A two-year study assessed the benefit of an enhanced oral health promotion program combined with a closely supervised tooth brushing program in schools , using toothpaste containing @,@ ppm F - and @ % arginine , on oral health and dental caries .


@ southern Thailand schools and @,@ pre-school children were recruited : @ schools with @,@ children as controls ; @ schools with @,@ children in the intervention groups .


Of the intervention schools five were classified as cooperative school and two as non-cooperative schools , based on the criteria of @ % participation in the prescribed tooth brushing activities .


The DMFT and DMFS increments ( `` enamel and dentine '' ) were @ and @ for the control group and @ and @ for the intervention groups .


These represent @ % and @ % reductions in caries respectively .


The DMFT and DMFS increments ( `` dentine threshold '' ) were @ and @ for the control group and @ and @ for the intervention group , representing @ % , and @ % reductions in caries incidence respectively .


For the more cooperative schools the benefits were greater : up to a @ % reduction in caries for DMFS ( `` dentine threshold '' ) .


At the @ month examination there were significant improvements in dental plaque scores with greater improvements seen in the intervention group , greater still in the cooperative schools .


This study documents the positive effect from use of fluoridated toothpaste ( @,@ ppm F - and @ % arginine ) administered by schoolteachers and undertaken via an enhanced school oral health program .


Optimising oral health interventions for young children in Thai schools may have a significant impact on caries incidence resulting in reductions of up to @ % reductions in caries for all schools included in the study and up to @ % for the most cooperative .


Activation of the vascular endothelial growth factor receptor ( VEGFR ) and the oncogenic Src pathway has been implicated in the development of castration-resistant prostate cancer ( CRPC ) in preclinical models .


Cediranib and dasatinib are multi-kinase inhibitors targeting VEGFR and Src respectively .


Phase II studies of cediranib and dasatinib in CRPC have shown single agent activity .


Docetaxel-pretreated CRPC patients were randomized to arm A : cediranib alone ( @ mg/day ) versus arm B : cediranib ( @ mg/day ) plus dasatinib ( @ mg/day ) given orally on @-week cycles .


Primary endpoint was @-week progression-free survival ( PFS ) as per the Prostate Cancer Clinical Trials Working Group ( PCWG@ ) .


Patient reported outcomes were evaluated using Functional Assessment of Cancer Therapy-Prostate ( FACT-P ) and Present Pain Intensity ( PPI ) scales .


Correlative studies of bone turnover markers ( BTM ) , including bone alkaline phosphate ( BAP ) and serum beta-C telopeptide ( B-CTx ) were serially assayed .


Results A total of @ patients , @ per arm , were enrolled .


Baseline demographics were similar in both arms .


Median number of cycles = @ in arm A ( range @-@ ) and @ in arm B ( range @-@ ) .


Twelve-week PFS was @ % in arm A versus @ % in arm B ( p = @ ) .


Median PFS in months ( arm A versus B ) was : @ versus @ ( @ % CI : @-@ @ versus @-not reached ) .


Most common grade @ toxicities were hypertension , anemia and thrombocytopenia in arm A and hypertension , diarrhea and fatigue in arm B.


One treatment-related death ( retroperitoneal hemorrhage ) was seen in arm A. FACT-P and PPI scores did not significantly change in either arm .


No correlation between BTM and PFS was seen in either arm .


Although limited by small numbers , this randomized study showed that the combination of VEGFR and Src targeted therapy did not result in improved efficacy and may be associated with a worse outcome than VEGFR targeted therapy alone in patients with CRPC .


ClinicalTrials.gov number : NCT@ .


Colonoscopy is associated with pain and discomfort in the majority of patients when performed without sedation .


We performed a prospective and randomized study to compare warm water instillation and standard air-insufflation colonoscopy techniques without any sedation .


The data of @ patients ( @ female and @ male ) were statistically analyzed .


Patients were randomized into two groups by using computer generated list .


In group A , standard colonoscopy with air insufflation was performed .


In group B colonoscopy was performed by warm water infusion into the bowel .


No analgesic , antispasmodic or sedative medications were used .


After colonoscopy , the level of pain during colonoscopy experienced by the patient was measured using the visual analog scale ( VAS ) .


There were no statistically significant differences in gender and average age between the two groups of patients .


Cecal intubation was successful in all patients ( @ % ) .


All colonoscopies were performed without complications .


Patients who had colonoscopy with water immersion had a significantly lower level of pain on the VAS ( @ vs @ ) , p = @ .


We confirmed the advantages of warm water instillation for colonoscope insertion in reducing pain without compromising the time to reach the cecum , success of cecum intubation or patient safety .


To evaluate safety , ocular tolerability and pharmacokinetics of @ % and @ % cis-urocanic acid ( cis-UCA ) eye drops .


In this phase I , double-blinded , placebo-controlled trial , @ healthy volunteers were randomized to three treatment arms : @ % cis-UCA ( @ subjects ) , @ % cis-UCA ( @ subjects ) and placebo eye drops ( @ subjects ) .


In the first part , the subjects were dosed topically on a randomized eye with one drop three times at @ @ hr intervals during @ day .


In the second part , the subjects self-administered three daily drops at @ @ hr intervals on both eyes for @ days .


Physical examination of the eyes was performed seven times during the study .


Tolerability of cis-UCA was assessed by ocular comfort rating questionnaire .


Pharmacokinetic blood and urine samples were analysed under good laboratory practice ( GLP ) .


All subjects completed both parts of the study .


There were no significant adverse events ( AEs ) .


The most common treatment-related ocular AE was eye irritation ( @ % of subjects ) .


Cis-UCA concentrations in plasma remained below the limit of quantification ( @ g/ml ) in all but two subjects .


The fraction of the administered drug excreted into urine over the total collection period ranged from @ % to @ % of the last dose and from @ % to @ % of the daily dose .


Topical ocular administration of cis-UCA solution is safe and apart from mild - and short-lasting eye irritation after administration well tolerated in healthy adult subjects .


Topical ocular dosing leads to transient systemic exposure to cis-UCA that does not cause systemic AEs .


Diode lasers are becoming popular in gingival treatment following orthodontic treatments .


Despite their merit and clinical implications , postoperative pain and bleeding after surgery with diode lasers are not assessed except in few controversial studies .


This controlled clinical trial was conducted on @ healthy orthodontic patients aged @-@ years , needing esthetic-only gingivectomy in the anterior maxilla .


The patients were randomly divided into two groups of @ each : experimental ( laser-assisted surgery ) and control ( traditional surgery using scalpels ) .


The bleeding rate following the surgery was assessed using the bleeding criteria established by the World Health Organization .


The postsurgical pain level was recorded using visual analog scales immediately after the surgery and in patients who consumed analgesics , also @ h after the analgesic consumption .


The data were analyzed using the independent-samples t , Mann-Whitney U , and chi-square tests ( = @ ) .


The average bleeding rates were @ and @ in the conventional and laser groups , respectively ( Mann-Whitney U P < @ ) .


Experimental patients had no postsurgical pain ( VAS@ and VAS@ = @ ) .


In the control group , the average VAS@ pain was @ out of @ .


The difference between VAS@ values in the control/experimental groups was significant ( Mann-Whitney U P < @ ) .


@-nm diode laser seems promising in reducing postoperative bleeding and pain of patients needing cosmetic smile lift surgeries .


Theory-based process evaluations conducted alongside randomized controlled trials provide the opportunity to investigate hypothesized mechanisms of action of interventions , helping to build a cumulative knowledge base and to inform the interpretation of individual trial outcomes .


Our objective was to identify the underlying causal mechanisms in a cluster randomized trial of the effectiveness of printed educational materials ( PEMs ) to increase referral for diabetic retinopathy screening .


We hypothesized that the PEMs would increase physicians ' intention to refer patients for retinal screening by strengthening their attitude and subjective norm , but not their perceived behavioral control .


Design : A theory based process evaluation alongside the Ontario Printed Educational Material ( OPEM ) cluster randomized trial .


Postal surveys based on the Theory of Planned Behavior were sent to a random sample of trial participants two months before and six months after they received the intervention .


Setting : Family physicians in Ontario , Canada .


Participants : @,@ family physicians ( @ per intervention group ) from the OPEM trial were invited to participate , and @ % ( @/@ ) responded at time one and time two .


The final sample comprised @ family physicians fully completing questionnaires at both time points .


Main Outcome Measures : Primary : behavioral intention related to referring patient for retinopathy screening ; secondary : attitude , subjective norm , perceived behavioral control .


At baseline , family physicians reported positive intention , attitude , subjective norm , and perceived behavioral control to advise patients about retinopathy screening suggesting limited opportunities for improvement in these constructs .


There were no significant differences on intention , attitude , subjective norm , and perceived behavioral control following the intervention .


Respondents also reported additional physician - and patient-related factors perceived to influence whether patients received retinopathy screening .


Lack of change in the primary and secondary theory-based outcomes provides an explanation for the lack of observed effect of the main OPEM trial .


High baseline levels of intention to advise patients to attend retinopathy screening suggest that post-intentional and other factors may explain gaps in care .


Process evaluations based on behavioral theory can provide replicable and generalizable insights to aid interpretation of randomized controlled trials of complex interventions to change health professional behavior .


To determine whether cranberry capsules prevent urinary tract infection ( UTI ) in long-term care facility ( LTCF ) residents .


Double-blind randomized placebo-controlled multicenter trial .


Long-term care facilities ( LTCFs ) .


LTCF residents ( N = @ ; @ women , median age @ ) .


Cranberry and placebo capsules were taken twice daily for @ months .


Participants were stratified according to UTI risk ( risk factors included long-term catheterization , diabetes mellitus , @ UTI in preceding year ) .


Main outcomes were incidence of UTI according to a clinical definition and a strict definition .


In participants with high UTI risk at baseline ( n = @ ) , the incidence of clinically defined UTI was lower with cranberry capsules than with placebo ( @ vs @ per @ person-years at risk , P = @ ) ; the treatment effect was @ ( @ % confidence interval ( CI ) = @-@ @ ) .


For the strict definition , the treatment effect was @ ( @ % CI = @-@ @ ) .


No difference in UTI incidence between cranberry and placebo was found in participants with low UTI risk ( n = @ ) .


In LTCF residents with high UTI risk at baseline , taking cranberry capsules twice daily reduces the incidence of clinically defined UTI , although it does not reduce the incidence of strictly defined UTI .


No difference in incidence of UTI was found in residents with low UTI risk .


Combining bevacizumab with first-line or second-line chemotherapy improves progression-free survival in HER@-negative locally recurrent or metastatic breast cancer .


