Electromyography ( EMG ) from the splenius and upper trapezius was recorded during a normal workday .


Adherence to training and control interventions were @ % and @ % , respectively .


Compared with control , training increased isometric muscle strength @ % ( P < @ ) and decreased neck/shoulder pain intensity by @ % ( P < @ ) .


The frequency of periods with complete motor unit relaxation ( EMG gaps ) decreased acutely in the hours after training .


By contrast , at @-week follow-up , training increased average duration of EMG gaps by @ % , EMG gap frequency by @ % and percentage time below @ % , and @ % EMGmax by @ % and @ % , respectively , during the workday in m. splenius .


While resistance training acutely generates a more tense muscle activity pattern , the longitudinal changes are beneficial in terms of longer and more frequent periods of complete muscular relaxation and reduced pain .


To observe the curative effect of acupuncture intervention combined with hyperbaric oxygen chamber treatment for delayed encephalopathy in @ carbon monoxide ( CO ) poisoning patients .


A total of @ CO poisoning encephalopathy patients were randomized into control group ( n = @ ) and acupuncture group ( n = @ ) .


Patients of the two groups were all treated with medicines ( energy mixture solution , hormones , brain cell activators , calcium ion blockers , anti-inflammatory agents , etc. ) and hyperbaric oxygen treatment ( oxygen-inhaling for @ min/time ) .


Moreover , patients of the acupuncture group received acupuncture stimulation of bilateral Taixi ( KI @ ) , Xuanzhong ( GB @ ) , Hegu ( LI @ ) , Taichong ( LR @ ) , and Fengchi ( GB @ ) .


All the treatments were conducted once daily for @ days .


The therapeutic effect of the treatments for neurological function was assessed by NIH Stroke Scale ( NIHSS , @ points in total ; including @ items as consciousness , horizontal eye movement , visual power , visual field , facial muscular motion , limb movement , coordination movement , sensory and language levels , etc. ) .


After the treatment , of the @ and @ cases in the control and acupuncture groups , @ and @ were cured , @ and @ experienced marked improvement , @ and @ were improved , and @ and @ invalid , with the effective rates being @ % and @ % , respectively .


The therapeutic effect of the acupuncture group was significantly superior to that of the control group ( P < @ ) .


The average NIHSS score was @ + / - @ in the acupuncture group , being significantly lower than that ( @ + / - @ ) in the control group ( P < @ ) .


Acupuncture treatment can effectively strengthen the efficacy of hyperbaric oxygen therapy in the treatment of delayed encephalopathy caused by carbon monoxide poisoning .


Results of randomised controlled trials of newborn ( age @-@ days ) vitamin A supplementation have been inconclusive .


The WHO is coordinating three large randomised trials in Ghana , India , and Tanzania ( Neovita trials ) .


We present the findings of the Neovita trial in Ghana .


This study was a population-based , individually randomised , double-blind , placebo-controlled trial in the Brong Ahafo region of Ghana .


The trial participants were infants aged at least @ h , identified at home or facilities on the day of birth or in the next @ days , able to feed orally , and likely to stay in the study area for at least @ months .


They were randomly assigned ( ratio @:@ ) to receive either one oral dose of vitamin A ( @,@ IU ) or placebo immediately after recruitment .


The research team and parents of the infants were masked to treatment assignment .


Follow-up home visits were undertaken every @ weeks , when data were recorded for deaths , facility use , and care seeking .


The primary outcome was post-supplementation mortality to @ months of age .


Analysis was by intention to treat .


Potential adverse events were recorded at @ and @ days after supplementation .


This trial is registered with the Australian New Zealand Clinical Trials Registry ( ANZCTR ) CTRN@ .


We assessed @,@ livebirths for eligibility between Aug @ , @ , and Nov @ , @ .


We recruited @,@ newborn infants , with @,@ randomly assigned to receive vitamin A and @,@ to receive placebo .


Loss to follow-up was low with vital status at @ months of age reported for @,@ ( @ % ) infants .


We recorded @ post-supplementation deaths to @ months of age in the vitamin A group ( mortality risk @ in @ supplemented infants ) and @ deaths in the placebo group ( mortality risk @ per @ supplemented infants ) , relative risk ( RR ) @ ( @ % CI @-@ ; p = @ ) and risk difference ( RD ) @ ( @ % CI -@ to @ ; p = @ ) .


Adverse events within @ days of supplementation did not differ by trial group .


@ infants died in the first @ days after supplementation ; @ ( @ % ) in the vitamin A and @ ( @ % ) in the placebo group ( risk ratio -LSB- RR -RSB- @ , @ % CI @-@ , p = @ ) .


@ infants were reported to have a bulging fontanelle ; @ ( @ % ) in the vitamin A group and @ ( @ % ) in the placebo group ( RR @ , @-@ , p = @ ) .


The results of this trial do not support inclusion of newborn vitamin A supplementation as a child survival strategy in Ghana .


To assess the efficacy of two embolic agents in the treatment of symptomatic uterine leiomyomas .


A randomized , prospective , single-center study enrolled @ women with symptomatic uterine leiomyomas .


Uterine artery embolization ( UAE ) with spherical polyvinyl alcohol ( SPVA ) microspheres ( n = @ ; @-@ m and @-@ ,@ m ; near-stasis or stasis endpoint ) and tris-acryl gelatin ( TAG ) microspheres ( n = @ ; @-@ m ; `` pruned-tree '' endpoint ) was performed .


Infarction rates were calculated for the dominant tumor and for small ( < @ cm ) and large ( > @ cm ) nondominant tumors .


The primary endpoint was tumor infarction at @ hours measured by contrast-enhanced magnetic resonance imaging assessed by a blinded reviewer .


Baseline characteristics were similar between groups .


The primary endpoint was similar in both treatments ( @ % dominant tumor infarction ; SPVA .


@ % ; TAG , @ % , P = @ ) .


Complete infarction ( @ % ) was also similar between arms at @ hours and @ months .


Symptom severity was reduced and quality of life improved equally at @ and @ months in each treatment group .


Complications were minor in both groups .


Uterine leiomyoma infarction at @ hours and @ months after treatment with SPVA or TAG microspheres was comparable when using near-stasis as a procedural endpoint with SPVA microspheres .


Symptom relief was maintained for as long as @ months for both embolic agents .


Whereas routine prophylaxis for venous thromboembolism ( VTE ) is frequently utilized in the West , Asian physicians employ it much less often , based on its recorded rarity amongst their patients .


This study was designed to examine the incidence of VTE and to determine the optimal method of thromboembolic prophylaxis following gastrectomy for cancer .


In this prospective , randomized trial , patients were assigned to either an intermittent pneumatic compression ( IPC ) only or an IPC plus enoxaparin .


The primary end point of this study was to determine the VTE incidence rate within @ days of surgery .


A history with physical examinations for VTE and a serum d-dimer test was scheduled on postoperative days ( POD ) @ , @ , @ , and @ .


Duplex ultrasonography ( DUS ) was performed as an objective test for deep vein thrombosis at POD @ .


An interim analysis was performed to determine if it was ethical to continue the study .


This clinical trial was registered at www.clinicaltrials.gov ( NCT@ ) .


Among the @ patients , @ ( all from the IPC group ) were diagnosed with VTE ; these cases were asymptomatic , having been detected only on DUS @ days after surgery .


Postoperative bleeding occurred in @ cases , among which @ patients were in the IPC plus enoxaparin group .


This interim analysis showed a higher incidence of VTE in the IPC group but a higher bleeding rate in the IPC plus enoxaparin group .


We expect that this study , once completed , will provide information key to the determination of the optimal method for preventing VTE in Korean gastric cancer patients .


A number of trials have shown improved radiological alignment following total knee arthroplasty using computer-assisted surgery ( CAS ) compared with conventional surgery .


Few studies , however , have looked at functional outcomes .


We prospectively studied a cohort of @ patients that underwent TKA by a single surgeon .


Patients were randomised into @ groups : computer-assisted surgery for both the femur and the tibia , intramedullary guides for both the femur and the tibia , and an intramedullary guide for the femur and an extramedullary guide for the tibia .


Patients were followed-up post-operatively with the Short Form Health Survey ( SF-@ ) and Oxford Knee Score ( OKS ) questionnaires .


At a median follow-up of @ months ( range @-@ months ) , there was a trend towards higher OKS results in the CAS group , with a mean score of @ in the CAS group compared to @ in the extramedullary group and @ in the intramedullary group .


The difference seen in the OKS between CAS and the conventional groups had a significant unadjusted p-value ( @ ) , and approached significance when adjusted for age and sex ( @ ) .


There was a significant improvement in the OKS when the mechanical axis was within @ of neutral , versus those outside this range ( median of @ compared to @ , p = @ ) .


This study shows that clinically significant differences are being seen in functional scores of patients treated with CAS versus conventional guides , at medium-term follow up .


Our findings reinforce the tenet that a coronal mechanical axis of within @ of neutral equates to significantly better functional outcomes .


We aimed to compare patient-controlled thoracic or lumbar epidural analgesia methods after thoracotomy operations .


One hundred and twenty patients were prospectively randomized to receive either thoracic epidural analgesia ( TEA group ) or lumbar epidural analgesia ( LEA group ) .


In both groups , epidural catheters were administered .


Hemodynamic measurements , visual analog scale scores at rest ( VAS-R ) and after coughing ( VAS-C ) , analgesic consumption , and side effects were compared at @ , @ , @ , @ , @ , and @ hours postoperatively .


The VAS-R and VAS-C values were lower in the TEA group in comparison to the LEA group at @ , @ , @ , and @ hours after surgery ( for VAS-R , P = @ , P = @ , P = @ , and P = @ , respectively ; and for VAS-C , P = @ , P = @ , P = @ , and P = @ , respectively ) .


Total @-hour analgesic consumption was different between groups ( @ + / - @ mL versus @ + / - @ mL ; P = @ ) .


The comparison of postoperative complications revealed that the incidence of hypotension ( @/@ , @ % versus @/@ , @ % ; P = @ ) , bradycardia ( @/@ , @ % versus @/@ , @ % ; P = @ ) , atelectasis ( @/@ , @ % versus @/@ , @ % ; P = @ ) , and the need for intensive care unit ( ICU ) treatment ( @/@ , @ % versus @/@ , @ % ; P = @ ) were lower in the TEA group in comparison to the LEA group .


TEA has beneficial hemostatic effects in comparison to LEA after thoracotomies along with more satisfactory pain relief profile .


Gemifloxacin is a synthetic fluoroquinolone antimicrobial agent , which has potent activity against most Gram-negative and Gram-positive organisms .


It is indicated for the treatment of community-acquired pneumonia and acute bacterial exacerbation of chronic bronchitis .


The aim of this study was to assess the clinical potential of a new gemifloxacin @ mg intravenous formulation by comparing its pharmacokinetic characteristics with those of the branded Factive ( ) gemifloxacin tablet .


A single-dose , open-label , randomized-sequence , two-period crossover study was performed with @ healthy male volunteers .


The two treatment periods were separated by a @-week washout period .


Blood samples were taken for up to @ h post-dose .


Plasma gemifloxacin concentrations were determined by a validated high-performance liquid chromatography-tandem mass spectrometry method .


