Among @ patients randomized in the RCTs , @ ( @ % ) had @ tophus and @ visible tophi were recorded at baseline .


Overall tophus CR was recorded in @ % of patients in the biweekly group ( P = @ versus placebo ) , @ % in the monthly group , and @ % in the placebo group after six months of RCT therapy .


TT-CR rates at six months were @ % , @ % , and @ % of tophi , respectively .


Patients meeting the primary endpoint of sustained urate-lowering response to therapy ( responders ) were more likely than nonresponders to have an overall tophus CR at six months ( @ % vs @ % , respectively and @ % with placebo ) .


Pegloticase reduced tophus burden in patients with refractory tophaceous gout , especially those achieving sustained urate-lowering .


Complete resolution of tophi occurred in some patients by @ weeks and in others with longer-term therapy .


The present study was designed to determine the effect of short-term moderate-intensity exercise training on arterial stiffness in patients with chronic kidney disease ( CKD ) stage@ .


Randomized controlled trial with a parallel-group design .


Testing and training sessions were performed at Springfield College .


@ ( treatment group , n = @ ; control group , n = @ ) patients with CKD with diabetes and/or hypertension completed the study .


The aerobic training program consisted of @ weeks of supervised exercise training at @ % -@ % peak oxygen uptake ( Vo@peak ) @ times per week , while the control group remained sedentary .


Identical testing procedures were performed following the @-week intervention .


The primary outcome was arterial stiffness .


Secondary outcomes were aerobic capacity , various blood parameters ( endothelin @ , nitrate/nitrite , and high-sensitivity C-reactive protein ) , and health-related quality of life .


Arterial stiffness was assessed with aortic pulse wave velocity ( PWV ) , aerobic capacity by Vo@peak , blood parameters by enzyme-linked immunosorbent assays , and health-related quality of life by the @-Item Short Form Health Survey ( SF-@ ) .


Participants attended @ sessions before being randomly assigned to either the treatment or control group .


Participants gave consent during the first session , whereas a graded exercise test with measurement of Vo@peak was completed during the second session .


During sessions @ and @ , aortic PWV was measured at rest prior to @ minutes of either moderate-intensity exercise training or seated rest .


A venous blood sample was obtained prior to exercise or rest and participants completed the SF-@ questionnaire .


@ weeks of training led to an @ % increase in Vo@peak for the treatment group ( P = @ ) , but no changes in aortic PWV .


Randomization was not concealed and was violated on one occasion ; also , use of an indirect measurement of endothelial function and the short duration of the intervention .


Short-term moderate-intensity exercise training does not alter arterial stiffness in patients with CKD , but seems to reduce endothelin @ levels .


Treatment satisfaction of men receiving phosphodiesterase @ inhibitors ( PDE@ ) for erectile dysfunction ( ED ) and their partners is essential to successful long-term therapy .


This study aims to assess treatment satisfaction , in men with a partial response to on-demand ( PRN ) PDE@ and their female partners , following tadalafil @mg once daily or placebo .


The study was randomized , double-blind , parallel , and placebo-controlled in men primarily with mild to moderate ED .


Treatment satisfaction was assessed following a @-week maximum dose PRN lead-in , @-week nondrug washout , and treatment through @ weeks .


Men were @ years old with ED for @ months and International Index of Erectile Function Erectile Function score of @ and < @ at screening and < @ following PRN lead-in .


Treatment satisfaction was assessed using the Treatment Satisfaction Scale ( TSS ) for patients and partners .


TSS domain scores range from @ to @ , with higher values indicating greater satisfaction .


Statistical comparisons were made using analysis of covariance .


Treatment satisfaction was significantly greater with tadalafil once daily vs. placebo across all TSS domains for both patients and their partners ( all P < @ ) .


For patients , mean scores for the TSS domains Confidence to Complete Sexual Activity and Satisfaction with Orgasm ranged from @ to @ after the PRN lead-in and @ to @ following the nondrug washout .


Following randomized treatment , scores for tadalafil and placebo were @ and @ , respectively , for Confidence to Complete Sexual Activity and @ and @ , respectively , for Satisfaction with Orgasm .


Results were comparable for other TSS domains and between men and their partners .


Treatment satisfaction was comparable for tadalafil @mg once daily and PRN PDE@ for both patients and female partners , suggesting that tadalafil once daily is a viable therapy option for men with ED who had a partial response to PRN PDE@ therapy .


Despite recent declines among young children , obesity remains a public health burden in the United States , including among Latino/Hispanic children .


The determining factors are many and are too complex to fully address with interventions that focus on single factors , such as parenting behaviors or school policies .


In this article , we describe a multisector , multilevel intervention to prevent and control childhood obesity in predominantly Mexican-origin communities in Southern California , one of three sites of the CDC-funded Childhood Obesity Research Demonstration ( CA-CORD ) study .


CA-CORD is a partnership between a university-affiliated research institute , a federally qualified health center , and a county public health department .


We used formative research , advisory committee members ' recommendations , and previous research to inform the development of the CA-CORD project .


Our theory-informed multisector , multilevel intervention targets improvements in four health behaviors : fruit , vegetable , and water consumption ; physical activity ; and quality sleep .


Intervention partners include @ families , a federally qualified health center ( including three clinics ) , @ early care and education centers , two elementary school districts ( and @ elementary schools ) , three community recreation centers , and three restaurants .


Intervention components in these sectors target changes in behaviors , policies , systems , and the social and physical environment .


Evaluation activities include assessment of the primary outcome , BMI z-score , at baseline , @ - , and @-months post-baseline , and sector evaluations at baseline , @ , and @ months .


Identifying feasible and effective strategies to prevent and control childhood obesity has the potential to effect real changes in children 's current and future health status .


Local anesthesia used for incision and drainage of abscesses is known to be painful .


We studied the analgesia provided by a lidocaine/tetracaine patch compared to injectable lidocaine during incision and drainage ( I&D ) of skin abscesses .


This was a prospective , double-blind , randomized , controlled trial carried out in the Emergency Department ( ED ) of an adult tertiary referral center .


Adult patients with a skin abscess in need of I&D were randomized to one of two groups .


One group received a lidocaine/tetracaine patch and injectable normal saline for anesthesia .


The second group received a placebo patch and injectable@ % lidocaine .


A visual analog pain scale was used to record the patient 's pain level prior to treatment , during the procedure , and after I&D .


There were @ patients enrolled in the study , including @ randomized to the lidocaine/tetracaine patch and @ to the injectable lidocaine .


Pain scores preprocedure were similar in the two groups .


Pain scores during I&D and postprocedure were compared between groups using a paired t-test .


Patients receiving injectable lidocaine experienced pain that was similar ( @ @ mm ; @ % confidence interval -LSB- CI -RSB- @-@ @ ) to those receiving the transdermal lidocaine/tetracaine patch ( @ mm @ ; @ % CI = @-@ @ ) , p = @ , with a power of @ % to detect a difference of @ mm at p @ ; although this was statistically significant , it was not clinically significant .


There was also no statistical difference between the two groups in the postprocedure pain scores ( p = @ ) .


Local injection of lidocaine provided clinically similar analgesia compared to the lidocaine/tetracaine patch during I&D of skin abscesses in the ED .


Pain at presentation and after the procedure was similar in both groups .


Emergency physicians should continue to use a local injected anesthetic for I&D of skin abscesses until a less painful alternative is identified .


To evaluate the efficacy and safety of selective laser trabeculoplasty ( SLT ) as a replacement for medical therapy in primary open-angle glaucoma ( POAG ) .


A prospective , randomized , controlled study.SLT treatment with SOLO SLT Nd : YAG laser was provided to @ participants with advanced POAG ( @ eyes , IOP @ mmHg , @ mmHg = @ kPa ) under anti-glaucomatous medications control ) .


A table of random numbers was created by simple randomization method .


Participants were randomly divided into two groups : the standard-energy group ( @ eyes ) , which received a @ standard-energy SLT treatment and the sub-threshold energy group ( @ eyes ) , which received a @ sub-threshold energy treatment .


The intraocular pressure ( IOP ) before and after SLT , daytime IOP curve , dosage of anti-glaucoma drugs and treatment complications were observed , which were be followed up for @-@ months ( average @ months ) .


Two-tailed t-test or paired t test was used when the continuous variables were normal distribution , such as the basic data , daily fluctuations of IOP , laser energy .


Non-parametric Mann-Whitney U test or Wilcoxon rank test was used when data was not distributed normally , such as drug category .


Chi-square or Fisher 's exact test was used when count variables such as success rate and complications were analyzed .


The number of anti-glaucomatous drugs used in the standard-energy group and the sub-threshold energy group before SLT was ( @ @ ) and ( @ @ ) , respectively ; whereas , after the last treatment , it reduced to ( @ @ ) and ( @ @ ) , respectively ( Z = -@ , -@ ; P < @ ) .


The success rate of the standard-energy group and the sub-threshold energy group was @ % , and @ % , respectively , which was not significant different ( P = @ ) .


Laser treatment was found to reduce the IOP fluctuation during the daytime.IOP fluctuation decreased from ( @ @ ) mmHg to ( @ @ ) mmHg in the standard-energy group , and decreased from ( @ @ ) mmHg to ( @ @ ) mmHg in the sub-threshold energy group , which was significant different ( t = @ , @ ; P < @ ) .


The total laser energy of the standard-energy group ( @ @ ) mJ was higher than the sub-threshold energy group ( @ @ ) mJ ( t = @ , @ ; P < @ ) .


However , there was no significant difference in the daily IOP fluctuations , success rate , reduction of medication categories , preoperative and postoperative IOP , and adverse reactions between the two groups .


SLT is a safe and effective replacement for medical therapy in primary open-angle glaucoma treatment .


SLT could reduce the applications of anti-glaucoma drugs .


There was no significant difference between therapeutic effects of which eyes received @ sub-threshold energy and @ standard-energy .


Aging results in a decline in the function of the respiratory muscles .


Inspiratory muscle training is emerging as a possible intervention to attenuate the decline of respiratory muscles in the elderly .


The aim of this study was to evaluate the efficacy of inspiratory muscle training on respiratory strength , diaphragm thickness , and diaphragmatic mobility in elderly women .


This was a controlled , randomized , and double-blind clinical trial , performed on @ elderly women distributed in two groups , training ( TG ) and control ( CG ) .


Over an @-week period a moderate intensity inspiratory muscle training protocol was followed in the TG , while CG followed a sham protocol .


In addition maximum expiratory and inspiratory pressure , mobility of the diaphragm and diaphragmatic thickness were evaluated by ultrasound .


After training , in TG maximal inspiratory pressure , maximal expiratory pressure , diaphragm thickness , and mobility increased by @ % , @ % , @ % , and @ % respectively , and their values were significantly higher than CG ( p < @ , p = @ , p = @ , and p = @ ) .