We assessed the efficacy and safety of further bevacizumab therapy in patients with locally recurrent or metastatic breast cancer whose disease had progressed after treatment with bevacizumab plus chemotherapy .


In this open-label , randomised , phase @ trial , we recruited patients who had HER@-negative locally recurrent or metastatic breast cancer that had progressed after receiving @ weeks or more of first-line bevacizumab plus chemotherapy from @ centres in @ countries .


Patients were randomly assigned ( @:@ ) by use of a central interactive voice response system using a block randomisation schedule ( block size four ) stratified by hormone receptor status , first-line progression-free survival , selected chemotherapy , and lactate dehydrogenase concentration , to receive second-line single-agent chemotherapy either alone or with bevacizumab ( @ mg/kg every @ weeks or @ mg/kg every @ weeks ) .


Second-line therapy was continued until disease progression , unacceptable toxicity , or consent withdrawal .


At progression , patients randomly assigned to chemotherapy alone received third-line chemotherapy without bevacizumab ; those randomly assigned to bevacizumab continued bevacizumab with third-line chemotherapy .


The primary endpoint was progression-free survival from randomisation to second-line progression or death in the intention-to-treat population .


This trial is ongoing , and registered with ClinicalTrials.gov , number NCT@ .


Between Feb @ , @ , and April @ , @ , @ patients were randomly assigned to treatment ( @ in each group ) .


The median duration of follow-up at the time of this prespecified primary progression-free survival analysis was @ months ( IQR @-@ ) in the chemotherapy-alone group and @ months ( @-@ ) in the combination group .


Progression-free survival was significantly longer for those patients treated with bevacizumab plus chemotherapy than for those with chemotherapy alone ( median : @ months -LSB- @ % CI @-@ -RSB- vs @ months -LSB- @-@ -RSB- , respectively , stratified hazard ratio -LSB- HR -RSB- @ -LSB- @ % CI @-@ -RSB- , two-sided stratified log-rank p = @ ) .


The most common grade @ or more adverse events were hypertension ( @ -LSB- @ % -RSB- of @ patients receiving bevacizumab plus chemotherapy vs @ -LSB- @ % -RSB- of @ patients receiving chemotherapy alone ) , neutropenia ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , and hand-foot syndrome ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) .


Grade @ proteinuria occurred in @ ( @ % ) of @ patients receiving combination therapy and one ( < @ % ) of @ patients receiving chemotherapy alone .


Serious adverse events were reported in @ ( @ % ) of @ patients receiving bevacizumab plus chemotherapy versus @ ( @ % ) of @ patients receiving chemotherapy alone .


These results suggest that continued VEGF inhibition with further bevacizumab is a valid treatment option for patients with locally recurrent or metastatic HER@-negative breast cancer whose disease was stabilised or responded to first-line bevacizumab with chemotherapy .


Evaluate tools to help pregnant women with prior cesareans make informed decisions about having trials of labor .


Randomized comparative trial .


A research assistant with a laptop met the women in quiet locations at clinics and at health fairs .


Pregnant women ( N = @ ) who had one prior cesarean and were eligible for vaginal birth after cesarean ( VBAC ) participated one time between @ and @ .


Women were randomized to receive either an evidence-based , interactive decision aid or two evidence-based educational brochures about cesarean delivery and VBAC .


Effect on the decision-making process was assessed before and after the interventions .


Compared to baseline , women in both groups felt more informed ( F = @ , p < @ ) , were more clear about their birth priorities ( F = @ , p = @ ) , felt more supported ( F = @ , p = @ , and overall reported less conflict ( F = @ , p < @ ) after receiving either intervention .


Women in their third trimesters reported greater clarity around birth priorities after using the interactive decision aid than women given brochures ( F = @ , p = @ ) .


Although both decision tools significantly reduced conflict around the birth decision compared to baseline , more work is needed to understand which format , the interactive decision aid or paper brochures , are more effective early and late in pregnancy .


Econazole nitrate is a broad-spectrum topical antifungal with activity against a variety of dermatophytes and yeasts .


A new topical dosage form , econazole nitrate topical foam @ % , utilizing patented Proderm Technology has been developed for treatment of interdigital tinea pedis .


To evaluate econazole nitrate foam @ % versus foam vehicle for treatment of interdigital tinea pedis .


Two randomized , double-blind , parallel-group , vehicle-controlled , multicenter studies enrolled males and females @ years old with a clinical diagnosis of interdigital tinea pedis and baseline fungal culture positive for a dermatophyte .


Subjects applied econazole nitrate foam @ % ( n = @ ) or foam vehicle ( n = @ ) once daily for @ weeks .


The primary endpoint was proportion of subjects achieving a complete cure ( negative KOH , negative fungal culture , complete resolution of all signs and symptoms ) at @ weeks post-treatment ( Day @ ) .


Secondary endpoints included mycologic cure ( negative KOH and negative culture ) and effective treatment ( mycologic cure + no or mild erythema and/or scaling and all other signs and symptoms absent ) .


The complete cure rate at Day @ was @ % for econazole nitrate foam @ % vs @ % for foam vehicle .


In addition , higher rates of mycologic cure ( @ % vs @ % ) and effective treatment ( @ % vs @ % ) were observed with econazole nitrate foam @ % versus the foam vehicle .


There were few adverse events and only nasopharyngitis and headache were experienced by > @ % of subjects .


No serious adverse events were reported for econazole nitrate foam @ % .


Econazole nitrate foam @ % exhibited superiority over foam vehicle for the primary and secondary endpoints with a high mycologic cure rate for all pathogens evaluated .


Econazole nitrate foam @ % was safe and well tolerated with a safety profile comparable with the foam vehicle .


Econazole nitrate foam @ % presents a novel alternative for the management of tinea pedis .


Thyroid dysfunction is associated with impaired cognitive development .


Perchlorate decreases thyroidal iodine uptake , potentially reducing thyroid hormone production .


It is unclear whether perchlorate exposure in early life affects neurodevelopment .


Historical cohort analysis .


From @ to @ , @,@ women at gestational age < @ weeks recruited from antenatal clinics in Cardiff , UK and Turin , Italy were enrolled in the Controlled Antenatal Thyroid Screening Study ( CATS ) .


We undertook a retrospective analysis of @ mother-child pairs in mothers who were hypothyroid/hypothyroxinemic during pregnancy and analyzed whether first trimester maternal perchlorate levels in the highest @ % of the study population were associated with increased odds of offspring IQ being in the lowest @ % at @ years of age .


Maternal urinary perchlorate , offspring IQ .


Urine perchlorate was detectable in all women ( median @ g/L ) ; iodine levels were low ( median @ g/L ) .


Maternal perchlorate levels in the highest @ % of the population increased the odds of offspring IQ being in the lowest @ % OR = @ ( @ % CI @ , @ ) P = @ with a greater negative impact observed on verbal OR = @ ( @ % CI @ , @ ) P = @ than performance IQ .


Maternal levothyroxine therapy did not reduce the negative impact of perchlorate on offspring IQ .


This is the first study using individual-level patient data to study maternal perchlorate exposure and offspring neurodevelopment and suggests that high-end maternal perchlorate levels in hypothyroid/hypothyroxinemic pregnant women have an adverse effect on offspring cognitive development , not affected by maternal levothyroxine therapy .


These results require replication in additional studies , including in the euthyroid population .


Varenicline has been shown to significantly reduce craving and several aspects of smoking reinforcement in clinical trials , compared with placebo .


This is the first report describing the concentration-effect relationship of varenicline on relief of craving .


The pharmacokinetics ( PK ) and pharmacodynamics ( PD ) of a single @mg dose of varenicline were investigated in @ smokers in a randomized , crossover study comparing the effect of varenicline with placebo on ameliorating abstinence-and cue-induced craving and withdrawal symptoms .


Subjects were asked to complete self-reported questionnaires ( Smoking Urges Scale and Minnesota Nicotine Withdrawal Scale -LSB- MNWS -RSB- ) and blood samples were simultaneously collected for measurement of varenicline concentrations .


Only the data from the @-hr postdose abstinence period ( just prior to the cue session ) were analyzed .


Data were described by a @-compartment PK model and a linear PD model with first-order onset/offset rate constants describing the placebo response `` kinetics . ''


Response was described as the net effect of the baseline , placebo , and drug responses .


Varenicline significantly decreased mean craving score when compared with placebo and the magnitude of this response was related to varenicline concentration .


The time-course and magnitude of both placebo and varenicline craving response were characterized by a large degree of unexplained variability .


Simulations were used to illustrate the expected craving response over time and its associated random variability after chronic dosing .


Craving reduction is associated with increased varenicline concentrations .


The relatively rapid onset of this effect within @ hr postdose suggests that , smokers may experience some craving relief after acute administration of varenicline .


This study aims to evaluate the effects on physical activity ( PA ) and eating behavior ( EB ) of a tailored behavioral medicine intervention and first-time continuous positive airway pressure ( CPAP ) treatment compared with first-time CPAP treatment and advice in patients with obstructive sleep apnea syndrome ( OSAS ) and overweight .


Seventy-three patients ( meanSD , @years ) with overweight ( body mass index ( BMI ) , @ ) and moderate or severe OSAS ( Apnea-Hypopnea Index , @ ) scheduled for CPAP prescription were randomized to a control group ( CPAP and advice on the association between weight and OSAS ) or an experimental group ( CPAP and a @-month behavioral medicine intervention targeting PA and EB ) .


At baseline and after @months , eating behavior ( food frequency screening and Dutch Eating Behavior Questionnaire ) , weight , BMI , and waist circumference were assessed at one point , while PA and sedentary time were measured with accelerometry during @days .


The experimental group reduced @ kg ( @ ) in weight and @cm ( @ ) in waist circumference , significantly more than the control group .


At @months , the experimental group ate more fruit and fish/shellfish than the control group .


Low and moderate to vigorous PA did not change over time either within or between groups .


Regarding BMI , steps , and sedentary time , there were within-group differences but no differences between groups .


The behavioral medicine intervention did not change physical activity but facilitated changes in EB in patients with OSAS and overweight .


The amount of weight loss and reduction in waist circumference favored the participants receiving this treatment .


Since the strategies for achieving behavioral changes were tailored according to the individual 's goals and personal functional behavioral analyses and progressed slowly in a graded manner , it might require higher PA quotas or a period longer than @months to reveal a behavioral change of larger proportions .


Preprocedural @-dimensional CT imaging of the aortic annular plane plays a critical role for transcatheter aortic valve replacement ( TAVR ) planning ; however , manual reconstructions are complex .