To calculate the pharmacokinetic parameters , noncompartmental analysis was performed .


The two formulations were considered to be pharmacokinetically equivalent if the @ % confidence intervals ( CIs ) of the log-transformed ratios ( intravenous/oral formulations ) of the area under the plasma concentration-time curve ( AUC ) from time zero to the time of the last measurable concentration ( AUClast ) and the AUC from time zero to infinity ( AUC ) were within the standard bioequivalence range ( @-@ @ ) .


Safety and tolerability were evaluated on the basis of physical examinations , vital signs , electrocardiograms , clinical laboratory tests and adverse event monitoring .


Seventeen subjects were enrolled , and @ subjects completed the study .


Sixteen subjects received intravenous @ mg gemifloxacin and @ received oral @ mg gemifloxacin .


The @ subjects in the pharmacokinetic analysis set had a mean ( standard deviation -LSB- SD -RSB- ) age , height and weight of @ ( @ ) years , @ ( @ ) cm and @ ( @ ) kg , respectively .


Both formulations had similar pharmacokinetic profiles .


For the intravenous formulation , the mean ( SD ) AUClast , AUC and maximum plasma concentration ( C max ) values were @ ( @ ) gh/mL , @ ( @ ) gh/mL and @ ( @ ) g/mL , respectively , while these values for the oral formulation were @ ( @ ) gh/mL , @ ( @ ) gh/mL and @ ( @ ) g/mL , respectively .


For the intravenous and oral formulations , the median ( range ) time to reach C max ( t max ) values were @ ( @-@ @ ) and @ ( @-@ @ ) h , respectively .


The mean relative bioavailability was @ % .


The @ % CI of the ratios of the log-transformed values of AUClast and AUC was @-@ @ .


There were no serious adverse events .


The intravenous and oral formulations were associated with treatment-emergent adverse event incidences of @ % ( @/@ ) and @ % ( @/@ ) , respectively .


After the intravenous formulation was administered , application site pain and paraesthesia were the most frequently reported adverse events ( @ and @ % , respectively ) .


All adverse events resolved spontaneously without treatment .


Intravenous @ mg and oral @ mg formulations of gemifloxacin are equivalent in terms of AUC following a single dose in healthy male subjects .


To explore the changes of goiter prevalence of children living in areas with high iodine in drinking water after removing iodized salt from their diet .


Three towns with median water iodine of @ - @ g/L were selected randomly in Hengshui city of Hebei province of China .


A total of @ and @ children in the @ towns were randomly selected to measure thyroid volume by ultrasound before and after removing iodized salt , respectively .


Their goiter status was judged using the criteria of age-specific thyroid volume recommended by the WHO .


After removing iodized salt , the overall goiter prevalence in the three towns significantly decreased from @ % ( @/@ ) to @ % ( @/@ ) ( P < @ ) .


The goiter prevalence in @ , @ and @ year-old children decreased respectively from @ % ( @/@ ) , @ % ( @/@ ) and @ % ( @/@ ) to @ % ( @/@ ) , @ % ( @/@ ) and @ % ( @/@ ) .


The goiter prevalence in boys and girls decreased from @ % ( @/@ ) and @ % ( @/@ ) to @ % ( @/@ ) and @ % ( @/@ ) , respectively .


The decreases in children 's goiter prevalence across gender and age group were all significant .


Children 's goiter prevalence decreased significantly after removing iodized salt from their diet for about one and half years in the HIA in Hebei province .


To observe the clinical effect and safety of Sulfasalazine ( SASP ) combined with ZHUANG medicine mediated thread moxibustion ( ZMMTM ) for patients with mild and moderate ulcerative colitis ( UC ) .


A total of @ UC patients were randomly and equally divided into moxibustion group ( SASP combined with ZMMTM ) and SASP medication group .


Patients of both groups were treated by oral administration of SASP ( @ g , tid ) for six weeks .


For patients of the moxibustion group , ZMMTM was applied to points Tianshu ( ST @ ) , Qihai ( CV @ ) , Guanyuan ( CV @ ) , and Dachangshu ( BL @ ) , once a day , for @ times .


The therapeutic effect was assessed according to Schroeder and colleagues ' method ( @ ) , scores of Baron ' s endoscope scale ( @ - @ scoring standards , @ ) , @ - @ scoring standards of activity indexes ( including @ items of diarrhea , hemorrhage , mucosal appearance and doctors ' evaluation ) , respectively .


Of the two @ UC patients in the medication and moxibustion groups , @ and @ had a complete remission in their symptoms , @ and @ experienced a remarkable improvement , @ and @ were effective , and @ and @ was invalid , with the effective rates being @ % and @ % , respectively .


Following the treatment , both endoscopic score and activity index in the moxibustion group were significantly lower than those of the medication group ( P < @ ) .


ZMMTM combined with medication is significantly superior to simple medication in relieving clinical symptoms of mild and moderate UC patients .


Any differences observed between natural glucagon-like peptide-@ ( GLP-@ ) and studies obtained with analogues might call for renewed considerations concerning the use and design of such analogues .


Thus , we aimed to evaluate the dose-response relationship of recombinant glucagon-like peptide-@ ( @-@ ) amide ( rGLP-@ ) administered by continuous subcutaneous infusion ( CSCI ) in subjects with type @ diabetes .


We compared the efficacy and safety of three doses of recombinant GLP-@ , ranging from @ to @ pmol/kg/min ( pkm ) and placebo , given by continuous subcutaneous infusion over @months in combination with metformin and sulphonylurea ( SU ) , to lower haemoglobin A@c ( HbA@c ) , fasting plasma glucose and weight in @ type @ diabetes patients with inadequate glycaemic control .


The mean decreases in HbA@c at endpoint ( week @ ) were significantly greater for all three rGLP-@ dose groups when each was compared with the placebo group , with the greatest decrease occurring in the @ pkm dose group ( -@ % , s.d. @ , p < @ ) .


The mean decreases in fasting plasma glucose from baseline to endpoint were significantly greater for all three rGLP-@ dose groups than for the placebo group , with the greatest decrease occurring in the @ pkm dose group ( -@ mg/dl , s.d. @ , p = @ ) .


Body weight was significantly reduced by @ kg ( s.d. @ ) in the @ pkm dose group only ( p = @ ) .


Administration of rGLP-@ by CSCI over a @-week period in combination with metformin and an SU had a dose dependent effect in lowering HbA@c and fasting plasma glucose .


However , administration of rGLP-@ by CSCI may be less effective with respect to lowering of body weight compared with the daily and once weekly analogues .


BMS-@ , a novel triple monoamine reuptake inhibitor , is an experimental monotherapy for sufferers of major depressive disorder who have had an inadequate response to an existing antidepressant treatment .


This study was conducted to evaluate the safety and tolerability , pharmacokinetics ( PK ) , and serotonin transporter ( SERT ) and dopamine transporter ( DAT ) occupancy for single doses of BMS-@ in healthy subjects .


Healthy subjects were assigned to seven BMS-@ dose panels ( @ , @ , @ , @ , @ , @ , and @ mg ; n = @ each ) , in which subjects were randomly allocated @:@ to a single BMS-@ dose or matched placebo .


Serial blood samples were collected on Days @ , @ , @ , @ , @ , and @ to characterize the PK of BMS-@ .


Following evaluation of the maximum tolerated dose , SERT occupancy was determined by applying -LSB- ( @ ) C -RSB- DASB positron emission tomography ( PET ) after single-dose BMS-@ ( @ or @ mg ; n = @ each ) and DAT occupancy by applying -LSB- ( @ ) C -RSB- PE@I PET after single-dose BMS-@ ( @ mg ; n = @ ) .


Single oral doses of BMS-@ ( @-@ mg ) were generally safe and well tolerated .


BMS-@ had a median T max of @-@ @ h and a mean apparent terminal T @/@ of @-@ h. Mean striatal SERT occupancies were @ @ % and @ @ % after single doses of @ and @ mg BMS-@ , respectively .


The mean striatal DAT occupancy was @ @ % after a single @ mg BMS-@ dose .


Single doses of BMS-@ have meaningful SERT and DAT occupancy and demonstrate an acceptable safety and tolerability profile in healthy control subjects .


To evaluate the safety and efficacy of the novel tenofovir prodrug , tenofovir alafenamide ( TAF ) , as part of a single-tablet regimen ( STR ) for the initial treatment of HIV-@ infection .


Phase @ , randomized , double-blind , double-dummy , multicenter , active-controlled study .


Antiretroviral naive adults with HIV-@ RNA @ copies per milliliter and a CD@ count @ cells per microliter were randomized @:@ to receive an STR of elvitegravir/cobicistat/emtricitabine / tenofovir alafenamide ( E/C/F / TAF ) or elvitegravir/cobicistat/emtricitabine / tenofovir disoproxil fumarate ( E/C/F / TDF ) , plus placebo for @ weeks .


Patients on both E/C/F / TAF ( n = @ ) and E/C/F / TDF ( n = @ ) had high rates of virologic suppression ( < @ HIV copies per milliliter ) at week @ ( @ % ; @ % ) and at week @ ( @ % ; @ % ) , and had similar improvements in CD@ at week @ ( @ ; @ ) , respectively .


Both treatments were well tolerated , and most adverse events were self-limiting and of mild to moderate severity .


Compared with patients on E/C/F / TDF , patients on E/C/F / TAF had smaller reductions in estimated creatinine clearance ( -@ vs. -@ mL/min , P = @ ) , significantly less renal tubular proteinuria , and smaller changes in bone mineral density for hip ( -@ % vs. -@ % , P < @ ) and spine ( -@ % vs. -@ % , P < @ ) .


Patients on E/C/F / TAF had higher increases in total cholesterol , low-density lipoprotein , and high-density lipoprotein , but the total cholesterol/high-density lipoprotein ratio was unchanged for both .


Treatment-naive patients given the STR that contained either TAF or TDF achieved a high rate of virologic success .


Compared with those receiving TDF , patients on E/C/F / TAF experienced significantly smaller changes in estimated creatinine clearance , renal tubular proteinuria , and bone mineral density .


Large-scale clinical trials have shown that routine monitoring of the platelet function in patients after percutanous coronary intervention ( PCI ) is not necessary .


However , it is still unclear whether patients received high-risk PCI would benefit from a therapy which is guided by a selective platelet function monitoring .


This explanatory study sought to assess the benefit of a therapy guided by platelet function monitoring for these patients .


Acute coronary syndrome ( ACS ) patients ( n = @ ) who received high-risk , complex PCI were randomized into two groups .


PCI in the two types of lesions described below was defined as high-risk , complex PCI : lesions that could result in severe clinical outcomes if stent thrombosis occurred or lesions at high risk for stent thrombosis .


The patients in the conventionally treated group received standard dual antiplatelet therapy .


The patients in the platelet function monitoring guided group received an antiplated therapy guided by a modified thromboelastography ( TEG ) platelet mapping : If inhibition of platelet aggregation ( IPA ) induced by arachidonic acid ( AA ) was less than @ % the aspirin dosage was raised to @ mg/d ; if IPA induced by adenosine diphosphate ( ADP ) was less than @ % the clopidogrel dosage was raised to @ mg/d , for three months .