Inspiratory muscle training of moderate intensity improves respiratory muscle strength , diaphragm thickness , and diaphragm mobility in elderly women and it should be considered to minimize changes associated with senescence .


Mobile technology can improve lifestyle programs , but the monitoring techniques and carer feedback need to be optimized .


To this end , we investigated the efficacy of telemonitoring physical activity and nutrition over @ months in patients with metabolic syndrome in a randomized , parallel-group , open trial .


Screening all over Germany yielded @ patients with metabolic syndrome .


All patients attended a single @-hour instruction meeting in their region concerning a combination diet and the importance of physical activity .


Thereafter they were randomized into a control group ( controls , n = @ ) or one of @ different intervention groups .


Both intervention groups were issued accelerometers , which measured physical activity , recorded daily weight and calorie intake , and transmitted these data to a central server for use by patient carers .


In the Active Body Control Program of University of Magdeburg ( ABC ) intervention group ( n = @ ) , information and motivation was ensured by weekly letters .


In the @sigma telephone coaching ( @S ) intervention group ( n = @ ) , this was accomplished by monthly telephone calls from the carers .


Clinical and biochemical data for all patients were collected at @ , @ , @ , and @ months without any regular face-to-face meetings between patients and carers .


The primary endpoint was weight loss and the secondary endpoint was the presence of metabolic syndrome .


After @ months the dropout rates in the control , @S , and ABC groups were respectively @ % , @ % , and @ % .


The adjusted relative weight losses after @ months were respectively @ % , @ % , and @ % ( all p < @ versus baseline ) .


ABC was more effective than @S ( p = @ ) ; @ % of the patients completing the study in the ABC group lost more than @ % of their baseline weight .


The diagnosis of metabolic syndrome was no longer applicable in @ % of the cases in the ABC group , in @ % of the @S group , and in @ % of the controls .


Telemonitoring of physical activity and nutrition markedly improves weight loss and markers of metabolic syndrome .


Little is known about the transfer of essential fatty acids ( FAs ) across the human blood-brain barrier ( BBB ) in adulthood .


In this study , we investigated whether oral supplementation with omega-@ ( n-@ ) FAs would change the FA profile of the cerebrospinal fluid ( CSF ) .


A total of @ patients ( @ receiving the n-@ FA supplement and @ receiving placebo ) were included in the study .


These patients were participants in the double-blind , placebo-controlled randomized OmegAD study in which @ patients with mild Alzheimer 's disease ( AD ) received @ g n-@ FA -LSB- high in docosahexaenoic acid ( DHA ) -RSB- or placebo daily for @ months .


CSF FA levels were related to changes in plasma FA and to CSF biomarkers of AD and inflammation .


At @ months , the n-@ FA supplement group displayed significant increases in CSF ( and plasma ) eicosapentaenoic acid ( EPA ) , DHA and total n-@ FA levels ( P < @ ) , whereas no changes were observed in the placebo group .


Changes in CSF and plasma levels of EPA and n-@ docosapentaenoic acid were strongly correlated , in contrast to those of DHA .


Changes in DHA levels in CSF were inversely correlated with CSF levels of total and phosphorylated tau , and directly correlated with soluble interleukin-@ receptor type II .


Thus , the more DHA increased in CSF , the greater the change in CSF AD/inflammatory biomarkers .


Oral supplementation with n-@ FAs conferred changes in the n-@ FA profile in CSF , suggesting transfer of these FAs across the BBB in adults .


Patients with advanced squamous-cell non-small-cell lung cancer ( NSCLC ) who have disease progression during or after first-line chemotherapy have limited treatment options .


This randomized , open-label , international , phase @ study evaluated the efficacy and safety of nivolumab , a fully human IgG@ programmed death @ ( PD-@ ) immune-checkpoint-inhibitor antibody , as compared with docetaxel in this patient population .


We randomly assigned @ patients to receive nivolumab , at a dose of @ mg per kilogram of body weight every @ weeks , or docetaxel , at a dose of @ mg per square meter of body-surface area every @ weeks .


The primary end point was overall survival .


The median overall survival was @ months ( @ % confidence interval -LSB- CI -RSB- , @ to @ ) with nivolumab versus @ months ( @ % CI , @ to @ ) with docetaxel .


The risk of death was @ % lower with nivolumab than with docetaxel ( hazard ratio , @ ; @ % CI , @ to @ ; P < @ ) .


At @ year , the overall survival rate was @ % ( @ % CI , @ to @ ) with nivolumab versus @ % ( @ % CI , @ to @ ) with docetaxel .


The response rate was @ % with nivolumab versus @ % with docetaxel ( P = @ ) .


The median progression-free survival was @ months with nivolumab versus @ months with docetaxel ( hazard ratio for death or disease progression , @ ; @ % CI , @ to @ ; P < @ ) .


The expression of the PD-@ ligand ( PD-L@ ) was neither prognostic nor predictive of benefit .


Treatment-related adverse events of grade @ or @ were reported in @ % of the patients in the nivolumab group as compared with @ % of those in the docetaxel group .


Among patients with advanced , previously treated squamous-cell NSCLC , overall survival , response rate , and progression-free survival were significantly better with nivolumab than with docetaxel , regardless of PD-L@ expression level .


( Funded by Bristol-Myers Squibb ; CheckMate @ ClinicalTrials.gov number , NCT@ . )


To assess same-day and delayed reports of pain intensity during and after second-trimester medical termination of pregnancy ( MTOP ) .


A prospective randomized trial ( @ women ) comparing @ - and @-day mifepristone-misoprostol intervals .


Women reported intense pain -LSB- median visual analogue scale ( interquartile range ) -RSB- related to expulsion of the fetus -LSB- @ ( @-@ ) -RSB- .


Delayed reports of maximal pain described the pain as more intense than same-day reports -LSB- @ ( @-@ ) vs. @ ( @-@ ) , p < @ -RSB- .


Most women reported and readily remembered intense pain associated with fetal expulsion during second-trimester MTOP .


Adequate , properly timed pain management during second-trimester MTOP is crucial .


To determine the effect of reduced @-kV tube voltage with increased @-mAs tube current on radiation dose , image quality and estimated myocardial blood flow ( MBF ) of dynamic CT stress myocardial perfusion imaging ( CTP ) in patients with a normal body mass index ( BMI ) compared with a @-kV and @-mAs protocol .


Thirty patients with a normal BMI ( < @ kg/m ( @ ) ) with known or suspected coronary artery disease underwent adenosine-stress dual-source dynamic CTP .


Patients were randomised to @-kV/@-mAs ( n = @ ) or @-kV/@-mAs ( n = @ ) imaging .


Maximal enhancement and noise of the left ventricular ( LV ) cavity , contrast-to-noise ratio ( CNR ) and MBF of the two groups were compared .


Imaging with @-kV/@-mAs instead of @-kV/@-mAs was associated with @ % lower radiation dose ( mean dose-length product , @ vs @ mGy -LSB- Symbol : see text -RSB- cm ; P < @ ) with no significant difference in CNR ( @ vs @ ; P = @ ) or MBF in non-ischaemic myocardium ( @ vs @ ml/min/g ; P = @ ) .


Studies obtained using @-kV/@-mAs were associated with @ % higher maximal enhancement ( @ vs @ HU ; P < @ ) , and @ % greater noise ( @ vs @ ; P < @ ) .


Dynamic CTP using @-kV/@-mA instead of @-kV/@-mAs allowed @ % dose reduction without compromising image quality or MBF .


Tube voltage of @-kV should be considered for individuals with a normal BMI .


CT stress perfusion imaging ( CTP ) is increasingly used to assess myocardial function .


Dynamic CTP is feasible at @-kV in patients with normal BMI .


An @-kV/@-mAs protocol allows @ % dose reduction compared with @-kV/@-mAs .


Contrast-to-noise ratio and myocardial blood flow of the two protocols were comparable .


Cow 's milk protein allergy ( CMPA ) is treated using an elimination diet with an extensive protein hydrolysate .


We explored whether a thickened or nonthickened version was best for infants with suspected CMPA , which commonly causes regurgitation/vomiting .


Diagnosis of CMPA was based on a positive challenge test .


We compared the efficacy of two casein extensive hydrolysates ( eCH ) , a nonthickened version ( NT-eCH ) and a thickened version ( T-eCH ) , using a symptom-based score covering regurgitation , crying , stool consistency , eczema , urticarial and respiratory symptoms .


A challenge was performed in @/@ infants with suspected CMPA and was positive in @ % .


All confirmed CMPA cases tolerated eCH .


The symptom-based score decreased significantly in all infants within a month , and the highest reduction was in those with confirmed CMPA .


Regurgitation was reduced in all infants ( @-@ @ , p < @ ) , but fell more with the T-eCH ( -@ regurgitations/day vs. -@ , ns ) , especially in infants with a negative challenge ( -@ vs. -@ , ns ) .


eCH fulfilled the criteria for a hypoallergenic formula , and the NT-eCH and T-eCH formulas both reduced CMPA symptoms .


The symptom-based score is useful for evaluating how effective dietary treatments are for CMPA .


The treatment of gingival inflammation is associated with improved glycaemic control in diabetic patients .


The goal of this parallel-randomised controlled trial ( RCT ) was to test the shortterm effects of professional oral hygiene procedures on plasma glucose levels in systemically healthy individuals .


Systemically healthy individuals with gingivitis and no sign of periodontitis were enrolled at a private practice in Italy .


Patients were randomised to either a @ hour ( h ) session of professional oral hygiene procedures or to @ h in the waiting room .


Not fasting blood glucose levels were assessed by a blind examiner at baseline ( T@ ) , @ h ( T@ ) and @ h ( T@ ) after procedures and finally @ week after ( T@ ) .


Oral hygiene procedures were then performed also in the control group .


Twenty patients were randomly allocated to each group .


There were no drop-outs .


Blood glucose levels at T@ ( P = @ ) and time of measurement ( P = @ ) were statistically significant , while oral hygiene procedures were not ( mean difference between groups @ mg/dl , @ % CI -@ mg/dl ; @ mg/dl , P = @ ) .


Mean blood glucose levels decreased between T@ and T@ , were stable between T@ and T@ and showed similar levels to baseline after @ week ( T@ ) for both groups .


This short-term RCT showed that professional oral hygiene procedures were not able to influence plasma glucose levels in individuals with gingivitis , but otherwise systemically healthy .


The aim of the study was to extend research on the potential benefits of adding ongoing feedback , coaching , and consultation to initial therapist training workshops to ensure fidelity of delivery of evidence-based practices , specifically for the Incredible Years parenting program .


A randomized controlled trial compared two models for training therapists to deliver the parenting program for children at high risk of developing conduct problems .