Automated analysis software may improve reproducibility and agreement between readers but is incompletely validated .


In @ TAVR patients ( mean age , @ years ; @ % female ) undergoing preprocedural multidetector CT , automated reconstruction of the aortic annular plane and planimetry of the annulus was performed with a prototype of now commercially available software ( syngo.CT Cardiac Function-Valve Pilot ; Siemens Healthcare , Erlangen , Germany ) .


Fully automated , semiautomated , and manual annulus measurements were compared .


Intrareader and inter-reader agreement , intermodality agreement , and interchangeability were analyzed .


Finally , the impact of these measurements on recommended valve size was evaluated .


Semiautomated analysis required major correction in @ patients ( @ % ) .


In the remaining @ % , only minor correction was performed .


Mean manual annulus area was significantly smaller than fully automated results ( P < @ for both readers ) but similar to semiautomated measurements ( @ vs @ vs @ cm ( @ ) , respectively ) .


The frequency of concordant recommendations for valve size increased if manual analysis was replaced with the semiautomated method ( @ % agreement was improved to @ % ; @ % confidence interval for the difference -LSB- @ % -@ % -RSB- ) .


Semiautomated aortic annulus analysis , with minor correction by the user , provides reliable results in the context of TAVR annulus evaluation .


Chronic low-back pain ( cLBP ) is a common condition throughout the world , and acupuncture is widely sought for treatment .


As clinical evidence for the benefits of acupuncture grows , acupuncture for cLBP is receiving increased recognition and acceptance by both patients and professionals .


Time method acupuncture has been previously researched with respect to chronic gastritis .


For individuals with cLBP in the current study , the research team examined the efficacy of adding confluent acupoints , related to the daytime period in time method acupuncture , to regular acupuncture and also evaluated the persistence of the benefits of such acupuncture in comparison with regular acupuncture .


The study was a randomized , controlled trial ( RCT ) .


The setting was an outpatient clinic of the Dongzhimen Hospital in Beijing , China .


Participants were Chinese men and women with cLBP .


Sixty participants were randomly divided into @ groups to receive acupuncture .


The control group received a treatment that followed a routine acupuncture ( RA ) protocol , while the intervention group received a treatment that followed an RA protocol plus acupuncture in confluent points related to time ( TA ) .


The research team measured the change in participants ' scores using the visual analogue scale ( VAS ) , the number of therapy sessions needed , the number of days that participants were absent from work during the treatment period and at @ wk posttreatment , and the number of pain relapses between the end of treatment and the @ - and @-wk follow-ups .


VAS scores decreased from @ @ to @ @ in the intervention group compared with a decrease from @ @ to @ @ in the control group ( P = @ ) .


The intervention group received fewer therapy sessions ( @ @ ) than did the control group ( @ @ , P < @ ) .


Compared with the controls , the intervention group showed fewer days absent from work ( @ vs @ ; P = @ ) and fewer pain relapses ( @ vs @ ; P = @ ) at the @-wk follow-up .


In the @ groups combined , VAS decreased from @ @ before the first session of acupuncture to @ @ after the last session ( P < @ ) , and the number of therapy sessions needed for pain relief was @ @ .


Accompanying routine acupuncture with time method acupuncture can enhance the efficacy of treatment and the persistence of its benefits in individuals with cLBP .


To evaluate the effect of a protocol of local anesthesia and epinephrine associated with sedo-analgesia on post-TVT-O pain in comparison with infiltration of saline and epinephrine .


Forty-two patients undergoing TVT-O were randomized into two groups to receive periurethral infiltration with epinephrine only ( group A , n = @ ) or with epinephrine plus @ % lidocaine hydrochloride ( group B , n = @ ) .


Post-operative pain was assessed using a visual analog scale ( VAS ) from @ ( absence of pain ) to @ ( maximum pain possible ) , @ , @ , @ and @ h after the procedure .


The total amount of analgesia was recorded and the proportion of women reporting a pain VAS score @ , @ h after the procedure was calculated .


ANOVA for repeated measures and Bonferroni correction , the Student 's t test for independent samples , the Mann-Whitney U test , the Fisher exact test , or the ( @ ) test for parametric was used .


Pain level was significantly lower in group B @ ( p = @ ) and @ h ( p = @ ) after surgery , but not @ and @ h after the procedure .


No significant difference was observed in the proportion of women requesting analgesia and in the total dosage of analgesics between the two groups .


A significant higher proportion of women in group A reported a pain VAS score higher than four @ h after surgery in comparison with patients in group B.


This randomized study seems to indicate that systematic infiltration before TVT-O positioning with local anesthetic may reduce immediate post-operative pain .


Therapeutic hypothermia ( TH , @-@C ) has been shown to improve neurological outcome in comatose survivors of out-of-hospital cardiac arrest ( OHCA ) with ventricular tachycardia or fibrillation .


Earlier initiation of TH may increase the beneficial effects .


Experimental studies have suggested that starting TH during cardiopulmonary resuscitation ( CPR ) may further enhance its neuroprotective effects .


The aim of this study was to evaluate whether intra-arrest TH ( IATH ) , initiated in the field with trans nasal evaporative cooling ( TNEC ) , would provide outcome benefits when compared to standard of care in patients being resuscitated from OHCA .


We describe the methodology of a multi-centre , randomized , controlled trial comparing IATH delivered through TNEC device ( Rhinochill , Benechill Inc. , San Diego , CA , USA ) during CPR to standard treatment , including TH initiated after hospital admission .


The primary outcome is neurological intact survival defined as cerebral performance category @-@ at @days among those patients who are admitted to the hospital .


Secondary outcomes include survival at @days , proportion of patients achieving a return to spontaneous circulation ( ROSC ) , the proportion of patients admitted alive to the hospital and the proportion of patients achieving target temperature ( < @C ) within the first @hours since CA .


This ongoing trial will assess the impact of IATH with TNEC , which may be able to rapidly induce brain cooling and have fewer side effects than other methods , such as cold fluid infusion .


If this intervention is found to improve neurological outcome , its early use in the pre-hospital setting will be considered as an early neuro-protective strategy in OHCA .


Body weight-supported treadmill training ( BWSTT ) has produced mixed results compared with other therapeutic techniques .


The purpose of this study was to determine whether an intensive intervention ( intensive mobility training ) including BWSTT provides superior gait , balance , and mobility outcomes compared with a similar intervention with overground gait training in place of BWSTT .


Forty-three individuals with chronic stroke ( mean -LSB- SD -RSB- age , @ -LSB- @ -RSB- years ; mean -LSB- SD -RSB- time since stroke , @ -LSB- @ -RSB- years ) , were randomized to a treatment ( BWSTT , n = @ ) or control ( overground gait training , n = @ ) group .


Treatment consisted of @ hour of gait training ; @ hour of balance activities ; and @ hour of strength , range of motion , and coordination for @ consecutive weekdays ( @ hours ) .


Assessments ( step length differential , self-selected and fast walking speed , @-minute walk test , Berg Balance Scale -LSB- BBS -RSB- , Dynamic Gait Index -LSB- DGI -RSB- , Activities-specific Balance Confidence -LSB- ABC -RSB- scale , single limb stance , Timed Up and Go -LSB- TUG -RSB- , Fugl-Meyer -LSB- FM -RSB- , and perceived recovery -LSB- PR -RSB- ) were conducted before , immediately after , and @ months after intervention .


No significant differences ( = @ ) were found between groups after training or at follow-up ; therefore , groups were combined for remaining analyses .


Significant differences ( = @ ) were found pretest to posttest for fast walking speed , BBS , DGI , ABC , TUG , FM , and PR .


DGI , ABC , TUG , and PR results remained significant at follow-up .


Effect sizes were small to moderate in the direction of improvement .


Future studies should investigate the effectiveness of intensive interventions of durations greater than @ days for improving gait , balance , and mobility in individuals with chronic stroke .


The aim of this study was to evaluate the clinical benefit of valacyclovir when performing full-mouth periodontal debridement in patients with advanced chronic periodontitis .


Fifty-nine patients with advanced chronic periodontitis were randomly assigned into control-treatment group ( n = @ ) and intensive-treatment group ( n = @ ) .


All patients were given instructions of basic oral hygiene and a standard cycle of supragingival mechanical scaling and polishing .


Patients in the intensive-treatment group received oral valacyclovir for @ week , while patients in the control-treatment group received placebo .


Thereafter , patients in both groups underwent full-mouth intensive removal of subgingival dental plaque biofilms with the use of scaling and root planing within @ hours .


Periodontal parameters were evaluated before treatment and @ or @ months after treatment .


The data was statistically analyzed using SPSS@ @ software package .


No significant difference in clinical parameters was noted before treatment .


@ and @ months after treatment , the mean percentage reduction of sites with BOP and PD@ mm were significantly higher in the intensive-treatment group than in the control-treatment group ( P < @ ) .


Similarly , patients in the intensive-treatment group had higher mean PD reduction than those in the control-treatment group @ months ( P < @ ) and @ months after therapy ( P < @ ) .


However , the mean values of CAL reduction were slightly and not significantly higher in the intensive-treatment group than in the control-treatment group after therapy .


It may be concluded that valacyclovir significantly improves clinical results of full-mouth non-surgical periodontal debridement in advanced chronic periodontitis .


Heart rate was proposed as an emergent cardiovascular ( CV ) risk factor .


Previous studies have shown associations between increased heart rate and CV risk in various populations .


We aimed to evaluate the prognostic relevance of heart rate in a large contemporaneous medically optimized cohort of patients with stable chronic CV disease .


In a post hoc analysis of the ONTARGET/TRANSCEND trials , we evaluated associations between baseline and average heart rate in trial with CV risk in @ , @ patients followed for a median of @ years .


The primary outcome , major vascular events ( MVE ) , was a composite of CV death , myocardial infarction ( MI ) , stroke , and congestive heart failure ( CHF ) .


Pre-specified secondary outcomes included all-cause death and the individual components of the primary outcome .


Associations between heart rate and outcomes were computed with heart rate as a continuous variable , baseline heart rate > @ vs @ bpm , and across heart rate quintiles , adjusting for other markers of risk , beta-blocker and non-dihydropyridine calcium channel blocker use .


For each @ bpm increase in baseline and average heart rate , we observed a significant increase in risk of MVE , CV death , CHF and all-cause death .


There was a continuous relationship between MVE and baseline and , more importantly , average in-trial heart rate , with no observed threshold .


MVE , CV death , stroke , CHF , and all-cause death increased across heart rate quintiles .


There was no association between MI and HR .


Results were consistent in clinically relevant subgroups .


