , not because of understanding or perceived benefits of participation but rather autonomy and control .


Parents want to be more involved in the decision about DS and are significantly more concerned than adult participants about unknown future risks .


Parents have the same altruistic motivations and grasp of genomics studies as adult participants .


However , they are more concerned about future risks to their child , which probably motivates them to choose more restrictive DS options , but only when such options are made available .


To evaluate the safety , tolerability and immunogenicity of three different doses ( @ , @ and @ g ) of the novel antituberculous vaccine RUTI compared to placebo in subjects with latent tuberculosis infection .


Double-blind , randomized , placebo-controlled Phase II Clinical Trial ( @ patients randomized ) .


Three different RUTI doses and placebo were tested , randomized both in HIV-positive ( n = @ ) and HIV-negative subjects ( n = @ ) , after completion of one month isoniazid ( INH ) pre-vaccination .


Each subject received two vaccine administrations , @ Days apart .


Five patients withdrew and @ patients completed the study .


Assessment of safety showed no deaths during study .


Two subjects had serious adverse events one had a retinal detachment while taking INH and was not randomized and the other had a severe local injection site abscess on each arm and was hospitalized ; causality was assessed as very likely and by the end of the study the outcome had resolved .


All the patients except @ ( @ % ) patients of the placebo group ( @ HIV + and @ HIV - ) reported at least one adverse event ( AE ) during the study .