Therapists ( N = @ ) from ten community-based mental health service organizations in California were trained in either a three-day workshop model ( N = @ ) , based on active , experiential , self-reflective , principle-based learning , video modeling , and manuals , or an enhanced training model ( N = @ ) that included all elements of the workshop model plus ongoing expert coaching , video review of and feedback on group sessions , and consultation for therapists and agency supervisors .


Overall fidelity across both conditions was rated > @ on a @-point scale in seven of eight domains measured .


Therapists in the condition that received ongoing coaching and consultation were significantly stronger in four of the domains : practical support , collaboration , knowledge , and skill at mediating vignettes .


Consultation and expert coaching for training therapists beyond the standard three-day training enhanced skills and therapists ' adherence to the model .


It is unclear if a modest reduction in dietary salt intake has beneficial effects on vascular function .


The aim was to compare the effects of @ g salt/day with @ g salt/day intake on measures of vascular function and explore mechanisms of effect in overweight and obese adults .


Twenty-five overweight/obese subjects ( BMI @-@ kg/m ( @ ) ) completed a randomised cross-over study of @ weeks each on a reduced salt ( RS ) ( @ g/day ) and usual salt diet ( US ) ( @ g/day ) .


Flow-mediated-dilatation ( FMD ) , @ h blood pressure ( BP ) , augmentation index ( AIx ) , pulse wave velocity ( PWV ) , plasma and urinary nitrate/nitrite , asymmetric dimethylarginine ( ADMA ) , renin , aldosterone and endothelin-@ and vascular adhesion molecules were measured after @ days and @ weeks .


Adherence to the diets was determined from two @ h urine collections .


Urinary sodium excretion was @ @ mmol/@ h US vs @ @ mmol/@ h RS ( p = @ ) .


Following the RS diet there was a significant improvement in FMD from @ @ % to @ @ % ( P < @ ) and decrease in serum endothelin-@ from @ @ pg/ml to @ @ pg/ml ( P < @ ) .


Endothelium-independent vasodilatation was also significantly different between treatments ( P < @ ) .


AIx , PWV , serum ADMA and plasma and urinary nitrate/nitrite concentrations were not different between treatments .


Change in FMD was related to the urinary sodium : creatinine ratio ( r = -@ , P < @ ) and was independent of blood pressure .


Aldosterone and renin were unchanged .


A small reduction in dietary salt intake of @ g/day improves endothelial function in normotensive overweight and obese subjects .


This response may be mediated by serum endothelin-@ .


This small reduction in salt had no effect on aldosterone and renin concentrations .


This trial was registered with the Australian and New Zealand Clinical Trials Registry Unique Identifier : ACTRN@ http://www.anzctr.org.au/ACTRN@.aspx .


To evaluate the potential of antimicrobial photodynamic therapy ( aPDT ) as an adjunct to scaling and root planing ( SRP ) in the treatment of chronic periodontitis .


In a single-centred randomized and controlled clinical trial , @ patients ( @ females and @ males ) with untreated chronic periodontitis were randomly assigned to receive SRP with aPDT ( test group ) or SRP alone ( control group ) .


Clinical parameters and halitosis were recorded for @months after treatment by a periodontist who was blinded to the procedure .


Inter-group and intra-group statistical analyses were performed .


Significant difference between the two groups with respect to each variable was assessed using non-parametric Rank Order ancova .


Probing pocket depth and clinical attachment levels showed statistically significant reduction in the test group on evaluation at @months and @months as compared to the control group ( p < @ ) .


A statistically significant improvement in gingival index and gingival bleeding index was seen for the test group after @weeks and @month of aPDT ( p < @ ) , whereas the improvement in gingival index and gingival bleeding index at @months and in plaque index at @weeks after aPDT was less ( p < @ ) .


Also , a significant difference was detected for the test group at @month in terms of halitosis ( p < @ ) , which did not persist for long .


Antimicrobial photodynamic therapy acts as a beneficial adjunct to SRP in non-surgical treatment and management of chronic periodontitis in short-term .


Further studies are required to assess the long-term effectiveness of aPDT .


To evaluate weight retention @ months postpartum and factors associated among women who had received prenatal care at Health Care Centers in Porto Alegre , southern Brazil .


Pregnant women in the last trimester were identified at @ Health Care Centers .


Socioeconomic , demographic and anthropometrics data were obtained .


Six and @ months after delivery , the women received home visits for anthropometric measures .


The gestational weight gain was defined by pre-pregnancy Body Mass Index ( BMI ) .


Weight retention was defined as the difference between pre-gestational weight and weight at postpartum .


Data were analyzed using McNemar 's Test , ANOVA with Bonferroni correction and multiple linear regression .


Of the @ pregnant women recruited , @ were assessed @ months after delivery .


Women were more likely to be overweight @ months postpartum compared to the pre-pregnancy period ( @ versus @ % ) and weight retention during the @ months postpartum was more than @ kg in @ % of the women .


Weight retention in the postpartum period was higher among women who were overweight ( @ @ kg ) compared to those who were of normal weight during the pre-pregnancy period ( @ @ kg ) .


Pre-pregnancy BMI , gestational weight gain , and maternal age were associated with gestational weight retention @ months postpartum ( p < @ ) .


Adequate prenatal care is necessary to minimize the adverse effects of excessive weight gain during pregnancy on women 's health .


Few anaphylaxis education materials have been prospectively evaluated in randomized controlled trials .


Our objective was to evaluate the American Academy of Allergy , Asthma & Immunology Anaphylaxis Wallet Card ( AAAAI-AWC ) as an anaphylaxis education mini-handout for health care professionals .


We performed a randomized controlled study of the AAAAI-AWC with residents in general pediatrics at Miami Children 's Hospital .


Participants in the intervention group completed a pretest about anaphylaxis , heard a @-minute PowerPoint presentation based on the AAAAI-AWC , reviewed the AAAAI-AWC , and discussed it with the presenter .


After this , participants took a post-test immediately and a follow-up test @ weeks later .


Participants in the control group took the pretest , were handed an AAAAI-AWC , studied it briefly , then took the post-test immediately and the follow-up test @ weeks later .


Fifty-five residents participated .


Regardless of the amount of time spent studying the AAAAI-AWC , when the pretests were compared with the post-tests and follow-up tests , residents in both the intervention and control groups were more likely to recognize anaphylaxis symptoms ( P < @ ) , name asthma as the most common comorbid disease in children with fatal or near-fatal anaphylaxis ( P < @ ) , and recall the names of epinephrine auto injectors ( P < @ ) and the epinephrine doses available in these auto injectors ( P < @ ) .


When the pretests were compared with the post-tests and the follow-up tests , residents in the intervention group were more likely than controls to identify the body organ systems involved in severe or fatal anaphylaxis correctly ( P < @ ) .


The AAAAI-AWC is a practical , concise anaphylaxis education mini-handout for pediatric residents , a time-challenged group of health care professionals .


To investigate whether functionally based resistance exercise could improve strength , physical function , and disability among prostate cancer survivors ( PCS ) on androgen deprivation therapy ( ADT ) ; and to explore potential mediators of changes in outcomes from exercise .


Randomized controlled trial .


Academic medical center .


PCS ( N = @ ; mean age , @ y ) on ADT .


PCS were randomized to moderate to vigorous intensity resistance training or stretching ( placebo control ) for @ year .


Maximal leg press and bench press strength , objective and self-reported physical function , and self-reported disability .


Hierarchical linear modeling was used to test for significant group time differences adjusting for covariates .


Retention in the study was @ % , and median attendance to supervised classes was @ % in the resistance group .


No study-related injuries occurred .


Maximal leg strength ( P = @ ) and bench press strength ( P = @ ) were improved after @ year of resistance training , whereas little change occurred from stretching .


Self-reported physical function improved with resistance training , whereas decreases occurred from stretching ( P = @ ) .


Disability lessened more with resistance training than stretching ( P = @ ) .


One-year change in leg press strength mediated the relation between groups ( resistance or stretching ) and @-year change in self-reported disability ( P < @ ) .


One year of resistance training improved muscle strength in androgen-deprived PCS .


Strengthening muscles using functional movement patterns may be an important feature of exercise programs designed to improve perceptions of physical function and disability .


Findings from this study contribute to the mounting evidence that exercise should become a routine part of clinical care in older men with advanced prostate cancer .


Few studies have assessed associations between craving and subsequent opioid use .


We prospectively evaluated the relative utility of two craving questionnaires to predict opioid use among opioid-dependent patients in outpatient treatment .


Opioid-dependent patients ( n = @ ) initiating buprenorphine treatment were assessed every two weeks for @ months .


Craving was measured using the : ( @ ) Desires for Drug Questionnaire ( DDQ ) and ( @ ) Penn Alcohol-Craving Scale adapted for opioid craving ( PCS ) .


Multi-level logistic regression models estimated the effects of craving on the likelihood of opioid use .


Craving assessed at time t was entered as a time-varying predictor of opioid use at time t +@ .


Craving scores plateaued at approximately @ weeks after initiation of buprenorphine .


In adjusted regression models , a @-point increase in PCS scores ( on a @-point scale ) was associated with a significant increase in the odds of opioid use at the subsequent assessment ( OR = @ , @ % CI @ ; @ , p < @ ) .


The odds of opioid use at the subsequent follow-up assessment increased significantly as DDQ desire and intention scores increased ( OR = @ , @ % CI @ ; @ , p < @ ) , but was not significantly associated with DDQ negative reinforcement ( OR = @ , @ % CI @ ; @ , p > @ ) or DDQ control ( OR = @ , @ % CI @ ; @ , p > @ ) scores .


Self-reported craving for opioids was modestly associated with subsequent relapse to opioid use among a cohort of patients treated with buprenorphine .


Assessment of craving may provide clinical utility in predicting relapse among treated opioid-dependent patients .


Neurotoxic metabolites and oxidative and nitrosative stress reactions play a crucial role in the pathways leading to neuronal cell death and neurodegeneration .


The bioavailability of the many antioxidant ingredients a vitamin and trace element composition was investigated , to reveal the neuroprotective ( preventive ) potential of the composition .


We recruited @ healthy volunteers , assigned them randomly and double blind to a placebo and verum group .


Physicians excluded volunteers with severe chronic diseases or interfeering medications .


@ participants finished the six month trial .


Laboratory parameters were determined @ ) before participation , and @ ) after three and @ ) six months .


We confirmed the bioavailability of ingredients , and determined metabolic parameters associated with the integrity of the blood brain barrier , mitochondrial deficiency ( Q @ ) , neurodegeneration ( homocystein ) , and antioxidative capacity ( e.g. lipidperoxidation ) , and superoxiddismutase activity .


Starting from baseleine , after three months neuroprotective ingredients increased within their physiological borders , folic acid ( p < @ ) , pyridoxin ( p < @ ) , cobalamin ( p = @ ) , and the fat soluble vitamin tocopherol ( p < @ ) .


In parallel , homocytein decreased after @ and @ months ( p < @ , and p < @ , respectively ) .