There were modest but significant improvements in C-statistic and in statistical measures of model calibration for models that included heart rate for MVE , CV death , CHF and all-cause death .


This large study examined and quantitated associations between heart rate and CV events in a contemporary medically optimized population with stable CV disease .


Resting and , in particular , in-trial average heart rate are independently associated with significant increases in CV events and all-cause death .


Lumbar laminectomy is a commonly performed procedure in neurosurgical and orthopedic practice .


Postoperative pain reliefhelps in early mobilization , initiation of physiotherapy , provides satisfaction to the patients and plays an important role in reducing the morbidity and mortality .


This prospective study investigated the simple technique of instillation of wound with bupivacaine and leaving a contact time of @ seconds on postoperative pain following lumbar laminectomy .


@ ASA I and II patients scheduled for laminectomy were randomly allocated to receive either @ ml of normal saline ( group I ) or @ % of bupivacaine ( group II ) into the wound after securing hemostasis .


After a dwell time of @sec the wound was closed in layers without mopping or suctioning .


After extubation , the pain scores were evaluated by visual analog scale at every @ hrs .


for @hrs and also the time for first demand of analgesia , number of analgesic demands and the total amount of analgesia consumed were noted by an independent observer .


The median duration of analgesia in group I was @ -LSB- @-@ -RSB- and in group II @ -LSB- @-@ -RSB- hrs .


with a p = @ .


The number of demands and the amount of analgesia consumed was also statistically significant .


Wound instillation technique is simple , safe and effective in management of acute pain management after lumbar laminectomy and can be used as one among the multimodal armamentarium in pain management .


The Mothers After Gestational Diabetes in Australia Diabetes Prevention Program ( MAGDA-DPP ) is a randomized controlled trial ( RCT ) that aims to assess the effectiveness of a structured diabetes prevention intervention for women who had gestational diabetes .


The original protocol was published in Trials ( http://www.trialsjournal.com/content/@/@/@ ) .


This update reports on an additional exclusion criterion and change in first eligibility screening to provide greater clarity .


The new exclusion criterion `` surgical or medical intervention to treat obesity '' has been added to the original protocol .


The risks of developing diabetes will be affected by any medical or surgical intervention as its impact on obesity will alter the outcomes being assessed by MAGDA-DPP .


The screening procedures have also been updated to reflect the current recruitment operation .


The first eligibility screening is now taking place either during or after pregnancy , depending on recruitment strategy .


To compare prostatic arterial embolization ( PAE ) and transurethral resection of the prostate ( TURP ) in the care of patients with benign prostatic hyperplasia ( BPH ) .


This prospective randomized clinical trial was approved by the institutional review board .


A total of @ patients provided written informed consent and were randomly assigned to undergo PAE ( n = @ ) or TURP ( n = @ ) .


The groups were compared regarding relevant adverse events and complications .


Functional results -- including improvement of International Prostate Symptom Score ( IPSS ) , quality of life ( QOL ) , peak urinary flow , postvoiding residual urine volume , prostate-specific antigen ( PSA ) level , and prostate volume -- were assessed at @ - , @ - , @ - , @ - , and @-month follow-up between January @ , @ , and January @ , @ .


Student t test , ( @ ) test , Fisher exact test , and repeated measures analysis of variance were used , as appropriate .


Overall technical success rates for TURP and PAE were @ % and @ % , respectively ; the clinical failure rates were @ % and @ % , respectively .


The six functional results showed improvements after TURP and PAE at all follow-up time points when compared with preoperative values ( P = @ ) .


However , the TURP group showed greater degrees of improvement in the IPSS , QOL , peak urinary flow , and postvoiding residual urine volume at @ and @ months , as well as greater reductions in the PSA level and prostate volume at all follow-up time points , when compared with the PAE group ( P < @ ) .


The PAE group showed more overall adverse events and complications ( P = @ ) , mostly related to acute urinary retention ( @ % ) , postembolization syndrome ( @ % ) , and treatment failures ( @ % technical ; @ % clinical ) .


Both procedures resulted in significant clinical improvements in the treatment of BPH .


However , the advantages of the PAE procedure must be weighed against the potential for technical and clinical failures in a minority of patients .


The aim of this trial was to compare the effects of resistance training versus passive physical therapy on quality of life ( QoL ) , fatigue , and emotional distress outcomes during radiation therapy in patients with spinal bone metastases under radiotherapy ( RT ) .


In this randomized trial , @ patients were treated from September @ until March @ into one of the two groups : isometric resistance training or physical therapy with thirty patients in each group during RT. .


EORTC QLQ-BM@ , EORTC QLQ-FA@ , and FBK-R@ were assessed at baseline , three months , and six months after RT. .


Psychosocial aspects in resistance training group ( Arm A ) were significantly improved after three ( p = @ ) and six months ( p = @ ) .


Other rated items of the QLQ-BM@ painful site , and pain characteristics were without significant differences .


Functional interference showed a positive trend after six months ( p = @ ) .


After six months , physical fatigue ( p = @ ) , and interference with daily life ( p = @ ) according to the QLQ-FA@ assessment improved in Arm A significantly .


Emotional distress was in Arm A lower after six months ( p = @ ) .


The Cohen 's effect size confirmed the clinically significant improvement of these findings .


In this group of patients we were able to show that guided isometric resistance training of the paravertebral muscles can improve functional capacity , reduce fatigue and thereby enhance QoL over a @-months period in patients with stable spinal metastases .


The results offer a rationale for future large controlled investigations to confirm these findings .


Isotretinoin-Lidose , the first new formulation of isotretinoin in @ years , differs from previously approved isotretinoin formulations in that it is less dependent on the presence of fat in the gut for absorption .


Evaluate the safety profiles of isotretinoin-Lidose and food-dependent generic isotretinoin in the largest clinical study with isotretinoin-@ randomized patients from @ study sites .


Determine if the efficacy of this new formulation is noninferior to an existing isotretinoin .


Multicenter , double-blind , randomized , parallel-group , noninferiority trial .


Study medication was taken with meals twice daily for @ weeks .


Patients were followed for @ weeks after the last dose .


Safety evaluations included recordings of adverse events , assessments for depression , anxiety , emergent psychotic symptoms , and suicidal ideation/behavior , as well as DEXA and X-ray evaluations and changes in bone age .


Two co-primary efficacy outcomes were measured to assess noninferiority : a ) change in total nodular facial and truncal lesion count at from baseline to week @ and b ) percentage of patients who experienced at least @ % reduction in nodular facial and truncal lesion count from baseline to week @ .


Although isotretinoin-Lidose can be taken without meals , it was given with food because the absorption of both formulations in the study had to be similar to detect noninferiority .


The safety profile of the @ formulations was comparable .


Criteria for noninferiority for both co-primary efficacy outcomes were met based on predetermined margins .


Safety and efficacy of isotretinoin-Lidose is similar and noninferior to food-dependent generic isotretinoin , respectively .


To optimize contrast media ( CM ) injection protocols by individually tailoring the dose to the patient 's body weight ( BW ) , body mass index ( BMI ) and heart rate ( HR ) at dual-source computed tomography coronary angiography ( DSCT-CA ) .


A total of @ patients were prospectively enrolled and were randomly assigned to four groups .


The control group received @ ml CM at @ ml/s .


For the HR-optimized group , the injection duration was the same as the scan duration plus @ s.


In the Body-optimized group , the dose of CM was tailored to BW and BMI .


In the HR + Body-optimized group , CM protocols tailored to body size and scan duration were applied .


Individual variability of arterial attenuation and incidence of arterial over-opacification ( attenuation > @ HU ) in the four groups were compared .


Correlations between BW , BMI , HR , and arterial attenuations were evaluated in the four groups , respectively .


Reduced individual variability of arterial attenuation and a significantly lower incidence of arterial over-opacification were found in the Body-optimized group and HR + Body-optimized group .


Arterial attenuation was inversely correlated with BW , BMI , and HR in the control group , inversely correlated with BW and BMI in the HR-optimized group , and inversely correlated with HR in the Body-optimized group .


In the HR + Body-optimized group , arterial attenuation was not significantly correlated with BW , BMI , or HR respectively .


CM protocols individually tailored to BW , BMI , and HR can lead to reduced individual variability and a lower incidence of over-opacification of arterial attenuation , but also can reduce the influence of BW , BMI , and HR on arterial attenuations at DSCT-CA .


The probability and risk of operations increase in patients with type @ diabetes mellitus .


For diabetic patients , blood glucose control is a key factor to improving the prognosis of surgery .


During perioperative period , insulin therapy is usually advised to be used for surgical patients with type @ diabetes .


However , the insulin regimen which one is better remains controversial .


In this study , we estimated the efficacy , safety and advantage of different insulin therapy strategy during perioperative period .


A total of @ cases of surgical patients with type @ diabetes mellitus enrolled in the present study .


According to the glucose level at admission , all patients were divided into relatively high glucose group ( group A , fasting blood glucose ( FBG ) @ mmol/L ) and higher glucose group ( group B , FBG > @ mmol/L ) .


Patients in group A randomly accepted premixed insulin twice a day , or basal insulin plus oral medications , and were divided into group A@ and A@ respectively .


Patients in group B randomly received premixed insulin twice daily , basal insulin plus oral hypoglycemic agents , or basal insulin plus preprandial insulin , and were divided into group B@ , B@ and B@ respectively .


The data of the preoperative preparation time , the daily doses of insulin used in different periods , postoperative incision healed installments , hypoglycemic events , the total hospitalization time , postoperative complications were all collected and statistically analyzed .


Compared the main outcome measures in groups treated by premixed insulin therapy , both in preoperative preparation and postoperative period , the daily insulin dosage and the frequency of hypoglycemic events were decreased in groups treated by basal insulin therapy ( P < @ ) .


The preoperative preparation time and the total hospitalization time in groups with basal insulin therapy were shorter than that in groups with premixed insulin therapy ( P < @ ) .


The incision healing rate of stage I , II and III among different therapy protocols were significantly different ( P < @ ) .


Basal insulin therapy could be used in diabetic patients undergoing elective major and medium surgery during whole perioperative period .


Basal insulin therapy strategy , including a single injection of basal insulin and basal insulin plus preprandial insulin injection subcutaneously , is superior to premixed insulin therapy in the perioperative blood glucose management , and it could be viewed as the best choice in glucose control during perioperative period .


Women have unfavorable prognosis after myocardial infarction ( MI ) .


This text describes sex differences in mortality and in the power of risk predictors in contemporarily-treated MI patients .


A population of @ MI patients ( @ % females ) was followed up for @years .


Effects of sex and age on total mortality were investigated by multivariable Cox analysis .


