The intervention was @ one-hour sessions , delivered twice a week by teaching assistants .


The proportion of participants recruited per school was calculated .


Session delivery and session attendance was calculated for intervention schools .


Weekday and after-school ( @ to @ pm ) moderate to vigorous intensity physical ( MVPA ) was assessed by accelerometer at baseline ( T@ ) , during the last few weeks of the intervention ( T@ ) and four months after the intervention had ended ( T@ ) .


The costs of delivering the intervention were estimated .


Five intervention schools ran all @ of the intended sessions .


Of the remaining five , three ran @ , one ran @ and one ran @ sessions .


Mean attendance was @ % .


The adjusted difference in weekday MVPA at T@ was @ minutes ( @ % CI -@ to @ ) .


Sex-stratified analyses indicated that boys obtained @ more minutes of weekday MVPA than the control group ( @ % CI @ to @ ) at T@ with no effect for girls ( @ minutes , @ % CI -@ to @ ) .


There was no evidence that participation in the programme increased MVPA once the club sessions ceased ( T@ ) .


The indicative average cost of this intervention was @,@ per school or @ per participating child during its first year and @,@ per school or @ per participating child thereafter .


The effect of the Action @:@ intervention was comparable to previous physical activity interventions but further analysis indicated that there was a marked sex difference with a positive impact on boys and no evidence of an effect on girls .


The Action @:@ intervention holds considerable promise but more work is needed to enhance the effectiveness of the intervention , particularly for girls .


The aim of this study was to evaluate the impact of intravascular ultrasound ( IVUS ) guidance on the final volume of contrast agent used in patients undergoing percutaneous coronary intervention ( PCI ) .


To date , few approaches have been described to reduce the final dose of contrast agent in PCIs .


We hypothesized that IVUS might serve as an alternative imaging tool to angiography in many steps during PCI , thereby reducing the use of iodine contrast .


A total of @ patients were randomized to angiography-guided PCI or IVUS-guided PCI ; both groups were treated according to a pre-defined meticulous procedural strategy .


The primary endpoint was the total volume contrast agent used during PCI .


Patients were followed clinically for an average of @ months .


The median total volume of contrast was @ ml ( interquartile range -LSB- IQR -RSB- : @ to @ ml ; minimum , @ ml ; maximum , @ ml ) in the angiography-guided group versus @ ml ( IQR : @ to @ ml ; minimum , @ ml ; maximum , @ml ) in the IVUS-guided group ( p < @ ) .


Similarly , the median volume of contrast/creatinine clearance ratio was significantly lower among patients treated with IVUS-guided PCI ( @ -LSB- IQR : @ to @ -RSB- vs. @ -LSB- IQR : @ to @ , respectively ; p < @ ) .


In-hospital and @-month outcomes were not different between patients randomized to angiography-guided and IVUS-guided PCI .


Thoughtful and extensive use of IVUS as the primary imaging tool to guide PCI is safe and markedly reduces the volume of iodine contrast compared with angiography-alone guidance .


The use of IVUS should be considered for patients at high risk of contrast-induced acute kidney injury or volume overload undergoing coronary angioplasty .


( Minimizing cOntrast utiliZation With IVUS Guidance in coRonary angioplasTy -LSB- MOZART -RSB- ; NCT@ ) .


General anesthesia ( GA ) is the most commonly used anesthetic technique for spinal surgery .


This study aimed to compare spinal anesthesia ( SA ) and GA in patients undergoing spinal surgery , in terms of perioperative outcome and cost effectiveness .


The study included @ patients with ASA ( American Society of Anesthesiologists ) physical status I-II .


The patients were randomized to receive SA ( n = @ ) or GA ( n = @ ) .


Heart rate ( HR ) , mean arterial blood pressure ( MABP ) , blood loss , duration of surgery , duration of anesthesia , surgeon satisfaction , and duration in the post-anesthesia care unit ( PACU ) were recorded .


Postoperative analgesic requirement , nausea and vomiting ( PONV ) , perioperative hemodynamic variables , and anesthetic costs were determined .


HR and MABP were significantly higher in the GA group than in the SA group at the end of surgery and at PACU admission .


Duration of anesthesia , surgeon satisfaction , postoperative analgesic requirement , and anesthetic costs were significantly higher in the GA group .


Mean blood loss was lower in the SA group than in the GA group , but the difference was not significant .


Duration of surgery , duration in the PACU , perioperative hemodynamic variables , and complications were similar in both groups .


SA could be considered a reliable alternative to GA in patients undergoing lumber spine surgery , as it is clinically as effective as GA , but more cost effective .


Obese men are more likely to have poor dietary patterns compared to women , increasing diet-related chronic disease risk .


The impact of a male-only weight loss intervention on dietary intakes is under-evaluated .


The aim was to determine whether overweight/obese men randomised to self-help paper-based resources with or without online support , achieved greater improvements in diet compared with Wait-list controls at @ and @ months following a gender tailored weight-loss intervention .


Dietary intake was assessed using a @-item semi-quantitative food frequency questionnaire ( FFQ ) , in a secondary analysis of a three-arm weight loss RCT grounded in Social Cognitive Theory ; ( @ ) RESOURCES : gender-tailored weight loss resources ( DVD , handbooks , pedometer , tape measure ) ; ( @ ) Online : resources plus website and efeedback , ( @ ) Wait-list control .


Energy , total fat , saturated fat , and carbohydrate intakes decreased in the online group , which differed significantly from controls at @ - and @-month follow-up ( P < @ ) .


There was a significant reduction in energy , fat and carbohydrate intakes in the Resource group at @ and @ months , but no difference from controls ( P > @ ) .


In the online group there was an increase in % energy from core foods and decrease in % energy from energy-dense nutrient-poor foods ( P < @ ) that was significantly different compared to controls at @ and @ months ( P < @ ) .


Results suggest that men randomised to the SHED-IT intervention arms were able to implement key dietary messages up to @ months compared to controls .


Future interventions should include targeted and gender-tailored messages as a strategy to improve men 's dietary intake within weight loss interventions .


To compare the efficacy and safety of sublingual misoprostol with intracervical dinoprostone gel for cervical ripening in prelabour rupture of membrane after @ weeks of gestation .


One eighty-eight women having > @ weeks of gestation with PROM , singleton viable fetus and no prior caesarean section were randomized to sublingual misoprostol ( @ g every @ h and maximum of @ doses ) and intracervical dinoprostone ( @ mg every @ h and maximum of @ doses ) .


Oxytocin augmentation was commenced in those with a satisfactory Bishop score , inadequate contractions and who did not go into spontaneous active labour .


Primary outcome measures were induction-delivery interval and the number of women that went into spontaneous labour without oxytocin augmentation .


There was a significant reduction in induction to delivery interval in sublingual misoprostol group compared to intracervical dinoprostone ( @ @ h vs @ @ h ; p = @ ) .


There was a significant reduction in duration of rupture of membrane to delivery interval ( p = @ ) , @st stage of labour ( p = @ ) in sublingual misoprostol group as compared to the intravaginal dinoprostone group .


There was no difference observed in spontaneous vaginal delivery between the groups ( @ ) .


Oxytocin requirement was significantly higher in the dinoprostone group p = @ ) .


There were more maternal adverse effects of sublingual misoprostol ( p = @ ) .


However , maternal and neonatal safety profiles were comparable .


Sublingual misoprostol and intracervical dinoprostone at the dose studied are equally efficacious in achieving spontaneous vaginal delivery , reduction in induction-delivery interval and in reducing the need for oxytocin , in women after @ weeks gestation with rupture of membranes .


Oral nutritional supplements ( ONS ) are often considered for hospitalized patients with acute severe malnutrition , however the compliance to the supplements is known to be variable .


The aim of our study was to investigate whether providing a lower volume of ONS at a higher frequency during medication rounds would improve the intake of the supplements .


In this randomized controlled trial , @ malnourished inpatients ( mean age @ years , @ % male , median LOS @ days ) were randomized to receive ONS ( @ kcal and @ g Protein per @ ml serving ) in one of three different schemes .


The usual care group ( n = @ ) was offered ONS @ ml twice per day in between meals .


This was compared to two intervention groups that were offered ONS during medication rounds : intervention group @ ( n = @ ) received @ ml of ONS twice per day , at @ and @ o'clock , and intervention group @ ( n = @ ) received @ ml of ONS four times a day , at @ , @ , @ and @ o'clock .


Follow-up was performed until discharge or until ONS was no longer needed , with a maximum follow-up period of @ days .


The primary outcome measure was the percentage of patients who consumed at least @ % of the prescribed volume of ONS .


No significant differences were observed between the control groups and intervention group @ ( risk difference of -@ % ( @ % CI -@ -@ ) .


However , the percentage of patients consuming at least @ % of the prescribed ONS was higher in intervention group @ , with a risk difference @ % ( @ % CI @-@ @ % ) and a mean increased intake of @ ml ( @ kcal ) per day , p < @ ) .


Median time ONS were taken was @ days ( range @-@ ) .


A higher frequency of a lower volume of ONS during medication rounds increased the compliance of patients needing ONS .


Clinical trial registration number NTR@ ; www.trialregister.nl .


To investigate whether low-dose dynamic CT of the liver with iterative reconstruction can reduce both the radiation dose and the amount of contrast medium .


This study was approved by our institutional review board .


@ patients were randomly assigned to one of two groups .


Group A/group B ( fifty-eight/fifty-five patients ) underwent liver dynamic CT at @/@ kV , with @/@ % adaptive statistical iterative reconstruction ( ASIR ) , with a contrast dose of @/@ mg I/kg , respectively .


Radiation exposure was estimated based on the manufacturer 's phantom data .


The enhancement value of the hepatic parenchyma , vessels and the tumor-to-liver contrast of hepatocellular carcinomas ( HCCs ) were compared between two groups .


Two readers independently assessed the CT images of the hepatic parenchyma and HCCs .


The mean CT dose indices : @ / @ mGy , the dose-length products : @ / @ mGy cm , for group A/group B.


The mean enhancement value of the hepatic parenchyma and the tumor-to-liver contrast of HCCs with diameters greater than @cm in the post-contrast all phases did not differ significantly between two groups ( P > @ ) .


The enhancement values of vessels in group B were significantly higher than that in group A in the delayed phases ( P < @ ) .


Two reader 's confidence levels for the hepatic parenchyma in the delayed phases and HCCs did not differ significantly between the groups ( P > @ ) .


Low-dose dynamic CT with ASIR can reduce both the radiation dose and the amount of contrast medium without image quality degradation , compared to conventional dynamic CT without ASIR .


Thoracoscopic wedge resection is generally accepted as a standard surgical procedure for primary spontaneous pneumothorax .


Because of the relatively high recurrence rate after surgery , additional procedures such as mechanical pleurodesis or visceral pleural coverage are usually applied to minimize recurrence , although mechanical pleurodesis has some potential disadvantages .


The aim of this study was to clarify whether an additional coverage procedure on thestaple line after thoracoscopic bullectomy prevents postoperative recurrence compared with additional pleurodesis .