Other paramters like zinc reacted slower , significant changes were observed only after @ months .


The observed metabolic changes and alteration of the oxidative status after @ and six month of regular intake underlines the compositions ' potential to ameliorate neurodegenerative processes .


We conclude that the subsitution of vitamins and trace-elements with natural source in a proper manner may be effective for neuroprotection in healthy population .


Weakness in knee flexion following anterior cruciate ligament ( ACL ) reconstruction is one of the key issues in the treatment of an ACL tear .


The purpose of this study was to examine and compare clinical outcome measures of ACL reconstruction using semitendinosus autograft ( ST ) versus semitendinosus + gracilis ( ST/G ) reconstructive techniques .


In a double-blind randomized clinical study , @ patients with an ACL tear underwent either ST ( @ ) or ST/G ( @ ) and observed for @year .


Both patients and the final examiner were unaware as to the type of graft received .


Patients were evaluated according to subjective criteria , functional assessment tests , knee isometric torques , knee laxity using KT-@ and knee range of motion .


The study included @ ( @ % ) female and @ ( @ % ) male patients with a mean age of @ in the ST group and @ in the ST/G group .


There were no significant differences found in surgical complications ; IKD ; Knee injury and Osteoarthritis Outcome Score ; Lysholm ; strength of the knee isometric flexors ; and flexion and extension loss between the two groups .


At the final visit , @ % of ST group and @ % of ST/G group had side-to-side difference of laxity < @mm ( n.s. ) .


Since anterior cruciate ligament reconstruction using quadrupled ST is more technically demanding than doubled STG and with there being no difference in outcomes and complications , no compulsory advice should be made on the former technique .


However , gracilis harvesting may not be necessary based on the function and strength of the knee .


Randomized controlled trial , Level I.


To evaluate whether wearing a wool cap , a routine practice used to prevent heat loss in premature infants , affects interpretation of electroencephalogram spectral analysis .


Eighteen premature infants ( median gestational age @ weeks , range @-@ ) without neurological complications were randomized to two channel ( C@ , C@ referred to Cz ) digital electroencephalogram recordings with ( @ min ) and without ( @ min ) wearing wool cap , at @ days of life .


Electroencephalogram was analyzed automatically by measurement of burst suppression ratio and asymmetry index and by Fast Fourier Transform to calculate total absolute spectral power ; relative spectral power in the ( @-@ @ Hz ) , ( @-@ @ Hz ) , ( @-@ @ Hz ) , and ( @-@ Hz ) frequency bands ; spectral edge frequency ; and mean dominant frequency .


The use of wool cap had no effect on all electroencephalogram parameters considered .


Gestational age showed an effect on relative spectral power of all considered bands , spectral edge frequency and mean dominant frequency , while no effect was seen on burst suppression ratio and asymmetry index .


Neonates born at gestational weeks lower than @ had significantly higher relative power in the band and lower relative power in the and bands .


Heat loss prevention using wool cap does not affect interpretation of spectral electroencephalogram .


Spectral values in our group of very premature infants without neurological complications correspond to normal data reported in the literature .


Maturation changes consist of reduction of relative power of the band , spectral edge frequency and mean dominant frequency .


There is a high prevalence of smoking and high burden of tobacco-related diseases among low-income populations .


Effective , evidenced-based smoking cessation treatments are available , but low-income smokers are less likely than higher-income smokers to use these treatments , especially the most comprehensive forms that include a combination of pharmacotherapy and intensive behavioral counseling .


The primary objectives of this randomized controlled trial are to compare the effects of a proactive tobacco treatment intervention compared to usual care on population-level smoking abstinence rates and tobacco treatment utilization rates among a diverse population of low-income smokers , and to determine the cost-effectiveness of proactive tobacco treatment intervention .


The proactive care intervention systematically offers low-income smokers free and easy access to evidence-based treatments and has two primary components : ( @ ) proactive outreach to current smokers in the form of mailed invitation materials and telephone calls containing targeted health messages , and ( @ ) facilitated access to free , comprehensive , evidence-based tobacco cessation treatments in the form of NRT and intensive , telephone-based behavioral counseling .


The study aims to include a population-based sample ( N = @ ) of adult smokers enrolled in the Minnesota Health Care Programs ( MHCP ) , a state-funded health insurance plan for low-income persons .


Baseline data is obtained from MHCP administrative databases and a participant survey that is conducted prior to randomization .


Outcome data is collected from a follow-up survey conducted @months after randomization and MHCP administrative data .


The primary outcome is six-month prolonged smoking abstinence at one year and is assessed at the population level .


All randomized individuals are asked to complete the follow-up survey , regardless of whether they participated in tobacco treatment .


Data analysis of the primary aims will follow intent-to-treat methodology .


There is a critical need to increase access to effective tobacco dependence treatments .


This randomized trial evaluates the effects of proactive outreach coupled with free NRT and telephone counseling on the population impact of tobacco dependence treatment .


If proven to be effective and cost-effective , national dissemination of proactive treatment approaches would reduce tobacco-related morbidity , mortality , and health care costs for low income Americans .


Angina affects more than @ million people worldwide .


Secondary prevention interventions such as cardiac rehabilitation are not widely available for this population .


An Internet-based version could offer a feasible alternative .


Our aim was to examine the effectiveness of a Web-based cardiac rehabilitation program for those with angina .


We conducted a randomized controlled trial , recruiting those diagnosed with angina from general practitioners ( GPs ) in primary care to an intervention or control group .


Intervention group participants were offered a @-week Web-based rehabilitation program ( `` ActivateYourHeart '' ) .


The program was introduced during a face-to-face appointment and then delivered via the Internet ( no further face-to-face contact ) .


The program contained information about the secondary prevention of coronary heart disease ( CHD ) and set each user goals around physical activity , diet , managing emotions , and smoking .


Performance against goals was reviewed throughout the program and goals were then reset/modified .


Participants completed an online exercise diary and communicated with rehabilitation specialists through an email link/synchronized chat room .


Participants in the control group continued with GP treatment as usual , which consisted of being placed on a CHD register and attending an annual review .


Outcomes were measured at @-week and @-month follow-ups during face-to-face assessments .


The primary outcome measure was change in daily steps at @ weeks , measured using an accelerometer .


Secondary outcome measures were energy expenditure ( EE ) , duration of sedentary activity ( DSA ) , duration of moderate activity ( DMA ) , weight , diastolic/systolic blood pressure , and body fat percentage .


Self-assessed questionnaire outcomes included fat/fiber intake , anxiety/depression , self-efficacy , and quality of life ( QOL ) .


A total of @ participants were recruited and randomized to the intervention ( n = @ ) or the usual care ( n = @ ) group ; @ and @ participants completed the @-week and @-month follow-ups , respectively .


The mean number of log-ins to the program was @ ( SD @ , range @-@ ) , an average of @ log-ins per week per participant .


Change in daily steps walked at the @-week follow-up was +@ ( SD @ ) in the intervention group and -@ ( SD @ ) in the control group ( @ % CI @-@ , P = @ ) .


Significant intervention effects were observed at the @-week follow-up in EE ( +@ kcal , @ % CI @-@ @ , P = @ ) , DSA ( -@ minutes , @ % CI -@ to -@ , P = @ ) , DMA ( +@ minutes , @ % CI @-@ @ , P = @ ) , weight ( -@ kg , @ % CI -@ to -@ , P = @ ) , self-efficacy ( @ % CI @-@ @ , P = @ ) , emotional QOL score ( @ % CI @-@ @ , P = @ ) , and angina frequency ( @ % CI @-@ @ , P = @ ) .


Significant benefits in angina frequency ( @ % CI @-@ @ , P = @ ) and social QOL score ( @ % CI @-@ @ , P = @ ) were also observed at the @-month follow-up .


An Internet-based secondary prevention intervention could be offered to those with angina .


A larger pragmatic trial is required to provide definitive evidence of effectiveness and cost-effectiveness .


To compare the clinical efficacy of olive oil and the Saj ( ) cream on the occurrence and severity of striae gravidarum .


Parallel randomized controlled clinical trial .


West Health Centre , Lolagar and Akbarabadi Hospitals , Tehran , Iran .


@ Nulliparous women at their second trimester of pregnancy randomly ( simple randomization ) allocated into three groups of olive oil , the Saj ( ) cream , and control that finally @ of them ( @ subjects in each group ) completed the study .


Control group did not receive any medication/intervention .


At gestational age of @-@ weeks the participants were evaluated regarding the occurrence of striae on abdominal skin and its severity that were primary outcome of the study .


In the olive oil group , striae occurred in @ % of the participants , which were mild , moderate , and severe in @ % , @ % , and @ % of the cases , respectively .


In those who received Saj ( ) cream , striae occurred in @ % of the cases , which were mild , moderate and severe in @ % , @ % , and @ % of the cases , respectively .


With regard to the control group , striae occurred in @ % of the participants , among which striae were mild , moderate , and severe in @ % , @ % , and @ % of the cases , respectively .


There were no statistically significant differences among the three studied groups regarding the incidence or severity of striae .


Neither olive oil nor the Saj ( ) cream were effective in preventing the occurrence of striae gravidarum or affecting its severity .


Further studies to examine the effect of other herbal/chemical preparations on occurrence of striae gravidarum are recommended .


Elevated soluble CD@ ligand ( sCD@L ) was shown to be related to cardiovascular events , but the role of sCD@L in predicting recurrent stroke remains unclear .


Baseline sCD@L levels were measured in @ consecutive patients with acute minor stroke and transient ischemic attack , who had previously been enrolled in the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events ( CHANCE ) trial .


Cox proportional-hazards model was used to assess the association of sCD@L with recurrent stroke .


Patients in the top tertile of sCD@L levels had increased risk of recurrent stroke comparing with those in the bottom tertile , after adjusted for conventional confounding factors ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


The patients with elevated levels of both sCD@L and high-sensitive C-reactive protein also had increased risk of recurrent stroke ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


Elevated sCD@L levels independently predict recurrent stroke in patients with minor stroke and transient ischemic attack .


Microglia have been associated with inflammatory changes underlying diabetic retinopathy .


To investigate whether low-dose oral doxycycline monohydrate , a drug capable of inhibiting microglial activation , can improve or slow the deterioration of retinal function and whether it can induce regression or slow progression of diabetic retinopathy in patients with mild to moderate nonproliferative diabetic retinopathy ( NPDR ) .


Randomized , double-masked , @-month proof-of-concept clinical trial .


We randomized @ patients ( from the Penn State Hershey Eye Center ) with at least @ eye with mild to moderate NPDR ( Early Treatment Diabetic Retinopathy Study level @-@ ) to doxycycline monohydrate , @ mg/d , or daily placebo for @ months .


Mean change at @ months compared with baseline in the foveal sensitivity of matrix frequency-doubling perimetry in each treatment group .