The primary efficacy endpoint was a composite of myocardial infarction , emergency target vessel revascularization ( eTVR ) , stent thrombosis , and death in six months .


This study included @ patients ; @ and @ in the conventionally treated group and platelet function monitoring guided group , respectively .


No significant differences were observed in the baseline clinical characteristics and interventional data between the two groups .


In the platelet function monitoring guided group , the mean IPA induced by AA and ADP were ( @ @ ) % ( range , @ % to @ % ) and ( @ @ ) % ( range , @ % to @ % ) , respectively .


The AA-induced IPA of forty-three ( @ % ) patients was less than @ % and the ADP-induced IPA of fifty-seven ( @ % ) patients was less than @ % ; therefore , their drug dosages were adjusted .


The TEG was rechecked one to four weeks after PCI , and the results indicated that the IPAs had significantly improved ( P < @ ) .


However , no significant differences were found in the rates of the primary efficacy endpoint .


Rates in the conventionally treated group and platelet function monitoring guided group were @ % and @ % , respectively ( hazard ratio : @ ; P = @ ) .


An antiplatelet therapy guided by TEG monitored platelet function could not improve clinical efficacy even in ACS patients treated with high-risk complex PCI .


This study was conducted to determine the effect of oral midazolam ( OM ) or intranasal dexmedetomidine ( IND ) on the EC@ of sevoflurane for successful laryngeal mask airway placement in children .


We hypothesize that premedication with either agent might reduce the sevoflurane EC@ for laryngeal mask airway placement in children to a similar extent .


Fifty-two American Society of Anesthesiologists ( ASA ) I children ( aged @-@ years ) scheduled for general anesthesia with laryngeal mask airway were randomized to one of the three groups : group M received @ mg kg ( -@ ) OM with honey and intranasal saline , group D received @ g kg ( -@ ) IND along with oral honey , and group P received oral honey and intranasal saline at least @ min prior to induction of anesthesia .


Anesthesia was induced with incremental sevoflurane up to @ % in @ % O@ .


A predetermined target endtidal sevoflurane ( ETsevo ) concentration ( @ % in the first child of all three groups ) was sustained for @ min before the attempt of laryngeal mask airway insertion by adjusting dial concentration .


No intravenous anesthetic or neuromuscular blockade was used .


ETsevo was increased/decreased ( step size @ % ) using Dixon 's and Massey 's up and down method in next patient depending upon previous patient 's response .


Placement of the laryngeal mask airway without movement , coughing , biting , or bucking was considered as successful .


EC@ of sevoflurane was calculated as the average of the crossover midpoints in each group , which was further confirmed by probit analysis .


The EC@ of sevoflurane for laryngeal mask airway placement after OM ( @ @ ) and IND ( @ @ ) premedications was significantly lower than the placebo group ( @ @ , P < @ ) .


The EC@ ( @ % CI ) derived from probit regression analysis was @ % ( @-@ @ % ) with OM , @ % ( @-@ @ % ) with IND , and @ % ( @-@ @ % ) with placebo group .


Oral midazolam and IND premedications significantly reduce the sevoflurane EC@ for laryngeal mask airway insertion in children by @ % and @ % , respectively .


To evaluate the safety of different doses of subconjunctival bevacizumab and their effects on the recurrence rate after primary pterygium excision .


This prospective randomized placebo-controlled clinical study was conducted on @ eyes ( @ patients ) .


The visual acuity , refractive astigmatism , horizontal length of the pterygium , and recurrence risk factors were recorded .


There were no statistically significant differences between the groups for age , sex , horizontal length of pterygium , preoperative visual acuity , astigmatism , and recurrence risk factors .


The pterygium was excised from the conjunctival side and then peeled off the cornea .


The bare sclera was covered with a rotational conjunctival flap from the superonasal area .


After surgery , Group @ ( @ patients ) , Group @ ( @ patients ) and Group @ ( @ patients ) received @ mg bevacizumab , @ mg bevacizumab , and Balanced Salt Solution ( BSS ) subconjunctivally , respectively .


Postoperatively , horizontal length of corneal epithelial defect , conjunctival congestion , and lacrimation were checked on the first and seventh day .


The rate of recurrence ( > @ mm fibrovascular overgrowth on the cornea ) at month @ was compared between the groups .


There were no statistically significant differences between the groups for all measured variables except for moderate conjunctival congestion on the first postoperative day which was more common in the bevacizumab groups ( P = @ ) .


Four eyes in Groups @ ( @ % ) and @ ( @ % ) and @ in Group @ ( @ % ) experienced recurrence ( p = @ ) .


All recurrences occurred at month @ and subsequently thereafter .


In our study , perioperative injections of subconjunctival bevacizumab had no effect on primary pterygium recurrence and were not associated with any specific local complications .


Although many malaria control programmes in sub-Saharan Africa use indoor residual spraying with long-lasting insecticidal nets ( LLINs ) , the two studies assessing the benefit of the combination of these two interventions gave conflicting results .


We aimed to assess whether the addition of indoor residual spraying to LLINs provided a significantly different level of protection against clinical malaria in children or against house entry by vector mosquitoes .


In this two-arm cluster , randomised , controlled efficacy trial we randomly allocated clusters of Gambian villages using a computerised algorithm to LLINs alone ( n = @ ) or indoor residual spraying with dichlorodiphenyltrichloroethane plus LLINs ( n = @ ) .


In each cluster , @-@ children , aged @ months to @ years , were surveyed at the start of the @ transmission season and followed in @ and @ by passive case detection for clinical malaria .


Exposure to parasite transmission was assessed by collection of vector mosquitoes with both light and exit traps indoors .


Primary endpoints were the incidence of clinical malaria assessed by passive case detection and number of Anopheles gambiae sensu lato mosquitoes collected per light trap per night .


Intervention teams had no role in data collection and the data collection teams were not informed of the spray status of villages .


The trial is registered at the ISRCTN registry , number ISRCTN@ .


LLIN coverage in @ was @ ( @ % ) of @ children in the indoor residual spraying plus LLIN group and @ ( @ % ) of @ in the LLIN group .


In @ , @ children were enrolled , @ completed passive case detection , and @ ( @ % ) had complete clinical and covariate data .


In @ , @ children remained in the study , @ more were enrolled , @ completed passive case detection , and @ ( @ % ) had complete data .


Indoor residual spraying coverage per cluster was more than @ % for both years in the indoor residual spraying plus LLIN group .


Incidence of clinical malaria was @ per child-month at risk in the LLIN group and @ per child-month at risk in the indoor residual spraying plus LLIN group in @ , and @ per child-month at risk in the LLIN group and @ per child-month at risk in the indoor residual spraying plus LLIN group in @ .


The incident rate ratio was @ ( @ % CI @-@ @ ) controlling for confounders and cluster by mixed-effect negative binomial regression on all malaria attacks for both years .


No significant difference was recorded in the density of vector mosquitoes caught in light traps in houses over the two transmission seasons ; the mean number of A gambiae sensu lato mosquitoes per trap per night was @ ( @-@ @ ) in the LLIN group and @ ( @-@ @ ) in the indoor residual spraying plus LLIN group ( p = @ in the random-effects linear regression model ) .


We identified no significant difference in clinical malaria or vector density between study groups .


In this area with high LLIN coverage , moderate seasonal transmission , and susceptible vectors , indoor residual spraying did not provide additional benefit .


The purpose of the study was to examine changes in quality of life measures in patients who have undergone an intensive exercise program following a single level microdiskectomy .


Randomized controlled trial with blinded examiners .


The study was conducted in outpatient physical therapy clinics .


Ninety-eight participants ( @ male , @ female ) who had undergone a single-level lumbar microdiskectomy allocated to receive exercise and education or education only .


A @-week periodized exercise program of lumbar extensor strength and endurance training , and mat and upright therapeutic exercises was administered .


Quality of life was tested with the Short Form @ ( SF-@ ) .


Measurements were taken @-@ weeks postsurgery and following completion of the @-week intervention program .


Since some participants selected physical therapy apart from the study , analyses were performed for both an as-randomized ( two-group ) design and an as-treated ( three-group ) design .


In the two-group analyses , exercise and education resulted in a greater increase in SF-@ scales , role physical ( @ vs. @ ) and bodily pain ( @ vs. @ ) , and the physical component summary ( @ vs. @ ) .


In the three-group analyses , post-hoc comparisons showed exercise and education resulted in a greater increase in the SF-@ scales , physical function ( @ vs. @ ) and bodily pain ( @ vs. @ ) , and the physical component summary ( @ vs. @ ) when compared with usual physical therapy .


An intensive , progressive exercise program combined with education increases quality of life in patients who have recently undergone lumbar microdiskectomy .


To analyze the impact of the eSET followed by single-embryo cryotransfer versus double embryo transfer in older women ( < @ years ) without taking into account embryo quality .


This is a prospective randomised clinical trial performed on @ couples attempting a first IVF cycle in a Public Hospital in Spain .


The women in Group @ received eSET plus a single-embryo cryotransfer , and those in Group @ received a double embryo transfer ( DET ) .


In the intention-to-treat analysis , the cumulative live birth delivery rate in the eSET group was similar to the results obtained for the DET group ( @ % vs. @ % ; p = @ ) .


The rate of multiple gestation was significantly lower in the eSET group than in the DET group ( @ % vs. @ % ; p < @ ) .


The findings obtained in the per-protocol analysis were similar to those obtained in the intention-to-treat analysis .


The per-protocol analysis revealed no significant differences in the rate of implantation ( @ % in eSET vs. @ % in DET ; p = @ ) , in cumulative pregnancy rates per transfer ( @ % in eSET vs. @ % in DET ; p = @ ) or in the cumulative live birth delivery rate ( @ % in eSET vs. @ % in DET ; p = @ ) .


In the cycles with eSET , there were no twin pregnancies ( @ % in eSET vs. @ in DET ; p < @ ) .


For women aged under @ years with good prognosis , without taking embryo quality as a criterion for inclusion , an eSET policy can be applied , achieving acceptable cumulative clinical pregnancy rates and birth rates .


To evaluate the effect of nursing intervention on the quality of life of patients with advanced schistosomiasis .


A total of @ cases of advanced schistosomiasis were randomly divided into a control group and an experimental group ( @ cases each ) .


The patients in the control group received the conventional nursing , while the patients in the experimental group received the conventional nursing plus other interventions such as the health education , psychological counseling and diet guidance .


The complications and scores of life quality of the patients in the @ groups were observed and compared .


The awareness of knowledge about the disease improved from @ % to @ % , the incidence of complications decreased from @ % to @ % , and the scores of life quality improved significantly in the experimental group , which were much better than those in the control group .


The nursing intervention on the quality of life of patients with advanced schistosomiasis is effective .


Mentorship within academic institutions influences research productivity ; no published studies have addressed whether encouragement on a national level would have similar effects .


We studied whether contact by a journal 's editorial board members would affect submission rates or journal selection by authors .


Authors of potentially publishable conference materials presented at national conferences sponsored by the Society of Teachers of Family Medicine were randomized to receive an invitation to submit work to Family Medicine or to receive no contact .


After @ years , we surveyed authors regarding whether a manuscript had been attempted and , if completed , where it had been submitted and eventually published .


