Cost-effectiveness will explored in terms of quality-adjusted life years using the EuroQol-@D measure of health-related quality of life .


The clinical and economic outcomes of this trial will provide the evidence to help policy makers , clinicians and guideline developers decide on the merits of including BA as a first-line treatment of depression .


Eccentric muscle actions are important to the development of muscle mass and strength and may affect bone mineral density ( BMD ) .


This study 's purpose was to determine the relative effectiveness of five different eccentric : concentric load ratios to increase musculoskeletal parameters during early adaptations to resistance training .


Forty male subjects performed a supine leg press and calf press training program @ days week ( -@ ) for @ weeks .


Subjects were matched for pre-training leg press @-repetition maximum strength ( @-RM ) and randomly assigned to one of five training groups .


Concentric training load ( % @-RM ) was constant across groups , but within groups , eccentric load was @ , @ , @ , @ , or @ % of concentric load .


Muscle mass ( dual energy X-ray absorptiometry ; DXA ) , strength ( @-RM ) , and BMD ( DXA ) were measured pre - and post-training .


Markers of bone metabolism were assessed pre - , mid - and post-training .


The increase in leg press @-RM in the @ % group ( @ @ % ) was significantly greater ( P < @ ) than the @ % ( @ @ % ) , @ % ( @ @ % ) and @ % ( @ @ % ) groups , but not the @ % group ( @ @ % ; P = @ ) .


All groups , except the @ % group , increased calf press @-RM ( P < @ ) .


Leg lean mass and greater trochanter BMD were increased only in the @ % group ( P < @ ) .


Early-phase adaptations to eccentric overload training include increases in muscle mass and site-specific increases in BMD and muscle strength which are not present or are less with traditional and eccentric underload training .


Eccentric overload provides a robust musculoskeletal stimulus that may benefit bedridden patients , individuals recovering from injury or illness , and astronauts during spaceflight .


To explore the effects of parecoxib sodium analgesia on serum concentrations of neuron-specific enolase ( NSE ) and S-@ and postoperative cognitive function of elderly patients undergoing acute replacement of femoral head .


After the approval of institutional review board and the provision of informed consent , @ patients over @ years old , undergoing acute replacement of femoral head under combined spinal and epidural anesthesia and midazolam sedation at Qingdao Municipal Hospital and Qingdao Hiser Medical Center from January @ to May @ , were randomly assigned into control group ( group C , n = @ ) and parecoxib group ( group P , n = @ ) .


In group P , parecoxib sodium @/@ mg ( based on weight @ kg ) was administered via an intravenous injection after admission with @ hours intervals for six times .


In group C , morphine @/@ mg was given initially .


Additional morphine @ mg was given to maintain the pain visual analog scale ( VAS ) of @ points or less in both groups .


Primary observation indices : ( @ ) postoperative time and additional amount of morphine ; ( @ ) rate of postoperative delirium ( POD ) and postoperative cognitive dysfunction ( POCD ) at @ days , @ week , @ months and @ months postoperation ( T@-T@ ) ; ( @ ) se rum levels of NSE and S-@ were measured at the timepoints of before analgesia ( t@ ) , before anesthesia ( t@ ) , end of surgery ( t@ ) and @ hours , @ hours , @ hours postoperation ( t@-t@ ) ; ( @ ) other serious complications .


Compared with group C , the additional amount of morphine , postoperative time , rate of POD and POCD at T@-T@ , the level of NSE at t@-t@ and S-@ at t@-t@ were lower in group P ( P < @ ) .


No other serious complications were observed .


Parecoxib sodium analgesia reduces the rate of POD and POCD in elderly patients with neuroprotective effects .


Pattern differentiation and diagnosis are fundamental principles of Traditional Chinese Medicine ( TCM ) .


Studies have shown low inter-rater reliability in TCM pattern diagnoses .


This variability may originate from both the identification and the interpretation of symptoms and signs .


To examine the inter-rater reliability in TCM pattern diagnoses made in the style of Maciocia for @ case histories by eight acupuncturists and to explore the impact of demographic factors on the diagnostic conclusion .


Further , the association between the diagnosis and the presence of symptoms was examined for a single TCM diagnosis .


Eight acupuncturists independently diagnosed @ women ( @ fertile , @ infertile ) based on written case histories .


Descriptive statistics , logistic regression and inter-rater reliability ( ) were used .


Poor inter-rater reliability on TCM patterns ( < @ ) and large variation in the number of TCM pattern diagnoses were found .


Sex , duration of practice and education had a highly significant effect ( p < @ ) on the use of TCM patterns and working hours had a significant effect ( p = @ ) .


There was considerable intra - and inter-rater variation in the use of symptoms to make a diagnosis .


Symptoms occurring frequently as well as infrequently were inconsistently used to diagnose Liver Qi Stagnation .


The study was limited by a small sample size .


The results showed extensive variation and poor inter-rater reliability in TCM diagnoses .


Demographic variables influenced the frequency of diagnoses and symptoms were used inconsistently to set a diagnosis .


The variability shown could impede individually tailored treatment .


This randomized phase III trial was conducted to confirm noninferiority of amrubicin plus cisplatin ( AP ) compared with irinotecan plus cisplatin ( IP ) in terms of overall survival ( OS ) in chemotherapy-naive patients with extensive-disease ( ED ) small-cell lung cancer ( SCLC ) .


Chemotherapy-naive patients with ED-SCLC were randomly assigned to receive IP , composed of irinotecan @ mg/m ( @ ) on days @ , @ , and @ and cisplatin @ mg/m ( @ ) on day @ every @ weeks , or AP , composed of amrubicin @ mg/m ( @ ) on days @ , @ , and @ and cisplatin @ mg/m ( @ ) on day @ every @ weeks .


A total of @ patients were randomly assigned to IP ( n = @ ) and AP ( n = @ ) arms .


The point estimate of OS hazard ratio ( HR ) for AP to IP in the second interim analysis exceeded the noninferior margin ( HR , @ ) , resulting in early publication because of futility .


In updated analysis , median survival time was @ ( IP ) versus @ months ( AP ; HR , @ ; @ % CI , @ to @ ) , median progression-free survival was @ ( IP ) versus @ months ( AP ; HR , @ ; @ % CI , @ to @ ) , and response rate was @ % ( IP ) versus @ % ( AP ; P = @ ) .


Adverse events observed in IP and AP arms were grade @ neutropenia ( @ % v @ % ) , grade @ to @ febrile neutropenia ( @ % v @ % ) , and grade @ to @ diarrhea ( @ % v @ % ) .


AP proved inferior to IP in this trial , perhaps because the efficacy of amrubicin as a salvage therapy was differentially beneficial to IP .


IP remains the standard treatment for extensive-stage SCLC in Japan .


It has been reported that the direction of the guidewire J-tip is associated with misplacement of a central venous catheter .


We hypothesized that real-time ultrasound-guided infraclavicular subclavian venous cannulation would be less influenced by the direction of guidewire J-tip compared to landmark method .


Sixty adult patients who required subclavian venous catheterization for neurosurgery were enrolled in this prospective randomized controlled study .


Patients were randomly divided into a landmark group ( n = @ ) or an ultrasound group ( n = @ ) .


After the subclavian vein was punctured , the guidewire was advanced with the guidewire J-tip directed cephalad .


Misplacement or advancement failure of the guidewire was regarded as an unsuccessful placement .


Postoperative chest radiography was performed to confirm pneumothorax and the location of the catheter tip .


The two groups were comparable with respect to age , gender , height , and weight distribution .


The incidence of unsuccessful guidewire placement was lower in the ultrasound group than in the landmark group ( @ % vs. @ % , P = @ ) .


Among the unsuccessful guidewire placements , the incidence of misplacement were comparable between the groups and were all located in the ipsilateral internal jugular vein ( @ % vs. @ % ) .


However , the incidence of advancement failure was significantly higher in landmark group ( @ % vs. @ % , P = @ ) .


There were no complications such as pneumothorax or hemothorax .


The proper placement of guidewire was less influenced by the direction of the guidewire J-tip with ultrasound-guided subclavian venous cannulation than with the landmark approach .


Human papillomavirus ( HPV ) - based screening needs triage .


In most randomized controlled trials ( RCTs ) on HPV testing with cytological triage , cytology interpretation has been blind to HPV status .


Women age @ to @ years enrolled in the New Technology in Cervical Cancer ( NTCC ) RCT comparing HPV testing with cytology were referred to colposcopy if HPV positive and , if no cervical intraepithelial neoplasia ( CIN ) was detected , followed up until HPV negativity .


Cytological slides taken at the first colposcopy were retrieved and independently interpreted by an external laboratory , which was only aware of patients ' HPV positivity .


Sensitivity , specificity , and positive ( PPV ) and negative ( NPV ) predictive values were computed for histologically proven CIN@ + with HPV status-informed cytology for women with a determination of atypical squamous cells of undetermined significance ( ASCUS ) or more severe .


All statistical tests were two-sided .


Among HPV-positive women , informed cytology had cross-sectional sensitivity , specificity , PPV and @-NPV for CIN@ + of @ % ( @ % confidence interval -LSB- CI -RSB- = @ to @ ) , @ % ( @ % CI = @ to @ ) , @ % ( @ % CI = @ to @ ) , and @ ( @ % CI = @ to @ ) , respectively .


Cytology was also associated with subsequent risk of newly diagnosed CIN@ + and CIN@ + .


The cross-sectional relative sensitivity for CIN@ + vs blind cytology obtained by referring to colposcopy and following up only HPV positive women who had HPV status-informed cytology greater than or equal to ASCUS was @ ( @ % CI = @ to @ ) , while the corresponding relative referral to colposcopy was @ ( @ % CI = @ to @ ) .


Cytology informed of HPV positivity is more sensitive than blind cytology and could allow longer intervals before retesting HPV-positive , cytology-negative women .


We tested the hypothesis that observationally and genetically elevated YKL-@ is associated with elevated lipids and lipoproteins and with increased risk of ischemic vascular disease .


We conducted cohort and Mendelian randomization studies in @ @ individuals from the Danish general population , with measured plasma levels of YKL-@ ( n = @ @ ) , plasma lipids and lipoproteins ( n = @ @ ) , and CHI@L@ rs@ genotype ( n = @ @ ) .


From @ to @ , @ individuals developed ischemic stroke , @ ischemic cerebrovascular disease , @ myocardial infarction , and @ @ developed ischemic heart disease .


The @ % to @ % versus @ % to @ % YKL-@ percentile category was associated with a @ % increase in triglycerides , but only with minor changes in other lipids and lipoproteins .


For these categories , the multifactorially adjusted hazard ratio was @ ( @ % confidence interval , @-@ @ ) for ischemic stroke , @ ( @-@ @ ) for ischemic cerebrovascular disease , @ ( @-@ @ ) for myocardial infarction , and @ ( @-@ @ ) for ischemic heart disease .


When compared with rs@ CC homozygosity , the presence of G-allele was associated with a doubling ( GC ) or tripling ( GG ) in YKL-@ levels , but not with triglyceride levels or with risk of ischemic vascular disease .