We also compared the @ groups with respect to change from baseline to @ months in functional variables ( Humphrey photopic visual field testing using the Swedish interactive thresholding algorithm @-@ strategy , contrast sensitivity , dark adaptation , visual acuity , and quality of life ) and anatomical variables ( diabetic retinopathy severity level , area of retinal thickening , central subfield thickness on optical coherence tomography , and macular volume on optical coherence tomography ) .


From baseline to month @ , no significant difference was detected between groups with respect to all visual function and anatomical outcomes assessed .


Although a link between low-dose oral anti-inflammatory agents and subclinical improvement in inner retinal function has been suggested in patients with severe NPDR or non-high-risk proliferative diabetic retinopathy , the same association was not found in the present study of patients with mild to moderate NPDR .


The different findings in the @ patient populations may relate to a differential effect of doxycycline on different stages of diabetic retinal dysfunction , or the sample size of the present study may be too small to detect a treatment effect of doxycycline in patients with mild to moderate NPDR .


To investigate the acute residual hormonal and neuromuscular responses exhibited following a single session of mechanical vibration applied to the upper extremities among different acceleration loads .


Thirty male students were randomly assigned to a high vibration group ( HVG ) , a low vibration group ( LVG ) , or a control group ( CG ) .


A randomized double-blind , controlled-parallel study design was employed .


The measurements and interventions were performed at the Laboratory of Biomechanics of the University of L'Aquila .


The HVG and LVG participants were exposed to a series of @ trials @ s of synchronous whole-body vibration ( WBV ) with a @-s pause between each trial and a @-min pause after the first @ trials .


The CG participants assumed an isometric push-up position without WBV .


The outcome measures were growth hormone ( GH ) , testosterone , maximal voluntary isometric contraction during bench-press , maximal voluntary isometric contraction during handgrip , and electromyography root-mean-square ( EMGrms ) muscle activity ( pectoralis major -LSB- PM -RSB- , triceps brachii -LSB- TB -RSB- , anterior deltoid -LSB- DE -RSB- , and flexor carpi radialis -LSB- FCR -RSB- ) .


The GH increased significantly over time only in the HVG ( P = @ ) .


Additionally , the testosterone levels changed significantly over time in the LVG ( P = @ ) and the HVG ( P = @ ) .


MVC during bench press decreased significantly in the LVG ( P = @ ) and the HVG ( P = @ ) .


In the HVG , the EMGrms decreased significantly in the TB ( P = @ ) muscle .


In the LVG , the EMGrms decreased significantly in the DE ( P = @ ) and FCR ( P = @ ) muscles .


Synchronous WBV acutely increased GH and testosterone serum concentrations and decreased the MVC and their respective maximal EMGrms activities , which indicated a possible central fatigue effect .


Interestingly , only the GH response was dependent on the acceleration with respect to the subjects ' responsiveness .


The purpose of this study was to assess long-term safety and tolerability of desvenlafaxine ( administered as desvenlafaxine succinate ) in children and adolescents with major depressive disorder ( MDD ) .


An @ week , multicenter , open-label , fixed-dose study of children ( ages @-@ years ) and adolescents ( ages @-@ years ) with MDD was followed by a @ month , flexible-dose extension study .


Patients were administered desvenlafaxine @-@mg / day ( children ) or @-@mg / day ( adolescents ) for a total of @ months .


Treatment-emergent adverse events ( AEs ) , withdrawals because of AEs , laboratory tests , vital signs , and the Columbia Suicide-Severity Rating Scale ( C-SSRS ) were collected .


Eight month safety results from the lead-in plus extension studies are reported for extension study participants , using lead-in study day -@ as baseline .


Forty patients were enrolled in both studies ( @ children ; @ adolescents ) .


Of those , four children and three adolescents withdrew because of AEs .


Treatment-emergent AEs reported by three or more patients were upper abdominal pain ( @ % ) and headache ( @ % ) in children , and somnolence ( @ % ) , nausea ( @ % ) , upper abdominal pain ( @ % ) , and headache ( @ % ) in adolescents .


Negativism ( oppositional behavior ) in a child was the single serious AE reported .


No deaths occurred during the lead-in or extension studies .


Mean pulse rates demonstrated statistically significant increases from lead-in study baseline to final evaluation ( children , +@ bpm ; adolescents , +@ bpm ; p@ @ ) .


No statistically significant change in blood pressure was observed at final evaluation .


Two adolescents ( @ children ) reported suicidal ideation on the C-SSRS at screening assessment and during the lead-in and/or extension trials ; one adolescent reported suicidal ideation after screening only .


Long-term ( @ month ) treatment with desvenlafaxine was generally safe and well tolerated in depressed children and adolescents .


To evaluate the effect of a programme of active self-correction and task-oriented exercises on spinal deformities and health-related quality of life ( HRQL ) in patients with mild adolescent idiopathic scoliosis ( AIS ) ( Cobb angle < @ ) .


This was a parallel-group , randomised , superiority-controlled study in which @ patients were randomly assigned to a rehabilitation programme consisting of active self-correction , task-oriented spinal exercises and education ( experimental group , @ subjects ) or traditional spinal exercises ( control group , @ subjects ) .


Before treatment , at the end of treatment ( analysis at skeletal maturity ) , and @ months later ( follow-up ) , all of the patients underwent radiological deformity ( Cobb angle ) , surface deformity ( angle of trunk rotation ) and HRQL evaluations ( SRS-@ questionnaire ) .


A linear mixed model for repeated measures was used for each outcome measure .


There were main effects of time ( p < @ ) , group ( p < @ ) and time by group interaction ( p < @ ) on radiological deformity : training in the experimental group led to a significant improvement ( decrease in Cobb angle of > @ ) , whereas the control group remained stable .


Analysis of all of the secondary outcome measures revealed significant effects of time , group and time by group interaction in favour of the experimental group .


The programme of active self-correction and task-oriented exercises was superior to traditional exercises in reducing spinal deformities and enhancing the HRQL in patients with mild AIS .


The effects lasted for at least @ year after the intervention ended .


To evaluate the effect of intraoperative acupuncture on posttonsillectomy pain in the pediatric population .


Prospective , double-blind , randomized , placebo-controlled trial .


Patients aged @ to @ years undergoing tonsillectomy were recruited at a tertiary children 's hospital between February @ and May @ .


Participants were block-randomized to receive acupuncture or sham acupuncture during anesthesia for tonsillectomy .


Surgeons , staff , and parents were blinded from treatment .


Tonsillectomy was performed by one of two surgeons using a standard technique ( monopolar cautery ) , and a single anesthetic protocol was followed .


Study endpoints included time spent in the postanesthesia care unit , the amount of opioids administered in the perioperative period , and pain measures and presence of nausea/vomiting from postoperative home surveys .


Fifty-nine children aged @ to @ years were randomized to receive acupuncture ( n = @ ) or sham acupuncture ( n = @ ) .


No significant demographic differences were noted between the two cohorts .


Perioperative data were recorded for all patients ; @ % of patients later returned home surveys .


There were no significant differences in the amount of opioid medications administered or total postanesthesia care unit time between the two cohorts .


Home surveys of patients but not of parents revealed significant improvements in pain control in the acupuncture treatment-group postoperatively ( P = @ and @ , respectively ) , and oral intake improved significantly earlier in the acupuncture treatment group ( P = @ ) .


No adverse effects of acupuncture were reported .


This study demonstrates that intraoperative acupuncture is feasible , well tolerated , and results in improved pain and earlier return of diet postoperatively .


Results supporting the use and the effectiveness of positive expiratory , pressure devices in chronic obstructive pulmonary disease ( COPD ) patients are still controversial , We have tested the hypothesis that adding TPEP or IPPB to standard pharmacological therapy may provide additional clinical benefit over , pharmacological therapy only in patients with severe COPD .


Fourty-five patients were randomized in three groups : a group was treated ; with IPPB , a group was treated with TPEP and a group with pharmacological ; therapy alone ( control group ) .


Primary outcome measures included the measurement of scale or , questionnaire concerning dyspnea ( MRC scale ) , dyspnea , cough , and , sputum ( BCSS ) and quality of life ( COPD assessment test ) ( CAT ) .


Secondary , outcome measures were respiratory function testing , arterial blood gas , analysis , and hematological examinations .


Both patients in the IPPB group and in the TPEP group showed a significant , improvement in two of three tests ( MRC , CAT ) compared to the control , group.However , in the group comparison analysis for , the same variables between IPPB group and TPEP group we observed a , significant improvement in the IPPB group ( P. @ for MRC and P. @ for , CAT ) .


The difference of action of the two techniques are evident in the results of , pulmonary function testing : IPPB increases FVC , FEV@ , and MIP ; this reflects , its capacity to increase lung volume .


Also TPEP increases FVC and FEV@ ( less , than IPPB ) , but increases MEP , while decreasing total lung capacity and , residual volume .


The two techniques ( IPPB and TPEP ) improves significantly dyspnea ; quality of ; life tools and lung function in patients with severe COPD .


IPPB demonstrated a greater effectiveness to improve dyspnea and quality of life tools ( MRC , CAT ) than TPEP .


Data from randomized trials are lacking on the benefits and risks of initiating antiretroviral therapy in patients with asymptomatic human immunodeficiency virus ( HIV ) infection who have a CD@ + count of more than @ cells per cubic millimeter .


We randomly assigned HIV-positive adults who had a CD@ + count of more than @ cells per cubic millimeter to start antiretroviral therapy immediately ( immediate-initiation group ) or to defer it until the CD@ + count decreased to @ cells per cubic millimeter or until the development of the acquired immunodeficiency syndrome ( AIDS ) or another condition that dictated the use of antiretroviral therapy ( deferred-initiation group ) .


The primary composite end point was any serious AIDS-related event , serious non-AIDS-related event , or death from any cause .


A total of @ patients were followed for a mean of @ years .


At study entry , the median HIV viral load was @,@ copies per milliliter , and the median CD@ + count was @ cells per cubic millimeter .


On May @ , @ , on the basis of an interim analysis , the data and safety monitoring board determined that the study question had been answered and recommended that patients in the deferred-initiation group be offered antiretroviral therapy .


The primary end point occurred in @ patients in the immediate-initiation group ( @ % ; @ events per @ person-years ) , as compared with @ patients in the deferred-initiation group ( @ % ; @ events per @ person-years ) , for a hazard ratio of @ ( @ % confidence interval -LSB- CI -RSB- , @ to @ ; P < @ ) .


Hazard ratios for serious AIDS-related and serious non-AIDS-related events were @ ( @ % CI , @ to @ ; P < @ ) and @ ( @ % CI , @ to @ ; P = @ ) , respectively .


More than two thirds of the primary end points ( @ % ) occurred in patients with a CD@ + count of more than @ cells per cubic millimeter .


The risks of a grade @ event were similar in the two groups , as were the risks of unscheduled hospital admissions .