A total of @,@ patients in @ hospitals with primary spontaneous pneumothorax undergoing thoracoscopic bullectomy were enrolled .


After bullectomy with staplers , patients were randomly assigned to either the coverage group ( n = @ ) or the pleurodesis group ( n = @ ) .


In the coverage group , the staple line was covered with absorbable cellulose mesh and fibrin glue .


The pleurodesis group underwent additional mechanical abrasion on the parietal pleura .


The coverage group and the pleurodesis group showed comparable surgical outcomes .


After a median follow-up of @ months , the postoperative @-year recurrence rate was @ % in the coverage group and @ % in the pleurodesis group .


The @-year recurrence rate requiring intervention was @ % in the coverage group and @ % in the pleurodesis group .


The coverage group showed better recovery from pain .


In terms of postoperative recurrence rate , visceral pleural coverage after thoracoscopic bullectomy was not inferior to mechanical pleurodesis .


Visceral pleural coverage may potentially replace mechanical pleurodesis , which has potential disadvantages such as disturbed normal pleural physiology .


Lung cancer ( LC ) is the most common cause of cancer death in Denmark , and triaging patients through fast-track diagnostic pathways is recommended to improve patient outcome .


Data on the most efficient triage organisation of such pathways are limited .


The aim of this study was to test a strategy of a straight-to-test model for patients referred to the fast-track pathway .


Outcomes were number of computed tomographies ( CT ) performed , use of specialist time and staff acceptability .


We performed a randomised controlled study enrolling @ patients who were referred from general practice to fast-track LC evaluation ( @ January-@ December @ ) .


Half of the patients were randomly assigned to the intervention and went straight to a chest CT before chest-physician evaluation .


Time was measured for patients at random days .


Acceptability was examined in a focus group interview .


In the intervention group , @ % of patients had a CT performed compared with @ % in the control group .


There was no difference in the number of CTs between the groups ( risk difference ( RD ) = @ % ( @ % confidence interval ( CI ) : @-@ @ ; p = @ ) ) .


In the intervention group , chest-physician time was @ min .


( min.-max. : @-@ @ min . )


lower per referred patient than in the control group .


Giving general practitioners direct access to a CT did not change the number of CTs performed and significantly reduced chest-physician time per patient .


In addition , the strategy was associated with high levels of staff acceptability .


To assess the efficacy and safety of sono-electro-magnetic therapy compared to placebo in men with refractory CPPS .


In a randomized , placebo-controlled , double-blind single center trial , we assessed the effect of sono-electro-magnetic therapy in men with treatment refractory CPPS .


Sixty male patients were randomly assigned to treatment with either sono-electro-magnetic ( n = @ ) or placebo therapy ( n = @ ) for @ weeks .


The primary outcome was a change in the National Institutes of Health Chronic Prostatitis Symptom Index ( NIH-CPSI ) from baseline to @ weeks .


The @-week difference between sono-electro-magnetic and placebo therapy in changes of the NIH-CPSI total score was -@ points ( @ % CI -@ to @ , p = @ ) .


In secondary comparisons of NIH-CPSI sub-scores , we found differences between groups most pronounced for the quality-of-life sub-score ( difference at @ weeks -@ , @ % CI -@ to -@ , p = @ ) .


In stratified analyses , the benefit of sono-electro-magnetic therapy appeared more pronounced among patients who had a symptom duration of @ months or less ( difference in NIH-CPSI total score -@ , @ % CI -@ to @ ) than in patients with a longer symptom duration ( -@ , @ % CI -@ to @ ; p for interaction = @ ) .


Sono-electro-magnetic therapy did not result in a significant improvement of symptoms in the overall cohort of treatment refractory CPPS patients compared to placebo treatment .


Subgroup analysis indicates , however , that patients with a symptom-duration of @ months or less may benefit from sono-electro-magnetic therapy , warranting larger randomized controlled trials in this subpopulation .


The prevalence of diabetes has been growing rapidly in developing countries .


This causes devastating economic burdens and increases demands on the health care system .


Therefore , there is an urgent need to find a cost-effective and multi-faceted approach for diabetes care .


Peer support models provide a potentially low-cost , flexible means which complements the current existing health care services .


In this way , trained peer leaders can become qualified extensions to a formal healthcare system , capable of assisting education delivery and bolstering the efforts of professional staff .


As such , creating a cultural specific peer support program and determining whether it is acceptable and cost-effective in rural communities of China is crucial .


This study aims to implement and evaluate biophysical and psychosocial outcomes of peer support program for people with type @ diabetes in rural communities , and to explore the program 's feasibility and sustainability in China .


This study is a cluster randomised controlled trial .


All consenting patients will be randomised by community staff members to receive either peer support or the control care .


The data collection and analysis including social demographics , health status , psychosocial status , economic status and biomedical measures will be collected at baseline , @ months , and @ months .


The primary indicator measured is the change in HbA@c , whereas secondary indicators include biophysical , psychosocial functioning and other lifestyle factors .


Finally , economic evaluations will determine whether the program is cost effective .


This protocol is a cluster randomized , controlled trial of group-based peer support for people with type @ diabetes in the community settings of rural China .


Results from this trial may provide evidence to the effectiveness of peer support ; furthermore , they will provide valuable information concerning the acceptability and feasibility of a new approach to improve diabetes self-management among resource-constrained settings .


Evidence-based treatments for posttraumatic stress disorder ( PTSD ) have not been established for adolescents despite high prevalence of PTSD in this population .


To examine the effects of counselor-delivered prolonged exposure therapy compared with supportive counseling for adolescents with PTSD .


A single-blind , randomized clinical trial of @ adolescent girls with PTSD using a permuted block design .


Counselors previously naive to prolonged exposure therapy provided the treatments in a community mental health clinic .


Data collection lasted from February @ through March @ .


Participants received fourteen @ - to @-minute sessions of prolonged exposure therapy ( n = @ ) or supportive counseling ( n = @ ) .


All outcomes were assessed before treatment , at mid-treatment , and after treatment and at @ - , @ - , and @-month follow-up .


The primary outcome , PTSD symptom severity , was assessed by the Child PTSD Symptom Scale-Interview ( range , @-@ ; higher scores indicate greater severity ) .


Secondary outcomes were presence or absence of PTSD diagnosis assessed by the DSM-IV Schedule for Affective Disorders and Schizophrenia for School-Age Children and functioning assessed by the Children 's Global Assessment Scale ( range , @-@ ; higher scores indicate better functioning ) .


Additional secondary measures , PTSD severity assessed by the Child PTSD Symptom Scale-Self-Report ( range , @-@ ; higher scores indicate greater severity ) and depression severity assessed by the Children 's Depression Inventory ( range , @-@ ; higher scores indicate greater severity ) , were also assessed weekly during treatment .


Data were analyzed as intent to treat .


During treatment , participants receiving prolonged exposure demonstrated greater improvement on the PTSD symptom severity scale ( difference between treatments in improvement , @ ; @ % CI , @-@ @ ; P < @ ) and on all secondary outcomes ( loss of PTSD diagnosis : difference , @ % , @ % CI , @ % -@ % ; P = @ ; self-reported PTSD severity : difference , @ ; @ % CI , @-@ @ ; P = @ ; depression : difference , @ ; @ % CI , @-@ @ ; P = @ ; global functioning : difference , @ ; @ % CI , @-@ @ ; P = @ ) .


These treatment differences were maintained through the @-month follow-up : for interviewer-assessed PTSD ( difference , @ ; @ % CI , @-@ @ ; P = @ ) , loss of PTSD diagnosis ( difference , @ ; @ % CI , @-@ @ ; P = @ ) , self-reported PTSD ( difference , @ ; @ % CI , @-@ @ ; P = @ ) , depression ( difference , @ ; @ % CI , @-@ @ ; P = @ ) , and global functioning ( difference , @ ; @ % CI , @-@ @ ; P = @ ) .


Adolescents girls with sexual abuse-related PTSD experienced greater benefit from prolonged exposure therapy than from supportive counseling even when delivered by counselors who typically provide supportive counseling .


Having shown in a recent randomized controlled trial that evidence-based patient information ( EBPI ) significantly increased knowledge on primary prevention of diabetes compared to standard patient information , we now investigated interaction between socioeconomic status ( SES ) and the effect of an EBPI .


@,@ visitors ( aged @-@ years , without known diabetes ) to the `` Techniker Krankenkasse '' and the `` German Diabetes Center '' websites were randomized .


The intervention group received a newly developed on-line EBPI , the control group standard on-line information .


The primary outcome measure was knowledge , classified as `` good/average/poor '' .


We analyzed associations of knowledge with socioeconomic variables ( education , vocational training , employment , subjective social status ) combined with intervention effect including interactions , adjusted for possible confounding by knowledge before intervention , self-reported blood glucose measurements , blood pressure , blood lipid levels , age and gender .


Logistic regression models were fitted to the subpopulation ( n = @ ) with complete values in these variables.Education ( high vs. low ) was significantly associated with knowledge ( good vs. average/poor ) ; however , there was no significant interaction between education and intervention .


After adjustment , the other socioeconomic variables were not significantly associated with knowledge .


Socioeconomic variables did not significantly change the effect of the intervention .


There was a tendency towards a lower effect where lower educated individuals were concerned .


Possibly the power was too low to detect interaction effects .


Larger studies using SES-specific designs are needed to clarify the effect of SES .


We suggest considering the socioeconomic status when evaluating a decision aid , e.g. an EBPI , to ensure its effectiveness not only in higher socioeconomic groups .


Childhood asthma is a serious and common chronic disease that requires the attention of nurses and other school personnel .


Schools are often the first setting that children take the lead in managing their asthma .


Often , children are ill prepared for this role .


Our study evaluated a school-based , multifaceted asthma program that targeted students with asthma and the broader school community .


A randomized trial involving @ schools with grades @-@ and @ children with asthma and their families was conducted .


Outcomes of interest for the child , at @year , were urgent care use and school absenteeism for asthma , inhaler technique , and quality of life , and for the school , at @months , were indicators of a supportive school environment .


Improvements were observed at the child and school level for the intervention group .


Fewer children in the intervention group had a school absence ( @ % vs @ % ; p < @ ) , required urgent care for asthma ( @ % vs @ % ; p < @ ) , or reported a day of interrupted activity ( @ % vs @ % ; p < @ ) , and had improved quality of life ( @ vs @ ; p < @ ) .


Schools in the intervention group were more likely to have practices supporting an asthma-friendly environment .


Implementation of a multifaceted school-based asthma program can lead to asthma-friendly schools that support children with asthma to be successful managers of their asthma and experience improved quality of life and decreased disease associated burden .


The potential role of renal denervation ( RD ) in patients with AF and less severe hypertension is unknown .


The purpose of this study was to assess the potential role of RD as an adjunct to pulmonary vein isolation ( PVI ) in patients with atrial fibrillation ( AF ) and moderate resistant or severe resistant hypertension .


The data for this study were obtained from @ different prospective randomized studies , analyzed by meta-analysis .