A doubling in YKL-@ was associated with a multifactorially adjusted observational hazard ratio for ischemic stroke of @ ( @-@ @ ) , and a genetic odds ratio of @ ( @-@ @ ) .


Corresponding risk estimates were @ ( @-@ @ ) observationally and @ ( @-@ @ ) genetically for ischemic cerebrovascular disease , @ ( @-@ @ ) observationally and @ ( @-@ @ ) genetically for myocardial infarction , and @ ( @-@ @ ) observationally and @ ( @-@ @ ) genetically for ischemic heart disease .


Elevated YKL-@ was associated with a @ % increase in triglyceride levels and with a @-fold increased risk of ischemic stroke , whereas genetically elevated YKL-@ were not .


The association of QRS duration ( QRSd ) with morbidity and mortality is understudied in patients with atrial fibrillation ( AF ) .


We sought to assess any association of prolonged QRS with increased risk of death or hospitalization among patients with AF .


QRS duration was retrieved from the baseline electrocardiograms of patients enroled in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management ( AFFIRM ) study and divided into three categories : < @ , @-@ , @ ms. Cox models were applied relating the hazards of mortality and hospitalizations to QRSd .


Among @ patients with AF , @ died and @ were hospitalized .


Compared with those with QRS < @ ms , patients with QRS @ ms , had an increased mortality -LSB- hazard ratio ( HR ) @ , @ % confidence interval ( CI ) : @-@ @ , P < @ -RSB- and hospitalizations ( HR @ , @ % CI : @-@ @ , P = @ ) over an average follow-up of @ years .


Importantly , for patients with QRS @-@ ms , mortality and hospitalization were also increased ( HR @ , P = @ and @ , P = @ , respectively ) .


In subgroup analysis based on heart failure ( HF ) status ( previously documented or ejection fraction < @ % ) , mortality was increased for QRS @ ms patients with ( HR @ , P < @ ) and without HF ( HR @ , P = @ ) .


In the QRS @-@ ms group , mortality was increased ( HR @ , P = @ ) for those with HF , but not significantly among those without HF ( HR @ , P = @ ) .


Among patients with AF , QRSd @ ms was associated with a substantially increased risk for mortality ( all-cause , cardiovascular , and arrhythmic ) and hospitalization .


Interestingly , an increased mortality was also observed among those with QRS @-@ ms and concomitant HF .


This study sought to examine the association between thyroid status and clinical outcomes in patients in the CORONA ( Controlled Rosuvastatin Multinational Trial in Heart Failure ) study .


Hypo - and hyperthyroidism were associated with worse clinical outcomes in the SCD-HeFT ( Sudden Cardiac Death in Heart Failure Trial ) .


In CORONA , @,@ patients underwent baseline thyroid-stimulating hormone ( TSH ) measurement , @ of which ( @ % ) were receiving thyroid replacement therapy ( TRT ) .


Patients were classified as euthyroid ( TSH : @ to @ U/ml , and no TRT ) , hyperthyroid ( < @ U/ml and no TRT ) , or hypothyroid ( > @ U/ml and no TRT ) .


The outcome composites of cardiovascular ( CV ) death or hospitalization for heart failure ( HF ) , the components of this composite , and all-cause death were compared among hyperthyroid , hypothyroid , and euthyroid states , using multivariable models adjusting for previously reported prognostic variables .


A total of @ % of patients were euthyroid , @ % were hypothyroid , and @ % were hyperthyroid .


Compared with euthyroid patients , hypothyroid patients were more likely to have a history of stroke , had worse renal function and higher N-terminal pro-B-type natriuretic peptide ( NT-proBNP ) levels , were more likely to be treated with an antiarrhythmic drug ( or have an implantable cardioverter defibrillator ) , and were less likely to smoke or be treated with a beta-blocker or angiotensin-converting enzyme inhibitor/angiotensin receptor blocker .


In univariate analyses , hypothyroidism was associated with an increased risk of the composite outcome of CV death or HF hospitalization ( hazard ratio : @ ; @ % confidence interval : @ to @ ; p = @ ) , as well as all-cause death ( HR : @ ; @ % confidence interval : @ to @ ; p = @ ) .


However , after adjustment for other known predictors of outcome , the associations were weakened , and when NT-proBNP was added to the models , the association between hypothyroidism and all outcomes was eliminated .


Thyroid status is not an independent predictor of outcome in heart failure with reduced ejection fraction .


( Controlled Rosuvastatin Multinational Study in Heart Failure -LSB- CORONA -RSB- ; NCT@ ) .


To report long-term efficacy and safety results of the SANTE trial investigating deep brain stimulation of the anterior nucleus of the thalamus ( ANT ) for treatment of localization-related epilepsy .


This long-term follow-up is a continuation of a previously reported trial of @ - vs @-V ANT stimulation .


Long-term follow-up began @ months after device implantation with stimulation parameters adjusted at the investigators ' discretion .


Seizure frequency was determined using daily seizure diaries .


The median percent seizure reduction from baseline at @ year was @ % , and @ % at @ years .


The responder rate ( @ % reduction in seizure frequency ) at @ year was @ % , and @ % at @ years .


In the @ years of follow-up , @ % of subjects were seizure-free for at least @ months .


There were no reported unanticipated adverse device effects or symptomatic intracranial hemorrhages .


The Liverpool Seizure Severity Scale and @-item Quality of Life in Epilepsy measure showed statistically significant improvement over baseline by @ year and at @ years ( p < @ ) .


Long-term follow-up of ANT deep brain stimulation showed sustained efficacy and safety in a treatment-resistant population .


This long-term follow-up provides Class IV evidence that for patients with drug-resistant partial epilepsy , anterior thalamic stimulation is associated with a @ % reduction in seizure frequency and a @ % serious device-related adverse event rate at @ years .


To investigate the effects of elastic tubing training compared with conventional resistance training on the improvement of functional exercise capacity , muscle strength , fat-free mass , and systemic inflammation in patients with chronic obstructive pulmonary disease .


A prospective , randomized , eight-week clinical trial .


The study was conducted in a university-based , outpatient , physical therapy clinic .


A total of @ patients with moderate chronic obstructive pulmonary disease .


Participants were randomly assigned to perform elastic tubing training or conventional resistance training three times per week for eight weeks .


The primary outcome measure was functional exercise capacity .


The secondary outcome measures were peripheral muscle strength , health-related quality of life assessed by the Chronic Respiratory Disease Questionnaire ( CRDQ ) , fat-free mass , and cytokine profile .


After eight weeks , the mean distance covered during six minutes increased by @ meters ( @ ) in the elastic tubing group and by @ meters ( @ ) in the conventional group ( p < @ ) .


The muscle strength and quality of life improved in both groups ( P < @ ) , with no significant differences between the groups .


There was a trend toward an improved fat-free mass in both groups ( P = @ ) .


After the first and last sessions , there was an increase in interleukin @ ( IL-@ ) and interleukin @ ( IL-@ ) in both groups , while tumour necrosis factor alpha ( TNF - ) was stimulated only in the conventional training group .


Elastic tubing training had a greater effect on functional exercise capacity than conventional resistance training .


Both interventions were equally effective in improving muscle strength and quality of life .


To determine whether daily self-weighing ( DSW ) is associated with disordered eating ( DE ) symptoms within an adult lifestyle intervention ( LI ) , and to examine changes in DE symptoms during the @-month trial .


One-hundred and seventy-eight adults ( @ % female , @ % White , @ @ years , BMI = @ @ kg/m@ ) were enrolled in a randomized trial testing @ dietary prescriptions within a LI ( standard vs. limited dietary variety ) .


Both arms were taught DSW and had the same contact schedule and calorie and activity goals .


Frequency of weighing and DE were assessed at @ , @ , @ , and @ months .


Analyses controlled for treatment arm .


At baseline , @ % of participants reported weighing daily compared with @ % , @ % , and @ % at @ , @ , and @ months , respectively .


There was no relationship between change in frequency of self-weighing and change in DE symptoms at any time point .


Further , there were no significant differences between those who weighed daily versus < daily on DE composite scores at baseline or @ months ; at @ and @ months participants who weighed daily reported lower DE scores compared with those who weighed < daily ( p = @ and @ at @ and @ months , respectively ) .


Participants who weighed daily achieved better weight losses than those weighing < daily at @ and @ months ( p = @ and < @ ) .


There was a significant reduction over time in DE symptoms ( p < @ ) and a reduction in odds of meeting criteria for Binge Eating Disorder ( BED ; ps < @ ) .


Daily self-weighing did not appear to be related to increased disordered eating behavior and was associated with better weight loss outcomes .


The benefit of antibiotic prophylaxis for simple hand lacerations ( lacerations that do not involve special structures ) has not been adequately studied .


To assess the feasibility of a randomized controlled trial to determine the role of antibiotic prophylaxis in emergency department ( ED ) patients with simple hand lacerations .


Randomized , double-blind , placebo-controlled pilot trial in @ urban academic EDs .


Adult ( @ years old ) patients with simple hand lacerations were randomized to cephalexin , @ mg ; clindamycin , @ mg ; or placebo ( every @ hours for @ days , all in identical capsules ) .


( @ ) feasibility determined by the number of patients who agreed to enroll and number of patients who completed follow-up , ( @ ) infection rate ( determined by @ physicians at @-@ days ) , ( @ ) satisfaction with wound appearance ( measured by a visual analogue scale at @ days via phone ) .


Medians , quartiles , and percentages with @ % confidence intervals ( CI ) were used to present data .


Groups were compared with Kruskal-Wallis and Fisher exact tests , when appropriate .


Over a @-month period , @ patients were approached , and @ consented to enrollment ( @ % ; @ % CI , @-@ % ) .


Five were lost to follow-up ( @/@ , @ % ; @ % CI , @ % -@ % ) .


Only one patient had infection on follow-up for an infection rate of @ % ( @ % CI , @ % -@ % ) .


Patient 's satisfaction with wound appearance did not differ among the groups .


The findings of this pilot study support the feasibility of a randomized , double-blind , controlled trial .


The low rate of infection suggests the need of a large sample size for the trial .


To determine the effect of prior oophorectomy in healthy postmenopausal women on the rate of loss of bone mineral density ( BMD ) and rate of increase in carotid artery intima-media thickness ( CIMT ) .


Secondary analysis from a randomized controlled trial .


University-based research clinic .


Two hundred twenty-two healthy postmenopausal women in the Greater Los Angeles area .


Baseline and annual screening of BMD and assessment of CIMT every @ months for a total of @ years .


Changes in BMD and CIMT during postmenopausal years .


Among women who were menopausal for more than @ years , the rate of CIMT progression was statistically significantly less in women with intact ovaries compared with those in women with prior oophorectomy .


In women @-@ years postmenopause , there was a trend toward a slower loss of BMD in those who retained their ovaries , and in women more than @ years postmenopause there was significantly less BMD loss in those who retained their ovaries .