A total of @ submissions were reviewed , @ met inclusion criteria , and @ authors responded to the survey ( @ % ) .


There were no differences in demographics , scholarly activity in general , or faculty status between study groups .


There was no significant difference in whether manuscripts based on targeted projects had been written , completed , submitted , or published .


There was a significant difference in where manuscripts were submitted with the inviting journal receiving proportionately more submissions from the group of authors that had been contacted ( @ % Contacted group , @ % No-Contact ) .


Simple encouragement from editorial board members of a national peer-reviewed journal in the form of a single e-mail invitation did not increase the scholarly production of authors .


Encouragement may , however , increase the likelihood that completed works are submitted to the inviting journal , which is a useful finding for journals interested in soliciting scholarly works of interest .


The objective of this multicenter , randomized study was to investigate the efficacy of the hydrophilic resorbable film PREVADH in preventing postoperative adhesions following myomectomy .


Women scheduled for laparotomic myomectomy with intramural and/or subserous myomas of > @mm in diameter , and who wished to preserve fertility , were eligible .


Patients were randomized immediately prior to abdominal wall closure to receive either hydrophilic resorbable film applied directly to the incisions ( P-Group , n = @ ) or @mL Ringer 's lactate solution instilled into the pelvic cavity ( R-Group , n = @ ) .


Incidence , severity , and extent of postoperative adhesions to the uterine incisions and adnexal and abdominopelvic adhesions were assessed during second-look laparoscopy @-@ weeks after the initial surgery .


Unedited videotapes of this second-look procedure were reviewed by two blinded independent surgeons .


Fifty-four patients ( P-Group , n = @ ; R-Group , n = @ ) underwent second-look laparoscopy .


Significantly fewer P-Group patients developed adhesions to uterine incisions than R-Group patients ( @ % vs. @ % , P = @ ) .


Adhesions , which were confirmed by independent reviewers , were found in significantly fewer P-Group sites than R-Group sites ( @ % vs. @ % , P = @ ) .


No serious adverse events related to the barriers used or adhesion-related complications were reported in either group .


The hydrophilic resorbable anti-adhesion film PREVADH significantly reduced adhesion incidence and severity after laparotomic myomectomy .


Elevated plasma concentrations of liver function tests are prevalent in patients with chronic heart failure ( HF ) .


Little is known about liver function in patients with acute HF .


We aimed to assess the prevalence and prognostic value of serial measurements of liver function tests in patients admitted with acute decompensated HF .


We investigated liver function tests from all @ patients from the Relaxin for the Treatment of Patients With Acute Heart Failure study at baseline and during hospitalization .


The end points were worsening HF through day @ , @-day mortality or rehospitalization , and @-day mortality .


Mean age was @ @ years , @ % were male , and most patients were in New York Heart Association functional class III/IV ( @ % ) .


Abnormal liver function tests were frequently found for alanine transaminase ( ALT ; @ % ) , aspartate transaminase ( AST ; @ % ) , alkaline phosphatase ( @ % ) , and total bilirubin ( @ % ) , and serum albumin ( @ % ) and total protein ( @ % ) were decreased .


In-hospital changes were very small .


On a continuous scale , baseline ALT and AST were associated with @-day mortality ( hazard ratios -LSB- HRs ; per doubling -RSB- @ -LSB- P = @ -RSB- and @ -LSB- P = @ -RSB- , respectively ) and worsening HF through day @ ( HRs -LSB- per doubling -RSB- @ -LSB- P = @ -RSB- and @ -LSB- P = @ -RSB- , respectively ) .


Albumin was associated with @-day mortality ( HR @ ; P = @ ) but not with worsening HF ( HR @ ; P = @ ) .


Total protein was associated with only worsening HF ( HR @ ; P = @ ) .


Abnormal liver function tests are often present in patients with acute HF and are associated with an increased risk for mortality , rehospitalization , and in-hospital worsening HF .


To evaluate the effects of epinephrine ( @:@,@ ) in the epidural space on the incidence of blood vessel injury by epidural catheter insertion for cesarean section .


Prospective observational study .


University-affiliated teaching hospital .


Four hundred laboring women with singleton cephalic presentations at term who underwent cesarean section and requested continuous epidural analgesia .


Predistension of @ mL of isotonic sodium chloride solution containing epinephrine ( @:@,@ ) or @ mL of isotonic sodium chloride solution through an epidural needle before catheter insertion .


Cases with bloody fluid in the epidural needle or catheter during catheter insertion , aspiration of frank blood from the epidural catheter , and blood noted in the caudal end of the epidural catheter upon removal were recorded .


Eight parturients were excluded from the analysis for technical reasons .


There were no significant differences between patients in the @ groups with respect to cases with bloody fluid in the epidural needle during catheter insertion ( @ % vs @ % , P = @ ) , the epidural catheter during catheter placement ( @ % vs @ % , P = @ ) , aspiration of frank blood in the epidural catheter ( @ % vs @ % , P = @ ) , and blood noted in the caudal end of the epidural catheter upon removal ( @ % vs @ % ; P > @ ) .


Twenty-five micrograms of epinephrine ( @:@,@ ) in the epidural space does not reduce the incidence of blood vessel injury induced by insertion of an epidural catheter .


The incidence of vaccine-preventable disease is increasing .


Several guidelines recommend annual influenza vaccination for patients with inflammatory bowel disease .


Using the Business Objects database of Clalit Health Services in the Tel Aviv district we identified all patients older than @ years with a diagnosis of Crohn 's disease ( CD ) on December @ , @ .


This cohort was followed until December @ , @ .


Subjects without inflammatory bowel disease older than @ years served as controls .


The uptake of annual influenza vaccination was recorded .


The study included @ patients with CD ( @ -LSB- @ % -RSB- men , age @ @ years , disease duration @ @ months ) and @ controls ( @ -LSB- @ % -RSB- men , P < @ , age @ @ years , P < @ ) .


The mean number of influenza vaccines received from @ to @ was @ @ and @ @ in CD and controls , respectively ( P < @ ) .


Uptake was higher in patients with CD aged @ to @ years and @ to @ years , compared with controls ( @ @ versus @ @ , P < @ and @ @ versus @ @ , P = @ , respectively ) .


Vaccination uptake increased significantly over time in both groups ( P < @ ) .


Predictors of vaccination in CD included age , female sex , immunosuppression , and cardiovascular disease .


Uptake of influenza vaccination in CD has increased over the past @ years , and among subjects older than @ years , uptake remains higher in age-matched controls .


Nevertheless , overall uptake remains low , particularly in young males .


Environmental enteric dysfunction ( EED ) is an acquired syndrome of impaired gastrointestinal mucosal barrier function that is thought to play a key role in the pathogenesis of stunting in early life .


It has been conceptualized as an adaptive response to excess environmental pathogen exposure .


However , it is clinically similar to other inflammatory enteropathies , which result from both host and environmental triggers , and for which immunomodulation is a cornerstone of therapy .


In this pilot double-blind randomized placebo-controlled trial , @ children with severe acute malnutrition and evidence of EED were assigned to treatment with mesalazine or placebo for @ days during nutritional rehabilitation .


Primary outcomes were safety and acceptability of the intervention .


Treatment with mesalazine was safe : there was no excess of adverse events , evidence of deterioration in intestinal barrier integrity or impact on nutritional recovery .


There were modest reductions in several inflammatory markers with mesalazine compared to placebo .


Depression of the growth hormone -- insulin-like growth factor-@ axis was evident at enrollment and associated with inflammatory activation .


Increases in the former and decreases in the latter correlated with linear growth .


Intestinal inflammation in EED is non-essential for mucosal homeostasis and is at least partly maladaptive .


Further trials of gut-specific immunomodulatory therapies targeting host inflammatory activation in order to optimize the growth benefits of nutritional rehabilitation and to address stunting are warranted .


Funded by The Wellcome Trust .


Attenuating postreperfusion syndrome during orthotopic liver transplant is very important for transplant anesthesiologists because of the syndrome 's complications .


Oxygen-derived free radicals play an important role in the genesis of postreperfusion syndrome , but the effect of mannitol ( a free radical scavenger ) on attenuating the syndrome is unclear.OBJECTIVES-To investigate the effectiveness of infusing mannitol during the anhepatic phase in preventing postreperfusion syndrome , as indicated by postreperfusion cardiac output and central venous oxygen saturation .


In a randomized clinical trial , @ patients who had undergone orthotopic liver transplant were allocated to @ groups .


During the anhepatic phase , patients in the mannitol group received @g/kg mannitol , whereas those in the control group received physiological saline .


Mean arterial pressure , cardiac output , and central venous oxygen saturation were measured before and after the portal vein was declamped .


Serum levels of sodium and potassium were recorded at baseline and after portal vein declamping.Setting-Shiraz Organ Transplant Center , Shiraz , Iran .


In the mannitol group , no significant change was found in mean arterial pressure , cardiac output , and central venous oxygen saturation before and after declamping of the portal vein ( P = @ , P = @ , and P = @ , respectively ) .


However , after declamping in the control group , mean arterial pressure , cardiac output , and central venous oxygen saturation were significantly lower than before declamping ( P = @ , P = @ , and P < @ , respectively ) .


No significant change in serum levels of sodium and potassium from baseline to after declamping were found in either group .


Infusion of mannitol @ g/kg during the anhepatic phase was effective in attenuating postreperfusion syndrome without stress about hyperkalemia or hyponatremia during anesthesia .


Prior studies have found that smokers with STEMI have lower mortality rates and a more favorable response to fibrinolytic therapy than nonsmokers , phenomenon defined as `` the smoker 's paradox '' .


Still poorly explored is the impact of cigarette smoking in patients undergoing primary percutaneous coronary intervention .


Aim of the current study was to evaluate the impact of cigarette smoking on scintigraphic infarct size in STEMI patients undergoing primary PCI .


Our population is represented by @ STEMI patients undergoing primary PCI .


Infarct size was evaluated at @ days by technetium-@m-sestamibi .


Smoking was associated with younger age ( p < @ ) , a lower prevalence of female gender ( p < @ ) , hypertension ( p < @ ) , diabetes ( p = @ ) , shorter ischemia time ( p = @ ) , but higher rates of previous PCI ( p = @ ) .


No differences were observed in other clinical or angiographic characteristics .


In particular , smoking did not affect the rate of postprocedural TIMI @ flow .


As shown in Fig. @ , smoking did not affect infarct size ( @ % -LSB- @ % -@ % -RSB- vs @ % -LSB- @ % -@ % -RSB- , p = @ ) .


Similar results were observed in subanalyses according to infarct location ( anterior STEMI , p int = @ ) , gender ( p int = @ ) age , ( p Int = @ ) , diabetes ( p int = @ ) .


The absence of any impact of smoking on infarct size was confirmed after correction for baseline characteristics , such as age , gender , hypertension , diabetes , previous PCI , ischemia time ( OR -LSB- @ % CI -RSB- = @ -LSB- @-@ @ -RSB- , p = @ ) .


This study shows that among STEMI patients undergoing primary PCI smoking status does not affect infarct size .


Continuous intraoperative norepinephrine infusion combined with restrictive deferred hydration improves surgical field visibility , and significantly decreases intraoperative blood loss and postoperative complications in patients undergoing radical cystectomy and urinary diversion .