Mortality predictors were investigated by receiver-operator characteristics analysis .


Stepwise multivariable Cox regression was used to create sex-specific predictive models .


Thirty-day mortality was @-fold higher in women .


However , sex was not a significant mortality predictor in a model adjusted for age .


Predictors for @-year mortality performed differently in male and female patients .


In women , a sex-specific model provided better risk stratification than a sex-neutral model .


The unfavorable prognosis of female MI patients can be explained by advanced age .


Sex-specific predictive models might improve risk stratification in female survivors of acute MI .


The aim of this study was to compare the outcomes of dorsal onlay urethroplasty using buccal mucosa graft ( BMG ) versus penile skin flap ( PSF ) in the repair of long anterior urethral strictures .


Patients with long anterior urethral strictures were randomized to receive either dorsal onlay BMG urethroplasty or PSF urethroplasty .


All patients were evaluated preoperatively and during follow-up with the International Prostate Symptom Score ( IPSS ) and uroflowmetry .


Success was reported when there were no obstructive symptoms on IPSS , with a peak urinary ow rate ( Qmax ) of at least @ ml/s .


Failure was reported in patients with obstructive symptoms , Qmax less than @ ml/s and evidence of recurring stricture on urethrography .


The study included @ and @ patients in the BMG and PSF groups , respectively .


The mean operative time was significantly shorter in the BMG than in the PSF group .


The success rate was higher in the BMG than in the PSF group ( @ % vs @ % ) , but not statistically significant different .


The PSF group included one case of extensive skin loss , three cases with superficial skin necrosis and two with minor penile torsion .


In the BMG group , there were three cases of perioral numbness and another three had increased salivation .


The incidence of troublesome postvoid urinary dribbling was significantly higher in the PSF than in the BMG group .


After @ months of urethroplasty , patient satisfaction was statistically significantly higher in the BMG than in the PSF group .


BMG and PSF dorsal onlay urethroplasty had similar success rates .


However , BMG is technically easier , takes less operative time and has a potential advantage in reducing postoperative morbidity , therefore leading to satisfaction for most patients .


Pulpotomy is the common therapy for cariously exposed pulps in symptom-free primary molar teeth .


Formocresol ( FC ) is considered the gold standard dressing agent for pulpotomy , but concerns have been raised over the years about its safety .


Other alternative pulpotomy agents have been investigated and suggested .


The objective was to evaluate and compare the clinical and radiographic response of FC and white mineral trioxide aggregate ( MTA ) as pulpotomy materials on primary molars .


Fifty primary molars , with deep carious lesion that exposed a vital but asymptomatic pulp , in @ children aged @-@ years were treated with conventional pulpotomy procedure .


The teeth were divided randomly into two groups .


Group I ( FC ) and group II ( MTA ) .


The treated teeth were evaluated clinically and radiographically and were followed-up for @ months .


At the end of the @ months follow-up , the clinical success rates for FC and MTA were @ % and @ % , respectively .


There was a statistically significant difference ( P = @ ) between the clinical success rates of FC and MTA .


While the radiographic success rates for FC and MTA were @ % and @ % , respectively , there was no statistically significant difference between the radiographic success of MTA and FC .


White MTA showed a higher clinical and radiographic success rate when compared to FC as a pulpotomy agent in vital primary molars , and it has a potential to become a replacement for FC in primary molars .


Diabetic nephropathy ( DN ) is a serious and common complication of diabetes mellitus leading to end-stage renal disease in up to @ % of diabetic patients .


The first manifestation of DN in humans is microalbuminuria , which arises from the increased passage of albumin through the glomerular filtration barrier .


Reactive oxygen species , inflammatory cytokines , and growth factors are key players in the context of damage to the glomerular filtration barrier .


In this study the herbal combination Canephron ( ) N , containing lovage root , rosemary leaves , and centaury herb , was administered to patients with DN to study the effects on microalbuminuria and overall oxidant/antioxidant status .


An open study involving @ patients with DN was performed to compare the effects of Canephron N administered concomitantly with standard antidiabetic therapy and an angiotensin-converting enzyme ( ACE ) inhibitor , with the standard therapy and ACE inhibitor treatment alone .


After @ months of therapy the level of microalbuminuria decreased significantly in the study group compared with the control group .


Canephron N had a positive effect on the antioxidant defense status and lipid peroxidation levels .


In addition , liver aminotransferase levels did not change .


With respect to the excellent tolerability , the study results encourage use of the herbal combination as an add-on therapy in patients with DN .


The aim of this study was to assess the feasibility of hybrid coronary revascularization ( HCR ) in patientswith multivessel coronary artery disease ( MVCAD ) referred for standard coronary artery bypass grafting ( CABG ) .


Conventional CABG is still the treatment of choice in patients with MVCAD .


However , the limitations of standard CABG and the unsatisfactory long-term patency of saphenous grafts are commonly known .


A total of @ patients with MVCAD involving the left anterior descending artery ( LAD ) and a critical ( > @ % ) lesion in at least @ major epicardial vessel ( except the LAD ) amenable to both PCI and CABG and referred for conventional surgical revascularization were randomly assigned to undergo HCR or CABG ( in a @:@ ratio ) .


The primary endpoint was the evaluation of the safety of HCR .


The feasibility was defined by the percent of patients with a completeHCR procedure and the percent of patients with conversions to standard CABG .


The occurrence of major adverse cardiac events such as death , myocardial infarction , stroke , repeated revascularization , and major bleeding within the @-month period after randomization was also assessed .


Most of the pre-procedural characteristics were similar in the @ groups .


Of the patients in the hybrid group , @ % had complete HCR and @ % patients were converted to standard CABG .


At @ months , the rates of death ( @ % vs. @ % , p = NS ) , myocardial infarction ( @ % vs. @ % , p = NS ) , major bleeding ( @ % vs. @ % , p = NS ) , and repeat revascularization ( @ % vs. @ % , p = NS ) were similar in the @ groups .


In both groups , no cerebrovascular incidents were observed .


HCR is feasible in select patients with MVCAD referred for conventional CABG .


( Safety and Efficacy Study of Hybrid Revascularization in Multivessel Coronary Artery Disease -LSB- POL-MIDES -RSB- ; NCT@ ) .


In this study , we sought to identify a criterion for the intermediate-risk grouping of patients with cervical cancer who exhibit any intermediate-risk factor after radical hysterectomy .


In total , @ patients with pathologically proven stage IB-IIA cervical cancer with any intermediate-risk factor after radical hysterectomy were randomly assigned to two groups , a development group and a validation group , at a ratio of @:@ ( @ patients :@ patients ) .


To predict recurrence , multivariate models were developed using the development group .


The ability of the models to discriminate between groups was validated using the log-rank test and receiver operating characteristic ( ROC ) analysis .


Four factors ( histology , tumour size , deep stromal invasion ( DSI ) , and lymphovascular space involvement ( LVSI ) ) were significantly associated with disease recurrence and included in the models .


Among the nine possible combinations of the four variables , models consisting of any two of the four intermediate-risk factors ( tumour size @cm , DSI of the outer third of the cervix , LVSI , and adenocarcinoma or adenosquamous carcinoma histology ) demonstrated the best performance for predicting recurrence .


This study identified a ` four-factor model ' in which the presence of any two factors may be useful for predicting recurrence in patients with cervical cancer treated with radical hysterectomy .


In order to meet the patients wish for compensation of presbyopia in a flexible way , even in cases of an already pseudophacic eye , sulcus-fixated additional intraocular lenses ( IOL ) have been developed as an alternative to multifocal IOLs ( MIOL ) in the capsular bag .


This allows subsequent application of multifocal optics .


Furthermore , these additional lenses offer a relatively simple opportunity for postoperative refractive fine tuning or , in cases of incompatibility , a minimally invasive explantation of the multifocal part of the optical system .


The objective of our work was the examination of a diffractive multifocal additional IOL and its functional characteristics .


In a prospective , monocentric trial @ eyes of @ patients had cataract surgery with implantation of a monofocal IOL into the capsular bag and simultaneous implantation of a multifocal additional IOL into the sulcus .


The visual acuity was tested at different distances @ weeks and @ months postoperatively .


At the @ month follow-up contrast sensitivity and defocus curves were additionally assessed .


Patients with bilateral implantation filled in a questionnaire to assess their subjective satisfaction of postoperative visual quality .


All eyes had an uneventful postoperative course .


At both follow-ups an uncorrected distance and near visual acuity ( VA ) of @ LogMAR or better was achieved .


In intermediate vision @ out of @ eyes after @ weeks and @ out of @ eyes after @ months reached an uncorrected VA of @ LogMAR or better .


The defocus curves showed a typical two-peaked shape .


At intermediate distance ( -@ D of defocus ) the median VA was @ LogMAR .


Contrast sensitivity testing showed results in the upper region of the standard range of age-matched , healthy patients .


The examined type of diffractive additional IOL achieved good to very good functional results , which are comparable to corresponding IOLs in the capsular bag .


Multifocal additional IOLs can be considered as a useful extension of refractive surgical alternatives for the compensation of presbyopia .


The possibility to implant the multifocal optic part independently of the primary surgery , the minimal invasivity of the procedure and the likewise time-independent reversibility can be pointed out as special qualities of these IOL .


Clinical trials suggest that statins have beneficial effects on the cardiovascular system independent from their cholesterol lowering properties .


In patients with chronic kidney disease stage II-III , we tested the hypothesis that atorvastatin increased systemic and renal nitric oxide ( NO ) availability using L-N ( G ) - monomethyl arginine ( L-NMMA ) as an inhibitor of NO production .


In a randomized , placebo-controlled , crossover study patients were treated with atorvastatin for @ days with standardized diet and fluid intake .


Glomerular filtration reate ( GFR ) , fractional excretions of sodium ( FENa ) , urinary excretion of aquaporin-@ ( u-AQP@ ) and epithelial sodium channels ( u-ENaC ) , vasoactive hormones ( renin , angiotensin II , aldosterone , arginine vasopressin , endothelin-@ and brain natriuretic peptide ) and central blood pressure ( BP ) estimated by applanation tonometry were measured before and after systemic administration of the NO inhibitor L-NMMA .


Atorvastatin caused a significant reduction in U-ENaC , but sodium excretion , C H @ O , FENa and u-AQP@ were not changed by atorvastatin .


L-NMMA reduced renal effect variables , including GFR , FENa and u-ENaC and increased brachial BP and central BP to a similar extent during both treatments .


Vasoactive hormones were changed in the same way by L-NMMA during atorvastatin and placebo treatment .