As time from menopausal transition increases , retained ovaries are associated with a slower rate of bone loss and a slower rate of thickening of the carotid artery wall compared with rates in menopausal women with oophorectomy .


To investigate the hypothesis that paracetamol is absorbed faster from a hot drink than from a standard tablet using simultaneous scintigraphic imaging and pharmacokinetic sampling .


Twenty-five healthy male volunteers received both paracetamol formulations in a randomised manner .


The formulation administered in the first treatment arm was radiolabelled to allow scintigraphic monitoring .


In both treatment arms , blood samples were taken for assessing paracetamol absorption .


Following the hot drink , paracetamol absorption was both significantly faster and greater over the first @min post-dose compared with the tablet , as evidenced by the median time to reach t@ @ g/mL of @ and @ min , respectively , and AUC@-@ of @ and @ h * ng/mL , respectively .


In addition , tmax was significantly shorter for the hot drink ( median time = @ h ) compared with the tablet ( @ h ) .


However , Cmax was significantly greater following the tablet ( @,@ ng/mL ) compared with the hot drink ( @,@ ng/mL ) .


Onset of gastric emptying after the hot drink was significantly faster than after the standard tablet ( @ versus @ min ) , as confirmed scintigraphically .


Compared with a standard tablet , a hot drink provides faster absorption of paracetamol potentially due to more rapid gastric emptying .


Despite its documented importance , communication between clinicians and patients ' families in the intensive care unit often fails to meet families ' needs , and interventions to improve communication are needed .


Use of a communication facilitator-an additional staff member-to improve communication between clinicians and patients ' families is the focus of an ongoing randomized trial .


The clinical team 's acceptance of the communication facilitator as an integral part of the team is important .


To explore clinicians ' perceptions of the usefulness of a communication facilitator in the intensive care unit .


Fourteen semistructured qualitative interviews to assess perspectives of physicians , nurses , and social workers who had experience with the communication facilitator intervention on the intervention and the role of the facilitator .


Methods based on grounded theory were used to analyze the data .


Clinicians perceived facilitators as ( @ ) facilitating communication between patients ' families and clinicians , ( @ ) providing practical and emotional support for patients ' families , and ( @ ) providing practical and emotional support for clinicians .


Clinicians were enthusiastic about the communication facilitator but concerned about overlapping or conflicting roles .


Clinicians in the intensive care unit saw the facilitator intervention as enhancing communication and supporting both patients ' families and clinicians .


They also identified the importance of the facilitator within the interdisciplinary team .


Negative perceptions about the use of a facilitator should be addressed before the intervention is implemented , in order to ensure its effectiveness .


The impact of boosted protease inhibitor therapy on inflammatory and cardiovascular biomarker levels in treatment-naive HIV-infected patients remains unclear and may differ between agents .


Unconjugated bilirubin elevation , which favourably affects vascular biomarkers and cardiovascular disease risk in Gilbert 's syndrome , occurs with atazanavir .


CASTLE was a @-week study comparing efficacy and safety in treatment-naive HIV-@-infected patients randomized to atazanavir/ritonavir ( ATV/r ) versus lopinavir/ritonavir ( LPV/r ) , each in combination with tenofovir disoproxil fumarate/emtricitabine .


In this substudy , fasting plasma tumour necrosis factor - ( TNF - ) , interleukin-@ ( IL-@ ) , high sensitivity C-reactive protein ( hs-CRP ) , plasminogen activator inhibitor-@ ( PAI-@ ) and fibrinogen were assessed at baseline , week @ , @ , @ and @ .


Impact of grade @-@ hyperbilirubinaemia on biomarkers was examined .


CASTLE demonstrated similar efficacy in both treatment arms with higher rates of hyperbilirubinaemia on ATV/r and elevated lipids on LPV/r .


In this substudy ( n = @ ) , patterns of biomarker expression were similar between the ATV/r and LPV/r groups and between-group differences in biomarker percentage change from baseline were not significant at @ and/or @ weeks .


Hyperbilirubinaemia did not influence fasting biomarker expression .


No significant differences were noted between ATV/r and LPV/r for biomarker percentage changes from baseline .


Furthermore , no association was found between total bilirubin levels and biomarker expression .


Bone graft substitutes are widely used for reconstruction of posttraumatic bone defects .


However , their clinical significance in comparison to autologous bone grafting , the gold-standard in reconstruction of larger bone defects , still remains under debate .


This prospective , randomized , controlled clinical study investigates the differences in pain , quality of life , and cost of care in the treatment of tibia plateau fractures-associated bone defects using either autologous bone grafting or bioresorbable hydroxyapatite/calcium sulphate cement ( CERAMENT | BONE VOID FILLER ( CBVF ) ) .


CERTiFy ( CERament Treatment of Fracture defects ) is a prospective , multicenter , controlled , randomized trial .


We plan to enroll @ patients with fresh traumatic depression fractures of the proximal tibia ( types AO @-B@ and AO @-B@ ) in @ participating centers in Germany .


Patients will be randomized to receive either autologous iliac crest bone graft or CBVF after reduction and osteosynthesis of the fracture to reconstruct the subchondral bone defect and prevent the subsidence of the articular surface .


The primary outcome is the SF-@ Physical Component Summary at week @ .


The co-primary endpoint is the pain level @ weeks after surgery measured by a visual analog scale .


The SF-@ Mental Component Summary after @ weeks and costs of care will serve as key secondary endpoints .


The study is designed to show non-inferiority of the CBVF treatment to the autologous iliac crest bone graft with respect to the physical component of quality of life .


The pain level at @ weeks after surgery is expected to be lower in the CERAMENT bone void filler treatment group .


CERTiFy is the first randomized multicenter clinical trial designed to compare quality of life , pain , and cost of care in the use of the CBVF and the autologous iliac crest bone graft in the treatment of tibia plateau fractures .


The results are expected to influence future treatment recommendations .


This study assesses the effect of sending a Survivorship Care Plan ( SCP ) to primary care physicians ( PCP ) on the communication of the PCP with the medical specialist and the patient and to describe PCPs ' opinions regarding the SCP .


In a pragmatic cluster randomized controlled trial conducted in @ hospitals , the PCP of endometrial and ovarian cancer patients received usual information , while in addition the SCP-care arm received a copy of the patient 's SCP .


A questionnaire was returned by @ PCPs ( @ % ) .


One third of the PCPs in the SCP-care arm indicated having received an SCP .


PCPs in the SCP-care arm were more likely to have had personal contact with the medical specialist ( @ vs. @ % , p = @ ) but were equally satisfied with the information as PCPs in the usual care arm ( @ vs. @ on a scale from @ to @ , p = @ ) .


Of all PCPs , @ % indicated they would want to receive an SCP in the future .


A quarter of the PCPs who received an SCP reported that the SCP supported contact with the patient .


However , the SCP was found too long .


Supplying an SCP to PCPs potentially has a positive effect on the communication between the PCP and the medical specialist .


The SCP should be concise and focused on PCPs ' needs , such as contact information and tailored information on patient diagnosis , treatment , and possible consequences .


In the light of transition of cancer care to PCPs , survivors may benefit from improved information provision and communication .


Resistance exercise ( RE ) may lead to a post-exercise hypotension ( PEH ) response .


Previous studies showed that green tea ( GT ) and its polyphenols , especially Epigallocatechin-@-gallate ( EGCG ) may have a favorable effect on blood pressure ( BP ) .


We investigated the green tea extract ( GTE ) effects on BP , heart rate ( HR ) , and rate pressure product ( RPP ) responses to a low-intensity RE in hypertensive women .


Middle-aged women ( n = @ , @ @ years old ; @ @ kg ; @ @ cm ) were randomly assigned into three groups of eight persons .


GTE consumption group ( T ) and RE group ( R ) , respectively , ingested GTE ( ~ @ mg EGCG ) and placebo ( PL ; maltodextrin ) capsules two times a day for three weeks and then completed @ circuits of six RE using @ % one repetition maximum ( @RM ) .


Patients of control group ( C ) just ingested PL and rested in a non-exercise control trial .


BP , HR and RPP were measured prior and post-exercise at @ , @ , @ , @ , and @ min .


The repeated measures analysis of variance ( ANOVA ) revealed that there were no significant alterations for arterial BP , HR and RPP of C group .


HR of T and R groups was increased immediately after RE .


A significant fall of systolic BP ( SBP ) and diastolic BP ( DBP ) occurred in both T and R groups for @ min post-exercise compared to resting values .


Mean arterial BP ( MAP ) and RPP decreased significantly after RE in both exercise groups from @ to @ min .


During @ and @ time points , T group had a lower RPP values than C group .


The differences between T and R groups were only MAP at @ and @ time points .


Three weeks of GTE ingestion did not influenced SBP , DBP and HR but may be have a favorable effect on MAP and RPP responses to an acute RE during @ h recovery of exercise .


This study was done to compare @ techniques of pulse oximeter sensor application during neonatal resuscitation for faster signal detection .


Sensor to infant first ( STIF ) and then to oximeter was compared with sensor to oximeter first ( STOF ) and then to infant in @ weeks gestations .


The primary outcome was time from completion of sensor application to reliable signal , defined as stable display of heart rate and saturation .


Time from birth to sensor application , time taken for sensor application , time from birth to reliable signal , and need to reapply sensor were secondary outcomes .


An intention-to-treat analysis was done , and subgroup analysis was done for gestation and need for resuscitation .


One hundred fifty neonates were randomized with @ to each technique .


The median ( IQR ) time from sensor application to detection of reliable signal was longer in STIF group compared with STOF group ( @ -LSB- @-@ -RSB- vs. @ -LSB- @-@ -RSB- seconds ; P < @ ) .


Time taken for application of sensor was longer with STIF technique than with STOF technique ( @ -LSB- @-@ -RSB- vs. @ -LSB- @-@ -RSB- seconds ; P = @ ) .


Time from birth to reliable signal did not differ between the @ methods ( STIF : @ -LSB- @-@ -RSB- seconds ; STOF : @ -LSB- @-@ -RSB- seconds -LSB- P = @ -RSB- ) .


Time taken for signal acquisition was longer with STIF than with STOF in both subgroups .


In the delivery room setting , the STOF method recognized saturation and heart rate faster than the STIF method .


The time from birth to reliable signal was similar with the @ methods .


Neocollagenesis can be achieved using a dermal rolling needle device , thereby reducing the appearance of acne scars .


To determine the efficacy of a needling device for treatment of acne scars .


We performed a single-center , rater-blinded , balanced ( @:@ ) , split-face , placebo-controlled , parallel-group randomized clinical trial at an urban academic institution .


The study took place from November @ , @ , through July @ , @ .


Twenty healthy adults ( age range , @-@ years ) with acne scars on both sides of the face were enrolled .


Fifteen individuals completed the study , and no enrolled participants were withdrawn for adverse effects .


For each participant , one side of the face was randomized for needling .


Three needling treatments were performed at @-week intervals .


