Intervention group doctor practices received continuing medical education ( CME ) about NSAIDs and patient activation tools promoting risk assessment and communication during visits .


Comparison group doctor practices received only CME .


Cross-sectional data were collected before and after the intervention .


Generalized linear latent and mixed models with logistic link tested relationships among the intervention , study phase , intervention by study phase interaction and patient-reported awareness of risks with either prescription or over-the-counter ( OTC ) NSAIDs .


Three hundred and forty-seven patients at baseline and @ patients at follow-up participated in this study .


The intervention -LSB- adjusted odds ratio ( AOR ) = @ , P = @ -RSB- , follow-up study phase ( AOR = @ , P = @ ) and intervention by study phase interaction ( AOR = @ , P = @ ) were not significantly associated with patient-reported awareness of any prescription NSAID risk .


Follow-up study phase was associated with increased odds of reporting any OTC NSAID risk awareness ( AOR = @ , P < @ ) , but the patient activation intervention and intervention by study phase interaction were not significantly associated with patient-reported awareness of any OTC NSAID risk ( AOR = @ , P = @ ; AOR = @ , P = @ , respectively ) .


Our point-of-care intervention encouraging shared decision making did not increase NSAID risk awareness .


Delirium is common after cardiac surgery and may be partly related to the systemic inflammatory response triggered by the surgery and the use of cardiopulmonary bypass .


We hypothesized that intraoperative administration of high-dose dexamethasone , a drug with potent anti-inflammatory effects , would reduce the incidence of delirium at any time point during the first @ postoperative days after cardiac surgery .


This was a single-center substudy within a larger , multicenter placebo-controlled randomized clinical trial , the Dexamethasone for Cardiac Surgery ( DECS ) trial that randomized patients @ years , undergoing cardiac surgery with cardiopulmonary bypass , to receive , in a double-blind fashion , either dexamethasone @ mg/kg or placebo at the induction of anesthesia .


Over the first @ postoperative days , we compared between groups the incidence of delirium ( based on the Confusion Assessment Method adapted for the intensive care unit , or after intensive care unit discharge , by the Confusion Assessment Method , accompanied by chart review ) , restraint use , and administered haloperidol , benzodiazepines , and opioids .


Data were analyzed according to the intention-to-treat principle .


The proportion of patients with delirium in the dexamethasone versus the placebo group was compared using the odds ratio ( OR ) with a @ % confidence interval ( CI ) .


The proportion also was compared using logistic regression to adjust for common baseline variables that might confound the presence of delirium between the @ groups .


Of @ eligible patients , @ subjects ( @ % ) had complete data .


The incidence of delirium was similar between the dexamethasone ( @ % ) and placebo ( @ % ) groups ( crude OR = @ , @ % CI , @-@ @ ; adjusted OR = @ , @ % CI , @-@ @ ) .


Among patients who developed delirium , the median ( interquartile range ) duration of delirium was similar between the dexamethasone and placebo groups ( @ -LSB- @-@ -RSB- vs @ -LSB- @-@ -RSB- days , respectively , P = @ ; WMWodds @ , @ % CI , @-@ @ ) .


Restraint use and the administration of haloperidol , benzodiazepines , and opioids were also similar between the @ groups .


The intraoperative administration of dexamethasone did not reduce the incidence or duration of delirium in the first @ days after cardiac surgery .


Intraoperative awareness ( IA ) is diagnosed when patients can recall their surroundings or an event related to the surgery that occurred while they were under general anaesthesia .


The female gender and Caesarean section are considered to be contributing factors .


The aim of the present study was to analyse the frequency of IA in patients undergoing general anaesthesia either for Caesarean section or gynaecological procedures .


ASA I and II women were included into the study .


Patients were randomly allocated to @ groups : A , B and C included patients qualified for elective gynaecological surgery , and group D comprised Caesarean section patients .


Premedication was not given .


Group A received total intravenous anaesthesia with TCI , and groups B , C and D received balanced anaesthesia .


The depth of anaesthesia was monitored with an AEP monitor .


Blinded structured interviews were conducted @ hours after anaesthesia and on postoperative days @ and @ .


@ patients were enrolled into the study .


@ patients reported diverse sensations connected to the anaesthesia ( Group A - @ patients , B - @ patients , C - @ patients , D - @ patients ) .


There were mainly dream sensations , but IA was present in @ cases .


In all of the cases , IA was recognised during the first interview .


One episode of awareness appeared in group B , and the other two appeared in group D.


One Caesarean section was complicated by intraoperative haemorrhage .


The patient from group B had similar sensations during previous anaesthesia .


Two women enrolled in the study reported awareness in the past , which did not occur this time .


Awareness during general anaesthesia occurs occasionally .


The frequency of occurrence in a group of patients undergoing general anaesthesia for uncomplicated Caesarean section is not higher than for other procedures .


The anaesthesia for Caesarean section , as well as for other procedures , may be accompanied by pleasant dreams .


This study tests whether the genetic predictor ( CHRNA@ nicotine receptor gene variants ) and an environmental risk factor ( partner smoking ) interact in the prediction of smoking reduction .


Subjects were from a community-based , longitudinal study of women ( n = @ ) who smoked before pregnancy , and a randomized comparative effectiveness smoking cessation trial ( n = @ ) .


Smoking reduction was defined as the trajectory of self-reported smoking quantities over time in the observational study , and as the trajectory of alveolar CO levels in the cessation trial .


In the pregnancy study , rs@ genotype and partner smoking status interacted such that the smoking reduction was lowest for expectant mothers with high genetic risk and partner smoking , and highest for those with high genetic risk but not partner smoking ( interaction of genotypepartner smoking on smoking quantity trajectory slope = @ , @ % CI = @ , @ , p = @ ) .


In the clinical trial , a similar interaction was found ( interaction = @ , @ % CI = @ , @ , p = @ ) .


Furthermore , these associations were moderated by pharmacotherapy such that the interactive relation of genetic and environmental factors occurred in the placebo group , but not in the active pharmacotherapy group ( interaction of genotypepartner smokingpharmacotherapy on CO trajectory slope = -@ , @ % CI = -@ , -@ , p = @ ) .


The CHRNA@ genetic risk synergized the effect of partner smoking , producing an especially low likelihood of successful smoking reduction in two complementary studies .


This suggests that the genetic vulnerability may be mitigated by altering environmental factors .


In addition , cessation pharmacotherapy neutralizes the increase in cessation failure associated with combined genetic and environmental risks , which has possible relevance to treatment algorithms .


Considering the extensive neural network of the oculomotor subsystems , traumatic brain injury ( TBI ) could affect oculomotor control and related reading dysfunction .


To evaluate comprehensively the effect of oculomotor-based vision rehabilitation ( OBVR ) in individuals with mTBI .


Twelve subjects with mTBI participated in a cross-over , interventional study involving oculomotor training ( OMT ) and sham training ( ST ) .


Each training was performed for @ weeks , @ sessions a week .


During each training session , all three oculomotor subsystems ( vergence/accommodation/version ) were trained in a randomized order across sessions .


All laboratory and clinical parameters were determined before and after OMT and ST. In addition , nearvision-related symptoms using the Convergence Insufficiency Symptom Survey ( CISS ) scale and subjective visual attention using the Visual Search and Attention Test ( VSAT ) were assessed .


Following the OMT , over @ % of the abnormal parameters significantly improved .


Reading rate , along with the amplitudes of vergence and accommodation , improved markedly .


Saccadic eye movements demonstrated enhanced rhythmicity and accuracy .


The improved reading-related oculomotor behavior was reflected in reduced symptoms and increased visual attention .


None of the parameters changed with ST.


OBVR had a strong positive effect on oculomotor control , reading rate , and overall reading ability .


This oculomotor learning effect suggests considerable residual neuroplasticity following mTBI .


Epidemiological studies of the association between bisphenol A ( BPA ) exposure and diabetes have been inconsistent .


The present study determined serum BPA concentrations in the Thai population and their association with hyperglycemia and diabetes .


In all , @ serum samples from the Thai National Health Examination Survey ( @ ) were used to determine BPA levels .


Impaired fasting glucose ( IFG ) was defined as fasting plasma glucose @ and < @mg/dL .


Diabetes was defined as a history of a physician 's diagnosis or fasting plasma glucose @mg/dL .


Multinomial logistic regression was used to examine the association of serum BPA with IFG and diabetes .


Of @ samples tested , BPA was detected in @ samples ( weighted percentage @ % ) , with a geometric mean concentration of @ ng/mL BPA .


Serum BPA levels were significantly higher among those with diabetes or IFG compared with normoglycemic individuals ( @ and @ vs @ ng/mL , respectively ; P < @ ) .