The initiation of antiretroviral therapy in HIV-positive adults with a CD@ + count of more than @ cells per cubic millimeter provided net benefits over starting such therapy in patients after the CD@ + count had declined to @ cells per cubic millimeter .


( Funded by the National Institute of Allergy and Infectious Diseases and others ; START ClinicalTrials.gov number , NCT@ . )


Weight gain during the childbearing years and failure to lose pregnancy weight after birth contribute to the development of obesity in postpartum Latinas .


Madres para la Salud -LSB- Mothers for Health -RSB- was a @-month , randomized controlled trial exploring a social support intervention with moderate-intensity physical activity ( PA ) seeking to effect changes in body fat , fat tissue inflammation , and depression symptoms in sedentary postpartum Latinas .


This report describes the efficacy of the Madres intervention .


The results show that while social support increased during the active intervention delivery , it declined to pre-intervention levels by the end of the intervention .


There were significant achievements in aerobic and total steps across the @months of the intervention , and declines in body adiposity assessed with bioelectric impedance .


Social support from family and friends mediated increases in aerobic PA resulting in decrease in percent body fat .


We sought to investigate the relationship between the SYNTAX score ( SS ) and stent thrombosis ( ST ) in patients with non-ST-segment elevation acute coronary syndromes ( NSTE-ACS ) undergoing percutaneous coronary intervention ( PCI ) .


The relationship between the SS and ST is undetermined .


We stratified @,@ patients undergoing PCI in the ACUITY trial by SS tertile according to the current population ( true tertiles , SS < @ , SS = @-@ , and SS > @ ) and by the SYNTAX trial ( original SYNTAX tertiles , SS < @ , SS = @-@ , and SS > @ ) .


Thirty-day and @-year rates of definite/probable ST were determined for each tertile .


A total @ ( @ % ) and @ ( @ % ) definite/probable ST events occurred by @ days and @ year , respectively .


When stratified by true tertiles , @-day and @-year rates of definite/probable ST were significantly greater in the highest tertile ( SS > @ ; @ % and @ % ) compared with the intermediate ( SS = @-@ ; @ % and @ % ) and lowest tertiles ( SS < @ ; @ % and @ % ) , P = @ and P = @ , respectively .


When stratified by original SYNTAX tertiles , @-day and @-year rates of definite/probable ST were significantly greater in the highest ( SS > @ ; @ % and @ % ) and intermediate tertiles ( SS = @-@ ; @ % and @ % ) compared with the lowest tertile ( SS < @ ; @ % and @ % ) , P < @ for both .


By multivariable analysis , the SS was an independent predictor for both @-day and @-year definite/probable ST.


In patients with NSTE-ACS undergoing PCI , the extent and severity of CAD , as assessed by the SS before revascularization , was strongly associated with the occurrence of ST both at @ days and @ year .


@ Wiley Periodicals , Inc. .


This study sought to identify the incidence , predictors , and prognostic impact of bleeding complications ( BC ) after surgical aortic valve replacement ( SAVR ) compared with transcatheter aortic valve replacement ( TAVR ) .


Bleeding complications after SAVR and TAVR are frequent and may be associated with an unfavorable prognosis .


In the randomized controlled PARTNER ( Placement of Aortic Transcatheter Valve ) I trial , @ patients from cohort A ( operable high risk ) were randomly assigned to SAVR or TAVR ( transfemoral -LSB- TF -RSB- if iliofemoral access was suitable or transapical -LSB- TA -RSB- if not ) and received the designated treatment .


First-generation Edwards SAPIEN valves and delivery systems ( Edwards Lifesciences , Irvine , California ) were used for TAVR , through a @ - or @-F sheath .


The @-day rates of major BC ( modified Valve Academic Research Consortium definitions ) , predictors of BC , and their association with @-year mortality were assessed .


A total of @ ( @ % ) , @ ( @ % ) , and @ ( @ % ) patients had major BC within @ days of the procedure after SAVR , TF-TAVR , and TA-TAVR , respectively ( p < @ ) .


SAVR was associated with a significantly higher @-day rate of transfusion ( @ % ) than either TF-TAVR ( @ % ) or TA-TAVR ( @ % ; p < @ ) .


Independent predictors of major BC were the occurrence of major vascular complications and use of intraprocedural hemodynamic support among TF-TAVR patients , severe procedural complications requiring conversion to open surgery among TA-TAVR patients , and the presence of low hemoglobin at baseline among SAVR patients .


Major BC was identified as the strongest independent predictor of @-year mortality among the full cohort .


However , risk-adjusted analyses demonstrated a significant interaction between BC and treatment strategy with respect to mortality , suggesting that BC after SAVR have a greater impact on prognosis than after TAVR .


Among high-risk aortic stenosis patients enrolled in the PARTNER I randomized trial , BC were more common after SAVR than after TAVR and were also associated with a worse long-term prognosis .


( THE PARTNER TRIAL : Placement of AoRTic TraNscathetER Valve Trial ; NCT@ ) .


Abuse of opioid analgesics has become a public health issue .


Some opioid abusers use intravenous administration to increase the magnitude of positive reinforcing effects .


Intravenous co-administration of oxycodone with naloxone , an opioid antagonist , may reduce these rewarding effects and discourage abuse .


A @:@ oxycodone : naloxone ( OXN ) tablet formulation has been studied in the USA for the management of moderate-to-severe chronic pain .


Intravenous administration of a @:@ oxycodone : naloxone solution ( sOXN ) reflects the oxycodone : naloxone ratio found in laboratory studies of OXN following tampering for intravenous administration .


The objective of this study was to characterize abuse-deterrent properties of sOXN .


This single-center , double-blind , randomized , placebo-controlled , active-controlled , crossover study enrolled nondependent recreational opioid users with experience using multiple ( two or more ) routes of administration .


Following demonstration that subjects could discern between placebo and oxycodone , @ eligible male and female subjects were randomized to receive intravenous injections of @ mg/kg oxycodone ( OXY ) , @ mg/kg oxycodone and @ mg/kg naloxone solution ( sOXN ) , or matching placebo over three visits .


Pharmacokinetics , pharmacodynamics , safety , and tolerability were assessed at scheduled times up to @h post-dose .


Parameters were computed and statistically compared among treatments .


Pharmacokinetics were similar between OXY and sOXN .


Subjects reported significantly fewer rewarding effects with sOXN compared with OXY ; differences between sOXN and placebo were generally not significant .


sOXN was well tolerated .


Significant reductions in drug liking and other subjective effects following administration of sOXN compared with OXY indicate that naloxone concentrations were sufficient to antagonize the effects of oxycodone when abused by the intravenous route of administration in opioid-experienced drug users .


Impaired trunk motor control is common after stroke .


Combining transcutaneous electrical nerve stimulation ( TENS ) with task-related trunk training ( TRTT ) has been shown to enhance the recovery of lower limb motor function .


This study investigated whether combining TENS with TRTT would enhance trunk control after stroke .


Methods .


Thirty-seven subjects with stroke were recruited into a randomized controlled clinical trial .


Subjects were randomly assigned to any one of the three @-week home-based training groups : ( @ ) TENS + TRTT , ( @ ) placebo TENS + TRTT , or ( @ ) control without active training .


The outcome measures included isometric peak trunk flexion torque and extension torque ; forward seated and lateral seated reaching distance to the affected and unaffected side ; and Trunk Impairment Scale ( TIS ) scores .


All outcome measures were assessed at baseline , after @ and @ weeks of training , and @ weeks after training ended at follow-up .


Both the TENS + TRTT and the placebo-TENS + TRTT groups had significantly greater improvements in isometric peak trunk flexion torque and extension torque , lateral seated reaching distance to affected and unaffected side , and TIS score than the control group after @ weeks of training .


The TENS + TRTT group had significantly greater and earlier improvement in its mean TIS score than the other @ groups .


Home-based TRTT is effective for improving trunk muscle strength , sitting functional reach and trunk motor control after stroke in subjects without somatosensory deficits .


The addition of TENS to the trunk augments the effectiveness of the exercise in terms of TIS scores within the first @ weeks of training .


This study was performed to investigate the effect of Seidlitzia rosmarinus on the clinical symptoms of benign prostatic hyperplasia .


This single-blind clinical trial included @ patients with voiding and storage symptoms in Shohada Ashayer Hospital of Khorramabad .


The patients were randomly divided into two groups of treatment with prazosin @mg/day plus Seidlitzia rosmarinus @g/day and treatment with prazosin @mg/day .


The clinical symptoms were measured using the International Prostate Symptoms Score ( IPSS ) questionnaire .


Serum prostate-specific antigen ( PSA ) level , prostate volume , and residual urine volume before and @ months after the intervention were measured .


The results of the study before the intervention did not show significant differences between the prazosin and Seidlitzia rosmarinus plus prazosin groups for the scores of clinical symptoms , PSA level , prostate volume , and residual urine volume ( p > @ ) .


However , significant differences were found between the two groups after the intervention for the mean change scores of clinical symptoms ( @ scores in the Seidlitzia rosmarinus group vs. @ scores in the control group ) ( p < @ ) , while no significant differences were found for the mean change scores of PSA level , prostate volume , and residual urine volume ( p > @ ) .


The results of the study showed that the simultaneous consumption of Seidlitzia rosmarinus and prazosin , compared to the consumption of prazosin alone , results in significant improvements in the clinical symptoms of benign prostatic hyperplasia .


To evaluate whether a disease activity guided strategy of dose reduction of two tumour necrosis factor ( TNF ) inhibitors , adalimumab or etanercept , is non-inferior in maintaining disease control in patients with rheumatoid arthritis compared with usual care .


Randomised controlled , open label , non-inferiority strategy trial .


Two rheumatology outpatient clinics in the Netherlands , from December @ to May @ .


@ patients with rheumatoid arthritis and low disease activity using adalimumab or etanercept ; @ allocated to the dose reduction strategy , @ to usual care .


Disease activity guided dose reduction ( advice to stepwise increase the injection interval every three months , until flare of disease activity or discontinuation ) or usual care ( no dose reduction advice ) .


Flare was defined as increase in DAS@-CRP ( a composite score measuring disease activity ) greater than @ , or increase greater than @ and current score of at least @ .


In the case of flare , TNF inhibitor use was restarted or escalated .


Difference in proportions of patients with major flare ( DAS@-CRP based flare longer than three months ) between the two groups at @ months , compared against a non-inferiority margin of @ % .


Secondary outcomes included TNF inhibitor use at study end , functioning , quality of life , radiographic progression , and adverse events .


Dose reduction of adalimumab or etanercept was non-inferior to usual care ( proportion of patients with major flare at @ months , @ % v @ % ; difference @ % , @ % confidence interval -@ % to @ % ) .