Two blinded dermatologists separately rated participants ' acne scars based on standard digital photographs obtained at baseline and at the @-month and @-month follow-up visits on the quantitative global scarring grading system .


Mean scar scores were significantly lower in the treatment group compared with baseline at @ months ( mean difference , @ ; @ % CI , @-@ @ ; P = @ ) and nominally but not significantly lower compared with baseline at @ months ( mean difference , @ ; @ % CI , -@ to @ ; P = @ ) .


In the control group , mean scar scores did not vary significantly from baseline at @ months ( mean difference , @ ; @ % CI , -@ to @ ; P = @ ) and at @ months ( mean difference , @ ; @ % CI , -@ to @ ; P > @ ) .


The needling procedure was not particularly painful , with a mean pain rating of @ of @ .


Participants perceived a @ % mean improvement in overall scar appearance on the treated side .


No adverse events were reported .


After @ needling treatments , there was improvement in the appearance of acne scars over time compared with the control group , with minimal pain reported .


Pro-inflammatory mediators are thought to play both peripheral and central roles in migraine pathophysiology .


Prostaglandins and leukotrienes , known as the eicosanoids , are degradation products of arachidonic acid and constitute signalization components of inflammatory pathways .


This study was designed to assess concentrations of leukotriene E@ ( LT-E@ ) and prostaglandin F@a ( PG-F@a ) in children with migraine .


This study involved patients aged @ years who presented to the Ondokuz Mayis University Children 's Hospital with migrainous headache between January and October @ .


Urinary LT-E@ and PG-F@a concentrations were measured in patients during a headache episode and at a headache-free time and in a control group .


The patient group consisted of @ girls and @ boys aged @-@ years diagnosed with migraine and having at least @ months of headache , whereas the control group consisted of @ girls and @ boys .


Mean standard deviation ( SD ) urinary LT-E@ concentrations were significantly higher in patients during a migraine episode than in controls ( @ pg/ml vs @ pg/ml , P < @ ) .


In patients with migraine , both urinary LT-E@ ( P < @ ) and PG-F@a ( P = @ ) levels were significantly higher during headache than during non-headache periods .


Urinary LT-E@ and PG-F@a were both significantly higher in children with migraine during headache than during non-headache periods .


The elevation in the levels of these inflammatory mediators was compatible with the hypothesis relating neuroinflammation in trigeminal vascular blood vessels with migraine pathophysiology .


Leukotriene antagonists may be effective in the prophylaxis of migraine attacks .


Repeated exposure to a neutral conditioned stimulus ( CS ) in the absence of a noxious unconditioned stimulus ( US ) elicits fear memory extinction .


The aim of the current study was to investigate the effects of mild tone exposure ( CS ) during slow wave sleep ( SWS ) on fear memory extinction in humans .


The healthy volunteers underwent an auditory fear conditioning paradigm on the experimental night , during which tones served as the CS , and a mild shock served as the US .


They were then randomly assigned to four groups .


Three groups were exposed to the CS for @ or @ min or an irrelevant tone ( control stimulus , CtrS ) for @ min during SWS .


The fourth group served as controls and was not subjected to any interventions .


All of the subjects completed a memory test @ h after SWS-rich stage to evaluate the effect on fear extinction .


Moreover , we conducted similar experiments using an independent group of subjects during the daytime to test whether the memory extinction effect was specific to the sleep condition .


Ninety-six healthy volunteers ( @ males ) aged @-@ y.


Participants exhibited undisturbed sleep during @ consecutive nights , as assessed by sleep variables ( all P > @ ) from polysomnographic recordings and power spectral analysis .


Participants who were re-exposed to the @ min CS either during SWS and wakefulness exhibited attenuated fear responses ( wake-@ min CS , P < @ ; SWS-@ min CS , P < @ ) .


Conditioned stimulus re-exposure during SWS promoted fear memory extinction without altering sleep profiles .


The physical and mental health of college-age youths tends to continuously decline around the world .


It is therefore important to promote health during this period .


As a traditional Chinese mind-body exercise , Tai Chi Chuan ( TCC ) may be an available selection .


However for the college student population , the evidence is unclear as to whether TCC can be recommended as an effective exercise for promoting their physical and psychological wellbeing .


Therefore high quality , rigorous , prospective , and well-controlled randomized trials are needed to further understand TCC serving as a psychological and physical intervention in college age populations .


We designed a randomized , single-blind , parallel-controlled trial with a sample size of @ participants .


All the participants who meet the inclusion criteria come from Fujian University of Traditional Chinese Medicine ( FJTCM ) .


Participants of the TCC training group will receive TCC training at a frequency of five days per week for one hour per day for @weeks .


No specific exercise will be administered on the participants in the control group .


Both physical and mental health outcomes , including balance ability , lower limb proprioception , flexibility , physical fitness , self-efficacy , psychological symptoms , attention span , stress , self-esteem , mood and mindfulness , quality of life , and quality of sleep .


Safety outcomes will be evaluated by blinded operators at baseline , @ and @-weeks post-intervention .


This protocol presents an objective design of a randomized , single-blind trial that will test the effectiveness and safety of TCC on the physical and psychological wellbeing of college students .


If the outcome is positive , the results will provide higher quality evidence of TCC on the physical and mental health of college age populations .


To assess whether the volume of callosal hyperintensities in the genu and splenium of older adults with mobility impairment is differentially associated with the degree of gain in gait speed after @ types of gait interventions .


Single-blind randomized controlled trial of @ types of gait exercises in older adults .


Research center in an academic institution .


Ambulatory adults ( N = @ ) aged @ years with a slow and variable gait .


Twelve-week physical therapist-guided trial of a conventional walking , endurance , balance , and strength ( WEBS ) intervention ( n = @ ) versus a timing and coordination of gait ( TC ) intervention ( n = @ ) .


Gain in gait speed after the intervention and its relation to callosal hyperintensities in the genu and splenium of the corpus callosum .


Gait speed improved in both the WEBS group ( mean change , @ m/s ) and the TC group ( mean change , @ m/s ; both P < @ ) .


The volume of white matter hypertintensities ( WMHs ) in the genu was differentially associated with gait speed gain ( group genual WMH interaction , P = @ ) .


Greater genual WMH volume was related to a smaller gait speed gain in the WEBS group ( P = @ ) but not in the TC ( P = @ ) group .


Splenial WMH volume was not differentially associated with gait speed gain ( interaction , P = @ ) .


Callosal hyperintensities differentially influence gait speed gain by the type of gait rehabilitation .


Mobility impaired older adults with genual hyperintensities may benefit from a rehabilitation program focused on motor skill learning rather than on strength and endurance training .


The purpose of this study was to determine whether iterative reconstruction improves the quality of cranial CT ( CCT ) images of stroke patients .


Fifty-one CCT studies of patients with infarction performed with either a low ( @ mAs ; n = @ ) or standard ( @ mAs ; n = @ ) dose were reconstructed with both filtered back projection ( FBP ) and sinogram-affirmed iterative reconstruction ( SAFIRE ) with five strength levels ( S@-S@ ) .


The resulting six image sets ( one FBP and one each for SAFIRE levels S@-S@ ) were rated separately by two blinded radiologists in terms of conspicuity of infarcted areas on a @-point scale .


Noise and infarct-to-normal brain as well as medullary-to-cortical contrast-to-noise ratios ( CNRs ) were measured .


Ratings , noise , and CNRs were intraindividually compared within the same dose group ( Fisher exact test ) and interindividually between the different dose groups ( Wilcoxon-Mann-Whitney U test ) .


The strength level S@ showed the best conspicuity of infarcted areas .


Compared with FBP , SAFIRE S@ statistically significantly ( p < @ ) reduced noise and improved CNRs without statistically significant differences in all subjective and objective criteria ( p > @ ) when the dose was reduced .


Patients examined with a @-mAs low-dose were exposed to a statistically significantly lower dose ( @ vs @ mSv ; p < @ ) .


Iterative reconstruction ( SAFIRE at strength level S@ ) leads to increased subjective and objective image quality in CCT and allows dose reduction ( -@ % ) without losses in the demarcation of ischemic lesions .


After-hours telephone communications are common in patient management .


Patterns of communication of key information during after-hours phone calls were evaluated , and the utility of problem-specific Situation , Background , Assessment , Recommendation ( SBAR ) forms in improving this communication was assessed .


In a randomized trial using a simulated on-call setting , @ nurses called physicians regarding six cases adapted from inpatient records and based on the six most common reasons for after-hours nurse-physician communication .


Three of the cases were handled without the SBAR forms ( control cases ) , and three cases were handled with the forms ( SBAR cases ) .


Two cue types of communication were evaluated : situation cues , which conveyed the patient 's situation ( for example , a patient is confused ) , and background cues , which conveyed problem-specific data indicated on the SBAR forms ( for example , the patient has a low sodium level ) .


Ninety-two phone calls were analyzed ( @ SBAR/@ controls ) .


Most of the nurses reported the situation cues ( SBAR @ % , control @ % , p = @ ) but not the background cues .


There was a trend toward fewer background cues communicated in the SBAR cases ( @ % versus @ % , p = @ ) .


In @ % of the cases , on average , nurses omitted information or reported wrong information regarding the background cue .


Physicians asked questions that resulted in the communication of the cues in a minority of the cases when the background cues were not originally provided by the nurses ( SBAR @ % , control @ % , p = @ ) .


In after-hours phone communication between physicians and nurses , significant information was often not communicated and physicians did not elicit the necessary information .


Simply providing an SBAR-based form did not ensure complete communication of key information .


The use of opioid analgesics in the United States has significantly increased in recent years .


However , there is minimal consensus on what discharge counseling should accompany these high-risk prescriptions and large variations in what is done in practice .


The objective of this study was to evaluate the effect of a dual-modality ( written and spoken ) literacy-appropriate educational strategy on patients ' knowledge of and safe use of opioid analgesics .


This was a prospective , randomized controlled trial .


Consecutive discharged patients at an urban academic ED ( > @,@ visits ) with new prescriptions for hydrocodone-acetaminophen were enrolled .


Patients were randomized to receive either usual care or the educational intervention .


The educational intervention was a one-page information sheet about hydrocodone-acetaminophen , which was both given to the patients and read aloud by the research assistant ( nonblinded ) .


Follow-up phone calls were conducted @ to @ days after the visit to assess patient knowledge about the medication and self-report of activities associated with safety of use ( e.g. , double-dipping with acetaminophen , storage , use with alcohol or while driving ) .


A total of @ patients were enrolled ; @ completed follow-up ( @ usual care and @ intervention ) .


No significant differences in baseline characteristics emerged between the study arms ; @ % were male , and @ % were white , with a median age of @ years .


Half of patients had non-back pain orthopedic injuries ( @ % ) .


On follow-up , overall knowledge was poor , with only @ % able to name both active ingredients in the medication .