We determined whether the intraoperative fluid regimen would affect functional results ( continence and erectile function ) @ year after orthotopic ileal bladder substitution .


We analyzed a subgroup of @ patients who received an ileal orthotopic bladder substitute .


The subgroup was part of a randomized trial in @ patients initially allocated to continuous norepinephrine administration starting with @ g/kg per hour combined with @ ml/kg per hour initially and @ ml/kg per hour crystalloid infusion after cystectomy ( norepinephrine/low volume group of @ ) or a standard crystalloid infusion of @ ml/kg per hour throughout surgery ( @ controls ) .


We prospectively assessed daytime and nighttime continence , and erectile function @ year postoperatively in the @-patient subgroup .


Daytime continence was reported by @ of @ patients ( @ % ) in the norepinephrine/low volume group and by @ of @ controls ( @ % ) ( p = @ ) , and nighttime continence was reported by @ ( @ % ) and @ ( @ % ) , respectively ( p = @ ) .


Erectile function recovery was reported by @ of @ preoperatively potent patients ( @ % ) in the norepinephrine/low volume group and by @ of @ controls ( @ % ) ( p = @ ) .


Patients who undergo radical cystectomy and orthotopic bladder substitution with continuous norepinephrine infusion and restrictive hydration during surgery have significantly better daytime continence and erectile function @ year postoperatively .


Women with depression in pregnancy are faced with difficult treatment decisions .


Untreated , antenatal depression has serious negative implications for mothers and children .


While antidepressant drug treatment is likely to improve depressive symptoms , it crosses the placenta and may pose risks to the unborn child .


Transcranial direct current stimulation is a focal brain stimulation treatment that improves depressive symptoms within @ weeks of treatment by inducing changes to brain areas involved in depression , without impacting any other brain areas , and without inducing changes to heart rate , blood pressure or core body temperature .


The localized nature of transcranial direct current stimulation makes it an ideal therapeutic approach for treating depression during pregnancy , although it has never previously been evaluated in this population .


We describe a pilot randomized controlled trial of transcranial direct current stimulation among women with depression in pregnancy to assess the feasibility of a larger , multicentre efficacy study .


Women over @ years of age and between @ and @ weeks gestation can be enrolled in the study provided they meet diagnostic criteria for a major depressive episode of at least moderate severity and have been offered but refused antidepressant medication .


Participants are randomized to receive active transcranial direct current stimulation or a sham condition that is administered in @ @-minute treatments over three weeks .


Women sit upright during treatment and receive obstetrical monitoring prior to , during and after each treatment session .


Depressive symptoms , treatment acceptability , and pregnancy outcomes are assessed at baseline ( prior to randomization ) , at the end of each treatment week , every four weeks post-treatment until delivery , and at @ and @ weeks postpartum .


Transcranial direct current stimulation is a novel therapeutic option for treating depression during pregnancy .


This protocol allows for assessment of the feasibility of , acceptability of and adherence with a clinical trial protocol to administer this treatment to pregnant women with moderate to severe depression .


Results from this pilot study will guide the development of a larger multicentre trial to definitively test the efficacy and safety of transcranial direct current stimulation for pregnant women with depression .


To compare the analgesic effect of ultrasound-guided Transversus Abdominis Plane ( TAP ) block versus Continuous Wound Infusion ( CWI ) with levobupivacaine after caesarean delivery .


We recruited parturients undergoing elective caesareans for this multicenter study .


Following written informed consent , they received a spinal anaesthetic without intrathecal morphine for their caesarean section .


The postoperative analgesia was randomized to either a bilateral ultrasound guided TAP block ( levobupivicaine = @ mg ) or a CWI through an elastomeric pump for @ hours ( levobupivacaine = @ mg the first day and @ mg/h thereafter ) .


Every woman received regular analgesics along with oral morphine if required .


The primary outcome was comparison of the @-hour area under the curve ( AUC ) pain scores .


Secondary outcomes included morphine consumption , adverse events , and persistent pain one month postoperatively .


Recruitment of @ women was planned but the study was prematurely terminated due to the occurrence of generalized seizures in one patient of the TAP group .


By then , @ patients with TAP and @ with CWI had completed the study .


AUC of pain at rest and during mobilization were not significantly different : @ -LSB- @-@ -RSB- in TAP versus @ -LSB- @-@ -RSB- in CWI ( P = @ ) and @ -LSB- @-@ -RSB- versus @ -LSB- @-@ @ -RSB- ( P = @ ) , respectively .


Morphine consumption ( @ -LSB- @-@ -RSB- mg in the TAP group and @ -LSB- @-@ @ -RSB- mg in the CWI group ( P = @ ) ) and persistent pain at one month were similar in both groups ( respectively @ % and @ % ( P = @ ) ) .


In cases of morphine-free spinal anesthesia for cesarean delivery , no difference between TAP block and CWI for postoperative analgesia was suggested .


TAP block may induce seizures in this specific context .


Consequently , such a technique after a caesarean section can not be recommended .


The objective was to determine whether adding a self-regulatory intervention ( SRI ) focused on self-monitoring of spontaneous physical activity ( SPA ) and sedentary behavior to a standard weight loss intervention improved maintenance of lost weight .


Older ( @-@ years ) , obese ( BMI = @-@ kg/m ( @ ) ) adults ( n = @ ) were randomized to a @-month weight loss intervention involving a hypocaloric diet ( DIET ) and aerobic exercise ( EX ) with or without the SRI to promote SPA and decrease sedentary behavior ( SRI+DIET+EX compared with DIET+EX ) .


Following the weight loss phase , both groups transitioned to self-selected diet and exercise behavior during a @-month follow-up .


Throughout the @-months , the SRI+DIET+EX group utilized real-time accelerometer feedback for self-monitoring .


There was an overall group by time effect of the SRI ( P < @ ) ; DIET+EX lost less weight and regained more weight than SRI+DIET+EX .


The average weight regain during follow-up was @ kg less in the SRI+DIET+EX group .


Individuals in this group maintained approximately @ % lower weight than baseline compared with those in the DIET+EX group whom maintained approximately @ % lower weight than baseline .


Addition of a SRI , designed to increase SPA and decrease sedentary behavior , to a standard weight loss intervention enhanced successful maintenance of lost weight .


Phenylephrine infusion is used to reduce hypotension during spinal anesthesia for cesarean delivery .


A prophylactic fixed rate infusion regimen may not improve hemodynamic control ; a variable rate regimen adjusted in response to changes in arterial blood pressure and heart rate may allow more accurate maintenance of baseline blood pressure .


We hypothesized that a combination of crystalloid solution coload with a variable rate phenylephrine infusion and phenylephrine rescue boluses may be associated with fewer physician interventions needed to maintain maternal systolic blood pressure within @ % of baseline and greater hemodynamic stability than crystalloid solution coload with phenylephrine rescue boluses alone .


In this prospective , double-blind study , @ patients received a coload with @ mL/kg lactated Ringer 's solution immediately after the initiation of spinal anesthesia .


Patients were randomized to receive a prophylactic variable rate phenylephrine infusion starting at @ g/kg/min ( group P ) or infusion of normal saline ( group S ) .


Maternal systolic blood pressure was maintained within @ % of baseline with rescue phenylephrine boluses using a preset algorithm .


During the predelivery period , the number of physician interventions ( primary outcome ) , hemodynamic performance , nausea/vomiting , and umbilical cord blood gas values were compared between the groups .


One patient from group S was excluded due to protocol violation .


Therefore , group P included @ patients and group S @ patients .


The median ( range ) number of physician interventions needed to maintain maternal hemodynamics within the target range ( @ -LSB- @-@ -RSB- vs @ -LSB- @-@ -RSB- , difference in median : @ , @ % confidence interval of difference : @-@ ) and incidence of hypotension ( @/@ -LSB- @ % -RSB- vs @/@ -LSB- @ % -RSB- ) were lower in group P compared with group S ( P < @ ) .


Group P had a higher incidence of hypertension compared with group S ( @/@ -LSB- @ % -RSB- vs @/@ -LSB- @ % -RSB- , P = @ ) .


The median performance error was closer to baseline ( P < @ ) with a smaller median absolute performance error ( P = @ ) in group P versus group S.


In group P , @/@ ( @ % ) patients had nausea/vomiting compared with @/@ ( @ % ) in group S ( P = @ ) .


The number needed to treat was @ women to prevent @ case of hypotension , and @ women to prevent @ case of nausea/vomiting ; the rate of hypertension was @ case per @ women treated .


Neonatal outcomes were not different between the @ groups .


Prophylactic variable rate phenylephrine infusion and rescue phenylephrine bolus dosing is more effective than relying on rescue phenylephrine bolus dosing with respect to limiting clinician workload and maternal symptoms during spinal anesthesia for cesarean delivery .


The aim of this study is to describe implementation of a randomized controlled trial of community-based participatory research ( CBPR ) approaches to increase park use and physical activity across @ diverse neighborhoods in Los Angeles .


Fifty parks were randomly assigned based on park size , facilities and programs , and neighborhood socio-demographic characteristics to : park director ( PD , @ parks ) ; PD and park advisory board of interested community members ( PD+PAB , @ parks ) ; and no-intervention control ( @ parks ) arms .


Between @ and @ , PDs and PABs from the @ intervention parks participated in community engagement , baseline assessment , marketing training , intervention design and implementation , and follow-up assessment .


Intervention parks ( PD and PD+PAB ) invested in new and diversified signage , promotional items , outreach or support for group activities like fitness classes and walking clubs , and various marketing strategies .


Scaling up CBPR methods across parks in @ diverse neighborhoods was challenging .


Working with departmental management and established structures for community input ( PABs ) and park policy ( PDs ) facilitated implementation and sustainability .


Scaling up CBPR methods across diverse communities involved tradeoffs .


CBPR is useful for tailoring research and enhancing community impact and sustainability , but more work is needed to understand how to conduct multi-site trials across diverse settings using CBPR .


Posterior-cruciate-ligament-retaining ( PCR ) and posterior-cruciate-ligament-stabilized ( PS ) arthroplasties are two major common practices in total knee arthroplasty ( TKA ) .


The hypothesis of the present study was that compared with the PCR technique , the PS technique is associated with a higher amount of postoperative blood loss and greater need for blood transfusion in cemented TKA .


In this prospective , randomized study , @ patients diagnosed with primary knee osteoarthritis were randomly assigned to either the PCR group ( Group I ) or the PS group ( Group II ) .


The exclusion criteria were rheumatological joint disease , previous knee surgery , anticoagulant therapy and hypertension .


There were no significant differences in age , body mass index and gender , between the groups .


The haemoglobin and haematocrit levels of each patient were recorded preoperatively and on postoperative days @ , @ and @ .


The postoperative suction drainage and blood transfusion volumes were also recorded .


There were no statistically significant differences in haemoglobin or haematocrit levels between the groups on postoperative days @ , @ and @ .


There were also no statistically significant differences in the total measured blood loss volume , postoperative drainage amounts or transfusion rates between the groups .


Use of the PS technique during cemented TKA does not appear to influence the amount of perioperative blood loss or the need for postoperative blood transfusion in general .