Patients with paroxysmal AF or persistent AF and moderate resistant hypertension ( office blood pressure BP @/@ mm Hg and < @/@ mm Hg ; first study ; n = @ ) or severe resistant hypertension ( @/@ mm Hg ; second study ; n = @ ) were randomized to PVI or PVI with RD. .


At @ months , @ of the @ PVI with RD patients ( @ % ) were AF-free vs @ of the @ patients ( @ % ) in the PVI-only group ( P = @ ) .


In patients with severe hypertension , @ of the @ PVI with RD patients ( @ % ) vs @ of the @ PVI-only patients ( @ % ) were AF-free ( P = @ ) .


For moderate hypertension , the differences were less dramatic : @ of @ ( @ % ) vs @ of @ ( @ % ) when RD added ( P = @ ) .


The superior efficacy of adding RD was most apparent in persistent AF and severe hypertension ( hazard ratio @ , confidence interval @-@ @ , P = @ ) .


Duration of the procedure and fluoroscopy were nonsignificantly longer in the RD group .


RD may improve the results of PVI in patients with persistent AF and/or severe resistant hypertension .


The slow digestion and amino acid absorption kinetics of isolated micellar casein have been held responsible for its relatively lower postprandial muscle protein synthetic response compared with rapidly digested proteins such as isolated whey .


However , casein is normally consumed within a milk matrix .


We hypothesized that protein digestion and absorption kinetics and the subsequent muscle protein synthetic response after micellar casein ingestion are modulated by the milk matrix .


The aim of this study was to determine the impact of a milk matrix on casein protein digestion and absorption kinetics and postprandial muscle protein synthesis in older men .


In a parallel-group design , @ healthy older men ( aged @ @ y ) received a primed continuous infusion of L - -LSB- ring - ( @ ) H@ -RSB- - phenylalanine , L - -LSB- ring-@ ,@ - ( @ ) H@ -RSB- - tyrosine , and L - -LSB- @ - ( @ ) C -RSB- - leucine , and ingested @ g intrinsically L - -LSB- @ - ( @ ) C -RSB- - phenylalanine and L - -LSB- @ - ( @ ) C -RSB- - leucine labeled casein dissolved in bovine milk serum ( Cas + Serum ) or water ( Cas ) .


Plasma samples and muscle biopsies were collected in the postabsorptive state and for @ min in the postprandial period to examine whole-body and skeletal muscle protein metabolism .


Casein ingestion increased plasma leucine and phenylalanine concentrations and L - -LSB- @ - ( @ ) C -RSB- - phenylalanine enrichments , with a more rapid rise after Cas vs. Cas + Serum .


Nonetheless , dietary protein-derived phenylalanine availability did not differ between Cas + Serum ( @ @ % , mean SEM ) and Cas ( @ @ % ) when assessed over the @-min postprandial period ( P = @ ) .


The milk matrix did not modulate postprandial myofibrillar protein synthesis rates from @ to @ min ( @ @ vs. @ @ % / h ) or from @ to @ min ( @ @ vs. @ @ % / h ) after Cas + Serum vs. Cas .


Similarly , no treatment differences in muscle protein-bound L - -LSB- @ - ( @ ) C -RSB- - phenylalanine enrichments were observed at @ min ( @ @ vs. @ @ ) or @ min ( @ @ vs. @ @ mole percent excess ) after Cas + Serum vs. Cas .


Casein ingestion in a milk matrix delays protein digestion and absorption but does not modulate postprandial muscle protein synthesis when compared to the ingestion of micellar casein only in healthy older men .


This trial was registered at Nederlands Trial Register as NTR@ .


On the basis of evidence that resistance to vascular endothelial growth factor ( VEGF ) receptor inhibition is caused by hypoxia-driven residual VEGF and other proangiogenic factors , combinations of agents from these classes were hypothesized to improve treatment outcomes relative to single-agent VEGF pathway blockade .


A total of @ patients with metastatic clear cell renal cell carcinoma were randomly assigned equally to arm A ( bevacizumab monotherapy @ mg/kg intravenously -LSB- IV -RSB- every @ weeks ) , B ( bevacizumab @ mg/kg IV every @ weeks and temsirolimus @ mg IV every week ) , C ( bevacizumab @ mg/kg IV every @ weeks and sorafenib @ mg orally twice daily on days @ to @ , @ to @ , @ to @ , and @ to @ ) , or D ( sorafenib @ mg twice daily and temsirolimus @ mg IV weekly ) .


Progression-free survival was the primary end point .


Among @ eligible treated patients , median PFS was @ months for bevacizumab alone ( @ % CI , @ to @ months ) , @ months for bevacizumab plus temsirolimus ( @ % CI , @ to @ months ) , @ months for bevacizumab plus sorafenib ( @ % CI , @ to @ months ) , and @ months for sorafenib plus temsirolimus ( @ % CI , @ to @ months ) .


Hazard ratios from stratified Cox proportional hazards models were @ , @ , and @ ( with respective P values of @ , @ , and @ ) for the three combinations , respectively , compared with bevacizumab alone .


Adverse events did not differ significantly among treatment arms .


The activity of sorafenib , temsirolimus , and bevacizumab administered in doublet combinations did not significantly improve median progression-free survival in comparison with bevacizumab monotherapy .


Full-time clinician educators are becoming more predominant in China , yet their effect is unknown .


The purpose of this study was to compare the teaching quality of full-time ( FT ) faculty with that of part-time ( PT ) faculty in one Chinese medical school .


In @ consecutive years , @ @rd year medical students were enrolled and randomly distributed into two groups , being taught by either a FT faculty member or a PT faculty member .


Their teaching quality was evaluated with student performance on a written exam , the standardized patient exam , and student satisfaction .


The students in the FT group always scored better on the written exam ( @st year = @ @ vs. @ @ , p < @ ; @nd year = @ @ vs. @ @ , p = @ ; @rd year = @ @ vs. @ @ , p < @ ) .


In the standardized patient exam , the students from FT groups always showed better performance in history taking and physical examination .


Students continually gave higher evaluations to FT faculty in questionnaires ( @st year = @ @ vs. @ @ ; @nd year = @ @ vs. @ @ ; @rd year = @ @ vs. @ @ , all ps < @ ) .


The teaching quality of FT faculty in clinical-skills training is better than PT faculty in this study .


Muscle loss and metabolic changes occur with disuse -LSB- i.e. bed rest ( BR ) -RSB- .


We hypothesized that BR would lead to a metabolically unhealthy profile defined by : increased circulating tumor necrosis factor ( TNF ) - , decreased circulating insulin-like-growth-factor ( IGF ) -@ , decreased HDL-cholesterol , and decreased muscle density ( MD ; measured by mid-thigh computerized tomography ) .


We investigated the metabolic profile after @ days of BR with @ @ % energy deficit in male individuals ( @-@ years ) randomized to resistance exercise with amino acid supplementation ( RT , n = @ ) or amino acid supplementation alone ( EAA , n = @ ) .


Upper and lower body exercises were performed in the horizontal position .


Blood samples were taken at baseline , after @ days of BR and @ days of recovery .


We found a shift toward a metabolically unfavourable profile after BR -LSB- compared to baseline ( BLN ) -RSB- in both groups as shown by decreased HDL-cholesterol levels ( EAA : BLN : @ @ vs. BR : @ @ mg/dL , RT : BLN : @ @ vs. BR : @ @ mg/dL ; p < @ ) and Low MD ( EAA : BLN : @ @ vs. BR : @ @ cm ( @ ) , RT : BLN : @ @ vs. BR : @ @ cm ( @ ) ; p < @ ) .


A healthier metabolic profile was maintained with exercise , including NormalMD ( EAA : BLN : @ @ vs. BR : @ @ cm ( @ ) , RT : BLN : @ @ vs. BR : @ @ cm ( @ ) ; p < @ , time-by-group ) ; although , exercise did not completely alleviate the unfavourable metabolic changes seen with BR .


Interestingly , both groups had increased plasma IGF-@ levels ( EAA : BLN :@ @ vs. BR @ @ ng/mL , RT : BLN :@ @ vs. BR : @ @ ng/mL ; p < @ ) and neither group showed TNF changes ( p > @ ) .


We conclude that RT can be incorporated to potentially offset the metabolic complications of BR .


The use of corticosteroids as adjunctive therapy might be effective in patients with community-acquired pneumonia ( CAP ) .


Oral administration of dexamethasone is a practical and safer alternative to the intravenous route .


Since patients hospitalized with pneumonia might have delayed gastric emptying , this study explored systemic exposure in terms of area under the concentration-time curve ( AUC ) of oral dexamethasone in patients hospitalized with CAP .


In this randomized , open label study , @ patients admitted with CAP were randomized to receive either @mg intravenous or @mg oral dexamethasone for @consecutive days .


Serial blood samples were obtained before and after drug administration .


Median AUC to infinity was @gl ( -@ ) h ( IQR @-@ ) for the intravenous group and @gl ( -@ ) h ( IQR @-@ ) for the oral group .


The AUC ratio of @mg oral and @mg intravenous dexamethasone was @ ( @ % confidence interval ( CI ) @ , @ ) , which represents a bioavailability of @ % ( @ % CI @ , @ ) after correction for differences in dexamethasone dose .


Bioavailability of oral dexamethasone in patients hospitalized with pneumonia is sufficient .


This makes oral dexamethasone an appropriate alternative for intravenous administration in these patients .


Depression is a common and distressing mental health problem that is responsible for significant individual disability and cost to society .


Medication and psychological therapies are effective for treating depression and maintenance anti-depressants ( m-ADM ) can prevent relapse .


However , individuals with depression often express a wish for psychological help that can help them recover from depression in the long-term .


A recently developed treatment , mindfulness-based cognitive therapy ( MBCT ) , shows potential as a brief group program for people with recurring depression.This trial asks the policy research question ; is MBCT with support to taper/discontinue antidepressant medication ( MBCT-TS ) superior to m-ADM in terms of : a primary outcome of preventing depressive relapse/recurrence over @ months ; and secondary outcomes of ( a ) depression free days , ( b ) residual depressive symptoms , ( c ) antidepressant medication ( ADM ) usage , ( d ) psychiatric and medical co-morbidity , ( e ) quality of life , and ( f ) cost effectiveness ?


An explanatory research question also asks whether an increase in mindfulness skills is the key mechanism of change.The design is a single-blind , parallel randomized controlled trial examining MBCT-TS versus m-ADM with an embedded process study .


To answer the main policy research question the proposed trial compares MBCT-TS with m-ADM for patients with recurrent depression .


Four hundred and twenty patients with recurrent major depressive disorder in full or partial remission will be recruited through primary care .


Depressive relapse/recurrence over two years is the primary outcome variable .


Analyses will be conducted following CONSORT standards and overseen by the trial 's Data Monitoring and Safety Committee .


Initial analyses will be conducted on an intention-to-treat basis , with subsequent analyses being per protocol .


The explanatory question will be addressed in two mutually informative ways : quantitative measurement of potential mediating variables pre - and post-treatment and a qualitative study of service users ' views and experiences .