The intervention group had better knowledge of precautions related to taking additional acetaminophen ( usual care @ % , @ % confidence interval -LSB- CI -RSB- = @ % to @ % vs. intervention @ % , @ % CI = @ % to @ % ; difference = @ , @ % CI of difference = @ to @ ) and knowledge of side effects ( usual care median = @ , interquartile range -LSB- IQR -RSB- @ to @ vs. intervention median = @ , IQR = @ to @ ; p < @ ) .


Additionally , those who received the intervention were less likely to have reported driving within @ hours after taking hydrocodone ( usual care @ % , @ % CI = @ % to @ % vs. intervention @ % , @ % CI = -@ % to @ % ; difference = @ , @ % CI of difference = @ to @ ) .


There was no difference between groups related to knowledge about drinking alcohol while taking hydrocodone ( overall @ % ) or knowledge that the opioid could be addictive ( overall @ % ) .


This simple strategy improved several , but not all , aspects of patient knowledge and resulted in fewer patients in the intervention arm driving while taking hydrocodone .


Integration of a patient education document into conversations about opioids holds promise for improving patient knowledge about these high-risk medications .


Problem adaptation therapy ( PATH ) is a treatment for older adults with major depression , cognitive impairment ( from mild cognitive deficits to moderate dementia ) , and disability .


Antidepressants have limited efficacy in this population and psychosocial interventions are inadequately investigated .


To test the efficacy of @-week PATH vs supportive therapy for cognitively impaired patients ( ST-CI ) in reducing depression and disability in @ older adults with major depression , cognitive impairment , and disability .


A randomized clinical trial at the Weill Cornell Institute of Geriatric Psychiatry from April @ , @ , to September @ , @ .


Interventions were administered at the participants ' homes .


Participants included @ older individuals ( age @ years ) with major depression and cognitive impairment to the level of moderate dementia .


They were recruited through collaborating community agencies of Weill Cornell Institute of Geriatric Psychiatry and were randomly assigned to @ weekly sessions of PATH or ST-CI ( @ % attrition rate ) .


Home-delivered PATH vs home-delivered ST-CI .


Problem adaptation therapy integrates a problem-solving approach with compensatory strategies , environmental adaptations , and caregiver participation to improve patients ' emotion regulation .


Supportive therapy for cognitively impaired patients focuses on expression of affect , understanding , and empathy .


Mixed-effects models for longitudinal data compared the efficacy of PATH with that of ST-CI in reducing depression ( Montgomery-Asberg Depression Rating Scale ) and disability ( World Health Organization Disability Assessment Schedule II ) during @ weeks of treatment .


Participants in PATH had significantly greater reduction in depression ( Cohen d , @ ; @ % CI , @-@ @ ; treatment time , F ( @,@ ) = @ ; P = @ ) and disability ( Cohen d , @ ; @ % CI , @-@ @ ; treatment time , F ( @,@ ) = @ ; P = @ ) than ST-CI participants during the @-week period ( primary outcomes ) .


Furthermore , PATH participants had significantly greater depression remission rates than ST-CI participants ( @ % vs @ % ; ( @ ) = @ ; P = @ ; number needed to treat = @ ) ( secondary outcome ) .


Problem adaptation therapy was more efficacious than ST-CI in reducing depression and disability .


Problem adaptation therapy may provide relief to a large group of depressed and cognitively impaired older adults who have few treatment options .


To examine the significant `` placebo effect '' in a randomized , double-blind , placebo-controlled interstitial cystitis/bladder pain syndrome trial .


Randomized clinical trials are the reference standard for therapeutic impact assessment .


However , proving efficacy of treatments for interstitial cystitis/bladder pain syndrome with rigorous placebo-controlled trials is difficult due to a significant effect of the placebo intervention .


Interstitial cystitis/bladder pain syndrome patients were randomized to receive subcutaneous adalimumab or subcutaneous placebo every @ weeks for @ weeks and outcome measures were assessed .


Of the @ patients , @ received adalimumab and @ received placebo .


Of the patients who received placebo , there was a statistically significant improvement demonstrated in the O'Leary-Sant Interstitial Cystitis Symptom and Problem Indexes of -@ ( @ % confidence interval -LSB- CI -RSB- , @-@ @ ) , Interstitial Cystitis Symptom Index of -@ ( @ % CI , @-@ @ ) , Interstitial Cystitis Problem Index of -@ ( @ % CI , @-@ @ ) , and Pelvic Pain , Urgency , Frequency scale of -@ ( @ % CI , @-@ @ ) at week @ compared with baseline .


Most of the significantly improved placebo patients felt their improvement was because they were more conscientious about following physician advice and feeling less stress while in the study .


Patients with moderate to severe interstitial cystitis/bladder pain syndrome had significant improvement after receiving only advice and support .


This intervention is risk free and inexpensive .


Physicians should review standard advice with all interstitial cystitis/bladder pain syndrome patients before starting medical therapy .


Restoring sinus rhythm in patients with heart failure ( HF ) and atrial fibrillation ( AF ) may improve left ventricular ( LV ) function and HF symptoms .


We sought to compare the effect of a catheter ablation strategy with that of a medical rate control strategy in patients with persistent AF and HF .


Patients with persistent AF , symptomatic HF , and LV ejection fraction < @ % were randomized to catheter ablation or medical rate control .


The primary end-point was the difference between groups in LV ejection fraction at @ months .


Baseline LV ejection fraction was @ % in the ablation group and @ % in the medical group .


Twenty-six patients underwent catheter ablation , and @ patients were rate controlled .


Freedom from AF was achieved in @/@ ( @ % ) at @ months off antiarrhythmic drugs .


LV ejection fraction at @ months in the ablation group was @ % compared with @ % in the rate control group ( P = @ ) .


Ablation was associated with better peak oxygen consumption ( @ versus @ mL/kg per minute ; P = @ ) and Minnesota living with HF questionnaire score ( @ versus @ ; P = @ ) compared with rate control .


Catheter ablation is effective in restoring sinus rhythm in selected patients with persistent AF and HF , and can improve LV function , functional capacity , and HF symptoms compared with rate control .


Clinical Trial Registration - URL : http://www.clinicaltrials.gov .


Unique identifier : NCT@ .


To investigate the effect of letrozole in decreasing the early-stage ovarian hyperstimulation syndrome ( OHSS ) occurrence during the luteal phase for patients of OHSS high-risk after oocyte retrieval .


A total of @ high-risk OHSS patients were randomly divided into two groups after oocyte retrieval .


Patients in experiment group ( n = @ ) received @ mg letrozole per day from the retrieval day and last for @ days .


Others in control group ( n = @ ) received placebo .


The serum concentration of FSH , LH , estradiol ( E@ ) , progesterone ( P ) and vascular endothelial growth factor ( VEGF ) from the day of hCG injection to days after injection ( @ days , @ days , @ days ) were measured .


And the incidence of moderate and severe OHSS was observed .


The concentration of E@ on the indicated days ( @ days , @ days , @ days after hCG injection ) in experiment group and control group were ( @ @ @ ) versus ( @@@ ) pmol/L , ( @ @ ) versus ( @ @ @ ) pmol/L , ( @ @ ) versus ( @ @ ) pmol/L ; the concentration of VEGF on the indicated days in the two groups were ( @ ) versus ( @ ) ng/L , ( @ ) versus ( @ ) ng/L , ( @ ) versus ( @ ) ng/L ; the concentration of E@ and VEGF were lower than those in control group ( all P < @ ) .


The FSH concentration in experiment group were ( @ ) and ( @ ) U/L on the day of fifth and eighth day after hCG injection , which were significantly higher than ( @ ) and ( @ ) U/L in control group ( P < @ ) ; the LH concentration in experiment group were ( @ ) and ( @ ) U/L on the day of fifth and eighth day after hCG injection , which were significantly higher than ( @ ) and ( @ ) U/L in control group ( P < @ ) .


The incidence of moderate and severe OHSS was signicantly decreased after letrozole treatment compared with control group -LSB- @ % ( @/@ ) versus @ % ( @/@ ) , P < @ -RSB- .


Administration of @ mg/d letrozole for @ days during the luteal phase can reduce the E@ and VEGF levels for the high-risk OHSS patients who needed cryopreserve all embryos , and also reduce the occurrence of early OHSS .


Combination therapy with acetylsalicylic acid and dipyridamole is first-line treatment in secondary prevention of strokes .


Approximately @ % of patients report headache as a side effect of dipyridamole .


Dose escalation of dipyridamole reduces this side effect .


In practice , different dose escalation schemes are used .


In theory , slower dose escalation than a standard scheme reduces headaches even more .


This study aimed to find the best dose escalation scheme for prevention of headaches as a side effect of dipyridamole in the secondary prevention of strokes .


In this randomized , open-label , @-week trial , @ patients who had an ischemic stroke or transient ischemic attack were randomized to receive either a standard or slow dose escalation scheme of dipyridamole .


Participants were asked to report the four most common side effects of dipyridamole in a study diary on study days @ , @ , @ , @ , @ , @ and @ .


They were asked to score headache intensity on a visual analog scale ( VAS ) .


Participants were unaware that the trial was focused on headaches .


Primary end point was to determine if a slow dose escalation scheme reduces the percentage of patients with headaches .


Secondary objective was to determine the number of patients who discontinued treatment with dipyridamole because of headaches .


Overall @ patients ( @ % ) of the final population reported headache , @ ( @ % ) in the standard dose escalation group and @ ( @ % ) in the slow dose escalation group ( p = @ ) .


In the standard dose escalation group patients scored headaches ( VAS > @ ) on an average of @ days and patients in the slow dose escalation group on @ days ( p = @ ) .


Mean VAS scores on study days @ , @ , @ , @ , @ and @ ranged from @ to @ in both groups .


These scores did not differ significantly .


However , on day @ patients scored a significantly lower mean VAS score in the standard dose escalation group than in the slow dose escalation group ( @ vs. @ ; p = @ ) .


In the standard dose escalation group @ patients ( @ % ) discontinued treatment because of side effects of dipyridamole and @ patients ( @ % ) in the slow dose escalation group ( p = @ , Fisher 's exact test ) .


We showed that slower than standard dose escalation of dipyridamole in combination therapy with acetylsalicylic acid does not reduce headaches as a side effect .


The use of such schemes should be discontinued in clinical practice .


Slow dose escalation might , however , reduce the number of patients who discontinue treatment , but further research is needed to confirm this .


Despite major advances in transplant medicine , improvements in long-term kidney allograft survival have not been commensurate with those observed shortly after transplantation .


The formation of donor-specific antibodies ( DSA ) and ongoing antibody-mediated rejection ( AMR ) processes may critically contribute to late graft loss .


However , appropriate treatment for late AMR has not yet been defined .


There is accumulating evidence that the proteasome inhibitor bortezomib may substantially affect the function and integrity of alloantibody-secreting plasma cells .


The impact of this agent on the course of late AMR has not so far been systematically investigated .


The BORTEJECT Study is a randomized controlled trial designed to clarify the impact of intravenous bortezomib on the course of late AMR .


In this single-center study ( nephrological outpatient service , Medical University Vienna ) we plan an initial cross-sectional DSA screening of @,@ kidney transplant recipients ( functioning graft at @days ; estimated glomerular filtration rate ( eGFR ) > @ml/minute/@ @ m@ ) .