After adjusting for potential confounders , compared with the first quartile ( @ ng/mL ) , the overall adjusted odds ratios ( OR ) of serum BPA concentration in the third and fourth quartiles ( @-@ @ and @ ng/mL , respectively ) for IFG were @ ( @ % confidence interval -LSB- CI -RSB- @ , @ ) and @ ( @ % CI @ , @ ) , respectively ; for diabetes , the adjusted OR were @ ( @ % CI @ , @ ) and @ ( @ % CI @ , @ ) , respectively , with a slightly stronger association among men than in women .


Serum BPA concentrations were not associated with IFG , but were positively associated with diabetes in the Thai population .


Further prospective studies are needed to confirm the relationship .


Reduced arterial elasticity contributes to an obesity-related increase in cardiovascular risk in adults .


To evaluate the effect of fat loss on arterial elasticity in obese adolescents at risk of type @ diabetes .


A secondary data analysis of the RESIST study was performed in two hospitals in Sydney , Australia .


The study included @ subjects ( ages , @ to @ y ; @ males ) with prediabetes and/or clinical features of insulin resistance .


A @-month lifestyle plus metformin intervention .


Arterial elasticity and systemic vascular resistance were measured using radial tonometry pulse contour analysis , percentage body fat ( % BF ) was measured by dual-energy x-ray absorptiometry , and insulin sensitivity index was derived from an oral glucose tolerance test and lipids .


Adolescents ( n = @ ) with decreased % BF ( mean change -LSB- range -RSB- , -@ % -LSB- -@ to -@ % -RSB- ) after the intervention had significant increases in the mean large arterial elasticity index ( mean change -LSB- @ % CI -RSB- , @ -LSB- @ to @ -RSB- mL/mm Hg * @ ; P = @ ) and insulin sensitivity index ( @ -LSB- @ to @ -RSB- ; P = @ ) and a decrease in systemic vascular resistance ( -@ -LSB- -@ to -@ -RSB- dyne * s * cm ( -@ ) ; P = @ ) .


There were no significant changes in these parameters in adolescents who increased their % BF .


Nor was there any significant change in the mean small arterial elasticity index in either group .


Long-term follow-up of these adolescents is warranted to assess whether the observed changes in vascular elasticity will lead to a clinical benefit including reduced cardiovascular morbidity and mortality .


The Lifestyle in Pregnancy intervention in obese pregnant women resulted in significantly lower gestational weight gain compared with the control group , but without improvement in rates of clinical pregnancy complications .


The impact of the lifestyle intervention on metabolic measurements in the study participants is now reported .


The Lifestyle in Pregnancy study was a randomized controlled trial among @ obese women ( BMI @-@ kg/m ) who were allocated in early pregnancy to lifestyle interventions with diet counselling and physical activities or to the control group .


Fasting blood samples , including plasma glucose , insulin , lipid profile and capillary blood glucose during a @-h oral glucose tolerance test were carried out three times throughout pregnancy .


Insulin resistance was estimated with the homeostasis model assessment of insulin resistance .


Three hundred and four women ( @ % ) were followed until delivery .


Women in the intervention group had a significantly lower change in insulin resistance ( HOMA-IR ) from randomization to @-@ weeks ' gestation compared with control subjects ( mean SD : @ @ vs. @ @ , P = @ ) .


Despite a significantly lower gestational weight gain in the intervention group , there was no difference between the groups with respect to total cholesterol , HDL , LDL or triglycerides .


Lifestyle intervention in obese pregnant women resulted in attenuation of the physiologic pregnancy-induced insulin resistance .


Despite restricted gestational weight gain , there were no changes in glucose or lipid metabolism between the groups .


Phototherapy , ie , bright light therapy , is an effective and safe treatment of major depressive disorder ( MDD ) .


It exerts rapid mood-elevating activity , similar to antidepressant medications , most likely mediated through both monoaminergic and circadian system melatonergic mechanisms .


We assessed the efficiency of bright light therapy as an adjuvant treatment to antidepressant pharmacotherapy in patients with severe MDD randomized by Hamilton Depression Rating Scale ( HDRS ) score to either ( @ ) @ mg venlafaxine hydrochloride daily at @:@ AM or ( @ ) @ mg venlafaxine plus @-minute light of @ lux the initial week of clinical management ( venlafaxine + bright light therapy ) daily at @:@ AM .


@ inpatients with severe MDD at the Psychiatry Clinic of Yznc Yl University Training and Education Hospital participated .


The study , which was conducted from January @ through June @ , entailed patients diagnosed with severe MDD based on DSM-IV-TR for the first time .


Mood states were assessed by the HDRS , Profile of Mood States ( POMS ) , and Beck Depression Inventory ( BDI ) before treatment and at @ , @ , @ , and @ weeks of treatment .


On the basis of the HDRS score as the primary outcome variable , both strategies significantly improved depression and negative mood states already at the first treatment week ( P < @ ) .


Differences in therapeutic effects by treatment strategy were remarkable at the second and fourth weeks of clinical management ( P = @ and P = @ , respectively ) , with beneficial effects continuing until trial conclusion .


Those treated with venlafaxine + bright light therapy evidenced significantly lower HDRS depression scores ( P < @ ) as well as BDI scores ( P < @ ) and POMS negative mood states scores ( depression-dejection , tension-anxiety , anger-hostility , fatigue-inertia , and confusion-bewilderment subscales ; all P < @ ) after the second week .


At week @ of the trial , @ ( @ % ) of the @ venlafaxine + bright light therapy patients versus just @ ( @ % ) of the @ venlafaxine patients ( P < @ ) attained the target goal of treatment , a HDRS score @ , indicative of mild depression , and , although not statistically significant in our small sample study ( P = @ ) , at week @ , @ % of venlafaxine + bright light therapy patients ( n = @ ) versus just @ % of the venlafaxine patients ( n = @ ) experienced complete remission of depression ( HDRS score @ ) .


Both venlafaxine and venlafaxine + bright light therapy treatment strategies significantly reversed the depressive mood of patients with severe MDD ; however , the latter induced significantly stronger and more rapid beneficial effects .


Future longer-term studies with large sample sizes , nonetheless , are required to confirm and generalize these results to patients of diverse ethnicities and cultures with both severe and mild MDD .


Diabetic nephropathy ( DN ) is one of the major late complications of diabetes .


Treatment aimed at slowing down the progression of DN is available but methods for early and definitive detection of DN progression are currently lacking .


The ` Proteomic prediction and Renin angiotensin aldosterone system Inhibition prevention Of early diabetic nephRopathy In TYpe @ diabetic patients with normoalbuminuria trial ' ( PRIORITY ) aims to evaluate the early detection of DN in patients with type @ diabetes ( T@D ) using a urinary proteome-based classifier ( CKD@ ) .


In this ancillary study of the recently initiated PRIORITY trial we aimed to validate for the first time the CKD@ classifier in a multicentre ( @ different institutions providing samples from @ T@D patients ) prospective setting .


In addition we also investigated the influence of sample containers , age and gender on the CKD@ classifier .


We observed a high consistency of the CKD@ classification scores across the different centres with areas under the curves ranging from @ to @ .


The classifier was independent of age ( range tested @-@ years ) and gender .


Furthermore , the use of different urine storage containers did not affect the classification scores .


Analysis of the distribution of the individual peptides of the classifier over the nine different centres showed that fragments of blood-derived and extracellular matrix proteins were the most consistently found .


We provide for the first time validation of this urinary proteome-based classifier in a multicentre prospective setting and show the suitability of the CKD@ classifier to be used in the PRIORITY trial .


To compare the analgesic efficacy and rate of wound healing of combination of @ % Glyceryl Trinitrate and @ % lignocaine ointments with @ % Glyceryl Trinitrate and @ % lignocaine ointment separately after Milligan Morgan hemorrhoidectomy .


Randomized control trial .


Combined Military Hospital , Kharian , Malir and Bannu .


November @ to August @ .


Patients undergoing Milligan Morgan hemorrhoidectomy were randomized into @ groups by using computer generated table .


Group A received combination of @ % Glyceryl Trinitrate and @ % lignocaine ointment , Group B @ % lignocaine and Group C received @ % Glyceryl Trinitrate ointment .


These ointments were given on twice daily basis .


Pain scores were measured on a @mm Visual Analog Scale .


Pain scores and quantity of oral analgesics used were compared daily until the @th post-operative day .


The time required for complete healing ( in weeks ) was also compared .


Out of @ patients , @ ( @ Group A , @ Group B and @ Group C ) completed the study .