The clinical relevance of this study is that the difference in blood loss between the PCR and PS techniques does not need to be considered by surgeons when performing TKA .


Radical retropubic prostatectomy ( RRP ) is associated with an increased risk of intraoperative blood loss and the necessity of transfusions .


This prospective randomised clinical study evaluates the influence of thoracic epidural analgesia ( TEA ) on blood loss in RRP .


@ patients were randomised : TEA in group @ ( n = @ ; general anaesthesia + TEA ) comprised continuous administration of @ % bupivacaine , while group @ ( n = @ ; general anaesthesia alone ) received intravenous analgesia with fentanyl ( intubation : @ g/kg ; maintenance : @-@ @ mg ) .


A restrictive infusion regimen ( < @,@ ml until specimen removal ) was administered in both groups .


Blood loss , infusion rates and anaesthesiological parameters were recorded and analysed using regression models and analyses of variance .


Haemoglobin difference between the pre - and the first postoperative day ( group @ : @ @ g/dl ; group @ : @ @ g/dl ; p = @ ) , overall blood loss ( group @ : @ @ ml ; group @ : @ @ ml ; p = @ ) and transfusion rates ( @ % intraoperatively ; @ % postoperatively ; p = @ ) did not show group differences .


In regression analysis blood loss was influenced by preoperative haemoglobin levels ( p < @ ) , patients ' weight ( p = @ ) and duration of the operation ( p = @ ) .


This study did not demonstrate a direct impact of TEA on intraoperative blood loss and transfusion rates in RRP .


Further randomised clinical trials are needed to evaluate an impact of the different anaesthetic procedures presented alone or in combination on blood loss .


Currently , short-axis out-of-plane ( SA-OOP ) and long-axis in-plane ( LA-IP ) ultrasound techniques are used to guide radial artery cannulation .


In this study , we compared the success rate of a modified SA-OOP technique with that of traditional LA-IP .


One hundred sixty-four patients who were to undergo liver surgery or splenic resection under general anesthesia were included .


Using a sealed envelope method , patients were randomly divided into @ groups : the modified SA-OOP or the LA-IP ultrasound guidance approaches .


The number of cannula insertion attempts until success was recorded in both groups .


The primary end point to compare the groups was the rate of cannula insertion successes on the first attempt .


The secondary end points were also recorded and compared : insertion failure rate , inner diameter of the radial artery , depth of artery from the skin , ultrasonic location time , cannulation time , and vascular complications including thrombosis , hematoma , edema , and vasospasm .


The cannula insertion success rate on the first attempt was significantly higher in the modified SA-OOP group compared with the LA-IP group ( proportion difference @ % , @ % confidence interval -LSB- CI -RSB- , @ % -@ % , P = @ ) .


However , the insertion failure rate was not different between groups ( @ % CI , -@ % to @ % , P = @ ) .


The ultrasonic location time was significantly decreased in the modified SA-OOP group compared with the LA-IP group ( mean difference -@ seconds , @ % CI , -@ to -@ seconds , P < @ ) .


However , there was no significant difference between groups for cannulation time ( @ % CI , -@ to @ seconds , P = @ ) , depth of artery ( @ % CI , -@ to @ mm , P = @ ) , and the diameter of the radial artery ( @ % CI , -@ to @ mm , P = @ ) .


The modified SA-OOP technique may improve the success rate of cannula insertion into the radial artery on the first attempt .


Chemotherapy-induced diarrhea ( CID ) is a relatively common adverse event in the treatment of patients with colorectal cancer .


The LAR for Chemotherapy-Induced Diarrhea ( LARCID ) trial evaluated the efficacy and safety of long-acting release octreotide ( octreotide LAR ) for the prevention of CID in this population .


Patients with colorectal cancer starting adjuvant or first-line treatment with a chemotherapy combination containing fluorouracil , capecitabine , and/or irinotecan were randomly assigned to receive octreotide LAR @ mg intramuscularly every @ weeks ( experimental arm ) or the physician 's treatment of choice in case of diarrhea ( control arm ) .


A total of @ patients were randomly assigned , most of whom received fluorouracil - and oxaliplatin-containing chemotherapy regimens .


The rate of diarrhea was @ % in the experimental group ( n = @ ) and @ % in the control group ( n = @ ) .


Treatment with octreotide LAR did not prevent or reduce the severity of CID .


Treatment choices for diarrhea management included loperamide in the majority of patients .


No benefit from octreotide LAR was identified in terms of need for diarrhea treatment , opioids , or intravenous hydration or in the rate of hospitalization or quality of life .


This study could not prove the efficacy of octreotide LAR in the prevention of CID .


Treatment with rituximab may be accompanied by a systemic cytokine release .


We studied the effects of a single dose of rituximab on cytokine levels in transplant patients and examined the underlying mechanism .


Twenty renal transplant recipients ( @ rituximab-treated , @ placebo-treated ) were recruited from a randomized clinical trial .


Rituximab or placebo was infused during surgery , and blood samples were taken before , during , and after surgery and analyzed for interleukin ( IL ) -@ , IL-@ , IL-@ , IL-@ , IL-@ , IL-@ , interferon - , macrophage inflammatory protein ( MIP ) -@ , transforming growth factor - , and tumor necrosis factor - .


in vitro , healthy donor peripheral blood mononuclear cells , purified B cells , monocytes , natural killer ( NK ) cells , or combinations thereof were incubated with rituximab , rituximab-F ( ab ' ) @ , or medium and MIP-@ , IL-@ , interferon - , and tumor necrosis factor - levels were measured in the supernatant .


Rituximab-treated patients had higher serum levels of IL-@ ( @ @ pg/mL vs @ @ pg/mL ; P < @ ) and MIP-@ ( @ @ pg/mL vs @ @ pg/mL ; P < @ ) compared to placebo-treated patients at @ hours after start of infusion .


There was no difference in the level of other cytokines .


In vitro , the addition of rituximab , but not rituximab-F ( ab ' ) @ fragments , only led to significantly increased levels of MIP-@ in co-cultures of B and NK cells .


Levels of MIP-@ were higher in patients with a high affinity Fc-receptor compared to those with a lower affinity FcRIIIa ( @ @ pg/mL vs @ @ pg/mL ; P < @ ) .


In addition to B-cell depletion , rituximab can modulate the immune response by inducing cytokine secretion , especially IL-@ and MIP-@ .


Rituximab-induced MIP-@ secretion depends on the combined presence of B cells and FcR-bearing cells , especially NK cells .


To compare a new low-dose levonorgestrel and ethinyl estradiol contraceptive patch ( Patch ) with a combination oral contraceptive ( Pill ; @ micrograms levonorgestrel , @ micrograms ethinyl estradiol ) regarding efficacy , safety , compliance , and unscheduled uterine bleeding .


Women ( @-@ years ; body mass index @-@ ) were randomized in a @:@ ratio to one of two groups : Patch only ( @ cycles ) or Pill ( six cycles ) followed by Patch ( seven cycles ) .


Investigators evaluated adverse events during cycles @ , @ , @ , @ , and @ .


Participants recorded drug administration and uterine bleeding on daily diary cards .


Compliance was assessed by measuring levonorgestrel and ethinyl estradiol plasma levels .


Pearl Index ( pregnancies per @ woman-years ) was calculated to evaluate efficacy .


Participants ( N = @,@ ) were randomized to Patch ( n = @,@ ) or Pill ( n = @ ) .


Approximately @ % were obese , more than @ % were racial or ethnic minorities , and more than @ % were new users of hormonal contraceptives .


Laboratory-verified noncompliance ( undetectable plasma drug levels ) was @ % of Patch and @ % of Pill users at cycle @ .


Pearl Indices ( @ % confidence intervals ) for the intention-to-treat population ( cycles @-@ ) were @ ( @-@ @ ) for Patch and @ ( @-@ @ ) for Pill ; excluding laboratory-verified noncompliant participants , Pearl Indices were @ ( @-@ @ ) for Patch and @ ( @-@ @ ) for Pill ( differences not statistically significant ) .


Incidence of unscheduled bleeding and incidence and severity of adverse events were similar for both contraceptives ( no statistically significant difference ) .


Efficacy and safety of the new contraceptive Patch are comparable to those of a Pill .


Laboratory-verified noncompliance and bleeding profile are similar between the two treatments .


The Patch was well tolerated .


Endocrine therapies include aromatase inhibitors and the selective estrogen receptor ( ER ) downregulator fulvestrant .


This study aimed to determine whether the reported efficacy of fulvestrant over anastrozole , and high - over low-dose fulvestrant , reflect distinct transcriptional responses .


Global gene expression profiles from ER-positive breast carcinomas before and during presurgical treatment with fulvestrant ( n = @ ) or anastrozole ( n = @ ) , and corresponding in vitro models , were compared .


Transcripts responding differently to fulvestrant and estrogen deprivation were identified and integrated using Gene Ontology , pathway and network analyses to evaluate their potential significance .


The overall transcriptional response to fulvestrant and estrogen deprivation was correlated ( r = @ in presurgical studies , r = @ in vitro ) , involving downregulation of estrogen-regulated and proliferation-associated genes .


The transcriptional response to fulvestrant was of greater magnitude than estrogen deprivation ( slope = @ in presurgical studies , slope = @ in vitro ) .


Comparative analyses identified @ genes and @ Gene Ontology categories affected differentially by fulvestrant .


Seventeen fulvestrant-specific genes , including CAV@/@ , SNAI@ , and NRP@ , associated with ER , androgen receptor ( AR ) , and TP@ , in a network regulating cell cycle , death , survival , and tumor morphology .


Eighteen genes responding differently to fulvestrant specifically predicted antiproliferative response to fulvestrant , but not anastrozole .


Transcriptional effects of low-dose fulvestrant correlated with high-dose treatment , but were of lower magnitude ( ratio = @ ) .


The transcriptional response to fulvestrant has much in common with estrogen deprivation , but is stronger with distinctions potentially attributable to arrest of estrogen-independent ER activity and involvement of AR signaling .


Genes responding differently to fulvestrant may have predictive utility .


These data are consistent with the clinical efficacy of fulvestrant versus anastrozole and higher dosing regimens .


To compare the impact of varying fluidic parameters on intraoperative intraocular pressure ( IOP ) fluctuations and postoperative outcomes .


Prospective randomized study of @ eyes undergoing cataract surgery that were randomly assigned to low ( aspiration flow rate : @ cc/min ; bottle height : @ cm ; vacuum : @ mm Hg ) and high ( aspiration flow rate : @ cc/min ; bottle height : @ cm ; vacuum : @ mm Hg ) fluidic parameter groups .


Real-time dynamic intraoperative IOP was measured during nuclear fragment removal .


Mean maximum and minimum IOP and percentage reduction in IOP from maximum were compared between groups .


Postoperatively , the rate of change in central corneal thickness and anterior chamber inflammation at days @ and @ , endothelial cell density at @ months , and corneal clarity on day @ were compared .


Minimum IOP in the low and high parameters groups was @ @ and @ @ mm Hg , respectively .


Maximum IOP in the low and high parameters groups was @ @ and @ @ mm Hg , respectively ( P < @ ) .


Mean percent reduction from maximum was @ % in the high parameters group compared to @ % in the low parameters group , with the difference being statistically significant ( P < @ ) .