In the dose reduction group , TNF inhibitor use could successfully be stopped in @ % ( @ % confidence interval @ % to @ % ) , the injection interval successfully increased in @ % ( @ % to @ % ) , but no dose reduction was possible in @ % ( @ % to @ % ) .


Functional status , quality of life , relevant radiographic progression , and adverse events did not differ between the groups , although short lived flares ( @ % v @ % ) and minimal radiographic progression ( @ % v @ % ) were more frequent in dose reduction than usual care .


A disease activity guided , dose reduction strategy of adalimumab or etanercept to treat rheumatoid arthritis is non-inferior to usual care with regard to major flaring , while resulting in the successful dose reduction or stopping in two thirds of patients.Trial registration Dutch trial register ( www.trialregister.nl ) , NTR @ .


Peeping testis is an inconsistently palpable/seen undescended testis that migrates back and forth at the internal inguinal ring .


Both open and laparoscopic orchiopexy are effective forms of management .


The present study aimed to evaluate the efficacy and safety of both approaches .


Between September @ and January @ , @ peeping inguinal testes were randomly treated with either open ( @ cases ) or laparoscopic ( @ cases ) orchiopexy procedures .


Spermatic vessels were preserved for all cases .


Operative details , postoperative morbidity and final testicular site and size were recorded .


The median age of the children was @ years ( range @-@ @ ) .


The follow-up period ranged from @ to @ years .


Of these testes , @ in the open surgery group and @ in the laparoscopic group maintained correct intrascrotal position ( P = @ ) .


Re-do orchiopexy was indicated for two cases in the surgical group ( P = @ ) .


No cases of testicular atrophy or hernia were encountered .


Open and laparoscopic orchiopexy procedures for peeping testes are fairly comparable .


However , laparoscopy is relatively more effective , as two re-do orchiopexies were required in the open surgical group .


The recommended screening interval when using the Papanicolaou ( Pap ) and human papillomavirus ( HPV ) test ( co-testing ) is @ years .


However because providers are reluctant to extend the screening interval , we launched a study to identify barriers to appropriate use of the co-test and to implement an educational intervention to promote evidence-based screening practices .


This article provides an overview of the study including the multi-component intervention and participant demographics .


The study was conducted in @ clinics associated with @ Federally Qualified Health Centers ( FQHCs ) in Illinois .


Each clinic received HPV tests to administer with routine Pap tests among enrolled patients ( n = @,@ ) and was assigned to a study arm : intervention arm ( n = @ ) received a multi-component educational intervention ( small media , academic detailing , and website ) for providers and printed educational materials for patients , and control arm ( n = @ ) received printed copies of general guidelines .


Clinic coordinators ( n = @ ) , providers ( n = @ ) , and patients ( n = @ ) completed baseline surveys to assess screening practices .


Providers reported an average age of @ years and were predominately female , non-Hispanic , and white .


Patients reported an average age of @ years and nearly two-thirds were Hispanic or black .


Of the @,@ patients , @ % had a normal co-test .


Lessons learned from the study included the importance of buy-in at a high level in the organization , a champion provider , and a clinical coordinator devoted to the study .


Materials from this study can be adapted to educate providers and patients on appropriate use of the co-test and encourage extended screening intervals as a safe and effective practice .


To compare the effectiveness of a core stability program with a task-oriented motor training program in improving motor proficiency in children with developmental coordination disorder ( DCD ) .


Randomized controlled pilot trial .


Outpatient unit in a hospital .


Twenty-two children diagnosed with DCD aged @-@ years were randomly allocated to the core stability program or the task-oriented motor program .


Both groups underwent their respective face-to-face training session once per week for eight consecutive weeks .


They were also instructed to carry out home exercises on a daily basis during the intervention period .


Short Form of the Bruininks-Oseretsky Test of Motor Proficiency ( Second Edition ) and Sensory Organization Test at pre - and post-intervention .


Intention-to-treat analysis revealed no significant between-group difference in the change of motor proficiency standard score ( P = @ ) , and composite equilibrium score derived from the Sensory Organization Test ( P = @ ) .


Further analysis showed significant improvement in motor proficiency in both the core stability ( mean change ( SD ) = @ ( @ ) ; p = @ ) and task-oriented training groups ( mean change ( SD ) = @ ( @ ) ; P = @ ) .


The composite equilibrium score was significantly increased in the task-oriented training group ( mean change ( SD ) = @ ( @ ) ; P = @ ) , but not in the core stability group ( mean change ( SD ) = @ ( @ ) ; P = @ ) .


In the task-oriented training group , compliance with the home program was positively correlated with change in motor proficiency ( = @ , P = @ ) and composite equilibrium score ( = @ , P = @ ) .


The core stability exercise program is as effective as task-oriented training in improving motor proficiency among children with DCD .


Plantago ovata husk therapy could be used in patients with Parkinson disease to reduce the symptoms of gastrointestinal disorders , but it is important to know whether this compound modifies levodopa pharmacokinetics .


The maintenance of constant plasma concentrations of levodopa abolishes the clinical fluctuations in parkinsonian patients .


The aim of this randomised clinical trial was to establish the influence of the fiber Plantago ovata husk in the pharmacokinetics of levodopa when administered to Parkinson patients well controlled by their oral medication .


To evaluate the effects of this fiber on several biochemical parameters .


@ volunteers participated in the study and received alternatively two treatments ( Plantago ovata husk or placebo ) with their usual levodopa/carbidopa oral dose .


On days @ ( initial situation ) , @ and @ of the study , blood samples were taken to assess levodopa pharmacokinetics and to determine biochemical parameters .


Levodopa Cmax was very similar in the initial situation ( @ ng/ml ) and after placebo administration ( @ ng/ml ) , being slightly lower ( @ ng/ml ) when Plantago ovata husk was given .


AUC was very similar in the three groups : initial situation .


- @ g.min / ml , fiber treatment .


- @ g.min / ml and placebo treatment .


- @ g.min / ml .


Fiber reduced significantly the number of peaks observed in the levodopa concentrations , maintaining concentrations more stable .


No significant differences were found in total cholesterol , LDL-cholesterol and triglycerides with the administration of Plantago ovata husk .


Plantago ovata husk administration caused a smoothing and homogenization of levodopa absorption , providing more stable concentrations and final higher levels , resulting in a great benefit for patients .


To investigate the effect of Longbishu Capsule ( , LBS ) , doxazosin , and combination therapy on benign prostatic hyperplasia ( BPH ) .


A randomized , double-blind , multi-center parallel trial was conducted involving @ patients in hospitals in Beijing ( @ cases ) , Heilongjiang ( @ cases ) , Sichuan ( @ cases ) , Shanghai ( @ cases ) , China .


They were randomly assigned with central randomization method to group A ( LBS placebo plus doxazosin ) , group B ( LBS plus doxazosin ) or group C ( LBS plus doxazosin placebo ) , @ cases for each group .


The international prostate symptom score , maximum urinary flow rate , postvoid residual urine volume and prostate volume were measured for evaluating the efficacy of the three treatments .


At baseline , there was no significant difference in the measured variables among the three groups .


After @-month treatment , the three groups showed significant improvements in IPSS and maximum urinary flow rate from baseline ( P < @ ) .


Although postvoid residual urine volume was not significantly different from the baseline in group A ( P > @ ) , it significantly decreased in group B and C ( P < @ ) .


The incidence of adverse events were similar among the three groups .


The treatment of LBS alone or LBS plus doxazosin was able to significantly improve IPSS in patients with BPH .


The treatments may reduce the increase in prostate volume and postvoid residual urine volume as well .


Inhalational induction in children is easiest to perform with the Ayres t-piece & bag ( Mapleson F ) .


Drawover anesthesia systems may be used but have not been studied .


The aim of this study was to examine the quality of induction of anesthesia in children comparing a continuous flow system using the Farman entrainer and the pediatric t-piece , to a pediatric drawover system .


We conducted a randomized controlled trial in accordance with departmental and institutional standards with @ subjects who received inhalational induction using either apparatus .


There was no evidence of a difference in the median Sp@ between the two methods ( P = @ ) neither was there a difference between the method of induction regarding abdominal distension ( P = @ ) or restraint ( P = @ ) .


Induction time using the pediatric drawover apparatus @ ( range @-@ ) seconds was significantly greater than the Farman entrainer/t-piece @ ( range @-@ ) seconds ( P < @ ) .


We consider that this difference is unlikely to be clinically significant in many cases ; however , the increased speed using the entrainer and t-piece may sometimes confer an advantage .


The reliability and validity of various Objective Structured Clinical Examinations ( OSCEs ) have been well documented in the medical and nursing literature .


The purpose of this study was to examine the effect of exam preparation methods on student performance and student satisfaction for an OSCE used to assess doctoral physical therapist students .


Sixty-five physical therapist students from two post-professional physical therapist programs were randomized to a rubric exam preparation group and a nonrubric exam preparation group for a musculoskeletal OSCE .


The OSCE was a midterm practical exam for a peripheral joint musculoskeletal course .


Upon completion of the exam , all students completed a post-exam satisfaction survey .


The results of the @ x @ ANCOVA that examined performance and satisfaction on the OSCE indicated a significant interaction between the group assignment and program , p < @ , for performance , and that satisfaction scores between the rubric and nonrubric groups and program were not significant for any of the questions asked on the post-examination survey .


Despite the reported benefit of utilizing rubrics , the findings of this study did not show a difference in student performance or satisfaction when using a rubric to prepare for an OSCE .


Single-site studies have demonstrated inadequate quality of discharge summaries in timeliness , transmission , and content , potentially contributing to adverse outcomes .


However , degree of hospital-level variation in discharge summary quality for patients hospitalized with heart failure ( HF ) is uncertain .


We analyzed discharge summaries of patients enrolled in the Telemonitoring to Improve Heart Failure Outcomes ( Tele-HF ) study .


We assessed hospital-level performance on timeliness ( fraction of summaries completed on the day of discharge ) , documented transmission to the follow-up physician , and content ( presence of components suggested by the Transitions of Care Consensus Conference ) .


We obtained @ discharge summaries from @ ( @ % ) patients discharged alive from @ hospitals .


Among hospitals contributing @ summaries , the median hospital dictated @ % of discharge summaries on the day of discharge ( range , @ % -@ % ; P < @ ) ; documented transmission of @ % of summaries to the follow-up physician ( range , @ % -@ % ; P < @ ) ; and included @ of @ Transitions of Care Consensus Conference elements ( range , @-@ @ ; P < @ ) .


Hospital course was typically included ( @ % ) , but summaries were less likely to include discharge condition ( @ % ) , discharge volume status ( @ % ) , or discharge weight ( @ % ) .


No discharge summary included all @ Transitions of Care Consensus Conference-endorsed content elements , was dictated on the day of discharge , and was sent to a follow-up physician .


Even at the highest performing hospital , discharge summary quality is insufficient in terms of timeliness , transmission , and content .