Demographic data were comparable in all three groups .


There were statistically significant reductions in pain scores and quantity of analgesics used from the first to the fourth post-operative days in Group A.


The time required for complete healing was also significantly reduced in the combination group .


There were no significant side effects in any group .


The combination of @ % GTN and @ % lignocaine showed better pain relief resulting in less use of oral analgesics and faster healing of the wound after Milligan Morgan hemorrhoidectomy .


Iron depleted deposits are the first link in the chain of events leading to iron deficiency which is the most prevalent nutritional shortage and main cause of anemia worldwide .


This situation can be prevented through food fortification .


To compare the efficacy of amino acid chelate iron with ferrous sulfate as fortifier of a dietary complement in preschoolers with iron deficiency .


This study was a blinded clinical trial with randomized groups .


We analyzed @ preschoolers with iron deficiency ( ferritin < @ ng/ml ) that received @ g of milk with @ mg of iron , either amino acid chelate or in the ferrous sulfate form .


After two months , hemoglobin , hematocrit and serum ferritin concentrations were measured .


In the ferrous sulfate group , ferritin concentration increased from @ ng/ml to @ ng/ml , while the variation was of @ ng/ml to @ ng/ml in the amino acid chelate group , with statistically differences in both cases .


Serum ferritin was different between groups , being higher in iron amino acid chelate group ( p = @ ) .


Hemoglobin and hematocrit levels did not change after the intervention .


Adverse reactions in the ferrous sulfate group were @ % , compared with @ % in the iron amino acid chelate group ; @ children had respiratory tract infection , without statistical differences .


Both compounds increased serum ferritin concentration , with a higher increase in those who were given milk with iron amino acid chelate .


There were no differences in the adverse reactions and infections incidences between the groups .


The purpose of this pilot study was to begin to examine the effect of dietary protein source ( soy protein versus non-soy protein ) during weight loss on body composition , and cardiometabolic and functional decline risk factors in older , abdominally obese adults .


Two-arm , single-blind , randomized , controlled trial .


Wake Forest School of Medicine , Winston-Salem NC @ , USA .


@ older ( @ years , @ % female ) , abdominally obese ( BMI : @ kg/m@ ; WC : @ cm ) men and women were randomized to participate in the study .


A @-week weight loss intervention , with participants randomized to consume soy protein-based meal replacements ( S ; n = @ ) or non-soy protein-based meal replacements ( NS ; n = @ ) , in addition to prepared meals , and all participants targeted to receive an individualized caloric deficit of @ kcal/day .


Body weight and composition ( assessed via DXA and CT ) , conventional biomarkers of cardiometabolic risk , and physical performance measures were assessed pre - and post-intervention .


Additional endpoints of feasibility ( accrual , participation , retention , compliance , and safety ) are reported .


A total of @ participants ( @ % female ) completed the study ( @ % retention ) and lost an average of @ kg over the @-week period , with no difference seen between groups ( p = @ ) .


Although nearly all measures of global and regional body composition were significantly reduced following the @-week intervention , differences were not observed between groups .


Among cardiometabolic risk factors and physical performance measures , only diastolic blood pressure was significantly lower in the NS group compared to the S group ( @ mmHg vs @ mmHg , respectively ; p = @ ) .


Interestingly , in groups combined , despite significant reductions in body weight and lean mass , no significant changes in @-meter walk time ( +@ s ) , short physical performance battery score ( +@ ) , grip strength ( -@ kg ) , or relative knee extensor strength ( -@ N/m/cm@ thigh muscle volume ) were observed .


Data presented here suggest that a @-week weight loss intervention , which incorporates S and NS meal replacement products , is associated with clinically significant weight loss and improvements in several parameters of cardiometabolic risk and unchanged physical function and strength .


RESULTS do not differ by protein source and suggest that soy protein is at least as good as other protein sources for weight loss during low-calorie dietary interventions in older adults .


Long-lasting insecticidal nets ( LLINs ) have limited effect on malaria transmitted outside of sleeping hours .


Topical repellents have demonstrated reduction in the incidence of malaria transmitted in the early evening .


This study assessed whether @ % DEET topical repellent used in combination with LLINs can prevent greater malaria transmission than placebo and LLINs , in rural Tanzania .


A cluster-randomized , placebo-controlled trial was conducted between July @ and August @ in a rural Tanzanian village .


Sample size calculation determined that @ clusters of @ households with five people/household were needed to observe a @ % treatment effect at the two-tailed @ % significance level , with @ % power , assuming a baseline malaria incidence of one case/person/year .


Ten clusters each were randomly assigned to repellent and control groups by lottery .


A total of @,@ individuals older than six months were enrolled .


All households in the village were provided with an LLIN per sleeping space .


Repellent and placebo lotion was replaced monthly .


The main outcome was rapid diagnostic test ( RDT ) - confirmed malaria measured by passive case detection ( PCD ) .


Incidence rate ratios were estimated from a Poisson model , with adjustment for potential confounders , determined a priori .


According-to-protocol approach was used for all primary analyses .


The placebo group comprised @ person-years with @ ( @ % C.I @-@ @ ) malaria cases/@ ,@ person-years .


The repellent group comprised @,@ person-years with @ ( @ % C.I @-@ @ ) cases/@ ,@ person-years , demonstrating a non-significant @ % reduction in malaria incidence rate in this group , ( Wilcoxon rank sum z = @ , p = @ ) .


Principal components analysis ( PCA ) of the socio-economic status ( SES ) of the two groups demonstrated that the control group had a higher SES ( Pearson 's chi square = @ , p = @ ) .


Lack of an intervention effect was likely a result of lack of statistical power , poor capture of malaria events or bias caused by imbalance in the SES of the two groups .


Low malaria transmission during the study period could have masked the intervention effect and a larger study size was needed to increase discriminatory power .


Alternatively , topical repellents may have no impact on malaria transmission in this scenario .


Design and implementation of repellent intervention studies is discussed .


Considerable evidence suggests that performance across a variety of cognitive tasks is effectively supported by the use of verbal and nonverbal strategies .


Studies exploring the usefulness of such strategies in children with specific language impairment ( SLI ) are scarce and report inconsistent findings .


To examine the effects of induced labelling and auditory cues on the performance of children with and without SLI during a categorization task .


Sixty-six school-age children ( @ with SLI , @ age-matched controls , @ language-matched controls ) completed three versions of a computer-based categorization task : one baseline , one requiring overt labelling and one with auditory cues ( tones ) on randomized trial blocks .


Labelling had no effect on performance for typically developing children but resulted in lower accuracy and longer reaction time in children with SLI .


The presence of tones had no effect on accuracy but resulted in faster reaction time and post-error slowing across groups .


Verbal strategy use was ineffective for typically developing children and negatively affected children with SLI .


All children showed faster performance and increased performance monitoring as a result of tones .


Overall , effects of strategy use in children appear to vary based on task demands , strategy domain , age and language ability .


Results suggest that children with SLI may benefit from auditory cues in their clinical intervention but that further research is needed to determine when and how verbal strategies might similarly support performance in this population .


The unenhanced MR angiography ( MRA ) technique time-spatial labeling inversion pulse ( time-SLIP ) may provide a safe alternative for evaluating the renal arteries for stenosis .


This international multicenter trial tested the hypothesis that time-SLIP unenhanced MRA is accurate and robust for assessing the renal arteries for stenosis in comparison with contrast-enhanced CT angiography ( CTA ) .


Four centers ( United States , Europe , Asia ) enrolled @ patients ( average age SD , @ @ years ; @ -LSB- @ % -RSB- men and @ -LSB- @ % -RSB- women ) .


Each patient underwent abdominal contrast-enhanced CTA and abdominal unenhanced MRA using time-SLIP with balanced steady-state free precession .


All images were visually assessed for quality ( arterial signal intensity ) and for the absence or presence of renal artery stenosis ( @ % or > @ % stenosis , respectively ) .


In addition , for arteries with any visible disease , the severity of the stenosis was quantified .


Two blinded readers evaluated each study .


No arteries were excluded from analysis .


Unenhanced MRA image quality was excellent for @ of @ patients ( @ % ) and good for @ of @ patients ( @ % ) .


CTA was used as the reference standard and showed that @ of @ renal arteries ( @ % ) had stenosis > @ % .


Unenhanced MRA correctly classified @ of the @ renal arteries with > @ % stenosis and correctly classified @ of the @ renal arteries as not having disease ( @ % stenosis ) to yield a sensitivity of @ % , specificity of @ % , and accuracy of @ % ( ( @ ) = @ ; p = @ , no statistically significant difference ) .