Rate of change in central corneal thickness was greater in the high parameters group at postoperative days @ and @ ( P < @ ) .


Anterior chamber inflammation and corneal clarity on the first postoperative day were significantly better in the low parameters group .


Higher aspiration flow rate and bottle heights are associated with high intraoperative IOPs of up to @ mm Hg .


Prolonged elevated IOP during cataract surgery was found to have more anterior segment inflammation and more edematous corneas .


We compare monopolar vs bipolar transurethral resection of the prostate in patients with benign prostatic hyperplasia , focusing on functional outcomes as well as rates of bleeding complications and the transurethral resection syndrome .


A total of @ patients with benign prostatic hyperplasia ( mean age @ years , range @ to @ ) were prospectively randomly assigned to undergo monopolar ( @ ) or bipolar ( @ ) transurethral resection of the prostate .


Patient characteristics of the @ groups were similar .


Hemoglobin ( as a marker of blood loss ) was measured preoperatively and perioperatively .


I-PSS , I-PSS-QoL score , maximal flow rate and post-void residual urine volume were assessed preoperatively and @ and @ months postoperatively .


Duration of surgery , indwelling catheter use and hospitalization were also documented , as were postoperative clot retention requiring removal by catheterization or surgery , and rates of bladder neck and/or urethral strictures .


No significant perioperative differences were found in duration of surgery , catheterization or hospitalization , or in blood loss or rates of blood transfusion and transurethral resection syndrome .


Postoperatively there were no significant differences in I-PSS or I-PSS-QoL scores , or rates of rehospitalization , clot retention , blood transfusions , reoperation or urethral strictures .


However , bladder neck stricture occurred significantly more often in the bipolar group ( @ % vs @ % , p = @ ) .


The @ and @-month followup showed significant and equal improvement in micturition in the @ groups .


Bipolar and monopolar transurethral resection of the prostate are effective and safe techniques for the surgical treatment of benign prostatic hyperplasia .


The only significant difference between them was a significantly higher rate of bladder neck strictures with bipolar resection of the prostate .


This study aimed ( @ ) to determine whether scanner arm rotation causes significant movement of the head restraint and ( @ ) to measure patient movement and its variation during the scan .


The iCAT scanner and a high-speed camera were used .


The @ patients were divided into @ groups : the open-eyed group and the blindfolded group .


The mean level of head restraint movement was @ mm , with a significantly higher level at the beginning , probably owing to the accelerating arm .


Mean movement of patients was @ mm and @ mm in the open-eyed and blindfolded groups , respectively .


Patient movement was also significantly higher at the beginning of the scan , when noise and vibrations are likely to surprise the patient .


Patient instruction and a dry-run scan should be done by clinicians .


Manufacturers should consider separating the seat and head restraint from the rest of the scanner to avoid vibration transfer .


The objective of this prospectively randomized phase II trial ( Trial registration : EUCTR@-@-@-DE ) was to compare the clinical response of primary breast cancer patients to neoadjuvant therapy with letrozole alone ( LET ) or letrozole and zoledronic acid ( LET + ZOL ) .


Patients were randomly assigned to receive either LET @ mg/day ( n = @ ) or the combination of LET @ mg/day and a total of seven infusions of ZOL @ mg every @ weeks ( n = @ ) for @ months .


Primary endpoint was clinical response rate as assessed by mammogram readings .


The study was terminated prematurely due to insufficient recruitment .


We report here on an exploratory analysis of this data .


Central assessment of tumor sizes during the treatment period was available for @ patients ( @ LET , @ LET + ZOL ) .


Clinical responses ( complete or partial ) were seen in @ % ( @ % CI : @-@ @ ) of the patients in the LET arm and @ % ( @ % CI : @-@ @ ) of those in the LET + ZOL arm ( P = @ ) .


A multivariate model showed an OR of @ ( @ % CI : @-@ @ ) for the experimental arm .


No increase in the clinical response rate was observed with the addition of ZOL to a neoadjuvant treatment regimen with LET .


However a trend towards a better reponse in the LET + ZOL arm could be observed .


This trend is consistent with previous studies that have investigated the addition of ZOL to chemotherapy , and it may support the evidence for a direct antitumor action of zoledronic acid .


To evaluate the efficacy and safety of conversion to lacosamide @ mg/day monotherapy in adults with focal epilepsy .


This historical-controlled , double-blind study ( NCT@ ) enrolled patients aged @-@ years on stable doses of @-@ antiepileptic drugs ( AEDs ) and experiencing @-@ partial-onset seizures per @ days during the @-week prospective Baseline .


Patients were randomized to lacosamide @ or @ mg/day ( @:@ ratio ) , starting at @ mg/day and titrated over @ weeks to randomized dose .


Patients then withdrew background AEDs over @ weeks and entered a @-week Monotherapy Phase .


The primary assessment was the Kaplan-Meier-predicted percentage of patients on @ mg/day in the full analysis set ( FAS ) meeting @ predefined seizure-related exit criterion by day @ , compared with the historical-control threshold ( @ % ) .


Four hundred twenty-five patients were enrolled and were eligible for safety analyses ( @ mg/day , n = @ ; @ mg/day , n = @ ) .


A total of @ ( @ % ) of @ patients completed the Lacosamide Maintenance Phase ( combined AED Withdrawal and Monotherapy Phases ) .


Among @ patients in the @ mg/day group in the FAS , @ ( @ % ) met @ exit criterion ; the Kaplan-Meier-predicted exit percentage at day @ for @ mg/day ( @ % ; @ % confidence interval -LSB- CI -RSB- @-@ @ % ) was lower than the historical control .


When exit events , withdrawal due to treatment-emergent adverse events ( TEAEs ) , and withdrawal due to lack of efficacy were summed ( n = @ ) , the predicted exit percentage ( @ % ; @ % CI @-@ @ % ) was also lower than the historical control .


Most patients receiving @ mg/day reported some improvement on the Clinical Global Impression of Change ( @ % ) and Patient Global Impression of Change ( @ % ) .


Overall , the most common ( > @ % ) TEAEs were dizziness ( @ % ) , headache ( @ % ) , nausea ( @ % ) , convulsion ( @ % ) , somnolence ( @ % ) , and fatigue ( @ % ) ; most ( @ % ) were mild-to-moderate in intensity .


Seventy-two patients ( @ % ) discontinued due to TEAEs .


Seventeen patients ( @ % , all receiving @ mg/day ) experienced serious AEs .


Lacosamide @ mg/day monotherapy was effective , with a favorable safety profile in patients with focal epilepsy .


Prolonged sitting time is detrimental for health .


Individuals with desk-based occupations tend to sit a great deal and sit-stand workstations have been identified as a potential strategy to reduce sitting time .


Hence , the objective of the current study was to examine the effects of using sit-stand workstations on office workers ' sitting time at work and over the whole day .


We conducted a randomized controlled trial pilot with crossover design and waiting list control in Sydney , Australia from September @ to July @ ( n = @ ; @ % female ; mean age @ years ) .


Participants used a sit-stand workstation for four weeks in the intervention condition .


In the time-matched control condition , participants received nothing and crossed over to the intervention condition after four weeks .


The primary outcomes , sitting , standing and walking time at work , were assessed before and after using the workstations with ActivPALs and self-report questionnaires .


Secondary outcomes , domain-specific sitting over the whole day , were assessed by self-report .


Linear mixed models estimated changes in outcomes adjusting for measurement time , study grouping and covariates .


Intervention participants significantly reduced objectively assessed time spent sitting at work by @ min/workday ( @ % CI : -@ , -@ ) and increased standing time at work by @ min/workday ( @ % CI : @ , @ ) ; these changes were significant relative to controls ( p = @ and p < @ , respectively ) .


Total sitting time significantly declined in intervention participants ( -@ min/workday ; @ % CI : -@ , -@ ) .


This study shows that introducing sit-stand workstations in the office can reduce desk-based workers ' sitting time at work in the short term .


Larger scale studies on more representative samples are needed to determine the public health impact of sit-stand workstations .


To determine whether falls can be prevented with minimally supervised exercise targeting potentially remediable fall risk factors , i.e. , poor balance , reduced leg muscle strength , and freezing of gait , in people with Parkinson disease .


Two hundred thirty-one people with Parkinson disease were randomized into exercise or usual-care control groups .


Exercises were practiced for @ to @ minutes , @ times weekly for @ months .


Primary outcomes were fall rates and proportion of fallers during the intervention period .


Secondary outcomes were physical ( balance , mobility , freezing of gait , habitual physical activity ) , psychological ( fear of falling , affect ) , and quality-of-life measures .


There was no significant difference between groups in the rate of falls ( incidence rate ratio -LSB- IRR -RSB- = @ , @ % confidence interval -LSB- CI -RSB- @-@ @ , p = @ ) or proportion of fallers ( p = @ ) .


Preplanned subgroup analysis revealed a significant interaction for disease severity ( p < @ ) .


In the lower disease severity subgroup , there were fewer falls in the exercise group compared with controls ( IRR = @ , @ % CI @-@ @ , p < @ ) , while in the higher disease severity subgroup , there was a trend toward more falls in the exercise group ( IRR = @ , @ % CI @-@ @ , p = @ ) .


Postintervention , the exercise group scored significantly ( p < @ ) better than controls on the Short Physical Performance Battery , sit-to-stand , fear of falling , affect , and quality of life , after adjusting for baseline performance .


An exercise program targeting balance , leg strength , and freezing of gait did not reduce falls but improved physical and psychological health .


Falls were reduced in people with milder disease but not in those with more severe Parkinson disease .


This study provides Class III evidence that for patients with Parkinson disease , a minimally supervised exercise program does not reduce fall risk .


This study lacked the precision to exclude a moderate reduction or modest increase in fall risk from exercise .


Platelet aggregation is enhanced in firefighters following short bouts of work in thermal protective clothing ( TPC ) .


We sought to determine if aspirin therapy before and/or following exertion in TPC prevents platelet activation .


In a double-blind , placebo-controlled study , @ firefighters were randomized to receive daily therapy ( @ mg aspirin or placebo ) for @ days before and a single dose ( @ mg aspirin or placebo ) following exercise in TPC resulting in four potential assignments : aspirin before and after exercise ( AA ) , placebo before and after exercise ( PP ) , aspirin before and placebo after exercise ( AP ) , and placebo before and aspirin after exercise ( PA ) .


Platelet closure time ( PCT ) was measured with a platelet function analyzer before the @-week treatment , after the @ week treatment period , immediately after exercise , and @ , @ , and @ minutes later .


Baseline PCT did not differ between groups .


PCT changed over time in all four groups ( p < @ ) rising to a median of > @ seconds -LSB- IQR @ , @ -RSB- in AA and > @ -LSB- @ , @ -RSB- in AP prior to exercise .


Following exercise , median PCT decreased to in all groups .


Median PCT returned to > @ seconds @ minutes later in AA and AP and rose to @ seconds in PA @ minutes after exercise .


Daily aspirin therapy blunts platelet activation during exertional heat stress and single-dose aspirin therapy following exertional heat stress reduces platelet activation within @ minutes .


Hyperglycemia improves when patients with type @ diabetes are placed on a weight-loss diet .