During , atorvastatin and placebo treatment , inhibition of nitric oxide synthesis induced the same response in brachial and central blood pressure , GFR , renal tubular function and vasoactive hormones .


Thus , the data do not support that atorvastatin changes nitric oxide availability in patients with mild nephropathy .


The reduced u-ENaC may reflect changes in sodium absorption in the nephron induced by atorvastatin .


The aim of the study is to present a comparison of short-term results of double - versus single-bundle anatomical reconstruction of the anterior cruciate ligament ( ACL ) using hamstring endons and their fixation with absorbable interference screws .


A total of @ patients with an isolated ACL lesion and the healthy contralateral knee who met the indication criteria for ACL double bundle reconstruction ( TISL , @ mm ; ICNW , @ mm ) were intra-operatively allocated at random to either double-bundle group ( DB , n = @ ) or single-bundle group ( SB , n = @ ) .


At @ months after surgery , @ patients ( DB group , n = @ ; SB group , n = @ ) , comprising @ men and @ women , were evaluated ; the average age was @ years and the injury-to-surgery interval was @ weeks .


Pre - and post-operative subjective criteria involved the IKDC and Lysholm score .


Objectively , the occurrence of graft failure , range of motion deficit , return to pre-injury sports activity , side-to-side difference in anterior laxity of both knees in @ flexion on a GNRB laximeter at an applied pressure of @ N and @ N , and pivot shift phenomenon were assessed .


No statistically significant difference was found in pre-operative values between the two groups .


Post-operatively , there were no significant differences in the occurrence of complete graft failure ( p = @ ; DB group , n = @ ; SB group , n = @ ) , range-of-motion deficit ( p = @-@ @ ) or return to pre-operative sports activity ( p = @ ) .


In the DB group , side-to-side anterior tibial shifts at a pressure of @ N ( medians = @ mm and @ mm for DB and SB groups , respectively ; p = @ ) and at a pressure of @ N ( DB group = @ mm ; SB group = @ mm ; p < @ ) were significantly different from the corresponding values in the SB group .


Positive results for the pivot shift test ( PST ) were significantly less frequent in the DB than the SB group ( Chi-square test = @ ) .


The SB group patients had a @-times ( odds ratio , @ ) higher risk of positive postoperative PST results than the DB group patients .


In both groups , a comparison of pre - and post-operative criteria showed significant improvement in both the subjective and the objective results .


The results of this study , in accordance with other authors ' conclusions , suggest that the double-bundle technique provides better control over rotational and anterior knee laxity and therefore restores knee biomechanics better .


However , other literature data do not confirm any significantly better outcomes of this method .


Since only short-term results have been obtained so far , the study will continue because only the long-term results can provide conclusive evidence of an advantage of one technique over the other .


Our study showed significantly better restoration of knee rotational and anterior laxity in the patients undergoing anatomical reconstruction of the ACL by the double-bundle technique .


The other evaluated criteria did not differ in relation to the technique used .


Increased blood pressure ( BP ) is commonly observed in patients treated with vascular endothelial growth factor pathway inhibitors , including axitinib .


Ambulatory BP monitoring ( ABPM ) and pharmacokinetic data were collected in a randomised , double-blind phase II study of axitinib with or without dose titration in previously untreated patients with metastatic renal cell carcinoma .


Aims of these analyses were to ( @ ) develop a population pharmacokinetic-pharmacodynamic model for describing the relationship between axitinib exposure and changes in diastolic BP ( dBP ) and ( @ ) simulate changes in dBP with different axitinib dosing regimens .


We employed a three-stage modelling approach , which included development of ( @ ) a baseline @-h ABPM model , ( @ ) a pharmacokinetic model from serial and sparse pharmacokinetic data , and ( @ ) an indirect-response , maximum-effect ( Emax ) model to evaluate the exposure-driven effect of axitinib on dBP .


Simulations ( N = @,@ ) were performed using the final pharmacokinetic-pharmacodynamic model to evaluate dBP changes on days @ and @ of treatment with different axitinib doses .


Baseline ABPM data from @ patients were best described by @-h mean dBP and two cosine terms .


The final indirect-response Emax model showed good agreement between observed @-h ABPM data and population and individual predictions .


The maximum increase in dBP was @ % , and the axitinib concentration at which @ % of the maximal increase in dBP was reached was @ ng/mL .


Our model adequately describes the relationship between axitinib exposure and dBP increases .


Results from these analyses may potentially be applied to infer dBP changes in patients administered axitinib at nonstandard doses .


To compare risk-adjusted differences between men and women @ and @ days after hip fracture surgery in not walking , ability to return home in a community-dwelling subset , not walking in a nursing home resident subset , and mortality within @ days .


Cohort study .


Data were from a randomized clinical trial that compared two blood transfusion protocols after hip fracture .


Individuals with hip fracture ( N = @,@ ; @ ( @ % ) male ) .


Walking , dwelling , and mortality were determined in telephone follow-up @ and @ days after randomization , which occurred within @ days of surgery .


Sex differences for each outcome were compared using univariate and multivariate regression adjusting for potential confounders .


Men were younger ( P < @ ) and more likely to have comorbidity ( P = @ ) than women at the time of hip fracture and to die within @ days , even after risk adjustment ( odds ratio ( OR ) = @ , @ % confidence interval ( CI ) = @-@ @ ) .


After risk adjustment , male survivors were as likely as female survivors not to walk ( OR = @ , @ % CI = @-@ @ ) and no less likely to return home ( OR = @ , @ % CI = @-@ @ ) @ days after hip fracture .


No differences were noted between male and female nursing home residents in not walking within @ days ( OR = @ , @ % CI = @-@ @ ) .


Although men experience higher mortality , male survivors can expect recovery of walking ability similar to that of female survivors and are as likely to return to community living .


A single subanesthetic infusion of the N-methyl-D-aspartate ( NMDA ) receptor antagonist ketamine has rapid and potent antidepressant properties in treatment-resistant major depressive disorder ( TRD ) .


As a family history of an alcohol use disorder is a positive predictor of ketamine 's antidepressant response and the strength of the association increases over time , we hypothesized that depressed subjects with a family history of an alcohol use disorder would have greater antidepressant durability and that riluzole would augment and/or extend ketamine 's antidepressant efficacy .


Fifty-two TRD subjects received an open-label infusion of ketamine ( @ mg/kg over @ minutes ) , and , four to six hours post-infusion , were randomized to either flexible-dose ( @-@mg / day ) riluzole or placebo in the following proportions : Family History Positive ( FHP ) riluzole ( n = @ ) , FHP placebo ( n = @ ) , Family History Negative ( FHN ) riluzole ( n = @ ) , and FHN placebo ( n = @ ) .


FHP subjects randomized to placebo had a greater antidepressant response than FHN subjects ; however , contrary to our initial hypothesis , there was no significant difference in antidepressant efficacy with riluzole .


Although potentially underpowered , there was no difference in overall time-to-relapse based on randomization status ( riluzole responders : n = @ , placebo responders : n = @ ) .


Yet , time-to-relapse was longer in FHP placebo responders ( n = @ ) compared to FHN placebo responders ( n = @ ) with , again , no significant difference in time-to-relapse in FHP riluzole responders ( n = @ ) compared to FHN riluzole responders ( n = @ ) .


Ketamine 's extended antidepressant durability in FHP TRD should be considered in the design and analysis of ketamine depression trials .


To investigate the effect of combination therapy of backward walking training and alpha-lipoic acid ( ALA ) treatment on the distribution of plantar pressure in patients with diabetic peripheral neuropathy ( DPN ) .


This study is a double-blinded , randomized controlled trial .


The test group was treated with combination therapy of backward walking exercise and ALA ( ALA for @wk , backward walking exercise for @wk ) , and the control group only received ALA treatment .


Clinical and laboratory setting .


Patients with DPN ( N = @ ) were divided into the test group ( n = @ ) or control group ( n = @ ) .


Backward walking exercise with ALA treatment for the test group ; lipoic acid treatment for the control group .


Plantar pressure before and after treatment was tested and analyzed with the flatbed plantar pressure measurement system .


After treatment , peak plantar pressure in the forefoot dropped for both the test and control groups ; peak plantar pressure for the test group dropped significantly .


Peak plantar pressure in the medial foot slightly increased for the test group , suggesting a more even distribution of plantar pressure in the test group after treatment .


The combination therapy of ALA and backward walking proved to be more effective than ALA monotherapy .


Backward walking also proved to have an ameliorating effect on balance ability and muscle strength of patients with DPN .


Hypertrophic resistance exercise ( HRE ) induces central and peripheral fatigue .


However , more detailed information about changes in corticospinal excitability remains to be elucidated .


Eleven volunteers participated in the upper arm HRE which included one repetition maximum ( @ RM ) control contractions and three sets of @ RM ( SET@-@ ) .


Transcranial magnetic stimulation ( TMS ) was applied during maximal isometric voluntary contraction ( MVC ) at the end of each set and during control contractions to study changes in corticospinal excitability .


Electrical stimulation was used in order to measure peripheral changes .


MVC decreased after each set when compared to control contractions .


Motor evoked potential ( MEP ) were @ % ( p < @ ) , @ and @ % after SET@ , SET@ and SET@ , respectively , when compared to pre-exercise value .


A significant reduction in MEP area between SET@ and SET@ ( p < @ ) was observed while silent period ( SP ) duration increased ( ~ @-@ms , p < @ ) simultaneously between these sets .


TMS-evoked twitch force during MVC increased significantly following each set when compared to pre-exercise value .


Simultaneously , a significant reduction was observed in resting twitch force over the sets .


The results of this study clearly support the existence of both central and peripheral fatigue during HRE of elbow flexors .


However , changes in the MEP area and SP suggest that during HRE of the elbow flexors , the corticospinal excitability increases first , until at some point , supraspinal fatigue takes over .


Actinic keratosis therapy can elicit unsightly and painful local skin responses ; assessment of treatment satisfaction and health-related quality of life ( QoL ) is important .


Ingenol mebutate gel is a novel topical field therapy for actinic keratosis .


Post-hoc analyses were performed based on patient-reported outcomes from phase-III trials ( n = @ ) to assess the effects of ingenol mebutate on QoL and the relationship between both QoL and treatment satisfaction , and degree of lesion clearance .


Patients received ingenol mebutate or vehicle for self-application to a @-cm ( @ ) contiguous area : @ % once daily for @ consecutive days ( face/scalp ) or @ % once daily for @ consecutive days ( trunk/extremities ) .


QoL ( Skindex-@ ) and Treatment Satisfaction Questionnaire for Medication data were recorded .