Of the @ misclassified arteries , only three had a clinically relevant misclassification ( CTA @ % stenosis and unenhanced MRA @ % stenosis or unenhanced MRA @ % stenosis and CTA @ % stenosis ) .


On average , measured stenotic severity ( n = @ arteries ) was similar for unenhanced MRA ( @ % @ % ) and CTA ( @ % @ % ) ( p = @ ) .


Compared with contrast-enhanced CTA , the unenhanced MRA technique time-SLIP shows promise for assessing the renal arteries for stenosis .


The unenhanced MRA technique time-SLIP may provide a safe alternative for evaluating the renal arteries for stenosis .


Although previous studies assessed the effects of Serenoa repens , quercetin and - sitosterol on inflammatory parameters , no randomized studies have tested the combination of these agents neither on BPH symptoms nor on the inflammatory pattern .


The aim of this trial was to evaluate the effects of Difaprost on voiding dysfunction , histological inflammatory alterations and apoptotic molecular mechanisms in BPH patients .


We included @ patients affected by BPH with obstructive symptoms eligible for surgery .


Patients were randomly assigned to two groups : @ patients received Difaprost for three months before surgery , and @ patients did not receive any additional therapy and were scheduled for surgery .


All patients receiving Difaprost were evaluated with uroflowmetry with post-void residual volume ( PVR ) evaluation , serum PSA , and IPSS questionnaire before and after treatment .


Moreover , we evaluated inflammatory patterns in prostatic specimens at final pathology .


Even without statistically significant differences on inflammatory pattern between patients receiving Difaprost and controls , patients receiving Difaprost had lower presence of edema and angiectasia at histological evaluation of prostate specimens .


Moreover , patients included in the treatment group had a clinically significant reduction of PVR ( @ vs. @ mL ; P = @ ) and a slight increase in Qmed ( @ vs. @ mL/s ; P = @ ) after three months of chronic treatment with Difaprost .


No statistically significant differences were recorded in other clinical parameters between patients receiving Difaprost and controls .


Although not statistically significant , patients treated with Difaprost showed an improvement in voiding function compared to controls ( namely , an increase in Qmed and a reduction of PVR ) .


Future trials with a larger number of patients and a longer treatment period could be necessary to evaluate the clinical efficacy of Difaprost .


To compare the long-term outcomes of a tension-free vaginal tape ( TVT ; Gynecare , Somerville , NJ , USA ) , autologous fascial sling ( AFS ) and xenograft sling ( porcine dermis , Pelvicol ; Bard , Murray Hill , NJ , USA ) in the management of female stress urinary incontinence ( SUI ) .


A multicentre randomised controlled trial carried out in four UK centres from @ to @ involving @ women requiring primary surgery for SUI .


The women were randomly assigned to receive TVT , AFS or Pelvicol .


The primary outcome was surgical success defined as ` women reporting being completely ` dry ' or ` improved ' at the time of follow-up ' .


The secondary outcomes included ` completely dry ' rates , changes in the Bristol Female Lower Urinary Tract Symptoms ( BFLUTS ) and EuroQoL EQ-@D questionnaire scores .


In all , @ ( @ % ) women were available for follow-up with a median ( range ) duration of @ ( @-@ @ ) years .


` Success ' rates for TVT , AFS and Pelvicol were @ % , @ % and @ % , respectively .


Comparing the @ - and @-year ` success ' rates , there was deterioration from @ % to @ % ( P < @ ) in the TVT arm and @ % to @ % ( P < @ ) in the AFS arm ; ` dry ' rates were @ % , @ % and @ % , respectively .


Overall , the ` dry ' rates favoured AFS when compared with Pelvicol ( P < @ ) and TVT ( P = @ ) .


The re-operation rate for persistent SUI was @ % ( two patients ) in the TVT arm , @ % ( five ) in the Pelvicol arm , while none of the patients in the AFS arm required further intervention .


Our study indicates there is not enough evidence to suggest a difference in long-term success rates between AFS and TVT .


However , there is some evidence that ` dry ' rates for AFS may be more durable than TVT .


To evaluate and compare the long-term outcome of unstable thoracolumbar burst fractures treated using anterior , posterior or combined anterior and posterior approaches .


The prospective randomised controlled study was conducted at the Tianjin @th Centre Hospital , Tianjin , China , and comprised patients of unstable thoracolumbar burst fracture operated between July @ and July @ and followed up for five years .


The patients were divided randomly into three groups of anterior , posterior and combined anterior and posterior approaches .


Clinical data was analysed using SPSS @ .


Of the @ cases in the study , @ ( @ % ) were male and @ ( @ % ) were female , with overall age ranging from @ to @ years .


There were @ ( @ % ) patients in the anterior group , @ ( @ % ) in the posterior group , and @ ( @ % ) in the combined anterior and posterior group .


Comparison was made between two respective groups .


The combined group was found to have the longest operation time ( p < @ ; p < @ , respectively ) , larger blood loss ( p < @ ; p < @ , respectively ) , longer hospital stay ( p < @ ; p < @ , respectively ) and higher hospitalisation costs ( p < @ ; p < @ , respectively ) .


The postoperative kyphotic angle was significantly smaller than preoperative one in all groups ( p < @ ; p < @ ; p < @ ) .


The anterior approach or combined anterior and posterior approach were better options in managing unstable thoracolumbar burst fracture , while the latter should be used only for the burst fracture with a significant posterior column injury .


Cervical cancer is the leading cause of cancer mortality among women in India .


Because Pap smear screening is not feasible in India , we need to develop effective alternatives .


A cluster-randomized controlled study was initiated in @ in Mumbai , India , to investigate the efficacy of visual inspection with acetic acid ( VIA ) performed by primary health workers in reducing cervical cancer mortality .


Four rounds of cancer education and VIA screening were conducted at @-month intervals in the screening group , whereas cancer education was offered once at entry to the control group .


The study was planned for @ years to include four screening rounds followed by four monitoring rounds .


We present results after @ years of follow-up .


Poisson regression method was used to calculate the rate ratios ( RRs ) ; two-sided ( @ ) was used to calculate the probability .


We recruited @ women from @ clusters in the screening group and @ women from @ comparable clusters in the control group .


In the screening group , we achieved @ % participation for screening and @ % compliance for diagnosis confirmation .


The incidence of invasive cervical cancer was @ per @ ( @ % confidence interval -LSB- CI -RSB- = @ to @ ) in the screening group and @ per @ ( @ % CI = @ to @ ) in the control group .


Compliance to treatment for invasive cancer was @ % in the screening group and @ % in the control group .


The screening group showed a statistically significant @ % reduction in cervical cancer mortality ( RR = @ ; @ % CI = @ to @ ; P = @ ) .


VIA screening by primary health workers statistically significantly reduced cervical cancer mortality .


Our study demonstrates the efficacy of an easily implementable strategy that could prevent @ cervical cancer deaths in India and @ deaths in resource-poor countries annually .


In a randomized controlled trial ( RCT ) in a blood bank in So Paulo , we tested the hypotheses that offering client-centered human immunodeficiency virus ( HIV ) counseling and testing to blood donors would : @ ) reduce the risk of HIV contamination in the blood supply by diverting higher-risk , test-seeking donors away from donation and @ ) increase return for results and referrals to care .


We randomly selected weeks between August @ and May @ when donors were offered HIV counseling and testing ( n = @ ) , leaving usual procedure weeks as control ( n = @ ) .


Few candidate donors chose HIV testing ( n = @ , @ % ) .


There was no significant difference in herpes simplex virus Type @ ( HSV-@ ) prevalence ( a marker of sexual risk ) among donors during intervention weeks compared to control ( @ % vs. @ % , p = @ ) .


No donor choosing testing was HIV infected , and there was no difference in HSV-@ prevalence between testers and donors ( @ % vs. @ % , p = @ ) .


Returning for positive results did not differ between testers and donors ( three of three vs. @ of @ , p = @ ) .


A higher proportion of donors acknowledged that HIV testing was a strong motivation to donate during intervention weeks compared to control ( @ % vs. @ % , p = @ ) .


The evidence of our RCT is that offering HIV counseling and testing at the time of donation would not change the risk of contamination in the blood supply , nor improve results disclosure and referral to care .


To evaluate the feasibility of day and night closed-loop insulin delivery in adults with type @ diabetes under free-living conditions .


Seventeen adults with type @ diabetes on insulin pump therapy ( means SD age @ @ years , HbA@c @ @ % , and duration of diabetes @ @ years ) participated in an open-label multinational three-center crossover study .


In a random order , participants underwent two @-day periods ( first day at the clinical research facility followed by @ days at home ) of sensor-augmented insulin pump therapy ( SAP ) or automated closed-loop insulin delivery .