If the results of our exploratory trial are extended to this definitive trial , MBCT-TS will be established as an alternative approach to maintenance antidepressants for people with a history of recurrent depression .


The process studies will provide evidence about the effective components which can be used to improve MBCT and inform theory as well as other therapeutic approaches .


The primary study objective was to compare the cosmetic result of radioguided seed localization ( RSL ) with wire localization ( WL ) .


A subgroup of patients enrolled in a multicentered , randomized trial comparing WL with RSL participated .


Frontal photographs were taken @ and @years postsurgery .


The European Organization for Research and Treatment of Cancer Cosmetic Rating System was used to evaluate cosmesis outcomes by the patient and a panel of @ raters .


The study enrolled @ patients ( WL , n = @ ; RSL , n = @ ) .


Most patients rated their overall cosmesis as `` excellent '' or `` good '' ( @ % WL , @ % RSL ) .


Patient and panel ratings on all cosmetic outcomes were similar between groups .


Multivariable regression for overall cosmesis found larger specimen volume and reoperation to be predictors of worse ratings .


All cosmetic outcomes assessed were similar after WL and RSL .


The comparable outcomes may reflect similar reoperation rates and volumes of excision between groups .


To determine the effectiveness of presenting individualized colorectal cancer ( CRC ) risk information for increasing CRC screening rates in primary care patients at above-average risk of CRC .


Randomized controlled trial .


Georgia Regents University in Augusta-an academic family medicine clinic in the southeastern United States .


Outpatients ( @ to @ years of age ) scheduled for routine visits in the family medicine clinic who were determined to be at above-average risk of CRC .


Individualized CRC risk information calculated from the Your Disease Risk tool compared with a standard CRC screening handout .


Intention to complete CRC screening .


Secondary measures included the proportions of subjects completing fecal occult blood tests , flexible sigmoidoscopy , and colonoscopy .


A total of @ consecutive records were reviewed to determine eligibility .


Overall , @ ( @ % ) of @ eligible participants were randomized to receive either individualized CRC risk information ( prepared by a research assistant ) or a standard CRC screening handout .


The intervention group had a mean ( SD ) age of @ ( @ ) years and the control group had a mean ( SD ) age of @ ( @ ) years .


Two-thirds of the participants in each group were female .


The intervention group and the control group were matched by race ( P = @ ) .


There was no significant difference between groups for intention to complete CRC screening ( P = @ ) .


Overall , @ % of the intervention participants and @ % of the control participants completed @ or more CRC screening tests ( P = @ ) .


Presentation of individualized CRC risk information by a nonphysician assistant as a decision aid did not result in higher CRC screening rates in primary care patients compared with presentation of general CRC screening information .


Future research is needed to determine if physician presentation of CRC risk information would result in increased screening rates compared with research assistant presentation .


Mechanisms such as neural sensitization and maladaptive cortical organization provide novel targets for therapy in chronic recurrent low back pain ( CLBP ) .


We investigated the effect of a transcranial direct current stimulation ( tDCS ) and peripheral electrical stimulation ( PES ) treatment on pain , cortical organization , sensitization and sensory function in CLBP .


Using a placebo-controlled crossover design , @ individuals received four treatments in separate sessions : ( i ) anodal tDCS/PES ; ( ii ) anodal tDCS/sham PES ; ( iii ) sham tDCS/PES ; or ( iv ) sham tDCS/sham PES .


Pain was assessed at baseline , immediately following , and at @ and @ days after treatment .


Motor cortical organization , sensitization and sensory function were measured before and immediately after treatment .


Combined tDCS/PES reduced pain and sensitization , normalized motor cortical organization and improved sensory function .


The reduction in pain was greater in individuals with more pronounced sensitization .


Applied alone , tDCS or PES also reduced pain .


However , with the exception of improved sensory function and reduced map volume following PES , clinical and neurophysiological outcomes were unaltered by tDCS or PES applied separately .


No changes were observed following sham treatment .


Our data suggest a combined tDCS/PES intervention more effectively improves CLBP symptoms and mechanisms of cortical organization and sensitization , than either intervention applied alone or a sham control .


Subcutaneous or intrafascial wound infiltration of local anaesthetic with systemic opioids has been shown to enhance patient comfort with improved analgesia and reduced opioid requirements .


To demonstrate improved pulmonary function when postoperative analgesia was provided by combined bupivacaine wound infiltration and systemic opioid .


In a prospective , randomized , placebo-controlled study , @ patients ( @ per group ) scheduled for elective gynaecological surgery under general anaesthesia had subcutaneous and intrafascial wound infiltration of @ ml , @ % bupivacaine ( study patients ) or @ ml @ % saline ( control ) just before the end of surgery .


Forced vital capacity ( FVC ) , forced expiratory volume in @ second ( FEV@ ) and peak expiratory flow rate ( PEFR ) were done before surgery and at @ , @ and @ hours postoperatively .


Student 's T and chi-square tests were used for tests of significance set at P < @ .


Postoperative analgesia was provided with intramuscular morphine @ mg/kg @ hourly and @mg/kg of intravenous paracetamol as rescue analgesia .


PEFR , FVC and FEV@ were reduced in both the control and study groups but the reduction was greater in the control group .


Bupivacaine wound infiltration produced statistically significant elevations in pulmonary function tests results at all assessment periods .


Lipid deposition on silicone hydrogel ( SiHy ) lenses , which are believed to be caused by their hydrophobic surface , can lead to discomfort , reduced vision , and inflammatory reactions .


This study used a highly specific and sensitive fluorometric enzymatic assay for ex vivo cholesterol analysis of seven types of SiHy lenses : balafilcon A , comfilcon A , enfilcon A , enhanced-lotrafilcon A , enhanced-lotrafilcon B , galyfilcon A , and senofilcon A.


Cholesterol sorption was assessed in @ previously worn SiHy lenses from @ clinical trials conducted in the United States and Australia between @ and @ .


Patients wore the lenses for @ to @ weeks .


Unworn negative control lenses for each lens material were obtained directly from the manufacturer .


Lipids were isolated from the lenses using a two-step chloroform : methanol extraction method , and total cholesterol was quantified using a fluorometric enzymatic assay .


Nonparametric Mann Whitney statistical analysis was performed to determine the differences in total cholesterol sorption between lens-specific data sets .


Enhanced-lotrafilcon A and enhanced-lotrafilcon B contact lenses showed significantly lower median total cholesterol sorption ( medianquartile , @ g/lens and @ g/lens , respectively ) than all other types of lenses that were tested ( P < @ ) .


By contrast , enfilcon A ( @ g/lens ) and galyfilcon A ( @ g/lens ) showed the highest median total cholesterol sorption of all tested lenses .


Cholesterol deposition in SiHy contact lenses seems to be lens polymer dependent .


Enhanced-lotrafilcon A and enhanced-lotrafilcon B both sorbed the lowest amount of cholesterol compared with the other five types of SiHy lenses that were tested in this study .


University students usually overestimate peer alcohol use , resulting in them ` drinking up ' to perceived norms .


Social norms theory suggests correcting these inflated perceptions can reduce alcohol consumption .


Recent findings by the current authors show portraying oneself as ' a drinker ' is considered by many students to be a socially desirable component of their Facebook identity , perpetuating an online culture that normalises binge drinking .


However , social networking sites have yet to be utilised in social norms interventions .


Actual and perceived descriptive and injunctive drinking norms were collected from @ university students .


Ninety-five students screened positive for hazardous drinking and were randomly allocated to a control group or intervention group that received social norms feedback via personalised Facebook private messages over three sessions .


At @ month post-intervention , the quantity and frequency of alcohol consumed by intervention group during the previous month had significantly reduced compared with baseline and controls .


Reductions were maintained @ months post-intervention .


Intervention group perceived drinking norms were significantly more accurate post-intervention .


This is the first study to test the feasibility of using Facebook to deliver social norms interventions .


Correcting misperceptions of peer drinking norms resulted in clinically significant reductions in alcohol use .


Facebook has many advantages over traditional social norms delivery , providing an innovative method for tackling problem drinking at university .


These results have implications for the use of Facebook to deliver positive messages about safe alcohol use to students , which may counter the negative messages regarding alcohol normally seen on Facebook .


Randomized trials evaluating efficacy of local infiltration analgesia ( LIA ) have been published but many of these lack standardized analgesics .


There is a paucity of reports on the effects of LIA on functional capability and quality of life .


@ patients undergoing unilateral total knee arthroplasty ( TKA ) were randomized into @ groups in this placebo-controlled study with @-month follow-up .


In the LIA group , a mixture of levobupivacaine ( @ mg ) , ketorolac ( @ mg ) , and adrenaline ( @ mg ) was infiltrated periarticularly .


In the placebo group , infiltration contained saline .


@ different patient-reported outcome measures ( PROMs ) were used for evaluation of functional outcome and quality of life .


During the first @ hours postoperatively , patients in the LIA group used less oxycodone than patients in the placebo group in both cumulative and time-interval follow-up .


The effect was most significant during the first @ postoperative hours .


The PROMs were similar between the groups during the @-year follow-up .


Single periarticular infiltration reduced the amount of oxycodone used and enabled adequate pain management in conjunction with standardized peroral medication without adverse effects .


No clinically marked effects on the functional outcome after TKA were detected .


The glomerular filtration rate ( GFR ) estimating equation incorporating both cystatin C and creatinine perform better than those using creatinine or cystatin C alone in patients with reduced GFR .


Whether this equation performs well in kidney transplant recipients cross-sectionally , and more importantly , over time has not been addressed .


We analyzed four GFR estimating equations in participants of the Angiotensin II Blockade for Chronic Allograft Nephropathy Trial ( NCT @ ) : Chronic Kidney Disease Epidemiology Collaboration equations based on serum cystatin C and creatinine ( eGFR ( CKD-EPI-Creat + CysC ) ) , cystatin C alone ( eGFR ( CKD-EPI-CysC ) ) , creatinine alone ( eGFR ( CKD-EPI-Creat ) ) and the Modification of Diet in Renal Disease study equation ( eGFR ( MDRD ) ) .


Iothalamate GFR served as a standard ( mGFR ) .


mGFR , serum creatinine , and cystatin C shortly after transplant were @ @ ml/min/@ @ m ( @ ) , @ @ mg/dl , and @ @ mg/l respectively .


eGFR ( CKD-EPI-Creat + CysC ) was most precise ( R ( @ ) = @ ) but slightly more biased than eGFR ( MDRD ) ; @ @ versus @ @ ml/min/@ @ m ( @ ) , respectively .


This improved precision was most evident in recipients with mGFR > @ ml/min/@ @ m ( @ ) .


For relative accuracy , eGFR ( MDRD ) and eGFR ( CKD-EPI-Creat + CysC ) had the highest percentage of estimates falling within @ % of mGFR ; @ and @ % , respectively .


Longitudinally , equations incorporating cystatin C most closely paralleled the change in mGFR .


eGFR ( CKD-EPI-Creat + CysC ) is more precise and reflects GFR change over time reasonably well .


eGFR ( MDRD ) had superior performance in recipients with mGFR between @ and @ ml/min/@ @ m ( @ ) .