DSA-positive recipients will be subjected to kidney allograft biopsy to detect morphological features consistent with AMR .


Forty-four patients with biopsy-proven AMR will then be included in a double-blind placebo-controlled intervention trial ( @:@ randomization stratified for eGFR and the presence of T-cell-mediated rejection ) .


Patients in the active group will receive two cycles of bortezomib ( @ mg/m@ over @weeks ; @-month interval between cycles ) .


The primary end point will be the course of eGFR over @months ( intention-to-treat analysis ) .


The sample size was calculated according to the assumption of a @ml/minute/@ @ m@ difference in eGFR slope ( per year ) between the two groups ( alpha : @ ; power : @ ) .


Secondary endpoints will be DSA levels , protein excretion , measured glomerular filtration rate , transplant and patient survival , and the development of acute and chronic morphological lesions in @-month protocol biopsies .


The impact of anti-humoral treatment on the course of late AMR has not yet been systematically investigated .


Based on the hypothesis that proteasome inhibition improves the outcome of DSA-positive late AMR , we suggest that our trial has the potential to provide solid evidence towards the treatment of this type of rejection .


To evaluate the effectiveness of daily tooth brushing with high-fluoride toothpaste on white spot lesion ( WSL ) formation in adolescents during treatment with fixed orthodontic appliances ( FOA ) .


Four hundred and twenty-four healthy @ - to @-year-old patients , referred to five Orthodontic Specialist Clinics , were randomized to use either toothpaste containing @ ppm fluoride or regular toothpaste with @ ppm fluoride .


To be eligible for inclusion , the patients had to be scheduled for bimaxillary treatment with FOA for an expected duration of at least @ year .


The primary and secondary outcome measures were prevalence and incidence of WSL , as registered from digital photos of the maxillary incisors , canines , and premolars taken before onset and immediately after debonding .


The photos were evaluated separately by two blinded and calibrated clinicians using a @-step score .


A random sample of @ cases was reassessed to check intra - and interexaminer reliability ( Kappa = @ ; @ ) .


The use of high-fluoride toothpaste resulted in fewer WSL ( P = @ ) with a prevented fraction of @ % .


The lateral incisor was most commonly affected in both groups .


To prevent WSL during treatment of FOA , daily use of high-fluoride toothpaste may be recommended .


Sensory properties of foods promote and guide consumption in hunger states , whereas satiation should dampen the sensory activation of ingestive behaviors .


Such activation may be disordered in obese individuals .


Using functional magnetic resonance imaging ( fMRI ) , we studied regional brain responses to food odor stimulation in the sated state in obese and normal-weight individuals targeting ventral frontal regions known to be involved in coding for stimulus reward value .


Forty-eight women ( @ normal weight ; @ obese ) participated in a @-day ( fed compared with fasting ) fMRI study while smelling odors of @ foods and an inedible , nonfood object .


Analyses were conducted to permit an examination of both general and sensory-specific satiation ( satiation effects specific to a given food ) .


Normal-weight subjects showed significant blood oxygen level-dependent responses in the ventromedial prefrontal cortex ( vmPFC ) to food aromas compared with responses induced by the odor of an inedible object .


Normal-weight subjects also showed general ( but not sensory-specific ) satiation effects in both the vmPFC and orbitofrontal cortex .


Obese subjects showed no differential response to the aromas of food and the inedible object when fasting .


Within - and between-group differences in satiation were driven largely by changes in the response to the odor of the inedible stimulus .


Responses to food aromas in the obese correlated with trait negative urgency , the tendency toward negative affect-provoked impulsivity .


Ventral frontal signaling of reward value may be disordered in obesity , with negative urgency heightening responses to food aromas .


The observed nature of responses to food and nonfood stimuli suggests that future research should independently quantify each to fully understand brain reward signaling in obesity .


The objective of the following study is to determine the effect of continuous insonation using @-MHz transcranial Doppler-ultrasound ( TCD-US ) on the recanalization rate and the short-term outcome in subjects with acute ischemic stroke due to middle cerebral artery ( MCA ) occlusion .


A total of @ patients with acute ischemic stroke due to MCA occlusion within @ h were recruited and randomly allotted to two groups ( @ patients in each group ) .


Group @ included patients who received @ h continuous TCD-US for MCA and Group @ included patients who did not receive @ h continuous TCD-US .


Patients in both groups were received MCA insonation and TCD study to measure mean flow velocity ( MFV ) in MCA one after the initial study at @ and @ min .


All patients received aspirin ( @-@ mg ) .


The clinical course during hospital stay was assessed before and after @ h of US insonation , at @ h after symptom onset using the National Institutes of Health Stroke Scale .


Change in MFV after insonation for Group @ in comparison to Group @ at @ time points was significantly high ( P < @ ) .


Sonothrombolysis is a therapeutic option to improve the outcomes in patients with acute ischemic stroke due to MCA occlusion .


Unsatisfactory colposcopy , an inability to visualize the entire transformation zone , is found in about @-@ % of the patients undergoing the procedure .


These patients usually require conization for a comprehensive evaluation of the cervix .


Our study aims to compare the efficacy and safety of vaginal misoprostol versus vaginal estradiol in overcoming unsatisfactory colposcopy .


We studied @ women with unsatisfactory colposcopy .


They were randomized into two groups : group I ( n = @ ) received @ g misoprostol vaginally and colposcopy was repeated after @ h , while the subjects in group II ( n = @ ) were prescribed a @-day course of @ g estradiol for vaginal insertion followed by a repeat colposcopy .


The efficacy and safety of these two drugs were compared .


Repeat colposcopy was satisfactory in @ % of the women given vaginal misoprostol compared to @ % of the women who used vaginal estradiol .


The difference was not statistically significant .


The adverse effects were reported more often by the women in the misoprostol group ( @ % ) as compared to those in estradiol group ( @ % ) ( p = @ ) .


Both estradiol and misoprostol were comparable in overcoming unsatisfactory colposcopy .


However , a higher incidence of adverse effects was noted with misoprostol as compared to estradiol .


Thymic stromal lymphopoietin ( TSLP ) is an epithelial-cell-derived cytokine that may be important in initiating allergic inflammation .


AMG @ is a human anti-TSLP monoclonal immunoglobulin G@ that binds human TSLP and prevents receptor interaction .


In this double-blind , placebo-controlled study , we randomly assigned @ patients with mild allergic asthma to receive three monthly doses of AMG @ ( @ mg ) or placebo intravenously .


We conducted allergen challenges on days @ and @ to evaluate the effect of AMG @ in reducing the maximum percentage decrease in the forced expiratory volume in @ second ( FEV@ ) .


We also measured the fraction of nitric oxide in exhaled air , blood and sputum eosinophils , and airway hyperresponsiveness .


The primary end point was the late asthmatic response , as measured @ to @ hours after the allergen challenge .


AMG @ attenuated most measures of allergen-induced early and late asthmatic responses .


The maximum percentage decrease in the FEV@ during the late response was @ % smaller in the AMG-@ group than in the placebo group on day @ ( P = @ ) and @ % smaller on day @ ( P = @ ) .


In addition , patients receiving AMG @ had significant decreases in levels of blood and sputum eosinophils before and after the allergen challenge and in the fraction of exhaled nitric oxide .


There were @ adverse events in the AMG-@ group , as compared with @ in the placebo group ; there were no serious adverse events .


Treatment with AMG @ reduced allergen-induced bronchoconstriction and indexes of airway inflammation before and after allergen challenge .


These findings are consistent with a key role for TSLP in allergen-induced airway responses and persistent airway inflammation in patients with allergic asthma .


Whether anti-TSLP therapeutics will have clinical value can not be determined from these data .


( Funded by Amgen ; ClinicalTrials.gov number , NCT@ . )


This study evaluated the effect of probiotic intervention using lactobacilli on oral malodor .


We conducted a @-day , double-blind , placebo-controlled , randomized crossover trial of tablets containing Lactobacillus salivarius WB@ ( @ @ ( @ ) colony-forming units per day ) or placebo taken orally by patients with oral malodor .


Organoleptic test scores significantly decreased in both the probiotic and placebo periods compared with the respective baseline scores ( P < @ and P = @ ) , and no difference was detected between periods .


In contrast , the concentration of volatile sulfur compounds ( VSCs ) ( P = @ ) and the average probing pocket depth ( P = @ ) decreased significantly in the probiotic period compared with the placebo period .


Bacterial quantitative analysis found significantly lower levels of ubiquitous bacteria ( P = @ ) and Fusobacterium nucleatum ( P = @ ) in the probiotic period .


These results indicated that daily oral consumption of tablets containing probiotic lactobacilli could help to control oral malodor and malodor-related factors .


To elucidate the safety profile and symptom-modifying effect of Alflutop and diacerein in the treatment of Kellgren-Lawrence Stages II-III knee osteoarthrosis ( OA ) in patients with oxalate nephropathy and Stages I-II chronic kidney disease ( CKD ) and to refine the effect of these drugs on urinary syndrome and renal function as compared to a response to nonsteroidal anti-inflammatory drugs -- cyclooxygenase inhibitors ( diclofenac ) .


This open-label comparative randomized trial enrolled @ female patients with Kellgren-Lawrence Stages II-III primary gonarthritis concurrent with oxalate nephropathy and Stages I-II CKD .


The patients were randomized into @ groups : @ ) @ patients took diclofenac sodium @ mg/day ; @ ) @ received a complex pharmaceutical on the basis of glycozaminoglycans Alflutop injection @ ml per day for @ days , then @ ml intraartricular twice weekly in the following month ; @ ) @ had diacerein ( diaflex , `` Rompharm Company '' ) in a dose of @ mg twice daily for @ months .


On day @ and day @ of treatment , the symptom - modifying effect was evaluated from changes in the joint pain and morning stiffness domains of the WOMAC index .


Renal function was measured using the estimated glomerular filtration rate ( GFR ) , uric acid clearance ( C ( ua ) ) , and urinary sediment .


On day @ of treatment , the patients taking diclofenac were found to have nephrotoxic effects ( lower GFR , C ( ua ) , evolving secondary hyperuricemia , progressive proteinuria , emerging microhematuria , elevated urinary levels of total lipid hydroperoxides , and enhanced calcium oxalate crystalluria ) .


Alflutop and diacerein exerted no negative effects on renal function .


On day @ day of treatment , all the patient groups showed a reduction in the WOMAC pain score .


The diclofenac group displayed a more marked decrease in the pain score than did the two other groups by day @ .


Otherwise by day @ of therapy with Alflutop and diacerein , the pain scores were reduced by @ and @ % , respectively , which was similar to those in the diclofenac group by day @ of a follow-up .


By day @ day of treatment , the stiffness score was also observed to fall in all the groups and achieved even lower values in the Alflutop and diacerein groups compared with diclofenac group .