The primary end point was the time when sensor glucose was in target range between @ and @ mmol/L during the @-day home phase .


During the home phase , the percentage of time when glucose was in target range was significantly higher during closed-loop compared with SAP ( median @ % -LSB- interquartile range @-@ -RSB- vs. @ % -LSB- @-@ -RSB- , P = @ ) .


Mean glucose ( @ vs. @ mmol/L , P = @ ) and time spent above target ( P = @ ) were lower during closed loop , while time spent below target was comparable ( P = @ ) .


Increased time in target was observed during both daytime ( P = @ ) and nighttime ( P = @ ) .


Compared with SAP , @ week of closed-loop insulin delivery at home reduces mean glucose and increases time in target without increasing the risk of hypoglycemia in adults with relatively well-controlled type @ diabetes .


Elevated homocysteine ( Hcy ) levels might play a role in the development of essential hypertension ( EH ) .


Telomere dynamics provide valuable insight into the pathogenesis of age-related diseases .


The contribution of Hcy to leukocyte telomere length ( LTL ) shortening in EH and the underlying mechanism was examined .


LTL ( ratio of the copy number of telomere -LSB- T -RSB- repeats to that of a single -LSB- S -RSB- gene , T/S ratio ) was inversely associated with age in patients with EH ( n = @ ) and healthy controls ( n = @ ) , but significantly decreased with the Hcy level only in patients with hypertension after adjustment for age and sex .


Age , hypertension and levels of Hcy and low-density lipoprotein combined contributed to LTL shortening ; an increased serum folate level could reverse the Hcy effect seen on multivariate regression analysis .


In addition , qPCR and methylation-specic PCR assay revealed that LTL shortening and mRNA expression and the methylation ratio of human telomerase reverse transcriptase ( hTERT ) were lower in patients with EH than in controls , and gradually decreased with increasing Hcy level , but not with blood pressure , in EH patients ( Ptrend < @ , @ and @ , respectively ) .


Furthermore , Hyperhomocysteinemia , but not hypertension , promoted telomerase reverse transcriptase DNA hypomethylation and reduced mRNA levels , which contributed to shortened LTL in the hypertension rat model .


Elevated Hcy but not hypertension was related to hTERT DNA hypomethylation and reduced mRNA level , thus contributing to the shortening of LTL hypertension .


This study aimed to evaluate differences in transcranial electrical motor evoked potential ( tcMEP ) amplitudes between desflurane/remifentanil and propofol/remifentanil anesthesia treatment plans in patients without preexisting motor deficits ( PMDs ) undergoing carotid endarterectomy ( CEA ) .


This prospective trial included @ patients who were randomly assigned to an effect group ( Group ( DESFLURANE ) ; n = @ ) or a control group ( Group ( STANDARD-PROPOFOL ) ; n = @ ) .


tcMEP amplitudes were measured @ min post-induction ( T@ ) either with desflurane or propofol .


Treatment was then changed to propofol in Group ( DESFLURANE ) .


After an additional @ min , the tcMEP amplitudes were reevaluated ( T@ ) .


Differences in amplitudes ( DW ) between T@ and T@ were calculated for each patient , and the means of these differences were compared between groups .


tcMEPs were recorded in all @ patients .


At T@ , the mean amplitude was @ ( SD @ ) V and @ ( SD @ ) V for Group ( STANDARD-PROPOFOL ) and Group ( DESFLURANE ) , respectively .


The absolute mean difference ( T@-T@ ) between groups was -@ V ( p = @ ) .


Desflurane reduces the tcMEP amplitude significantly more than propofol in patients without PMDs undergoing CEA .


TcMEPs were recorded in all patients regardless of the anesthesia regimen .


In patients with initially small amplitudes , desflurane may limit tcMEP recording because it produces a remarkable amplitude reduction , even in patients without PMDs .


The relative efficacy and safety of intravitreous aflibercept , bevacizumab , and ranibizumab in the treatment of diabetic macular edema are unknown .


At @ clinical sites , we randomly assigned @ adults ( mean age , @ years ) with diabetic macular edema involving the macular center to receive intravitreous aflibercept at a dose of @ mg ( @ participants ) , bevacizumab at a dose of @ mg ( @ participants ) , or ranibizumab at a dose of @ mg ( @ participants ) .


The study drugs were administered as often as every @ weeks , according to a protocol-specified algorithm .


The primary outcome was the mean change in visual acuity at @ year .


From baseline to @ year , the mean visual-acuity letter score ( range , @ to @ , with higher scores indicating better visual acuity ; a score of @ is approximately @/@ ) improved by @ with aflibercept , by @ with bevacizumab , and by @ with ranibizumab .


Although the improvement was greater with aflibercept than with the other two drugs ( P < @ for aflibercept vs. bevacizumab and P = @ for aflibercept vs. ranibizumab ) , it was not clinically meaningful , because the difference was driven by the eyes with worse visual acuity at baseline ( P < @ for interaction ) .


When the initial visual-acuity letter score was @ to @ ( equivalent to approximately @/@ to @/@ ) ( @ % of participants ) , the mean improvement was @ with aflibercept , @ with bevacizumab , and @ with ranibizumab ( P > @ for each pairwise comparison ) .


When the initial letter score was less than @ ( approximately @/@ or worse ) , the mean improvement was @ with aflibercept , @ with bevacizumab , and @ with ranibizumab ( P < @ for aflibercept vs. bevacizumab , P = @ for aflibercept vs. ranibizumab , and P = @ for ranibizumab vs. bevacizumab ) .


There were no significant differences among the study groups in the rates of serious adverse events ( P = @ ) , hospitalization ( P = @ ) , death ( P = @ ) , or major cardiovascular events ( P = @ ) .


Intravitreous aflibercept , bevacizumab , or ranibizumab improved vision in eyes with center-involved diabetic macular edema , but the relative effect depended on baseline visual acuity .


When the initial visual-acuity loss was mild , there were no apparent differences , on average , among study groups .


At worse levels of initial visual acuity , aflibercept was more effective at improving vision .


( Funded by the National Institutes of Health ; ClinicalTrials.gov number , NCT@ . )


Pre-exposure prophylaxis ( PrEP ) with daily oral emtricitabine ( FTC ) / tenofovir disoproxil fumarate may select for drug resistance if there is low adherence .


Plasma viral HIV-@ RNA level , CD@ + T-cell counts , and drug resistance were evaluated among seroconverting women in the FEM-PrEP trial ( clinicaltrials.gov NCT@ ) using standard clinical tests , allele-specific PCR ( ASPCR ) , and by deep sequencing .


Tenofovir , FTC , and their intracellular metabolites were measured in plasma and cells .


There was no difference in plasma HIV-@ RNA level or CD@ + cell count among seroconverters in the active arm versus those receiving placebo .


Tenofovir resistance was not observed .


FTC resistance was detected using clinical assays in five seroconverters ( four in the active arm and one in the placebo arm ) ; two in the active arm occurred among women having moderate concentrations of PrEP drugs in the blood .


The first evidence of infection occurred at the first postenrollment visit in three of the four with FTC resistance , although none had detectable viral nucleic acids at enrollment .


FTC-resistant minor variants were detected in an additional four seroconverters ( one in the active arm and three in the placebo arm ) .


Drug resistance detected during ineffective PrEP use had characteristics suggesting transmitted infection or incubating infection prior to starting PrEP .


The authors sought to determine the level of inspiratory pressure minimizing the risk of gastric insufflation while providing adequate pulmonary ventilation .


The primary endpoint was the increase in incidence of gastric insufflation detected by ultrasonography of the antrum while inspiratory pressure for facemask pressure-controlled ventilation increased from @ to @ cm H@O .


In this prospective , randomized , double-blind study , patients were allocated to one of the four groups ( P@ , P@ , P@ , and P@ ) defined by the inspiratory pressure applied during controlled-pressure ventilation : @ , @ , @ , and @ cm H@O .


Anesthesia was induced using propofol and remifentanil ; no neuromuscular-blocking agent was administered .


Once loss of eyelash reflex occurred , facemask ventilation was started for a @-min period while gastric insufflation was detected by auscultation and by real-time ultrasonography of the antrum .


The cross-sectional antral area was measured using ultrasonography before and after facemask ventilation .


Respiratory parameters were recorded .


Sixty-seven patients were analyzed .


The authors registered statistically significant increases in incidences of gastric insufflation with inspiratory pressure , from @ % ( group P@ ) to @ % ( group P@ ) according to auscultation , and from @ to @ % according to ultrasonography .