Improvements in all aspects of discharge summary quality are necessary to enable the discharge summary to serve as an effective transitional care tool .


To evaluate and compare the effcacy of preprocedural mouthrinses ( chlorhexidine digluconate and tea tree oil ) in reducing microbial content of aerosol product during ultrasonic scaling procedures by viable bacterial count .


It was a randomized single blind , placebo-controlled parallel group study .


Sixty subjects were randomly assigned to rinse @ ml of any one of the mouthrinses ( chlorhexidine digluconate or tea tree oil or distilled water ) .


Ultrasonic scaling was done for a period of @ minutes in presence of trypticase soy agar plates placed at standardized distance .


Plates were then sent for microbiological evaluation for the aerosol produced .


This study showed that all the antiseptic mouthwashes signifcantly reduced the bacterial colony forming units ( CFUs ) in aerosol samples .


Chlorhexidine rinses were found to be superior to tea tree when used preprocedurally in reducing aerolized bacteria .


This study advocates preprocedural dural rinsing with an effective antimicrobial mouthrinse during any dental treatment which generates aerosols , reduces the risk of cross-contamination with infectious agents in the dental operatory .


The aerolization of oral microbes occurring during dental procedures can potentially result in cross-contamination in the dental operatory and transmission of infectious agents to both dental professionals and patient .


It is reasonable to assume therefore , that any stratagem for reducing the viable bacterial content of these aerosols could lower the risk of cross-contamination .


We investigated the effects of weight loss and maintenance with diets that varied with regard to protein content and glycemic index ( GI ) on metabolic syndrome ( MetSyn ) status .


Secondary analyses were performed within the Diet , Obesity and Genes ( DiOGenes ) study ( @-@ ) , a randomized controlled dietary intervention .


Nine hundred and thirty-eight overweight and obese adults from eight European countries entered an @-wk low-calorie-diet period .


Seven hundred and seventy-three adults who lost at least @ % of their body weights were randomized to one of five ad libitum diets for @ mo : @ ) low-protein ( LP ) / low-GI ( LGI ) ; @ ) LP/high-GI ( HGI ) ; @ ) high-protein ( HP ) / LGI ; @ ) HP/HGI ; and @ ) control diet .


MetSyn prevalence and a standardized MetSyn score were assessed at baseline , after the low-calorie diet , and after the intervention .


Weight loss among participants while on the low-calorie diet significantly reduced MetSyn prevalence ( @ % versus @ % ; P < @ ) and MetSyn score ( -@ versus -@ ; P < @ ) .


During weight maintenance , significant changes in MetSyn score were observed between the groups , with the highest increase detected in the LP/HGI group ( P = @ , partial ( @ ) = @ ) .


Protein , GI , and their interaction did not have isolated effects on study outcomes .


Neither protein nor GI affected MetSyn status in this sample of European overweight and obese adults .


However , a diet with a combination of an increased protein-to-carbohydrate ratio with low-GI foods had beneficial effects on MetSyn factors .


To evaluate the optimal time interval from definitive surgery to commencing chemotherapy in early breast cancer ( EBC ) .


The relationship between time to initiation of adjuvant chemotherapy ( TTC ) , calculated in weeks , and disease-free ( DFS ) or overall survival ( OS ) , was assessed in @ EBC patients with rapidly proliferating tumours ( thymidine labelling index > @ % or G@ or Ki@ > @ % ) , randomised in a phase III clinical trial ( NCT@ ) to receive chemotherapy with or without anthracyclines ( epirubicincyclophosphamide , methotrexate and fluorouracil ( CMF ) versus CMFepirubicin versus CMF ) .


DFS , OS and @ % confidence intervals ( @ % confidence interval ( CI ) ) were calculated by the Kaplan-Meier method .


Multivariate Cox analysis was performed in relation with nodal involvement , oestrogen receptor and human epidermal growth factor receptor @ ( HER@ ) status , Ki@ value , type of adjuvant chemotherapy , menopausal status and tumour size .


At a median follow-up of @ months ( range @-@ ) , a prolonged TTC resulted in a significant increase in the risk of relapse : hazard ratio ( HR ) @ ( @ % CI @-@ @ , p = @ ) .


Using a backward elimination procedure , TTC , tumour size and nodal involvement remained significantly associated with DFS .


A time-dependent receiver-operating characteristic ( ROC ) curve analysis was subsequently utilised to evaluate the best cut-off for TTC , identifying @ weeks as the best threshold for longer OS ( p = @ ) : @-year OS @ % ( @ % CI @-@ ) for patients with a TTC < @ weeks and @ % ( @ % CI @-@ ) for the other group .


Our results confirm that a shorter TTC may reduce relapses and possibly also improve clinical outcome in patients with highly proliferating EBC .


The purpose of this study was to evaluate the relative bioavailability and safety of a multilayer extended-release bead methylphenidate ( MPH ) hydrochloride @mg ( MPH-MLR ) capsule or sprinkles ( @ % immediate-release -LSB- IR -RSB- ) versus MPH hydrochloride IR ( Ritalin ( ) ) tablets , and to develop a pharmacokinetic ( PK ) model simulating MPH concentration-time data for different MPH-MLR dosage strengths .


This was a single-center , randomized , open-label , three-period crossover study conducted in @ fasted healthy adults ( mean weightstandard deviation , @ kg ) assigned to single-dose oral MPH-MLR @mg capsule or sprinkles with applesauce , or Ritalin IR @mg ( @mg and @mg tablet ) administered at @ , @ , and @ hours .


MPH-MLR @mg capsule and sprinkles were bioequivalent ; ratios for maximum concentration ( Cmax ) , area under plasma drug concentration versus time curve ( AUC ) @-t , and AUC@-inf were @ ( @ % confidence interval -LSB- CI -RSB- , @-@ @ ) , @ ( @ % CI , @-@ @ ) , and @ ( @ % CI , @-@ @ ) , respectively .


MPH-MLR capsule/sprinkles produced highly comparable , biphasic profiles of plasma MPH concentrations characterized by rapid initial peak , followed by moderate decline until @ hours postdose , and gradual increase until @ hours postdose , culminating in an attenuated second peak .


Based on @ % CIs , total systemic exposure to MPH-MLR @mg capsule/sprinkles was similar to that for Ritalin IR @mg three times daily , but marked differences in Cmax values indicated that MPH-MLR regimens were not bioequivalent to Ritalin .


MPH Cmax and total systemic exposure over the first @ hours postdose with MPH-MLR capsule/sprinkles was markedly higher than that associated with the first dose of Ritalin .


All study drugs were safe and well tolerated .


The PK modeling in adults suggested that differences in MPH pharmacokinetics between MPH-MLR and Ritalin are the result of dosage form design attributes and the associated absorption profiles of MPH .


MPH-MLR @mg provides a long-acting biphasic pattern of plasma MPH concentrations with one less peak and trough than Ritalin IR .


The authors evaluated the effect of susceptibility-weighted imaging ( SWI ) for antiplatelet therapy on post-thrombolysis microbleeds ( MB ) .


A total of @ patients without symptomatic intracranial haemorrhage on computed tomography after thrombolysis were allocated to two groups : group A ( n = @ ) received antiplatelets @h after recombinant tissue plasminogen activator , regardless of SWI-detected haemorrhage ; group B ( n = @ ) received antiplatelets for patients without SWI-visualised haemorrhage .


Haemorrhage was detected by SWI in @ and @ patients in groups A and B , respectively .


The difference in mean NIHSS ( National Institutes of Health Stroke Scale ) score in group A between baseline and @ , @h , @ , @days was -@ , -@ , -@ , -@ , respectively ; in group B , the difference in mean NIHSS score between baseline and @ , @h , @ , @days was -@ , -@ , -@ , -@ , respectively .


The difference between groups in reduction of mean NIHSS score from baseline was @ ( p < @ ) at @h , @ ( p < @ ) at @h , @ ( p = @ ) at @days and @ ( p < @ ) at @days .


NIHSS scores at @ , @days and modified Rankin scale at @days were significantly lower in haemorrhage patients in groups B than in A , whereas the hospital stay was shorter and the rate of favourable outcome at @days was higher .


Our results indicated that SWI was an effective approach for the guidance of antiplatelet therapy in post-thrombolysis MB .


Medication errors can be caused by lack of agreement between what physicians believe patients are taking and what patients actually take .


There has been little systematic research to find the best way to reconcile medication lists in primary care .


The objective of this study was to assess the impact of @ interventions on agreement between electronic medical record medication lists and what patients report actually taking .


This study was a factorial randomized trial that randomized @ eligible patients ( English-speaking , age @ and older , taking at least @ prescriptions ) visiting @ primary care physicians ; @ completed the study .


Interventions included ( @ ) providing patients a printed copy of their current medication list at check-in and ( @ ) beginning the medication review with an open-ended question .


Patients were randomized to receive no intervention , one or the other intervention , or both interventions .


The outcome measure was agreement on all prescription and nonprescription medications , vitamins , and supplements between the list from the electronic medical record after the visit and a list based on patient report generated during a phone interview within a week of the office visit .


Agreement rates between medication lists and patient report for the @ study groups were : @ % in the no intervention group , @ % in the printed list only group , @ % in the open-ended question only group , and @ % in the combined intervention group .


Both a printed list and beginning a medication discussion with an open-ended question were required before any significant increase in agreement was observed .


While neither intervention alone improved medication list agreement , these interventions may have value in a multistep protocol to improve the agreement of medication lists in primary care offices .


Baseline agreement was much higher than expected , possibly reflecting a Hawthorne effect .


This study aimed to determine the effectiveness of using a wireless , portable vital signs monitor ( WVSM ) for predicting the need for lifesaving interventions ( LSIs ) in the emergency department ( ED ) and use a multivariate logistic regression model to determine whether the WVSM was an improved predictor of LSIs in the ED over the standard of care monitor currently being used .


This study analyzed @ consecutive patients transported from the scene via helicopter to a Level I trauma center .


For @ patients in the study , a WVSM was also attached to the patient 's arm and used to record and display prehospital and hospital physiologic data in real time on a handheld computer and in the trauma bay .


Multivariate logistic regression analyses were performed for accuracy in predicting needs for LSIs in control and WVSM subjects .


In addition , receiver operating characteristic curves were obtained to examine the discriminating power of the models for the outcome of one or more LSIs in the ED .


Of the @ patients , @ underwent @ LSIs in the ED .


Of these , @ patients wore the WVSM during transport in addition to the standard monitor .


Logistic regression analysis revealed that heart rate , respiratory rate , and systolic blood pressure were significantly associated with an increased risk for LSIs in the ED ( p < @ ) .


Receiver operating characteristic curve analysis also demonstrated better prediction for LSIs performed in the ED in WVSM subjects than in control subjects ( area under the curve , @ vs. @ , respectively ) .


The WVSM system leads to improved LSI accuracy in the ED .