We conducted a prospective , randomized , comparative study to compare the clinical outcome between the Trendelenburg position ureteroscopic lithotripsy ( tURSL ) and the conventional position ureteroscopic lithotripsy ( cURSL ) for the management of single proximal ureteral stone .


From January @ to September @ , consecutive patients with single proximal ureteral calculi less than @ cm and planned for ureteroscopic lithotripsy at our institution were enrolled in this study .


The eligible patients were randomized into cURSL group and tURSL group according to sequence of random numbers generated by computer .


In tURSL group , patients were turned into a Trendelenburg lithotomy position with head down @ while the conventional lithotomy position was applied in cURSL group .


URSL was performed using a @/@ @ F semi-rigid ureteroscope with holmium laser .


When retropulsion occurred , the stones fragments were followed by semi-rigid ureteroscope up to the renal collecting system .


The Olympus P@ flexible ureteroscope was used if there was any suspicion of stone migration into lower calices or incomplete stone fragmentation by semi-rigid ureteroscope .


Patients ' demographics between the two groups , perioperative course , clinical outcome and complication rates were compared .


Data were analyzed using Chi-square test , Fisher 's exact test or Student 's t test .


Binary logistic regression analysis was applied to estimate the effects of surgical position and stone size on stone migration .


A total of @ cases were finally analyzed in this study ( @ in cURSL group and @ in tURSL group ) .


The mean operative time was significantly prolonged in cURSL group than in tURSL group , while the stone-free rate ( SFR ) at @ weeks was significantly higher in tURSL group .


A statistically significant difference was found in stone migration rate between the two groups ( @ vs. @ % , P = @ ) .


In the stone migration subsetting , less stones fragments were found to migrate into lower calices in tURSL stone migration subgroup ( P = @ ) .


Also , the flexible ureteroscope utilization as well as the operative time was significantly decreased in tURSL stone migration subgroup ( @ vs. @ % , P = @ ) , ( @ @ min vs. @ @ min , P = @ ) with higher SFR after retrograde intrarenal surgery ( RIRS ) ( @ vs. @ % , P = @ ) .


The tURSL was safe and highly efficacious for the management of proximal ureteral calculus , especially in nonobese patient .


Even with important stone migration risk , it rendered higher SFR and less operative time compared with cURSL .


Moreover , less utilization of flexible ureteroscope and decreased deflection time in tURSL could potentially reduce the medical cost .


To investigate short-term and long-term effects of repetitive peripheral magnetic stimulation ( rpMS ) on spasticity and motor function .


Monocentric , randomized , double-blind , sham-controlled trial .


Neurologic rehabilitation hospital .


Patients ( N = @ ) with severe hemiparesis and mild to moderate spasticity resulting from a stroke or a traumatic brain injury .


The average time SD since injury for the intervention groups was @ @ weeks or @ @ weeks .


rpMS for @ minutes or sham stimulation with subsequent occupational therapy for @ minutes , @ times a day , over a @-week period .


Modified Tardieu Scale and Fugl-Meyer Assessment ( arm score ) , assessed before therapy , at the end of the @-week treatment period , and @ weeks after study treatment .


Additionally , the Tardieu Scale was assessed after the first and before the third therapy session to determine any short-term effects .


Spasticity ( Tardieu > @ ) was present in @ % of wrist flexors , @ % of elbow flexors , @ % of elbow extensors , and @ % of wrist extensors .


Compared with the sham stimulation group , the rpMS group showed short-term effects on spasticity for wrist flexors ( P = @ ) , and long-term effects for elbow extensors ( P < @ ) .


Arm motor function ( rpMS group : median @ -LSB- @-@ -RSB- ; sham group : median @ -LSB- @-@ -RSB- ) did not significantly change over the study period in either group , whereas rpMS had a positive effect on sensory function .


Therapy with rpMS increases sensory function in patients with severe limb paresis .


The magnetic stimulation , however , has limited effect on spasticity and no effect on motor function .


Abdominal pain is commonly reported by youth with IBD .


In a significant subset of youth , pain severity and pain catastrophizing ( i.e. , unhelpful thoughts related to the pain ) may contribute to more negative outcomes and greater impairment in functioning .


This study aimed to examine relationships of pain severity and pain catastrophizing with functional disability among a sample of youth with inflammatory bowel disease ( IBD ) .


Seventy-five youth aged @ to @ years completed ratings of abdominal pain severity , pain catastrophizing , and functional disability using validated measures .


Disease activity was rated by treating physicians .


Over half of participants reported abdominal pain in the past two weeks , and pain was present among those with and without clinical disease activity .


Nearly one-third of youth reported mild to moderate functional disability .


After controlling for gender , pain severity accounted for @ % of the variance in patient functional disability .


Moreover , pain catastrophizing contributed significant variance to the prediction of functional disability ( approximately @ % ) beyond the role of pain severity .


Greater attention to the role of pain catastrophizing in contributing to functional disability in youth with IBD may be important given that pain-related cognitions are modifiable via intervention .


This study attempted to clarify the mechanisms of action of fluoridated acidic liquid dentifrices against dental caries .


In the in vitro leg , enamel specimens were submitted to a pH-cycling model , treated with distinct dentifrices ( @ , @ gF/g pH @ and pH @ , @ or @ gF/g pH @ ) and analyzed using hardness .


Alkali-soluble fluoride ( F ) deposition was quantified on pre-demineralized specimens treated with the dentifrices .


In the clinical leg , @-to-@-year-old children who had been using liquid dentifrices for @ months ( @ gF/g pH @ or pH @ or @ gF/g pH @ ) had their plaque samples collected @ and @ min after the last brushing .


Fluoride uptake in whole plaque was evaluated .


The reduction of the pH had a partial preventive effect on subsurface hardness loss only .


-LSB- F -RSB- had a significant influence on the deposition of fluoride , surface and subsurface hardness loss .


In vivo , the reduction of the pH was able to significantly increase plaque F uptake , leading to similar levels as those found for the neutral dentifrice containing twice -LSB- F -RSB- .


The results obtained from in vitro studies whose design does not include the presence of dental plaque should be interpreted with caution .


The beneficial effects of fish and n-@ polyunsaturated fatty acids ( PUFAs ) consumption on atherosclerosis have been reported in numerous epidemiological studies .


However , to the best of our knowledge , the effects of a fish-based diet intervention on endothelial function have not been investigated .


Therefore , we studied these effects in postmenopausal women with type @ diabetes mellitus ( T@DM ) .


Twenty-three postmenopausal women with T@DM were assigned to two four-week periods of either a fish-based diet ( n-@ PUFAs @ g/day ) or a control diet in a randomized crossover design .


Endothelial function was measured with reactive hyperemia using strain-gauge plethysmography and compared with the serum levels of fatty acids and their metabolites .


Endothelial function was determined with peak forearm blood flow ( Peak ) , duration of reactive hyperemia ( Duration ) and flow debt repayment ( FDR ) .


A fish-based dietary intervention improved Peak by @ % , Duration by @ % and FDR by @ % , compared to the control diet .


Serum n-@ PUFA levels increased after the fish-based diet period and decreased after the control diet , compared with the baseline ( @ vs. @ vs. @ mmol/l , p < @ ) .


There was no correlation between serum n-@ PUFA levels and endothelial function .


An increased ratio of epoxyeicosatrienoic acid/dihydroxyeicosatrienoic acid was observed after a fish-based diet intervention , possibly due to the inhibition of the activity of soluble epoxide hydrolase .


A fish-based dietary intervention improves endothelial function in postmenopausal women with T@DM .


Dissociation between the serum n-@ PUFA concentration and endothelial function suggests that the other factors may contribute to this phenomenon .


To compare the rates of recurrence of chronic subdural hematoma following surgical evacuation by one of two methods , namely , using frontal and parietal burr holes without a drain or a single parietal burr hole with the addition of a subdural drain .


This was a randomized controlled trial with two groups of @ patients each .


Patients in group I had two burr holes and those in group II had a single burr-hole .


A subdural drain was placed for the second group , and this was removed @-@ hours later .


Patients were followed up for @ months and symptomatic recurrences underwent re-exploration .


@ out of @ patients in group I had recurrent hematomas requiring surgery while only two out of @ patients in group II had symptomatic recurrences .


The difference was statistically significant ( p = @ ) .


The use of a single burr hole with drain appears to be a safe and effective procedure for the treatment of chronic subdural hematoma .


Effective motor imagery performance , seen as strong suppression of the sensorimotor rhythm , is the key element in motor imagery therapy .


Therefore , optimization of methods to classify whether the subject is performing the imagery task is a prerequisite .


An optimal classification method should have high performance accuracy and use a small number of channels .


We investigated the additional benefit of the common spatial pattern filtering ( CSP ) to a linear discriminant analysis ( LDA ) classifier , for different channel configurations .


Ten hemispheric acute stroke patients and @ healthy subjects were included .


EEGs were recorded using @ channels .


The classifier was trained with a motor execution task .


For both healthy controls and patients , analysis of recordings was initially limited to @ and @ electrodes recording from the motor cortex area , and later repeated using @ electrodes .


No significant improvement on the addition of CSP to LDA was found ( in both cases , the area under the receiving operating characteristic ( AU-ROC ) @ ( acceptable ) ) .


We then repeated the LDA+CSP method on recordings of @ electrodes , since the use of imagery neuronal circuits may well extend beyond the motor area .


AU-ROC rose to @ , but no virtual ` most responsible ' electrode was observed .


Finally , in mild-to-moderate stroke patients we could successfully use the EEG data recorded from the healthy hemisphere to train the classifier ( AU-ROC @ ) .


Including only the channels on the unaffected motor cortex is sufficient to train a classifier .


Idiopathic inflammatory bowel disease ( IBD ) is a common chronic enteropathy in dogs .


There are no published studies regarding the use of probiotics in the treatment of canine IBD .


The objectives were to compare responses to treatment with either combination therapy ( prednisone and metronidazole ) or probiotic strains ( VSL # @ ) in dogs with IBD .


Twenty pet dogs with a diagnosis of IBD , ten healthy pet dogs , and archived control intestinal tissues from three euthanized dogs were used in this open label study .


Dogs with IBD were randomized to receive either probiotic ( D-VSL # @ , n = @ ) or combination drug therapy ( D-CT , n = @ ) .


Dogs were monitored for @ days ( during treatment ) and re-evaluated @ days after completing treatment .


The CIBDAI ( P < @ ) , duodenal histology scores ( P < @ ) , and CD@ + cells decreased post-treatment in both treatment groups .


FoxP@ + cells ( p < @ ) increased in the D-VSL # @ group after treatment but not in the D-CT group .


TGF - + cells increased in both groups after treatment ( P = @ ) with the magnitude of this increase being significantly greater for dogs in the D-VSL # @ group compared to the D-CT group .


Changes in apical junction complex molecules occludin and claudin-@ differed depending on treatment .