In groups P@ and P@ , detection of gastric insufflation by ultrasonography was associated with a statistically significant increase in the antral area .


Lung ventilation was insufficient for group P@ .


Inspiratory pressure of @ cm H@O allowed for reduced occurrence of gastric insufflation with proper lung ventilation during induction of anesthesia with remifentanil and propofol in nonparalyzed and nonobese patients .


( Anesthesiology @ ; @:@ -@ ) .


Chronic lymphedema occurs frequently in breast cancer patients and is associated with significant morbidity and reduced quality-of-life .


In this pilot study , the authors ( @ ) addressed whether conducting a larger randomized controlled trial of aqua lymphatic therapy ( ALT ) would be feasible and ( @ ) estimated the extent to which ALT combined with home-based exercise compared with home-based exercise alone would reduce arm disability in patients with breast cancer-related lymphedema .


Twenty-five women with breast cancer-related lymphedema were randomized to either ALT in addition to a home land-based exercise program ( ALT group ; n = @ ) or to a home land-based exercise program alone ( control group ; n = @ ) .


The participants were evaluated before and after a @-wk intervention period composed of weekly pool exercise sessions .


Main outcome measures were arm volume , arm disability , pain , and quality-of-life .


At follow-up , there was no statistical difference between the control and ALT groups in any of the outcomes , except for present pain intensity .


At the end of the study period , there was no change in the lymphedematous limb volume in either group .


Grip strength was improved in both groups .


Only the ALT group showed a statistically significant difference with a reduction in pain intensity score and arm disability .


Furthermore , quality-of-life significantly improved only in the ALT group .


Conducting a larger randomized controlled trial would be feasible .


In comparison with the beginning of the intervention , the participants in the ALT group showed significant beneficial changes after @ wks of treatment , whereas the control group did not improve .


ALT did not make the lymphedema volume worse and therefore may serve as a safe alternative to land-based treatments of breast cancer-related lymphedema .


The aim of the study was to elicit the safety and efficacy of breast stimulation as an intervention to prevent postdatism and as an aid in spontaneous onset of labour .


Primigravidas with cephalic presentation , without any high-risk factor , were recruited between @ to @ weeks of gestation .


@ patients were recruited and randomized into two groups ( n = @ ) .


Breast stimulation was advised to one group but not to the other group .


Bishop 's scoring was done at @ weeks and repeated at @ weeks of gestation .


Maternal and fetal outcomes were compared in two groups .


Bishop 's score changed from @ ( @ ) to @ ( @ ) in control group and from @ ( @ ) to @ ( @ ) in breast stimulation group after one week ( P value < @ ) .


The period of gestation at delivery was @ ( @ ) weeks in control group and @ ( @ ) weeks in intervention group ( P value : @ ) .


There were increased chances of vaginal delivery in intervention group ( P value : @ ) .


Duration of labor , hyperstimulation , presence of meconium stained liquor , postpartum hemorrhage , and neonatal outcomes were similar in both groups .


Breast stimulation in low-risk primigravidas helps in cervical ripening and increases chances of vaginal delivery .


We examined whether an empirically based , randomised controlled trial of a preventive intervention for divorced mothers and children had a long-term impact on offspring cortisol regulation .


Divorced mothers and children ( age @-@ ) were randomly assigned to a literature control condition or the @-week New Beginnings Program , a family-focused group preventive intervention for mothers and children in newly divorced families .


Fifteen years after the trial , offspring salivary cortisol ( n = @ ) was measured before and after a social stress task .


Multilevel mixed models were used to predict cortisol from internalizing symptoms , externalizing symptoms , group assignment and potential moderators of intervention effects .


Across the sample , higher externalizing symptoms were associated with lower cortisol reactivity .


There was a significant group-by-age interaction such that older offspring in the control group had higher reactivity relative to the intervention group , and younger offspring in the control group exhibited a decline across the task relative to younger offspring in the intervention group .


Preventive interventions for youth from divorced families may have a long-term impact on cortisol reactivity to stress .


Results highlight the importance of examining moderators of program effects .


The aim of this study was to compare the effect of administration of probiotics on feeding tolerance and growth outcomes of HIV-exposed ( but uninfected ) versus HIV non-exposed preterm infants .


The null hypothesis of this study states that there will be no difference in the feeding tolerance and growth outcomes for both probiotic-exposed and unexposed premature very low birth weight infants .


A randomized , double-blind , placebo-controlled trial was conducted during the period from July @ to August @ .


HIV-exposed and non-exposed premature ( < @ wk gestation ) infants with a birth weight of @ g and @ g were randomized to receive either a probiotic mixture or placebo .


The multispecies probiotic mixture consisted of @ @ ( @ ) CFU , Lactobacillus rhamnosus GG and Bifidobacterium infantis per day and was administered for @ d. Anthropometrical parameters , daily intakes , and feeding tolerance were monitored .


Seventy-four HIV-exposed and @ unexposed infants were enrolled and randomized ( mean birth weight @ g @ g , range , @-@ g ; mean gestational age @ wk ) .


In all @ probiotic doses were administered ( mean @ / infant ) .


There was no difference in the average daily weight gain for treatment groups or HIV exposure .


The HIV-exposed group achieved significantly higher z scores for length and head circumference at day @ than the unexposed group ( P < @ and P = @ , respectively ) .


There were no differences in the incidence of any signs of feeding intolerance and abdominal distension between the groups .


Probiotic supplementation did not affect growth outcomes or the incidence of any signs of feeding intolerance in HIV exposure .


The use of evidence-based guidelines can improve the care for asthma patients .


We implemented a computerized asthma management system in a pediatric emergency department ( ED ) to integrate national guidelines .


Our objective was to determine whether patient eligibility identification by a probabilistic disease detection system ( Bayesian network ) combined with an asthma management system embedded in the workflow decreases time to disposition decision .


We performed a prospective , randomized controlled trial in an urban , tertiary care pediatric ED .


All patients @-@ years of age presenting to the ED between October @ and February @ were screened for inclusion by the disease detection system .


Patients identified to have an asthma exacerbation were randomized to intervention or control .


For intervention patients , asthma management was computer-driven and workflow-integrated including computer-based asthma scoring in triage , and time-driven display of asthma-related reminders for re-scoring on the electronic patient status board combined with guideline-compliant order sets .


Control patients received standard asthma management .


The primary outcome measure was the time from triage to disposition decision .


The Bayesian network identified @ patients with asthma exacerbations , of which @ had an asthma diagnosis determined by an ED physician-established reference standard ( positive predictive value @ % ) .


The median time to disposition decision did not differ among the intervention ( @ min ; IQR = ( @ , @ ) ) and control group ( @ min ; IQR = ( @ , @ ) ) ; ( p = @ ) .


The hospital admission rate was unchanged between intervention ( @ % ) and control groups ( @ % ) ; ( p = @ ) .


ED length of stay did not differ among intervention ( @ min ; IQR = ( @ , @ ) ) and control group ( @ min ; IQR = ( @ , @ ) ) ; ( p = @ ) .


The control and intervention groups were similar in regards to time to disposition ; the computerized management system did not add additional wait time .


The time to disposition decision did not change ; however the management system integrated several different information systems to support clinicians ' communication .


Understanding the characteristics of young adults who have difficulty achieving a healthy weight may help develop more effective interventions .


Signal detection was conducted to identify subgroups of overweight/obese young adults more or less likely to lose weight ( @ % weight loss ) over @ months .


Data were collected from a diverse sample involved in a randomized controlled behavioral weight loss intervention ( N = @ ) .


Overall , @ % ( N = @ ) of participants achieved < @ % weight loss .


Change in self-monitoring weight , baseline score of gym attendance/participating in exercise classes , and change in eating less fat were the best predictors of weight loss .


These strategies may be particularly helpful to promote short-term weight loss in overweight/obese young adults .


The Central Retinal Enrichment Supplementation Trials ( CREST ) aim to investigate the potential impact of macular pigment ( MP ) enrichment , following supplementation with a formulation containing @mg lutein ( L ) , @mg zeaxanthin ( Z ) and @mg meso-zeaxanthin ( MZ ) , on visual function in normal subjects ( Trial @ ) and in subjects with early age-related macular degeneration ( AMD ; Trial @ ) .


CREST is a single center , double-blind , randomized clinical trial .


Trial @ ( @-month follow-up ) subjects are randomly assigned to a formulation containing @mgL , @mg MZ and @mg Z ( n = @ ) or placebo ( n = @ ) .