Improvement typically occurs soon after diet implementation .


This rapid response could result from low fuel supply ( calories ) , lower carbohydrate content of the weight-loss diet , and/or weight loss per se .


To differentiate these effects , glucose , insulin , C-peptide and glucagon were determined during the last @ h of a @-day period without food ( severe calorie restriction ) and a calorie-sufficient , carbohydrate-free diet .


Seven subjects with untreated type @ diabetes were studied .


A randomized-crossover design with a @-week washout period between arms was used .


Results from both the calorie-sufficient , carbohydrate-free diet and the @-day fast were compared with the initial standard diet consisting of @ % carbohydrate , @ % protein and @ % fat .


The overnight fasting glucose concentration decreased from @ ( standard diet ) to @ ( carbohydrate-free diet ) to @ mg/dl ( fasting ) .


The @ h glucose and insulin area responses decreased by @ % and @ % on day @ of the carbohydrate-free diet , and by @ % and @ % after fasting .


Overnight basal insulin and glucagon remained unchanged .


Short-term fasting dramatically lowered overnight fasting and @ h integrated glucose concentrations .


Carbohydrate restriction per se could account for @ % of the reduction .


Insulin could not entirely explain the glucose responses .


In the absence of carbohydrate , the net insulin response was @ % of the standard diet .


Glucagon did not contribute to the metabolic adaptations observed .


Exposure therapy in anorexia nervosa has preliminarily been shown to be effective for increasing food intake .


D-Cycloserine is a glutamatergic N-methyl-d-aspartate receptor agonist that has been shown to facilitate the benefits of exposure therapy for anxiety disorders by enhancing the emotional learning in the exposures ; therefore , we examined D-cycloserine-facilitation of exposure therapy to increase body mass index ( BMI ) in patients with anorexia nervosa .


Participants ( N = @ ) with anorexia nervosa ( diagnosed via DSM-IV ) were recruited from a partial hospitalization eating disorder clinic between February @ and November @ .


Participants were randomly assigned to receive exposure therapy plus D-cycloserine ( n = @ ) or placebo ( n = @ ) .


Participants completed psychoeducation and @ sessions of exposure therapy , with medication ( D-cycloserine vs placebo ) given prior to the first @ exposure sessions .


They also completed a @-month follow-up .


As hypothesized , participants in the D-cycloserine group showed a significantly greater increase in BMI than those in the placebo group ( Wilk = @ , F@ ,@ = @ , P = @ , p ( @ ) = @ ) .


D-Cycloserine participants gained @ pounds relative to @ pounds in the placebo group .


Both groups experienced significantly decreased anxiety over the course of therapy ( Wilk = @ , F@ ,@ = @ , P = @ , p ( @ ) = @ ) .


This study preliminarily demonstrates that D-cycloserine facilitates exposure therapy for anorexia nervosa , leading to increased weight gain .


A potential mechanism is that participants who receive D-cycloserine may generalize learning from within-session exposures to food intake during other similar meals , resulting in sustained increases in BMI .


Further research is needed to confirm these findings and test the putative mechanism that generalized learning from exposure therapy can increase BMI and stabilize a healthy weight .


A fixed-ratio combination of the basal insulin analogue insulin degludec and the glucagon-like peptide-@ ( GLP-@ ) analogue liraglutide has been developed as a once-daily injection for the treatment of type @ diabetes .


We aimed to compare combined insulin degludec-liraglutide ( IDegLira ) with its components given alone in insulin-naive patients .


In this phase @ , @-week , open-label , randomised trial , adults with type @ diabetes , HbA@c of @-@ % ( inclusive ) , a BMI of @ kg/m ( @ ) or less , and treated with metformin with or without pioglitazone were randomly assigned ( @:@:@ ) to daily injections of IDegLira , insulin degludec , or liraglutide ( @ mg per day ) .


IDegLira and insulin degludec were titrated to achieve a self-measured prebreakfast plasma glucose concentration of @-@ mmol/L .


The primary endpoint was change in HbA@c after @ weeks of treatment , and the main objective was to assess the non-inferiority of IDegLira to insulin degludec ( with an upper @ % CI margin of @ % ) , and the superiority of IDegLira to liraglutide ( with a lower @ % CI margin of @ % ) .


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


@ adults ( mean age @ years -LSB- SD @ -RSB- , HbA@c @ % -LSB- @ -RSB- , and BMI @ kg/m ( @ ) -LSB- @ -RSB- ) were randomly assigned , @ to IDegLira , @ to insulin degludec , and @ to liraglutide .


After @ weeks , mean HbA@c had decreased by @ % ( SD @ ) to @ % ( @ ) with IDegLira , by @ % ( @ ) to @ % ( @ ) with insulin degludec , and by @ % ( @ ) to @ % ( @ ) with liraglutide .


IDegLira was non-inferior to insulin degludec ( estimated treatment difference -@ % , @ % CI -@ to -@ , p < @ ) and superior to liraglutide ( -@ % , -@ to -@ , p < @ ) .


IDegLira was generally well tolerated ; fewer participants in the IDegLira group than in the liraglutide group reported gastrointestinal adverse events ( nausea @ vs @ % ) , although the insulin degludec group had the fewest participants with gastrointestinal adverse events ( nausea @ % ) .


We noted no clinically relevant differences between treatments with respect to standard safety assessments , and the safety profile of IDegLira reflected those of its component parts .


The number of confirmed hypoglycaemic events per patient year was @ for IDegLira , @ for liraglutide , and @ for insulin degludec .


Serious adverse events occurred in @ ( @ % ) of @ patients in the IDegLira group , eight ( @ % ) of @ in the insulin degludec group , and @ ( @ % ) of @ in the liraglutide group .


IDegLira combines the clinical advantages of basal insulin and GLP-@ receptor agonist treatment , resulting in improved glycaemic control compared with its components given alone .


This pilot study explores the feasibility of yoga as part of a treatment program for alcohol dependence .


Eighteen alcohol dependent patients were randomized to receive either treatment as usual or treatment as usual plus yoga .


Assessments were taken at baseline and six month follow-up .


` Riddargatan @ ' : an outpatient alcohol treatment clinic located in Stockholm , Sweden .


Treatment as usual consisted of psychological and pharmacological interventions for alcohol dependence .


The @-week yoga intervention included a weekly group yoga session .


Participants were encouraged to practice the yoga movements at home once per day .


Alcohol consumption ( timeline follow-back method , DSM-IV criteria for alcohol dependence , and the Short Alcohol Dependence Data questionnaire ) , affective symptoms ( the Hospital Anxiety and Depression Scale ) , quality of life ( Sheehan Disability Scale ) and stress ( the Perceived Stress Scale and saliva cortisol ) .


Yoga was found to be a feasible and well accepted adjunct treatment for alcohol dependence .


Alcohol consumption reduced more in the treatment as usual plus yoga group ( from @ to @ drinks per day ) compared to the treatment as usual only group ( from @ to @ drinks per day ) .


The difference was , however , not statistically significant ( p = @ ) .


Larger studies are needed to adequately assess the efficacy and long-term effectiveness of yoga as an adjunct treatment for alcohol dependence .


The optimal timing of endocrine therapy in non-metastatic prostate cancer ( PCa ) is still an issue of debate .


A randomised , double-blind , parallel-group trial comparing bicalutamide @mg once daily with placebo in addition to standard care in patients with hormone-nave , non-metastatic PCa .


Kaplan-Meier analysis was used to estimate overall survival ( OS ) and multivariate Cox proportional hazard model was performed to analyse time-to-event ( death ) .


A total of @ patients were included into the Scandinavian Prostate Cancer Group ( SPCG ) -@ study of which @ were randomised to receive bicalutamide in addition to their standard care and @ to receive placebo .


Median follow-up was @ years .


Overall , @ ( @ % ) patients died , @ ( @ % ) in the bicalutamide arm and @ ( @ % ) in the placebo arm , p = @ .


Bicalutamide significantly improved OS in patient with locally advanced disease ( hazard ratios ( HR ) = @ ( @ % confidence interval ( CI ) : @-@ @ , p = @ ) , regardless of baseline prostate-specific antigen ( PSA ) , with a survival benefit which was apparent throughout the study period .


In contrast , survival favoured randomisation to the placebo arm in patients with localised disease ( HR = @ ( @ % CI : @-@ @ ) , p = @ ) .


However , a survival gain from bicalutamide therapy was present in patients with localised disease and a baseline PSA greater than @ng/mL at randomisation .


In multivariate Cox proportional hazard model , only including patients managed on watchful waiting as their standard of care ( n = @ ) OS depended on age , World Health Organisation ( WHO ) grade , baseline PSA , clinical stage and randomised treatment .


Throughout the @ year follow-up period the addition of early bicalutamide to standard of care resulted in a significant OS benefit in patients with locally advanced PCa .


In contrast , patients with localised PCa and low PSA derived no survival benefit from early bicalutamide .


The optimal timing for initiating bicalutamide in non-metastatic PCa patients is dependent on disease stage and baseline PSA .


Epidemiological studies suggest the existence of a relationship between aircraft noise exposure and increased risk for myocardial infarction and stroke .


Patients with established coronary artery disease and endothelial dysfunction are known to have more future cardiovascular events .


We therefore tested the effects of nocturnal aircraft noise on endothelial function in patients with or at high risk for coronary artery disease .


@ Patients ( @p @-@ vessels disease ; @p with a high Framingham Score of @ % ) were exposed in random and blinded order to aircraft noise and no noise conditions .


Noise was simulated in the patients ' bedroom and consisted of @ events during one night .


Polygraphy was recorded during study nights , endothelial function ( flow-mediated dilation of the brachial artery ) , questionnaires and blood sampling were performed on the morning after each study night .


The mean sound pressure levels L eq ( @ ) measured were @ @ dB ( A ) in the Noise @ nights and @ @ dB ( A ) in the control nights .


Subjective sleep quality was markedly reduced by noise from @ @ to @ @ ( p < @ ) .


FMD was significantly reduced ( from @ @ to @ @ % ; p < @ ) and systolic blood pressure was increased ( from @ @ to @ @ mmHg ; p = @ ) by noise .


The adverse vascular effects of noise were independent from sleep quality and self-reported noise sensitivity .


Nighttime aircraft noise markedly impairs endothelial function in patients with or at risk for cardiovascular disease .


These vascular effects appear to be independent from annoyance and attitude towards noise and may explain in part the cardiovascular side effects of nighttime aircraft noise .


Providing advice to wear good quality shoes with appropriate fit is one of the possibilities GPs have when treating patients with foot problems .


The aims of this study are to ( i ) determine which shoe characteristics are important when providing shoe advice ; ( ii ) develop a shoe advice leaflet and ( iii ) evaluate if women choose better shoes with the aid of the leaflet .


We performed a literature search on the effect of separate shoe characteristics on foot pathologies and kinematics and developed an information leaflet with the aid of multidisciplinary experts .


The leaflet was tested in a group of women aged @ years or over who did not receive podiatric treatment or shoe advice in the year prior to the study .


The women were asked to select shoes ; half of them were provided with the leaflet .


Shoe characteristics were scored blinded for the condition by two podiatrists .


Data were analysed using a t-test for independent measures .