Alflutop and diacerein used by patients with knee OA do not produce nephrotoxic effects and by day @ demonstrated similar to diclofenac symptom-modifying effect by reducing pain and stiffness scores .


Diclofenac administration contributed to oxalate nephropathy progress .


Cesarean section is one of the most commonly performed operations in most countries of the world including Nepal .


Hence there is a load on the financial resources of healthcare system .


The rational of this study was to utilize the remaining No ' @ ' polyfilament after closing rectus sheath to stitch skin .


So , the primary objective was to determine the wound complication rates for subcuticular suture with No ' @ ' petcryl ( polyfilamentpolyglycolic acid ) Vs intermittent suture with nylon @-@ for skin closure at cesarean delivery and secondary objective was to compare postoperative pain and patient satisfaction about the scar .


One hundred and thirty eight women undergoing cesarean section at Chitwan Medical College was randomized to either intermittent skin suture with nylon @-@ or subcuticular with polyfilament No ' @ ' ( remaining suture after closing rectus sheath ) .


Evidence of wound infection , pain and overall satisfaction were assessed postoperatively .


The overall wound complications rate in subcuticular stitch with No ' @ ' polyfilament suture were similar as in intermittent mattress stitch with nylon @-@ ( @ % vs. @ % ) .


Pain on postoperative third day and six weeks and overall satisfaction about wound were similar in both groups .


Only prolong rupture of membrane > @ hours was found to be a significant risk factor of wound infection ( OR : @ ; p = @ ) .


The remaining no ' @ ' polyfilament suture ( petcryl ) after suturing rectus sheath can be safely used to close skin suture in cesarean section .


Failure of aldosterone suppression by sodium loading during fludrocortisone suppression testing ( FST ) or saline suppression testing ( SST ) confirms primary aldosteronism ( PA ) .


We previously found recumbent SST ( RSST ) to lack sensitivity .


Aldosterone levels can be higher upright ( e.g. seated ) than recumbent in patients with PA and upright levels are used during FST .


We therefore hypothesized that seated SST ( SSST ) is more sensitive than RSST , especially for posture-responsive PA. .


Of @ patients who underwent FST ( upright plasma aldosterone levels measured at @am basally and after @ days fludrocortisone @ mg @-hourly and oral salt loading ) , @ underwent SST ( aldosterone levels measured basally at @am and after infusion of @ L normal saline over @h ) both recumbent and seated in randomized order and at least @ weeks apart .


FST confirmed PA in @ of @ patients ( day @ upright aldosterone level > @ pmol/L ) , excluded PA in three and was originally `` inconclusive '' in five .


However , one with `` inconclusive '' FST had PA confirmed by lateralizing AVS and was reclassified `` unilateral PA '' .


Of @ with confirmed PA ( eight unilateral , @ bilateral , and five undetermined subtype ) , @ ( @ % ) tested positive by SSST ( @-h aldosterone level > @ pmol/L ) compared with @ ( @ % ) by RSST ( @-h plasma aldosterone level > @ pmol/L ) ( P < @ ) .


RSST missed one unilateral , all bilateral , and four with as-yet undetermined subtype .


RSST was positive in @ of @ ( @ % ) posture-unresponsive vs one of @ ( @ % ) posture-responsive patients ( P < @ ) .


These preliminary results suggest that seated SST may be superior to recumbent SST in terms of sensitivity for detecting PA , especially posture-responsive forms , and may represent a reliable alternative to FST .


Intensive hemodialysis ( HD ) may have significant benefits .


Recently , the role of extended hemodiafiltration ( HDF ) has gained interest .


The aim of this study was to evaluate the acute effects of extended HD and HDF on hemodynamic response and solute removal .


Randomized crossover trial .


Stable patients with end-stage renal disease undergoing conventional HD .


@ patients randomly completed a single study of @-hour HD ( HD@ ) , @-hour HDF ( HDF@ ) , @-hour HD ( HD@ ) , and @-hour HDF ( HDF@ ) , with a @-week interval between study sessions .


Between study sessions , patients received routine conventional HD treatments .


Acute hemodynamic effects and uremic toxin clearance .


Blood pressure and heart rate , pulse wave analysis , cardiac output , and microvascular density by sublingual capillaroscopy , as well as relative blood volume and thermal variables , were measured .


Clearance and removal of uremic toxins also were studied .


Long treatments showed more stability of peripheral systolic blood pressure ( change during HD@ , -@ mm Hg ; during HDF@ , -@ mm Hg ; during HD@ , -@ mm Hg -LSB- P = @ vs. HD@ ; P = @ vs. HDF@ -RSB- ; and during HDF@ , -@ mm Hg -LSB- P = @ vs. HD@ ; P = @ vs. HDF@ -RSB- ) .


A similar observation was found for peripheral diastolic and central blood pressures .


Cardiac output remained more stable in extended sessions ( change during HD@ , -@ L/min ; during HDF@ , -@ L/min ; during HD@ , -@ L/min -LSB- P = @ vs. HDF@ -RSB- ; and during HDF@ , -@ L/min -LSB- P = @ vs. HD@ ; P = @ vs. HDF@ ) , in line with the decreased relative blood volume slope in long dialysis .


No differences in microvascular density were found .


Energy transfer rates were comparable ( HD@ , @ W ; HDF@ , @ W ; HD@ , @ W ; and HDF@ , @ W ) .


Small-molecule and phosphate removal were superior during long treatments .


@-Microglobulin and fibroblast growth factor @ ( FGF-@ ) reduction ratios were highest in HDF@ .


Small sample size , only acute effects were studied .


Treatment time , and not modality , was the determinant for the hemodynamic response .


HDF significantly improved removal of middle molecules , with superior results in extended HDF .


Enhancing the reliability and responsiveness of motor assessments required to demonstrate therapeutic efficacy is a priority for Parkinson 's disease ( PD ) clinical trials .


The objective of this study is to determine the reliability and responsiveness of a portable kinematic system for quantifying PD motor deficits as compared to clinical ratings .


Eighteen PD patients with subthalamic nucleus deep-brain stimulation ( DBS ) performed three tasks for evaluating resting tremor , postural tremor , and finger-tapping speed , amplitude , and rhythm while wearing a wireless motion-sensor unit ( Kinesia ) on the more-affected index finger .


These tasks were repeated three times with DBS turned off and at each of @ different stimulation amplitudes chosen to yield small changes in treatment response .


Each task performance was video-recorded for subsequent clinician rating in blinded , randomized order .


Test-retest reliability was calculated as intraclass correlation ( ICC ) and sensitivity was calculated as minimal detectable change ( MDC ) for each DBS amplitude .


ICCs for Kinesia were significantly higher than those for clinician ratings of finger-tapping speed ( p < @ ) , amplitude ( p < @ ) , and rhythm ( p < @ ) , but were not significantly different for evaluations of resting or postural tremor .


Similarly , Kinesia scores yielded a lower MDC as compared with clinician scores across all finger-tapping subscores ( p < @ ) , but did not differ significantly for resting and postural tremor .


The Kinesia portable kinematic system can provide greater test-retest reliability and sensitivity to change than conventional clinical ratings for measuring bradykinesia , hypokinesia , and dysrhythmia in PD patients .


To evaluate the sedative effects , intra-operation , of music therapy in orthopedic surgery patients with locoregional anesthesia in the Hospital Clnic i Provincial of Barcelona .


Prospective comparative study on a random sample of @ patients undergoing or not music therapy .


The degree of anxiety was assessed with the Questionnaire STAIC .


The application of the music was done with a MP@ player and headphones .


The collected data were analyzed with Excel .


For the statistical analysis we used the SPSS-@ software and Chi-square test to test the hypothesis of whether there was relationship between the level of peace and music therapy .


After the analysis , the results of Chi-square were in the group of no sedation with/without music Chi@ = @ , P = @ .


The statistical significance level was p < @ .


No relationship was found between hearing music or not and the patient 's comfort level .


Most patients recommend listening to music in the operating room despite the sounds around do not bother them .


To investigate the effects of - blockers on cardiac protection and hemodynamic in patients with septic shock .


A prospective randomized controlled trial was conducted .


Forty-one patients with septic shock in accordance with early goal directed treatment and met the target within @ hours , and admitted to intensive care unit ( ICU ) of Affiliated Huxi Hospital of Jining Medical College from January @ to January @ were enrolled .


The patients were divided into treatment group ( n = @ ) and control group ( n = @ ) by random number table .


The patients in both groups were given the standard treatment , esmolol was giving to patients in treatment group in order to control the heart rate ( HR ) below @ bpm within @ hours , and the patients in control group only received standard treatment .


The changes in hemodynamic parameters -LSB- mean arterial pressure ( MAP ) , central venous pressure ( CVP ) , HR , cardiac index ( CI ) , stroke volume index ( SVI ) , systemic vascular resistance ( SVRI ) , global end diastolic volume index ( GEDVI ) -RSB- , biochemistry metabolic of tissue -LSB- central venous oxygen saturation ( ScvO ) , lactic acid ( Lac ) -RSB- , and cardiac markers -LSB- troponin I ( cTnI ) -RSB- before and @ , @ , @ , @ hours after the treatment were recorded .


( @ ) Before treatment , the hemodynamic parameters , tissue metabolism index and cTnI had no significant differences in both groups ( all P > @ ) .


( @ ) The hemodynamic parameters after treatment in the control group showed no significant difference compared with that before treatment .


HR and CI in the treatment group were gradually declined after treatment , SVRI and GEDVI were gradually increased .


There were significant differences in HR , CI , SVRI , and GEDVI between treatment group and control group from @ hours on -LSB- HR ( bpm ) : @ @ vs. @ @ , CI ( L min m ) : @ @ vs. @ @ , SVRI ( kPas L m ) : @ @ vs. @ @ , GEDVI ( mL/m ) : @ @ vs. @ @ , P < @ or P < @ -RSB- .


MAP , CVP and SVI in the treatment group showed no significant changes .


( @ ) Lac after treatment in both groups was decreased slowly , Lac ( mmol/L ) at @ hours after treatment was significantly decreased compared with that before treatment ( control group : @ @ vs. @ @ , treatment group : @ @ vs. @ @ , both P < @ ) .


The Lac of control group and treatment group were @ @ and @ @ at @ hours after treatment , and there was no significant difference between two groups ( all P > @ ) .


The ScvOwas not decreased in both groups .


( @ ) Compared with before treatment , cTnI in the control group was gradually increased , peaked at @ hours , and that in the treatment group was gradually increased , peaked at @ hours and then gradually declined .


Compared with control group , the cTnI ( g/L ) in the treatment group was decreased significantly at @ , @ , @ hours ( @ @ vs. @ @ , @ @ vs. @ @ , @ @ vs. @ @ , all P < @ ) .


- blockers ( esmolol ) can improve cardiac function and myocardial compliance , reduce the myocardial injury in patients with sepsis shock .


Although - blockers can decrease cardiac output , it has no influence on the circulation function and tissue perfusion .


Eosinophilic esophagitis ( EoE ) is a chronic antigen-mediated disease characterized by esophageal eosinophilia , remodeling , and fibrosis .