Trial @ ( @-month follow-up ) subjects are randomly assigned to a formulation containing @mgL , @mg MZ , @mg Z plus @mg vitamin C , @IU vitamin E , @mg zinc and @mg copper ( Intervention A ; n = @ ) or @mgL and @mg Z plus @mg vitamin C , @IU vitamin E , @mg zinc and @mg copper ( Intervention B ; n = @ ) .


Contrast sensitivity ( CS ) at @ cycles per degree represents the primary outcome measure in each trial .


Secondary outcomes include : CS at other spatial frequencies , MP , best-corrected visual acuity , glare disability , photostress recovery , light scatter , cognitive function , foveal architecture , serum carotenoid concentrations , and subjective visual function .


For Trial @ , AMD morphology , reading speed and reading acuity are also being recorded .


CREST is the first study to investigate the impact of supplementation with all three macular carotenoids in the context of a large , double-blind , randomized clinical trial .


This randomized double blind controlled study is aimed at determining the effect of repeated vibratory stimuli focally applied to the contracted quadriceps muscles ( repeated muscle vibration = rMV ) on bone mineral density , leg power and balance of postmenopausal osteoporotic women .


The study has been conducted on @ voluntary postmenopausal osteoporotic women , randomised at @ groups for rMV treatment and for control .


The treatment group underwent rMV ( @Hz , @-@ m ; three applications per day , each lasting @-minutes , for @ consecutive days ) applied to voluntary contracted quadriceps ( VC = vibrated and contracted group ) .


The control group , received a sham stimulation on contracted quadriceps ( NV = non vibrated group ) .


Bone mineral density T-score of proximal femur of the participants , was evaluated in two weeks before and @ days after intervention ; body balance and explosive leg power were measured @ day before , @ days and @ days after treatment .


VC group T-score at one year did n't change significantly relative to baseline values ( pretreatment : -@ , post-treatment -@ ) ; conversely in NV subjects T-score decreased significantly from -@ @ SD down to -@ @ SD .


A significant improvement of balance and explosive leg power was observed only in VC group at @ and @ days after the intervention .


We conclude that rMV is a safe , short-lasting and non-invasive treatment that can significantly and persistently improve muscle performance and can effectively counteract progressive demineralisation in postmenopausal and osteoporotic women .


To evaluate the efficacy of calf pulmonary surfactant ( PS ) in the treatment of respiratory distress syndrome ( RDS ) in late preterm and full-term infants .


A randomized controlled trial was designed to evaluate the efficacy of calf PS intratracheally given at different times and doses in infants with RDS who had a gestational age of @ weeks and an oxygenation index ( OI ) of @-@ .


The subjects were randomly assigned to treatment group @ ( n = @ ) , treatment group @ ( n = @ ) , and control group ( n = @ ) .


Treatment group @ was given PS ( @ mg/kg ) within @ hours after admission .


The control group was not given PS within @ hours after admission and was given PS ( @ mg/kg ) over @ hours after admission if having no remission by conventional therapy including mechanical ventilation .


For each group , a second dose of PS ( @ mg/kg ) was given if no remission was observed within @ hours after the first administration .


There were no significant differences in mortality between the three groups .


Treatment group @ had lower hospitalization expense and shorter duration of mechanical ventilation compared with treatment group @ , and treatment group @ had lower hospitalization expense and shorter duration of mechanical ventilation compared with the control group .


The incidence of ventilator-associated pneumonia and length of hospital stay in treatment group @ was lower than those in treatment group @ and control group .


Compared with the control group , Treatment groups @ and @ showed decreases in @ or more times of PS use , maximum OI , duration of continuous positive airway pressure treatment , and incidence of air leak syndrome and pulmonary hypertension .


Early use of sufficient PS in late preterm and full-term infants with RDS can reduce complications , secondary use of PS , duration of mechanical ventilation and length of hospital stay , and hospitalization expense .


To determine the association of arterial partial pressure of carbon dioxide PaCO@ with severe intraventricular haemorrhage ( sIVH ) , bronchopulmonary dysplasia ( BPD ) , and neurodevelopmental impairment ( NDI ) at @-@months in premature infants .


Secondary exploratory data analysis of Surfactant , Positive Pressure , and Oxygenation Randomised Trial ( SUPPORT ) .


Multiple referral neonatal intensive care units .


@ infants @@/@ to @@/@ weeks gestation randomised to different oxygenation ( SpO@ target @-@ % vs @-@ % ) and ventilation strategies .


Blood gases from postnatal day @ to day@ were analysed .


Five PaCO@ variables were defined : minimum ( Min ) , maximum ( Max ) , SD , average ( time-weighted ) , and a four level categorical variable ( hypercapnic ( highest quartile of Max PaCO@ ) , hypocapnic ( lowest quartile of Min PaCO@ ) , fluctuators ( hypercapnia and hypocapnia ) , and normocapnic ( middle two quartiles of Max and Min PaCO@ ) ) .


PaCO@ variables were compared for infants with and without sIVH , BPD and NDI ( death ) .


Multivariable logistic regression models were developed for adjusted results .


sIVH , BPD and NDI ( death ) were associated with hypercapnic infants and fluctuators .


Association of Max PaCO@ and outcomes persisted after adjustment ( per @mmHg increase : sIVH/death : OR @ ( @ to @ ) ; BPD/death : OR @ ( @ to @ ) ; NDI/death : OR @ ( @ to @ ) , death : OR @ ( @ to @ ) , all p < @ ) .


No interaction was found between PaCO@ category and SpO@ treatment group for sIVH/death , NDI/death or death .


Max PaCO@ was positively correlated with maximum FiO@ ( rs@ @ , p < @ ) and ventilator days ( rs@ @ , p < @ ) .


Higher PaCO@ was an independent predictor of sIVH/death , BPD/death and NDI/death .


Further trials are needed to evaluate optimal PaCO@ targets for high-risk infants .


Peyronie 's disease described as penile curvature , fibromathosis and pain that occur most often in men aged @ to @ years .


The main complaint that caused the patient to visit the clinic is nodules on the upper surface of the penis , causing curvature and distortion particularly during erection , but they do n't have any urinary problem .


In this study , we evaluated the effect of verapamil compared to pentoxifylline in Peyronie 's disease .


In this study , @ patients with signs and symptoms of Peyronie 's disease which were diagnosed and were in the age range @ to @ years enrolled .


The patients were randomly divided into @ groups .


First group received pentoxifylline orally at a dose of @ mg three times a day , in the second group verapamil ( @ mg every other week for up to @ sessions ) was injected into the lesion and the third group received both treatments in combination .


In patients , who received pentoxifylline , curvature reduction was @ % , plaque size reduction was @ % , the recovery rate of erectile dysfunction was @ % and pain reduced was @ % .


Each of these cases in patients , who used beta-blockers , was @ % , @ % , @ % and @ % .


In combination therapy , curvature reduction was @ % , plaque size reduction was @ % , the recovery rate of erectile dysfunction was @ % and pain reduced was @ % .


In our study there was no significant difference between two groups using verapamil or pentoxifylline , but there was a significant improvement in combination therapy group .


Due to our results we propose that combination therapy can improve results and should be considered as a choice in treatment of Peyronie 's disease .


Magnesium deficiency is associated with poor physical performance , but no trials are available on how magnesium supplementation affects elderly people 's physical performance .


The aim of our study was to investigate whether @ wk of oral magnesium supplementation can improve physical performance in healthy elderly women .


In a parallel-group , randomized controlled trial , @ healthy women ( mean SD age : @ @ y ) attending a mild fitness program were randomly allocated to a treatment group ( @ mg Mg/d ; n = @ ) or a control group ( no placebo or intervention ; n = @ ) by using a computer-generated randomization sequence , and researchers were blinded to their grouping .


After assessment at baseline and again after @ wk , the primary outcome was a change in the Short Physical Performance Battery ( SPPB ) ; secondary outcomes were changes in peak torque isometric and isokinetic strength of the lower limbs and handgrip strength .


A total of @ participants allocated to the treatment ( n = @ ) or control ( n = @ ) group were considered in the final analysis .


At baseline , the SPPB scores did not differ between the @ groups .


After @ wk , the treated group had a significantly better total SPPB score ( = @ @ points ; P = @ ) , chair stand times ( = -@ @ s ; P < @ ) , and @-m walking speeds ( = @ @ m/s ; P = @ ) than did the control group .


These findings were more evident in participants with a magnesium dietary intake lower than the Recommended Dietary Allowance .


No significant differences emerged for the secondary outcomes investigated , and no serious adverse effects were reported .


Daily magnesium oxide supplementation for @ wk seems to improve physical performance in healthy elderly women .


These findings suggest a role for magnesium supplementation in preventing or delaying the age-related decline in physical performance .