Faecalibacterium and Turicibacter were significantly decreased in dogs with IBD at T@ , with a significant increase in Faecalibacterium abundance observed in the animals treated with VSL # @ strains .


A protective effect of VSL # @ strains was observed in dogs with IBD , with a significant decrease in clinical and histological scores and a decrease in CD@ + T-cell infiltration .


Protection was associated with an enhancement of regulatory T-cell markers ( FoxP@ + and TGF - + ) , specifically observed in the probiotic-treated group and not in animals receiving combination therapy .


A normalization of dysbiosis after long-term therapy was observed in the probiotic group .


Larger scale studies are warranted to evaluate the clinical efficacy of VSL # @ in canine IBD .


Anaesthesia is required for catheter ablation of atrial fibrillation ( A-fib ) to achieve patient comfort and immobilization to avoid map shifts .


This study compared the analgesic and sedative efficacies of dexmedetomidine-remifentanil with those of midazolam-remifentanil for catheter ablation of A-fib .


Ninety patients were randomized to receive either intermittent midazolam boluses ( @-@ mg ) with @-@ @ g/kg/h of remifentanil ( MR group ) or dexmedetomidine @-@ @ g/kg/h after a loading dose of @ g/kg with @-@ @ g/kg/h of remifentanil ( DR group ) .


The sedation level assessed by the Ramsay sedation and bispectral index scores , haemodynamic variables , pain score ( @-point numerical scale ) , and satisfaction levels of the patients and cardiologists ( @-point numerical scale ) were recorded .


The Ramsay sedation score was significantly higher , and the bispectral index score was lower in the DR group ( P < @ ) compared with the MR group starting @ min after drug administration .


The incidence of desaturation ( SpO@ < @ % ) was significantly greater in the MR group compared with the DR group ( @ vs. @ , P < @ ) .


The pain score was significantly lower ( @ @ vs. @ @ , P = @ ) , and the satisfaction levels of interventionists were significantly higher ( @ @ vs. @ @ , P = @ ) in the DR group compared with the MR group .


The combination of dexmedetomidine and remifentanil provided deeper sedation , less respiratory depression , better analgesia , and higher satisfaction for the interventionist during catheter ablation of A-fib compared with midazolam plus remifentanil , even at a lower dose of remifentanil .


High frequency oscillatory ventilation ( HFOV ) is theoretically ideal for lung protective strategy ventilation ( LPSV ) in acute respiratory distress syndrome ( ARDS ) .


However , recent studies revealed unsatisfactory outcomes .


The authors conducted a study to examine this phenomenon in patients with early phase of moderate to severe ARDS .


To evaluate the effectiveness of HFOV in patients with early phase of moderate to severe ARDS .


The primary outcome was @ days all-cause mortality .


The study was a matched-case controlled clinical trial performed in the medical intensive care units , Faculty of Medicine , Siriraj Hospital .


The authors compared HFOV with LPSV in adult patients with the early phase of ARDS who received mechanical ventilation less than @ hours and had moderate to severe hypoxemia ( PaO/FiO@ ratio less than or equal @ ) .


Between June @ and February @ , @ patients with moderate to severe ARDS were included .


Fourteen patients who received HFOV were matched with @ patients who received LPSV .


The @-day mortality in HFOV group was @ % ; while in control group , @ % ( p = @ ) .


The authors found use of higher doses of sedative drugs and muscle relaxants in HFOV group .


In addition , this group had high-level of mean airway pressure ( mPaw ) .


The presence of hemodynamic instability was not different in both groups .


In adult patients in the early phase of moderate to severe ARDS who received mechanical ventilation for less than @ hours , HFOV did not decrease the @-day mortality .


Thus , this support should be only a rescue therapy for refractory hypoxemia cases and in highly selected patients .


Fluoroscopy-guided bronchoscopy is usually performed for the diagnosis of peripheral pulmonary lesions ( PPL ) , but the diagnostic yield varies widely among studies .


Endobronchial ultrasound ( EBUS ) can increase the diagnostic yield of bronchoscopic diagnosis of PPL .


To compare the diagnostic yield of fluoroscopy-guided bronchoscopy and EBUS with fluoroscopy-guided bronchoscopy in the study of PPL .


All patients who underwent bronchoscopy to study PPL from January @ to December @ were prospectively included .


@ consecutive patients were randomly distributed in two groups : EBUS and fluoroscopy ( @ patients , @ @ years ) or fluoroscopy alone ( @ patients , @ @ years ) .


The mean diameter of the lesions was @ @ mm .


Cytological brushing and transbronchial biopsies were obtained .


All procedures were performed under fluoroscopic guidance with intravenous conscious sedation .


EBUS was performed using an endoscopic ultrasound system equipped with a @-MHz radial miniprobe introduced via a guide-sheath .


Bronchoscopist , cytologist , study protocol , techniques and tools were the same throughout the whole study .


@ ( @ % ) patients had malignant disease .


A diagnosis with bronchoscopy was established in @ ( @ % ) patients .


EBUS plus fluoroscopy obtained a diagnostic yield in @ % of patients and fluoroscopy alone in @ % ( non-significant ) .


In contrast , for lesions smaller than @ mm , EBUS plus fluoroscopy guidance provided significantly greater diagnostic performance than fluoroscopy alone ( @ vs. @ % ; P = @ ) .


Bronchoscopy under EBUS plus fluoroscopy guidance is a technique that has become useful for the diagnostic of LPPs , especially those smaller than @ mm in diameter .


The clinical benefit of inhaled antibiotics in non-cystic fibrosis bronchiectasis has not been established in randomised controlled trials .


We aimed to assess safety and efficacy of aztreonam for inhalation solution ( AZLI ) in patients with non-cystic fibrosis bronchiectasis and Gram-negative bacterial colonisation .


AIR-BX@ and AIR-BX@ were two double-blind , multicentre , randomised , placebo-controlled phase @ trials , which included patients aged @ years or older who had bronchiectasis and history of positive sputum or bronchoscopic culture for target Gram-negative organisms .


Patients were randomly assigned to receive either AZLI or placebo ( @:@ ) .


Randomisation was done without stratification and the code was generated by a Gilead designee .


In both studies , two @-week courses of AZLI @ mg or placebo ( three-times daily ; eFlow nebulizer ) were each followed by a @-week off-treatment period .


Primary endpoint was change from baseline Quality of Life-Bronchiectasis Respiratory Symptoms scores ( QOL-B-RSS ) at @ weeks .


These trials are registered with ClinicalTrials.gov , numbers are NCT@ for AIR-BX@ and NCT@ for AIR-BX@ .


We recruited participants from @ ambulatory clinics for AIR-BX@ and @ ambulatory clinics for AIR-BX@ ; studies were done between April @ , @ , and July @ , @ .


In AIR-BX@ , of the @ patients screened , @ were randomly assigned to receive AZLI and @ to receive placebo .


The difference between AZLI and placebo for adjusted mean change from baseline QOL-B-RSS was not significant at @ weeks ( @ -LSB- @ % CI -@ to @ -RSB- , p = @ ) in AIR-BX@ , but was significant ( @ -LSB- @ to @ -RSB- , p = @ ) in AIR-BX@ .


The @ point difference in QOL-B-RSS after @ weeks in AIR-BX@ was not deemed clinically significant .


In both studies , treatment-related adverse events were more common in the AZLI group than in the placebo group , as were discontinuations from adverse events .


The most commonly reported treatment-emergent adverse events were dyspnea , cough , and increased sputum .


Each was more common for AZLI-treated than for placebo-treated patients , but the incidences were more balanced in AIR-BX@ .


AZLI treatment did not provide significant clinical benefit in non-cystic fibrosis bronchiectasis , as measured by QOL-B-RSS , suggesting a continued need for placebo-controlled studies to establish the clinical benefit of inhaled antibiotics in patients with this disorder .


To evaluate a novel aqueous oxygen peroxide ( AOP ) wound therapy ( BioxyQuell ) in a multi-centre , primary care-based , randomised , double-blind , placebo-controlled , parallel-group trial , monitoring long-term healing outcomes over @ months .


Sixty-one patients with chronic , stable venous leg ulceration were treated with either AOP solution or sterile water placebo applied as a lavage over @ weeks .


The patients ' wounds were dressed weekly and assessed fortnightly over the following @ weeks .


Patients who completed the initial @-week trial were invited into a @-month follow-up trial .


The primary endpoints of the study were wound healing at @ weeks , @ weeks , @ months and @ months , and wound size reduction during the treatment phase .


Secondary endpoints were reductions in wound bioburden and pain .


Patients treated with AOP were more likely to heal at @ months ( p = @ ) and @ months ( p = @ ) , but not at @ weeks ( p = @ ) or @ weeks ( p = @ ) .


Patients treated with AOP had greater wound area reduction ( p = @ ) , reductions in pain measured on a @-point scale ( p = @ ) and wound bioburden reduction ( p = @ ) during the treatment phase .


The addition of AOP treatment provides substantial benefits to patients with chronic venous leg ulceration compared with current best practice .


This study investigated interleukin-@ and nitric oxide plasma levels following surgery to determine whether there is a correlation between these two variables and if different desflurane anesthesia flow rates influence nitric oxide and interleukin-@ concentrations in circulation .


Forty patients between @ and @ years and ASA I-II physical status who were scheduled to undergo thyroidectomy were enrolled in the study .


Patients were allocated into two groups to receive two different desflurane anesthesia flow rates : high flow ( Group HF ) and low flow ( Group LF ) .


Blood samples were drawn at the beginning ( t@ ) and end ( t@ ) of the operation and after @h ( t@ ) .


Plasma interleukin-@ and nitric oxide levels were measured using an enzyme-linked-immunosorbent assay and a Griess reagents kit , respectively .


Hemodynamic and respiratory parameters were assessed .


There was no statistically significant difference between the two groups with regard to interleukin-@ levels at the times of measurement .


Interleukin-@ levels were increased equally in both groups at times t@ and t@ compared with preoperative concentrations .


For both groups , nitric oxide circulating concentrations were significantly reduced at times t@ and t@ compared with preoperative concentrations .


However , the nitric oxide value was lower for Group HF compared to Group LF at t@ .


No correlation was found between the IL-@ and nitric oxide levels .


Clinical usage of two different flow anesthesia forms with desflurane may increase interleukin-@ levels both in Group HF and Group LF ; nitric oxide levels circulating concentrations were significantly reduced at times t@ and t@ compared with preoperative concentrations ; however , at @h postoperatively they were higher in Group LF compared to Group HF .


No correlation was detected between interleukin-@ and nitric oxide levels .


It is unclear whether achieving multiple risk factor ( RF ) goals through protocol-guided intensive medical therapy is feasible or improves outcomes in type @ diabetes mellitus .


This study sought to quantify the relationship between achieved RF goals in the BARI @D ( Bypass Angioplasty Investigation Revascularization @ Diabetes ) trial and cardiovascular events/survival .


We performed a nonrandomized analysis of survival/cardiovascular events and control of @ RFs ( no smoking , non-high-density lipoprotein cholesterol < @ mg/dl , triglycerides < @ mg/dl , blood pressure -LSB- systolic < @ mmHg ; diastolic < @ mmHg -RSB- , glycosylated hemoglobin < @ % ) in BARI @D .