TGF-@ is a central regulator of EoE remodeling and increases esophageal smooth muscle ( ESM ) cell contraction .


In this study we aimed to understand the molecular mechanisms by which TGF-@ could induce ESM cell contraction .


We used primary human ESM cells and esophageal myofibroblasts ( EMFs ) to assess the mechanisms of TGF-@-induced contraction .


We analyzed the expression , phosphorylation , and function of phospholamban ( PLN ) , a sarcoendoplasmic reticulum regulatory protein induced by TGF-@ .


Expression of PLN , phospho-PLN , and its regulatory pathway was analyzed in the ESM of biopsy specimens from patients with EoE and control subjects .


Gene silencing in EMFs from patients with EoE was used to understand the role of PLN in contraction .


TGF-@ induced and phosphorylated PLN in primary human ESM cells and EMFs from patients with EoE .


PLN and phospho-PLN levels were increased in smooth muscle from patients with EoE compared with that seen in smooth muscle from control subjects in vivo .


PLN inhibition significantly diminished TGF-@-induced EMF contraction in patients with EoE .


PLN expression and ESM/EMF contraction depended on TGF - receptor I signals .


We describe a previously unrecognized mechanism for ESM cell contraction that depends on TGF-@ , its receptors , and PLN .


Because PLN levels are increased in smooth muscle from patients with EoE and PLN silencing diminishes contraction , we provide a novel potential mechanistic framework and therapeutic target for ESM dysfunction in patients with EoE .


To characterize the physiologic and behavioral effects of a single induction dose and two maintenance doses of alfaxalone delivered by water immersion in the anesthesia of koi ( Cyprinus carpio ) .


Prospective , within-subject complete crossover design .


Six adult koi ( Cyprinus carpio ) with a median body weight of @ g ( range @-@ @ g ) .


Koi were immersed in water containing @ mg L ( -@ ) alfaxalone until immobile and then maintained with alfaxalone at either @ or @ mg L ( -@ ) via a recirculating water system .


Times for anesthetic induction and recovery periods were recorded .


Physiologic and blood gas parameters were evaluated before , during and after the anesthetic trial .


Response to noxious stimuli was also assessed .


Median anesthesia induction time for all fish was @ minutes .


Median recovery time was @ and @ minutes in the @ and @ mg L ( -@ ) doses , respectively , which were significantly different ( p = @ ) .


Cessation of opercular movement occurred in @/@ and @/@ fish exposed to @ and @ mg L ( -@ ) dose respectively .


No difference was observed in median heart rate over the duration of the anesthetic events .


Response to noxious stimulation was @/@ and @/@ in the @ and @ mg L ( -@ ) doses respectively .


Oxygenation and ventilation did not change during the experiment , but there was a significant decrease in blood pH along with an increase in blood lactate concentration .


Administration of alfaxalone , via water immersion , as an induction and maintenance anesthesia agent provided rapid and reliable anesthesia of koi with no mortality .


The maintenance dose of @ mg L ( -@ ) was sufficient to prevent response to noxious stimuli but was associated with a clinically relevant depression in opercular rate .


Randomised trials provide evidence that patient decision aids improve outcomes with respect to patient knowledge , involvement and satisfaction in decision making .


It is less clear how these complex interventions are implemented within patient-clinician interactions and which components are active for improving decision processes .


To investigate the experiences of using a diabetes treatment decision aid and to explore how components within a complex intervention influenced the decision making process .


A pragmatic mixed methods study nested within the PANDAs cluster randomised trial of a patient decision aid .


Themes inductively derived from interviews and observation of consultations with further triangulation with results of decision quality and involvement measurements and case analyses .


The decision aid intervention was employed flexibly within the consultation with both the patient and clinician active in marshalling elements .


The decision aid improved processing and organization of information needed for decision making within the consultation interaction .


It also improved decision quality by preparing the patient for active involvement within the clinical consultation .


The intervention was acceptable , flexible and readily implemented in primary care consultations .


The decision aid was effective in facilitating cognitive processing .


The intervention also facilitated rehearsal in preparation for active roles in a shared decision process .


Individuals with posttraumatic stress disorder ( PTSD ) often exhibit high-risk substance use behaviors .


Complementary and alternative therapies are increasingly used for mental health disorders , although evidence is sparse .


Investigate the effect of a yoga intervention on alcohol and drug abuse behaviors in women with PTSD .


Secondary outcomes include changes in PTSD symptom perception and management and initiation of evidence-based therapies .


The current investigation analyzed data from a pilot randomized controlled trial comparing a @-session yoga intervention with an assessment control for women age @ to @ years with PTSD .


The Alcohol Use Disorder Identification Test ( AUDIT ) and Drug Use Disorder Identification Test ( DUDIT ) were administered at baseline , after the intervention , and a @-month follow-up .


Linear mixed models were used to test the significance of the change in AUDIT and DUDIT scores over time .


Treatment-seeking questions were compared by using Fisher exact tests .


The mean AUDIT and DUDIT scores decreased in the yoga group ; in the control group , mean AUDIT score increased while mean DUDIT score remained stable .


In the linear mixed models , the change in AUDIT and DUDIT scores over time did not differ significantly by group .


Most yoga group participants reported a reduction in symptoms and improved symptom management .


All participants expressed interest in psychotherapy for PTSD , although only two participants , both in the yoga group , initiated therapy .


Results from this pilot study suggest that a specialized yoga therapy may play a role in attenuating the symptoms of PTSD , reducing risk of alcohol and drug use , and promoting interest in evidence-based psychotherapy .


Further research is needed to confirm and evaluate the strength of these effects .


The aim of the study is to evaluate the long-term near-transfer effects of computerized working memory ( WM ) training on standard WM tasks in children with Attention-Deficit/Hyperactivity Disorder ( ADHD ) .


Sixty-seven children aged @-@ years in Vestfold/Telemark counties ( Norway ) diagnosed with F@ @ Hyperkinetic disorder ( ICD-@ ) were randomly assigned to training or control group .


The training group participated in a @-day training program at school , while the control group received treatment-as-usual .


Participants were tested one week before intervention , immediately after and eight months later .


Based on a component analysis , six measures of WM were grouped into composites representing Visual , Auditory and Manipulation WM.


The training group had significant long-term differential gains compared to the control group on all outcome measures .


Performance gains for the training group were significantly higher in the visual domain than in the auditory domain .


The differential gain in Manipulation WM persisted after controlling for an increase in simple storage capacity .


Systematic training resulted in a long-term positive gain in performance on similar tasks , indicating the viability of training interventions for children with ADHD .


The results provide evidence for both domain-general and domain-specific models .


Far-transfer effects were not investigated in this article .


A number of simulators have been developed to teach surgical trainees the basic skills required to effectively perform laparoscopic surgery ; however , consideration needs to be given to how well the skills taught by these simulators are maintained over time .


This study compared the maintenance of laparoscopic skills learned using box trainer and virtual reality simulators .


Participants were randomly allocated to be trained and assessed using either the Society of American Gastrointestinal Endoscopic Surgeons Fundamentals of Laparoscopic Surgery ( FLS ) simulator or the Surgical Science virtual reality simulator .


Once participants achieved a predetermined level of proficiency , they were assessed @ , @ , and @ months later .


At each assessment , participants were given @ practice attempts and assessed on their third attempt .


The study was conducted through the Simulated Surgical Skills Program that was held at the Royal Australasian College of Surgeons , Adelaide , Australia .


Overall , @ participants ( @ per group ) completed the training and all follow-up assessments .


There were no significant differences between simulation-trained cohorts for age , gender , training level , and the number of surgeries previously performed , observed , or assisted .


Scores for the FLS-trained participants did not significantly change over the follow-up period .


Scores for LapSim-trained participants significantly deteriorated at the first @ follow-up points ( @ and @ months ) ( p < @ ) , but returned to be near initial levels by the final follow-up ( @ months ) .


This research showed that basic laparoscopic skills learned using the FLS simulator were maintained more consistently than those learned on the LapSim simulator .


However , by the final follow-up , both simulator-trained cohorts had skill levels that were not significantly different to those at proficiency after the initial training period .


To compare the effects of @ NSAIDs ( phenylbutazone and meloxicam ) on renal function in horses .


@ Thoroughbred or Standardbred mares ( mean SD age , @ @ years -LSB- range , @ to @ years -RSB- ; mean body weight , @ @ kg -LSB- range , @ to @ kg -RSB- ) .


A randomized blinded placebo-controlled crossover study was conducted to examine the effects of treatment with phenylbutazone , meloxicam , or a placebo ( control solution ) on renal responses to the administration of furosemide , dobutamine , and exercise ( @ minutes at @ % of maximum heart rate ) .


Renal function was assessed by use of bilateral ureteral catheterization for simultaneous determination of creatinine clearance , sodium excretion , and urine flow rate .


Both phenylbutazone and meloxicam attenuated diuresis and natriuresis and reduced glomerular filtration rate , compared with results for the control solution , when horses were treated with furosemide .


Mean arterial blood pressure , urine flow rate , and glomerular filtration rate were increased during or after ( or both ) dobutamine infusion .


Both NSAIDs reduced urine flow rate and sodium excretion associated with dobutamine infusion and exercise but had no effect on glomerular filtration rate .


Responses to meloxicam , a cyclooxygenase ( COX ) -@ preferential agent , appeared comparable to those detected after phenylbutazone treatment , which suggested that COX-@ was the mediator of prostanoid-induced changes to renal function in horses and indicated that COX-@-preferential agents would be likely to have adverse renal effects similar to those for nonselective COX inhibitors in volume-depleted horses .


Cardiac autonomic neuropathy ( CAN ) and elevated nocturnal blood pressure are independent risk factors for cardiovascular disease in patients with diabetes .


Previously , associations between CAN , non-dipping of nocturnal blood pressure and coronary artery calcification have been demonstrated .


The present protocol describes a trial to test the efficacy of bedtime dosing of the ACE inhibitor enalapril on night time blood pressure and left ventricular mass in patients with type @ diabetes .


In a randomised , double-blind , two-way cross-over study , @ normoalbuminuric patients with type @ diabetes with CAN will be treated for @weeks with either morning or bedtime dosing of @mg enalapril , followed by @weeks of switched treatment regimen .


During each treatment period , two @h ambulatory blood pressure measurements will be performed and after each treatment period left ventricular mass will be determined by multisliced CT. .


Primary end points will be reduction in blood pressure and reduction in left ventricular mass .


To analyze prospectively the hypothalamic-pituitary-adrenal ( HPA ) axis and clinical outcome in patients treated with prednisone for exacerbated chronic obstructive pulmonary disease ( COPD ) .


Prospective observational study .


Patients presenting to the emergency department were randomized to receive @mg prednisone daily for @ or @ days in a placebo-controlled manner .


The HPA axis was longitudinally assessed with the @g corticotropin test and a clinical hypocortisolism score at baseline , on day @ before blinded treatment , at hospital discharge , and for up to @ days of follow-up .