Significant , positive associations between Treatment Satisfaction Questionnaire for Medication score and degree of clearance were identified for patients in the face/scalp ( effectiveness P < @ and global satisfaction P = @ ) and trunk/extremities ( P < @ and P = @ , respectively ) groups .


There was a significant association between Skindex-@ score and clearance for patients in the face/scalp group for change in symptoms ( P = @ ) , emotions ( P = @ ) , and overall Skindex-@ score ( P = @ ) from baseline .


Clinical trial population findings may not be generalizable to clinical practice .


Ingenol mebutate significantly improved patients ' QoL and treatment satisfaction .


Improvements were associated with higher degrees of actinic keratosis lesion clearance .


Left ventricular ( LV ) twist may be a compensatory mechanism to preserve ejection fraction ( EF ) .


In patients with hypertension , twist varies depending on the left ventricle 's degree of remodeling and systolic function ; it is increased in those with hypertension with normal EF ( HTNEF ) and diminished in those with hypertension with low EF ( HTLEF ) .


The ratio of collagen-degradation biomarkers in patients with hypertension is higher in those with low EFs than those with preserved EFs and may contribute to remodeling and systolic dysfunction .


The aim of this study was to evaluate the relationship between these biomarkers and LV twist in @ patients with hypertension , @ with EFs < @ % ( HTLEF group ) and @ with EFs @ % ( HTNEF group ) .


Net LV twist was measured using speckle-tracking echocardiography .


Markers of collagen turnover , including serum concentrations of matrix metalloproteinase-@ ( MMP@ ) , tissue inhibitor of MMP@ ( TIMP@ ) , and the ratio of MMP@ to TIMP@ , were measured .


Log TIMP@ , log MMP@ , and log MMP@/TIMP@ ratio levels were higher in the HTLEF group than the HTNEF group ( @ @ vs @ @ -LSB- P < @ -RSB- , @ @ vs @ @ -LSB- P < @ -RSB- , and -@ @ vs -@ @ -LSB- P < @ -RSB- , respectively ) .


Net LV twist was lower in the HTLEF group than the HTNEF group ( @ @ vs @ @ , P < @ ) .


An inverse correlation existed between log MMP@/TIMP@ and net LV twist after adjusting for age , EF , duration of heart failure , systolic blood pressure , LV mass index , and LV sphericity index at end-diastole ( r = -@ , P < @ ) .


This inverse correlation between twist and loss of myocardial collagen scaffolding in patients with hypertension with heart failure suggests that the integrity of the extracellular matrix may play an important role in preserving myocardial deformation .


Treatment approaches for major depressive disorder ( MDD ) result in approximately one third of patients achieving remission after a first treatment .


Added treatment generally improves remission rates , but approximately one third of all patients fail to respond after several treatments ( sequential monotherapies or combined treatment ) .


A pretreatment biomarker could help identify these patients .


Overactivity of the subcallosal cingulate has been associated with failure of response to treatment in MDD , and it is a potential candidate for such a biomarker .


Investigators enrolled @ patients with MDD currently not receiving treatment in a two-phase treatment study .


Patients underwent a fluorodeoxyglucose positron emission tomography scan .


After scanning , patients were randomly assigned to @ weeks of treatment with either escitalopram or cognitive-behavioral therapy ( CBT ) .


Patients not achieving remission after @ weeks of initial treatment were treated with an additional @ weeks of escitalopram plus CBT .


Subcallosal cingulate metabolism was compared between patients who failed to achieve a response and patients who achieved remission as a result of either phase one or phase two treatment .


This analysis was followed by a whole-brain analysis making the same comparison .


After two phases of treatment ( @ weeks ) , @ patients were identified as remitters , @ patients were responders , and @ patients were nonresponders .


Subcallosal cingulate metabolism was significantly higher in nonresponders than remitters .


In the follow-up whole-brain analysis , increased superior temporal sulcus activity was also associated with nonresponse to two treatments .


Patients with MDD who fail to achieve remission as a result of CBT or escitalopram , either alone or in combination , have a distinct brain metabolic pattern compared with patients who achieve remission as a result of CBT , escitalopram , or their combination .


World Health Organization ( WHO ) recommends that the episiotomy rate should be around @ % , which is already a reality in many European countries .


Currently the use of episiotomy should be restricted and physicians are encouraged to use their clinical judgment to decide when the procedure is necessary .


There is no clinical evidence corroborating any indication of episiotomy , so until the present moment it is not yet known whether episiotomy is indeed necessary in any context of obstetric practice .


To compare maternal and perinatal outcomes in women undergoing a protocol of not performing episiotomy versus selective episiotomy .


An open label randomized clinical trial will be conducted including laboring women with term pregnancy , maximum dilation of @ cm , live fetus in cephalic vertex presentation .


Women with bleeding disorders of pregnancy , indication for caesarean section and those without capacity to consent and without legal guardians will be excluded .


Primary outcomes will be frequency of episiotomy , delivery duration , frequency of spontaneous lacerations and perineal trauma , frequency of instrumental delivery , postpartum blood loss , need for perineal suturing , number of sutures , Apgar scores at one and five minutes , need for neonatal resuscitation and pH in cord blood .


As secondary outcomes frequency complications of perineal suturing , postpartum perineal pain , maternal satisfaction , neonatal morbidity and admission newborn in NICU will be assessed .


Women will be invited to participate and those who agree will sign the consent form and will be then assigned to a protocol of not conducting episiotomy ( experimental group ) or to a group that episiotomy is performed selectively according to the judgment of the provider of care delivery ( control Group ) .


The present study was approved by IMIP 's Research Ethics Committee .


Secondhand smoke ( SHS ) is a significant cause of acute respiratory illness ( ARI ) and @ times more common in indigenous children .


A single-blind randomized trial was undertaken to determine the efficacy of a family centered SHS intervention to reduce ARI in indigenous infants in Australia and New Zealand .


Indigenous mothers/infants from homes with @ smoker were randomized to a SHS intervention involving @ home visits in the first @ months of the infants ' lives ( plus usual care ) or usual care .


The primary outcome was number of ARI-related visits to a health provider in the first year of life .


Secondary outcomes , assessed at @ and @ months of age , included ARI hospitalization rates and mothers ' report of infants ' SHS exposure ( validated by urinary cotinine/creatinine ratios -LSB- CCRs -RSB- ) , smoking restrictions , and smoking cessation .


Two hundred and ninety-three mother/infant dyads were randomized and followed up .


Three quarters of mothers smoked during pregnancy and two thirds were smoking at baseline ( as were their partners ) , with no change for more than @ months .


Reported infant exposure to SHS was low ( @ % had smoke-free homes/cars ) .


Infant CCRs were higher if one or both parents were smokers and if mothers breast fed their infants .


There was no effect of the intervention on ARI events -LSB- @ intervention vs. @ usual care ( reference ) ; incidence rate ratio = @ , @ % confidence intervals ( CI ) = @-@ @ , p = @ -RSB- .


Despite reporting smoke-free homes/cars , mothers and their partners continue to smoke in the first year of infants ' lives , exposing them to SHS .


Emphasis needs to be placed on supporting parents to stop smoking preconception , during pregnancy , and postnatal .


Kangaroo care ( KC ) and maternal singing benefit preterm infants , and we investigated whether combining these benefitted infants and mothers .


A prospective randomised , within-subject , crossover , repeated-measures study design was used , with participants acting as their own controls .


We evaluated the heart rate variability ( HRV ) of stable preterm infants receiving KC , with and without maternal singing .


This included low frequency ( LF ) , high frequency ( HF ) and the LF/HF ratio during baseline ( @min ) , singing or quiet phases ( @min ) and recovery ( @min ) .


Physiological parameters , maternal anxiety and the infants ' behavioural state were measured .


We included @ stable preterm infants , with a postmenstrual age of @-@weeks .


A significant change in LF and HF , and lower LF/HF ratio , was observed during KC with maternal singing during the intervention and recovery phases , compared with just KC and baseline ( all p-values < @ ) .


Maternal anxiety was lower during singing than just KC ( p = @ ) .


No differences in the infants ' behavioural states or physiological parameters were found , with or without singing .


Maternal singing during KC reduces maternal anxiety and leads to autonomic stability in stable preterm infants .


This effect is not detected in behavioural state or physiological parameters commonly used to monitor preterm infants .


Finerenone decreases albuminuria in patients having heart failure with reduced ejection fraction and mild-to-moderate ( stage @-@ ) chronic kidney disease .


The MinerAlocorticoid Receptor Antagonist Tolerability Study-Diabetic Nephropathy ( ARTS-DN ; NCT@ ) is a multicenter , randomized , double-blind , placebo-controlled , parallel-group , phase @b study .


ARTS-DN investigated whether the mineralocorticoid receptor antagonist finerenone reduces albuminuria without causing major alterations in serum potassium levels in patients with type @ diabetes mellitus and a clinical diagnosis of DN who were receiving a renin-angiotensin-system ( RAS ) inhibitor .


Patients were randomized to oral finerenone @-@ mg or placebo once daily .


The primary objectives were to assess the ratio of the urinary albumin-to-creatinine ratio at day @ to that at baseline in patients receiving finerenone , and to compare it with that in the placebo group .


Additional exploratory analyses included evaluating changes from baseline in serum potassium levels , efficacy and safety biomarkers , and health-related quality of life .


Of @,@ patients screened , @ ( the sample population ) received at least one dose of finerenone/placebo .


Baseline characteristics included : male , @ % ; white , @ % ; very high albuminuria ( formerly macroalbuminuria ) , @ % ; high albuminuria ( formerly microalbuminuria ) , @ % ; median ( range ) estimated glomerular filtration rate , @ ( @-@ @ ) ml/min/@ @ m ( @ ) ; and systolic blood pressure ( mean standard deviation ) , @ @ mm Hg .


There was a history of cardiovascular disease in @ % , diabetic neuropathy in @ % , and diabetic retinopathy in @ % of patients .


ARTS-DN is the first phase @b trial of finerenone in combination with a RAS inhibitor in patients with type @ diabetes mellitus and a clinical diagnosis of DN .


Postprandial elevation of triglycerides impairs endothelial function and contributes to the development of atherosclerosis .


We investigated the effects of omega-@ fatty acids on postprandial endothelial function and lipid profiles .


Healthy volunteers -LSB- @ -RSB- were given supplementation at @g/day omega-@ fatty acids ( or were not treated ) for @ weeks in a randomised crossover study .


Postprandial levels of various lipids were monitored and endothelial function assessed by brachial artery flow-mediated dilation during fasting and after a standard cookie test .