Cox models with time-varying number of RFs in control were adjusted for baseline number of RFs in control , clinical characteristics , and trial randomization assignments .


In @,@ patients ( mean age @ years , @ % women ) followed up for @ years , the mean SD number of RFs in control improved from @ @ at baseline to @ @ at @ years ( p < @ ) .


The number of RFs in control during the trial was strongly related to death ( global p = @ ) and the composite of death , myocardial infarction , and stroke ( global p = @ ) in fully adjusted models .


Participants with @ to @ RFs in control during follow-up had a @-fold higher risk of death ( hazard ratio : @ ; @ % confidence interval : @ to @ ; p = @ ) and a @-fold higher risk of the composite endpoint ( hazard ratio : @ ; @ % confidence interval : @ to @ ; p = @ ) , compared with those with @ RFs in control .


Simultaneous control of multiple RFs through protocol-guided intensive medical therapy is feasible and relates to cardiovascular morbidity and mortality in patients with coronary disease and type @ diabetes mellitus .


( Bypass Angioplasty Revascularization Investigation in Type @ Diabetes -LSB- BARI @D -RSB- ; NCT@ ) .


The objective of this prospective multicenter cohort study was to characterise the use of pharmacological and non-pharmacological treatment for cardiovascular disease ( CVD ) risk factors and intermittent claudication ( IC ) symptoms in clinical practice patients with peripheral artery disease ( PAD ) , and to determine the care gap with international guidelines and evidence-based therapy .


From @ through @ , participating centres enrolled consecutive patients with PAD of atherosclerotic , origin demonstrated by ultrasound , ankle brachial index ( ABI ) < @ and symptoms of IC .


A seven item grid was built for the assessment of care gap ( percentage of patients eligible for a treatment who did not receive it ) .


cerebrovascular disease or at least two CVD risk factors .


Care gap was lower than @ % for any method to stop smoking , lipid lowering agents , antiplatelet and/or anticoagulation therapy and any kind of exercise program ; between @ % and @ % for ACE inhibitors / angiotensin II antagonist therapy ; between @ % and @ % for beta-blocker therapy ; and higher than @ % for supervised exercise program and use of cilostazol .


Patients with and without CADI cerebrovascular disease were differently treated with clopidogrel ( @ % and @ % , p < @ ) , any antiplatelet/anticoagulant therapy ( @ % and @ % , p < @ ) and beta-blockers ( @ % and @ % , p < @ ) .


All patients ( @ ) presented at least one CVC risk factor , @ % at least two , and @ % had either established CAD or


Many gaps with evidence-based recommendations are still present in the pattern of the use of pharmacological and non-pharmacological treatment for CVD risk factors and IC symptoms in clinical practice PAD patients .


This study applied a pharmacodynamic model-based approach to evaluate the long-term durability and glycemic control of pioglitazone in comparison with other oral glucose-lowering drugs in Japanese type @ diabetes mellitus ( T@DM ) patients .


Japanese T@DM patients were enrolled in a prospective , randomized , open-label , blinded-end point study and received pioglitazone with or without other oral glucose-lowering drugs ( excluding another thiazolidinedione -LSB- TZD -RSB- ) ( n = @ ) or oral glucose-lowering drugs excluding TZD ( n = @ ) .


Treatment was adjusted to achieve glycosylated hemoglobin ( HbA@c ) < @ % , and samples for fasting plasma glucose ( FPG ) and HbA@c were collected over @-@ years .


A simultaneous cascading indirect response model structure was applied to describe the time course of FPG and HbA@c .


HbA@c levels were described using both an FPG-dependent and an FPG-independent function .


To account for titration , drug effects for both treatment groups were implemented using a time-dependent Emax model .


Pioglitazone was superior in both time to maximum effect and the magnitude of reduction achieved in FPG and HbA@c .


A greater reduction in median FPG ( -@ mg/dL vs. -@ mg/dL ) was observed with pioglitazone ( P < @ ) .


Maximum drug effect for FPG was predicted to occur earlier ( @ months ) for pioglitazone than for the control group ( @ months ) .


The simulated additional reduction in FPG and HbA@c achieved with pioglitazone was predicted to be maintained beyond the currently observed study duration .


Pioglitazone was found to result in improved glycemic control and durability compared with control treatment .


This model-based approach enabled the quantification of differences in FPG and HbA@c for both treatment groups and simulation to evaluate longer-term durability on FPG and HbA@c .


The integrated treatment of first episode psychosis has been shown to improve functionality and negative symptoms in previous studies .


In this paper , we describe a study of integrated treatment ( individual psychoeducation complementary to pharmacotherapy ) versus treatment as usual , comparing results at baseline with those at @-month re-assessment ( at the end of the study ) for these patients , and online training of professionals to provide this complementary treatment , with the following objectives : @ ) to compare the efficacy of individual psychoeducation as add-on treatment versus treatment as usual in improving psychotic and mood symptoms ; @ ) to compare adherence to medication , functioning , insight , social response , quality of life , and brain-derived neurotrophic factor , between both groups ; and @ ) to analyse the efficacy of online training of psychotherapists .


This is a single-blind randomised clinical trial including patients with first episode psychosis from hospitals across Spain , randomly assigned to either a control group with pharmacotherapy and regular sessions with their psychiatrist ( treatment as usual ) or an intervention group with integrated care including treatment as usual plus a psychoeducational intervention ( @ sessions ) .


Training for professionals involved at each participating centre was provided by the coordinating centre ( University Hospital of lava ) through video conferences .


Patients are evaluated with an extensive battery of tests assessing clinical and sociodemographic characteristics ( Positive and Negative Syndrome Scale , State-Trait Anxiety Inventory , Liebowitz Social Anxiety Scale , Hamilton Rating Scale for Depression , Scale to Assess Unawareness of Mental Disorders , Strauss and Carpenter Prognostic Scale , Global Assessment of Functioning Scale , Morisky Green Adherence Scale , Functioning Assessment Short Test , World Health Organization Quality of Life instrument WHOQOL-BREF ( an abbreviated version of the WHOQOL-@ ) , and EuroQoL questionnaire ) , and brain-derived neurotrophic factor levels are measured in peripheral blood at baseline and at @ months .


The statistical analysis , including bivariate analysis , linear and logistic regression models , will be performed using SPSS .


This is an innovative study that includes the assessment of an integrated intervention for patients with first episode psychosis provided by professionals who are trained online , potentially making it possible to offer the intervention to more patients .


Heavy episodic drinking ( HED ) is a serious problem among college women at high-risk for developing eating disorders ( EDs ) .


The main objectives of this study are to determine the relationship of the self-rating of the effects of alcohol ( SRE ) questionnaire and HED over time , and to determine the effects of relationship breakups on HED among college-aged women at high-risk for EDs .


Data collected from @ participants in a randomized controlled trial evaluating the effectiveness of an ED prevention program were used in the analyses .


Measures included the SRE , obtained at baseline , and self-reports of the number of HED episodes and relationship breakups each month for the past @ months .


Generalized linear mixed-effect regression models with Poisson distribution were conducted to test the effects of several variables on reported HED episodes over @ months .


Analyses demonstrated that SRE scores and the presence of a breakup predicted increased HED over time .


The SRE may be useful in identifying individuals at risk of or with EDs who are at increased risk of HED .


Furthermore , relationship breakups predict HED .


Findings from the current study could be used to inform clinical interventions for this population .


The aim of this study was to compare the Ilizarov circular fixator ( IL ) and locked intramedullary nailing ( IM ) .


Patients with isolated tibia shaft fractures were randomly allocated to either the IL ( n = @ ) or IM ( n = @ ) method .


Conventional radiographs , postoperative pain assessment , self-appraisal scores and complications were evaluated .


At the clinical @-year follow-up , the patients were also evaluated by an independent observer .


The minority of patients had open fractures , two and nine patients in the IM and IL groups , respectively .


Eight patients in the IM group and four in the IL group sustained major complications ( p = @ ) .


In the IM group , two patients developed compartment syndrome , one deep infection , one hardware failure , one delayed union , one pseudarthrosis and two had a malunion .


In the IL group , two patients developed pseudarthrosis and two had a malunion .


Superficial pin-site infections were observed in @ patients in the IL group .


The fractures had healed radiographically at @ weeks in both groups .


At the @-year follow-up , there were differences in pain ( VAS ) and satisfaction ( VAS ) scores in favor of IL treatment ( VAS , p = @ and p = @ , respectively ) .


There were no differences between the groups with regard to range of motion ( ROM ) in the knee and ankle joints .


The registration of local tenderness and pain revealed that there were @ patients with anterior knee pain in the IM group and one in the IL group at the @-year follow-up ( p < @ ) .


The IL is a safe and reliable alternative to IM for the treatment of tibial shaft fractures , with a low complication rate and good clinical outcome .


Both treatments were well tolerated , but at the @-year follow-up the patients in the IM group had more pain and were less satisfied .


Finally , there was a high frequency of anterior knee pain in the IM group .


The objective of this study was to evaluate whether increased serum @-hydroxyvitamin D@ ( @OHD@ ) concentrations , in response to calcium/vitamin D ( CaD ) supplementation , are associated with improved lipids in postmenopausal women .


The parent trial was a double-blind , randomized , placebo-controlled , parallel-group trial designed to test the effects of CaD supplementation ( @,@ mg of elemental calcium + @ IU of vitamin D@ daily ) versus placebo in postmenopausal women .


Women from the general community , including multiple sites in the United States , were enrolled between @ and @ .


This cohort included @ white , @ African-American , and @ Hispanic participants who were randomly selected from the Women 's Health Initiative CaD trial .


Serum @OHD@ and lipid ( fasting plasma triglycerides -LSB- TG -RSB- , high-density lipoprotein cholesterol -LSB- HDL-C -RSB- , and calculated low-density lipoprotein cholesterol -LSB- LDL-C -RSB- ) levels were assessed before and after CaD randomization .


There was a @ % increase in mean serum @OHD@ concentrations after @ years ( @ % CI , @-@ @ , P < @ ) for women randomized to CaD ( @ ng/mL postrandomization mean ) compared with placebo ( @ ng/mL ) .


Women randomized to CaD had a @-mg / dL mean decrease in LDL-C ( P = @ ) .


Higher concentrations of @OHD@ were associated with higher HDL-C levels ( P = @ ) , along with lower LDL-C and TG levels ( P = @ and P < @ , respectively ) .


Supplemental CaD significantly increases @OHD@ concentrations and decreases LDL-C .


Women with higher @OHD@ concentrations have more favorable lipid profiles , including increased HDL-C , lower LDL-C , and lower TG .


These results support the hypothesis that higher concentrations of @OHD@ , in response to CaD supplementation , are associated with improved LDL-C .


To compare the effectiveness of expectant management versus methotrexate in selected cases of tubal ectopic pregnancy .


A double-blind randomized trial included @ selected patients with a confirmed diagnosis of tubal pregnancy who met the inclusion criteria ( hemodynamic stability , initial serum - hCG concentration < @,@ mIU/mL , declining titers of - hCG @ h prior to treatment , visible tubal pregnancy on transvaginal ultrasound , a tubal mass < @ cm and fertility desire ) .


The patients were divided into two groups : @ patients in the methotrexate group ( MTX @ mg/m ( @ ) administered as a single intramuscular dose ) and @ patients in the placebo group ( saline solution administered in a single intramuscular dose ) .


Quantitative variables were expressed as means standard deviations and compared by Student 's t test or Mann-Whitney test .


Dichotomous variables ( success/treatment failure ) were presented as proportions and compared by the Fisher exact test .


Successful treatment with negative titers of - hCG occurred in @ cases ( @ % ) of the methotrexate group and in @ ( @ % ) of the placebo group ( p > @ ) .


The - hCG values became undetectable at @ @ days in the methotrexate group and @ @ days in the placebo group ( p = @ ) .


This study showed no statistically significant difference between the treatment with methotrexate and placebo , with similar success rates and similar time interval for - hCG to become undetectable .


To compare intermittent treatment ( IT ) versus continuous treatment ( CT ) using cyproterone acetate ( CPA ) in bone metastatic prostate cancer patients , we conducted an open-label , multicenter randomized trial .


Continuous androgen deprivation therapy is the standard treatment in metastatic prostate cancer .


Intermittent treatment might maintain efficacy while toxicity and costs are reduced .


Patients received CPA @ mg tid in the prephase .


Patients with a PSA decline of @ % or PSA < @ ng/ml were randomized .


If patients were progressive , LHRH analogues were added .


Primary end point was time to PSA progression .


A total of @ patients were recruited ; @ reached a good response after @ or @ months and were randomized .


A total of @ patients randomized to IT and @ to CT. .


Patients on IT had an average of @ episodes on CPA , before LHRH analogues were started .


The mean time without treatment in IT was @ days versus @ days on treatment .


There were statistical significant differences between IT and CT in @ of the @ functional scales of EORTC QLQ C @ ; however , the clinical relevance of this finding appears modest .


Symptom and potency scales showed significant advantages for IT .


There were no differences in time to PSA progression on CPA , time to PSA and/or clinical progression on LHRH analogues and time to cancer-specific and overall survival .


IT by CPA is associated with less symptoms and modest advantages in QOL domains .


There were no differences in time to PSA progression , clinical progression or survival .


Nausea and vomiting are frequently seen in patients undergoing cesarean section ( CS ) under regional anesthesia .


We aimed to compare the antiemetic efficacy of ondansetron and dexamethasone combination with that of the use of each agent alone to decrease the incidence of post-delivery intraoperative nausea and vomiting ( IONV ) during CS under spinal anesthesia .


To compare the antiemetic efficacy of ondansetron and dexamethasone combination with that of the single use of each agent to decrease the incidence of postdelivery IONV during CS under spinal anesthesia .


A randomized , prospective , double blind study was performed on @ patients undergoing planned CS under spinal anesthesia .


Patients received @mg ondansetron in Group O , @mg dexamethasone in GroupD , @mg ondansetron +@ mg dexamethasone in Group OD intravenously within @-@ minutes after the umbilical cord was clamped .


Frequency of postdelivery IONV episodes was recorded .


A total of @ eligible patients were included in the study .


There were @ patients in Group O , @ patients in Group D and @ patients in Group OD .


There were no statistically significant difference between the groups in terms of baseline characteristics and intraoperative managements .


Frequency of intraoperative nausea , retching and vomiting experiences were similar between the groups ( p > @ ) .


Single dose @mg ondansetron , @mg dexamethasone , or combined use of @mg dexamethasone +@ mg ondansetron , given intravenously is all effective agents for the control of postdelivery IONV .


Combined use of dexamethasone and ondansetron for the same indication does not seem to increase the antiemetic efficacy .


We hypothesized increasing obstructive sleep apnea ( OSA ) severity would be associated with nondipping blood pressure ( BP ) in increased cardiovascular disease ( CVD ) risk .


Baseline data from @ cardiology patients recruited for a multicenter randomized controlled trial were examined .


Dipping was defined as a sleep-related BP or heart rate ( HR ) reduction of at least @ % .


Logistic regression models were fit , adjusting for age , sex , race , BMI , CVD risk factors , CVD , and study site .


There was a statistically significant @ % increase in the odds of nondipping SBP per @-unit increase in both apnea hypopnea index ( AHI ) and oxygen desaturation index ( ODI ) .


There was no significant relationship between AHI and nondipping mean arterial pressure ( MAP ) ; however , a @ % increase in the odds of nondipping MAP per @-unit increase in ODI was observed -LSB- odds ratio ( OR ) = @ ; @ % confidence interval ( CI ) @-@ @ -RSB- .


At severe OSA levels , a @ and @ % increase in odds of nondipping DBP per @-unit increase in AHI and ODI were observed , respectively .


A @ % -LSB- OR = @ ; @ % CI ( @-@ @ ) -RSB- increase in nondipping HR odds was observed with each increase in ODI until the upper quartile of ODI .


In patients at cardiovascular risk and moderate-to-severe OSA , increasing AHI and/or ODI were associated with increased odds of nondipping SBP and nondipping MAP .


More severe levels of AHI and ODI also were associated with nondipping DBP .


These results support progressive BP burden associated with increased OSA severity even in patients managed by cardiology specialty care .


In patients with retinitis pigmentosa ( RP ) , the inner segment ellipsoid zone ( EZ ; also known as the inner segment/outer segment -LSB- IS/OS -RSB- border ) is a marker of the usable visual field at a given point in time and of the progression of the disease over time .


Here we compare the change in the width per year of the EZ band in patients with autosomal dominant ( ad ) and x-linked ( xl ) RP .


Using optical coherence tomography ( OCT ) , @-mm horizontal and vertical line scans through the fovea were obtained for one eye of @ xlRP patients and @ adRP patients .


Scans were repeated on average @ years later ( range , @-@ @ years ) .


Using a manual segmentation procedure , the EZ band was delineated and its horizontal width ( HW ) and vertical width ( VW ) were determined .


The adRP and xlRP patients had similar initial EZ HW ( xlRP : @ @ , adRP : @ @ , P = @ ) and VW ( xlRP : @ @ , adRP : @ @ , P = @ ) .


However , between visits the absolute loss and percent loss of the EZ width per year was significantly greater for xlRP than adRP for both HW ( xlRP : @ @ / y , @ @ % / y ; adRP : @ @ / y , @ @ % / y ; P < @ ) and VW ( xlRP : @ @ / y , @ @ % / y ; adRP : @ @ / y , @ @ % / y ; P < @ ) .


There was a weak correlation between the loss of EZ width per year and the initial width for xlRP ( r ( @ ) = @ , P = @ ) , but no correlation for adRP ( r ( @ ) = @ , P = @ ) .


The test-retest difference of EZ HW was @ @ .


The OCT data here support a faster rate of loss per year in the case of xlRP .


( ClinicalTrials.gov number , NCT@ . )


The purpose of this study was to compare manipulative therapy ( MT ) plus rehabilitation to rehabilitation alone for recurrent ankle sprain with functional instability ( RASFI ) to determine short-term outcomes .


This was an assessor-blind , parallel-group randomized comparative trial .


Thirty-three eligible participants with RASFI were randomly allocated to receive rehabilitation alone or chiropractic MT plus rehabilitation .


All participants undertook a daily rehabilitation program over the course of the @-week treatment period .


The participants receiving MT had @ treatments over the same treatment period .


The primary outcome measures were the Foot and Ankle Disability Index and the visual analogue pain scale , with the secondary outcome measure being joint motion palpation .


Data were collected at baseline and during week @ .


Missing scores were replaced using a multiple imputation method .


Statistical analysis of the data composed of repeated-measures analysis of variance .


Between-group analysis demonstrated a difference in scores at the final consultation for the visual analogue scale and frequency of joint motion restrictions ( P @ ) but not for the Foot and Ankle Disability Index ( P = @ ) .


This study showed that the patients with RASFI who received chiropractic MT plus rehabilitation showed significant short-term reduction in pain and the number of joint restrictions in the short-term but not disability when compared with rehabilitation alone .


No validated patient-reported outcome ( PRO ) measure exists for functional dyspepsia ( FD ) assessment .


Verbal descriptions of different upper abdominal symptoms may be poorly distinguishable to patients .


To investigate whether understanding of FD symptoms is enhanced by pictograms symbolising the nature of the symptoms , besides verbal descriptors .


Consecutive FD patients were randomised to fill out a questionnaire assessing nineupper gastrointestinal symptoms ( post-prandial fullness , early satiation , epigastric pain , epigastric burning , bloating centred in the upper abdomen , nausea , vomiting , heartburn , regurgitation ) with or without accompanying pictograms .


Symptoms were rated for frequency and severity ( @-@ ) , and patients also identified the most bothersome symptom .


Subsequently , in-depth history was taken by an expert clinician , who filled out the same symptom ratings .


Concordance between patient and clinician ratings was quantified using chi-square and kappa statistics .


Content validity of pictograms was first confirmed by @ FD patients .


Next , @ patients ( @ women , age @ ) were randomised to questionnaires with or without pictograms .


The concordance with clinician 's assessment as gold standard rose from @ without to @ % for questions with pictograms ( P < @ ) .


Considering the Rome III subdivision , benefit in concordance with pictograms was present for post-prandial distress , epigastric pain syndrome and reflux symptoms .


Kappa statistics confirmed these gains ( weighted kappa values for concordance of symptom frequency ratings rose from @ to @ with pictograms ) , and also showed better concordance of the most bothersome symptom with pictograms .


Pictograms accompanying verbal descriptors significantly improve concordance of functional dyspepsia symptom ratings by patients with evaluation by their physicians .


Non-cellulose dried matrix spotting ( DMS ) cards are an alternative to filter paper ( FP ) for bloodspots .


We compared the interpatient distributions of bloodspot areas between DMS and FP for a fixed volume of application of whole blood , and examined correlations of areas with hematocrit .


EDTA-whole blood adult patient samples ( n = @ ; @ males , @ females ) were utilized after routine measurement of hemoglobin and hematocrit .


Replicate ( @ ) bloodspots were produced by bolus drop application of @L whole blood via a fixed-volume pipettor to either FP or DMS .


Dried bloodspot areas were determined by image analysis .


Hematocrits ( HCT ) were normally distributed ( HCT = @ % ) .


For both FP and DMS , bloodspot areas ( a , cm ( @ ) ) across patients were normally distributed : for FP , a = @ cm ( @ ) ( @ % ) ; for DMS , a = @ cm ( @ ) ( @ % ) .


Relative bloodspot area differences across the population range were > @ % for both DMS and FP .


Correlation of bloodspot areas to hematocrit was negative for FP ( r = -@ ) but positive for DMS ( r = +@ ) .


Interpatient variation in blood volume per area is a preanalytical variable for both DMS and FP bloodspots .