Omega-@ fatty acids reduced postprandial endothelial dysfunction compared with the control diet ( flow-mediated dilation at @h = -@ vs. -@ % , P = @ ) .


Postprandial levels of triglycerides , apolipoprotein B-@ , and remnant lipoprotein-cholesterol increased in untreated subjects , peaked at @-@h , and returned to baseline at @h , whereas low-density lipoprotein-cholesterol levels did not change .


Supplementation with omega-@ fatty acids significantly suppressed postprandial elevation of triglycerides ( incremental area under the curve = @ vs. @mg/h/dL , P = @ ) and remnant lipoprotein-cholesterol ( incremental area under the curve = @ vs. @ mg/h/dL , P = @ ) .


Supplementation with omega-@ fatty acids significantly suppressed the increase in triglyceride content in chylomicrons as well as in very-low-density lipoproteins from baseline to @h after the cookie test .


Omega-@ fatty acids significantly decreased postprandial triglyceride elevation and postprandial endothelial dysfunction , suggesting that omega-@ fatty acids may have vascular protective effects in postprandial state .


The beneficial results of a theory-practice pilot stress management program for Pharmacy and Biochemistry professionals and students .


Its importance as a complement of traditional academic education , as well as its potential for Pharmaceutical Care is also discussed .


A total of @ students and @ professionals took part in a program of @ sessions , aimed at improving stress management .


Ten of the students and @ professionals were randomly assigned to control groups .


Salivary cortisol levels and anxiety level tests before and after the program were used to assess efficacy .


Both the cortisol and the anxiety levels significantly decreased among students and professionals after the program , whereas it significantly increased in the student control group .


Anxiety levels significantly decreased in both students and professionals .


This type of pilot program proved effective for students .


In the case of health professionals , the sample size needs to be increased in order to achieve an acceptable level of statistical power .


Considering the shift of the pharmaceutical profession towards Pharmaceutical Care , the training of competences and attitudes like those described in this work could be of value .


This study aimed at comparing the effects of intermittent and repeated sprint ability training on physiological variables .


Sixteen young female basketball players were randomly allocated to intermittent training ( IT = @ ) or repeated sprint ability training ( RST = @ ) groups .


The following outcomes were measured at baseline and after @ weeks of training : Yo-Yo intermittent recovery ( Yo-Yo ) and repeated sprint ability ( RSA ) tests .


For all the variables investigated the effect of training type showed a different trend respect at current knowledge .


In the RSA , best time ( BT ) was a significant main effect of training time ( pre - vs. post - ) ( P < @ ) , and of the interaction training type/time ( P = @ ) .


The RST showed a decrease in BT of @ % ( P = @ ) while the IT showed a decrease of @ % ( P < @ ) .


In the IT there was a significant main effect of time for the total distance with an increment of @ % , and a significant main effect of time in the final speed with an increment of @ % .


These findings suggest that the two training methods used in this study can be an effective training strategy for inducing anaerobic and basketball-specific training schedules .


Besides , even when IT training is not done at very high speed , it can increase the maximum speed of the RSA .


The purpose of this study was to differentiate perfusion and vascular characteristics between benign and malignant breast lesions by @-dimensional contrast-enhanced sonography and evaluate their correlation with microvessel density and vascular endothelial growth factor ( VEGF ) expression for further clinical exploration .


Three-dimensional contrast-enhanced sonography was performed in @ patients with breast lesions , and sonographic characteristics were carefully observed for further analysis .


The mean microvessel density and VEGF expression were measured by immunohistochemical analysis .


Pathologic results showed @ benign and @ malignant cases .


Malignancy and benignity differed significantly in peripheral vessel characteristics ( number , distribution , course , degree of dilatation , and penetrating vessels ) , rim perfusion and coarseness degree , intratumoral perfusion type , and intratumoral vessel dilatation ( P < @ ) but not the presence of peripheral and intratumoral vessels and intratumoral perfusion ( P > @ ) .


The specificity of penetrating vessels was @ % for diagnosing malignancy .


The sensitivity , specificity , and accuracy of rim perfusion coarseness were @ % , @ % , and @ % respectively .


The sensitivity of the intratumoral perfusion type was @ % , whereas the specificity of intratumoral vessel dilatation was @ % .


Microvessel density and VEGF expression were significantly correlated with perfusion and vascular characteristics ( P < @ ) , except the presence of peripheral vessels , rim perfusion , and intratumoral perfusion ( P > @ ) .


The presence of intratumoral vessels was related to VEGF ( P < @ ) but not microvessel density ( P > @ ) .


Three-dimensional contrast-enhanced sonographic characteristics were statistically different between benign and malignant breast lesions .


Some of them also correlated significantly with microvessel density and VEGF expression and therefore have potential for objective evaluation of tumor angiogenesis .


Dehydroepiandrosterone ( DHEA ) has been proposed to improve pregnancy rates in women with diminished ovarian reserve undergoing in vitro fertilisation ( IVF ) treatment .


However , evidence regarding its efficacy is supported by a limited number of randomised controlled trials ( RCTs ) .


This double-blinded RCT aims to measure the effect of DHEA supplementation prior to and during controlled ovarian hyperstimulation on ovarian response prior to IVF treatment in women predicted to have poor ovarian reserve .


Sixty women with ovarian antral follicle count @ and serum anti-Mullerian hormone @ pmol/L undergoing IVF/intracytoplasmic sperm injection ( ICSI ) treatment at the Nurture fertility clinic , Nottingham will be recruited .


They will be randomised to either receive DHEA capsule @mg/day or placebo for at least @weeks before egg collection .


All participants will undergo standard long down regulation protocol using human menopausal gonadotropin @IU/day .


Serum samples and follicular fluids at the time of egg collection will be collected for hormonal immunoassays .


For ICSI participants , cumulus cells stripped from oocyte will be collected for cumulus gene expression analyses regarding oocyte competence .


Microdrops of oocyte culture media before the time of ICSI will be assessed for glucose , pyruvate and lactate utilisation .


Embryo transfer will be performed on day @ , @ or @ based on the number and quality of the embryos available .


Pregnancy will be defined as urine pregnancy test positive ( biochemical pregnancy ) and @-@weeks ultrasound scan with fetal heart beat ( clinical pregnancy ) and live birth .


It is planned to perform the molecular and nutritional fingerprint analyses in batches after finishing the clinical phase of the study .


Diabetes mellitus ( DM ) is an independent risk factor for atrial fibrillation ( AF ) .


Increased atrial electromechanical delay ( AEMD ) is known to be a precursor of AF .


In this study , we aimed to investigate AEMD in patients with type @ DM .


A total of @ participants were recruited to the present study .


Of them , @ were diabetic patients , and @ were healthy control subjects .


Basal characteristics were recorded and transthoracic echocardiography was performed for all study participants .


Basal characteristics were similar between the two groups .


There was significant intra-atrial and interatrial electromechanical delay in the diabetic group compared with the control group .


In the correlation analysis , no correlation existed between AEMD and hemoglobin A@C or fasting plasma glucose levels .


In the present study , we showed that there was significant AEMD in patients with type @ DM compared with healthy control subjects .


Increased AEMD might be an early marker of AF in this patient subset .


To clear this hypothesis , further studies are needed .


People with opioid dependence and HIV are concentrated within criminal justice settings ( CJS ) .


Upon release , however , drug relapse is common and contributes to poor HIV treatment outcomes , increased HIV transmission risk , reincarceration and mortality .


Extended-release naltrexone ( XR-NTX ) is an evidence-based treatment for opioid dependence , yet is not routinely available for CJS populations .


A randomized , double-blind , placebo-controlled trial of XR-NTX for HIV-infected inmates transitioning from correctional to community settings is underway to assess its impact on HIV and opioid-relapse outcomes .


We describe the methods and early acceptability of this trial .


In addition we provide protocol details to safely administer XR-NTX near community release and describe logistical implementation issues identified .


Study acceptability was modest , with @ ( @ % ) persons who consented to participate from @ total referrals .


Overall , @ % of the participants had previously received opioid agonist treatment before this incarceration .


Thus far , @ ( @ % ) of those agreeing to participate in the trial have initiated XR-NTX or placebo .


Of the @ referred patients who ultimately did not receive a first injection , the main reasons included a preference for an alternative opioid agonist treatment ( @ % ) , being ineligible ( @ % ) , not yet released ( @ % ) , and lost upon release before receiving their injection ( @ % ) .


Study findings should provide high internal validity about HIV and opioid treatment outcomes for HIV-infected prisoners transitioning to the community .


The large number of patients who ultimately did not receive the study medication may raise external validity concerns due to XR-NTX acceptability and interest in opioid agonist treatments .


There is an ongoing debate regarding the optimal criteria for return to sport after an acute hamstring injury .


Less than @ % isokinetic strength deficit is generally recommended but this has never been documented in professional football players after rehabilitation .


Our aim was to evaluate isokinetic measurements in MRI-positive hamstring injuries .


Isokinetic measurements of professional football players were obtained after completing a standardised rehabilitation programme .


An isokinetic strength deficit of more than @ % compared with the contralateral site was considered abnormal .


Reinjuries within @months were recorded .


@ players had a complete set of isokinetic testing before clinical discharge .


There were @ ( @ % ) grade @ and @ ( @ % ) grade @ injuries .


@ of @ players ( @ % ) had at least one of the three hamstring-related isokinetic parameters that display a deficit of more than @ % .


The percentage of players with @ % deficit for hamstring concentric @/s , @/s and hamstring eccentric was respectively @ % , @ % and @ % .


There was no significant difference of mean isokinetic peak torques and @ % isokinetic deficits in players without reinjury ( N = @ ) compared with players with reinjury ( N = @ ) .


When compared with the uninjured leg , @ % of the clinically recovered hamstring injuries showed at least one hamstring isokinetic testing deficit of more than @ % .


Normalisation of isokinetic strength seems not to be a necessary result of the successful completion of a football-specific rehabilitation programme .


The possible association between isokinetic strength deficit and increased reinjury risk remains unknown .


Early detection of lung cancer is crucial as the prognosis depends on the disease stage .


Chest radiographs has been the principal diagnostic tool for general practitioners ( GPs ) , but implies a potential risk of false negative results , while computed tomography ( CT ) has a higher sensitivity .


The aim of this study was to describe the implementation of direct access to low-dose CT ( LDCT ) from general practice .


We conducted a cohort study nested in a randomised study .


A total of @ general practices with @ GPs were randomised into two groups .


Intervention GPs were offered direct access to chest LDCT combined with a Continuing Medical Education ( CME ) meeting on lung cancer diagnosis .