To evaluate whether perioperative indomethacin and antibiotic administration at the time of examination-indicated cerclage placement prolongs gestation .


This is a randomized controlled trial performed at a single tertiary care hospital between March @ and November @ .


Women older than @ years of age with a singleton pregnancy between @@/@ and @@/@ weeks of gestation undergoing an examination-indicated cerclage were eligible .


Women were randomly assigned to receive either perioperative indomethacin and antibiotics or no perioperative prophylactic medications .


The primary outcome was gestational latency after cerclage placement .


Fifty women were required to be randomized to show , with @ % power , a @-day improvement in latency assuming a latency without intervention of @ days .


Fifty-three patients were enrolled with three lost to follow-up .


A greater proportion of pregnancies were prolonged by at least @ days among women who received indomethacin and perioperative antibiotics ( @ -LSB- @ % -RSB- compared with @ -LSB- @ % -RSB- , P = @ ) .


However , gestational age at delivery and neonatal outcomes were statistically similar between groups .


Among women receiving an examination-indicated cerclage in the second trimester , gestation was significantly more likely to be prolonged by @ days among women who received perioperative indomethacin and antibiotics .


The aim of this prospective randomized study was to evaluate a red clover based isoflavones supplementation in the treatment of climacteric syndrome and its effects on cardiovascular risk serum profile .


The study included @ healthy postmenopausal women that were randomly assigned to receive phytoestrogens tablets , amounting in a total daily intake of @ mg red clover isoflavones plus @ mg soy isoflavones ( n = @ ) , or placebo ( n = @ ) .


The authors evaluated teh following : daily number of hot flushes and Kupperman Index at baseline and after one and three months ; serum total , high-density lipoprotein ( HDL ) and low-density lipoprotein ( LDL ) cholesterol , triglycerides , prothrombin time ( PT ) , partial thromboplastin time ( PTT ) , fibrinogen , and antithrombin III ( ATIII ) at baseline and after three and six months .


One hundred twenty-eight patients completed the study : @ in the active group and @ in the placebo group .


The treatment led to a progressive significant reduction ( p < @ ) of the number of hot flushes in the active group compared to placebo already after one month , while Kupperman Index was statistically reduced after three months .


No significant variation in total cholesterol , LDL-cholesterol , HDL-cholesterol , triglycerides , PT , PTT , fibrinogen , and ATIII were found .


The present findings suggest that a red clover based isoflavones supplementation in healthy postmenopausal women is promptly effective on climacteric syndrome , improves neurovegetative symptoms , safe on cardiovascular risk serum profile , and does not modify lipids and coagulation .


Myofascial pain syndrome is a regional condition of muscle pain and stiffness and is classically characterized by the presence of trigger points in affected musculature .


Botulinum toxin type A ( BoNT-A ) has been shown to have antinociceptive properties and elicit sustained muscle relaxation , thereby possibly affording even greater relief than traditional strategies .


Our goal was to determine whether direct injection of BoNT-A into painful muscle groups is effective for cervical and shoulder girdle myofascial pain .


An enriched protocol design was used , wherein @ patients with cervical and shoulder girdle myofascial pain underwent injection of BoNT-A to determine their response to the drug .


Fifty-four responders were then enrolled in a @-week , randomized , double-blind , placebo-controlled trial .


Pain scales and quality of life measures were assessed at baseline and at routine follow-up visits until completion of the study after @ weeks .


Injection of BoNT-A into painful muscle groups improved average visual numerical pain scores in subjects who received a second dose of BoNT-A compared to placebo ( P = @ -LSB- @ , @ -RSB- ) .


Subjects who received a second dose of BoNT-A had a reduced number of headaches per week ( P = @ -LSB- @ , @ -RSB- ) .


Brief Pain Inventory interference scores for general activity and sleep were improved ( P = @ -LSB- @ , @ -RSB- and @ -LSB- @ , @ -RSB- , respectively ) in those who received a second dose of BoNT-A .


BoNT-A injected directly into painful muscle groups improves average pain scores and certain aspects of quality of life in patients experiencing severe cervical and shoulder girdle myofascial pain .


A prospective randomized trial was conducted to compare the impact of systemic chemotherapy versus multi-modality therapy ( complete cytoreductive surgery ( CRS ) , hyperthermic intraperitoneal chemotherapy ( HIPEC ) , and systemic chemotherapy ) on overall survival ( OS ) in patients with gastric carcinomatosis .


Patients with measurable metastatic gastric adenocarcinoma involving the peritoneum , and resectable to `` no evidence of disease '' were randomized to gastrectomy , metastasectomy , HIPEC , and systemic FOLFOXIRI ( GYMS arm ) or FOLFOXIRI alone ( SA arm ) .


Seventeen patients were enrolled ( @ evaluable ) ; @ of @ patients in the multi-modality GYMS arm achieved complete cytoreduction ( CCR@ ) .


Median OS was @ months in the GYMS arm and @ months in the SA arm .


Four patients in the GYMS arm survived > @ months , @ patients close to @ years at last follow-up , and @ patient more than @ years , with @ of these patients still alive .


No patient in the SA arm lived beyond @ months .


All patients surviving beyond @ months in the surgery arm achieved complete cytoreduction and had an initial Peritoneal Cancer Index ( PCI ) of @ .


Maximal cytoreductive surgery combined with regional ( HIPEC ) and systemic chemotherapy in selected patients with gastric carcinomatosis and limited disease burden can achieve prolonged survival .


To report additional ocular outcomes of intensive treatment of hyperglycemia , blood pressure , and dyslipidemia in the Action to Control Cardiovascular Risk in Diabetes ( ACCORD ) study .


Double @ factorial , multicenter , randomized clinical trials in people with type @ diabetes who had cardiovascular disease or cardiovascular risk factors .


In the glycemia trial , targets of intensive and standard treatment were : hemoglobin A@c < @ % and @ % to @ % , respectively , and in the blood pressure trial : systolic blood pressures of < @ and < @ mmHg , respectively .


The dyslipidemia trial compared fenofibrate plus simvastatin with placebo plus simvastatin .


Of the @ ACCORD Eye Study participants enrolled , @ had @-year data ( @ % of survivors ) .


Eye examinations and fundus photographs were taken at baseline and year @ .


Photographs were graded centrally for retinopathy severity and macular edema using the Early Treatment Diabetic Retinopathy Study ( ETDRS ) methods .


Three or more steps of progression on the ETDRS person scale or treatment of retinopathy with photocoagulation or vitrectomy .


As previously reported , there were significant reductions in the primary outcome in the glycemia and dyslipidemia trials , but no significant effect in the blood pressure trial .


Results were similar for retinopathy progression by @ , @ , and @ or more steps on the person scale and for @ steps on the eye scale .


In the subgroup of patients with mild retinopathy at baseline , effect estimates were large ( odds ratios , @ ; P < @ ) , but did not reach nominal significance for participants with no retinopathy or for those with moderate to severe retinopathy at baseline .


Slowing of progression of retinopathy by intensive treatment of glycemia was observed in ACCORD participants , whose average age and diabetes duration were @ and @ years , respectively , and who had cardiovascular disease or cardiovascular risk factors .


The effect seemed stronger in patients with mild retinopathy .


Similar slowing of progression was observed in patients treated with fenofibrate , with no effect observed with intensive blood pressure treatment .


This is the second study to confirm the benefits of fenofibrate in reducing diabetic retinopathy progression , and fenofibrate should be considered for treatment of diabetic retinopathy .


Cooking over open fires using solid fuels is both common practice throughout much of the world and widely recognized to contribute to human health , environmental , and social problems .


The public health burden of household air pollution includes an estimated four million premature deaths each year .


To be effective and generate useful insight into potential solutions , cookstove intervention studies must select cooking technologies that are appropriate for local socioeconomic conditions and cooking culture , and include interdisciplinary measurement strategies along a continuum of outcomes .


REACCTING ( Research on Emissions , Air quality , Climate , and Cooking Technologies in Northern Ghana ) is an ongoing interdisciplinary randomized cookstove intervention study in the Kassena-Nankana District of Northern Ghana .


The study tests two types of biomass burning stoves that have the potential to meet local cooking needs and represent different `` rungs '' in the cookstove technology ladder : a locally-made low-tech rocket stove and the imported , highly efficient Philips gasifier stove .


Intervention households were randomized into four different groups , three of which received different combinations of two improved stoves , while the fourth group serves as a control for the duration of the study .


Diverse measurements assess different points along the causal chain linking the intervention to final outcomes of interest .


We assess stove use and cooking behavior , cooking emissions , household air pollution and personal exposure , health burden , and local to regional air quality .


Integrated analysis and modeling will tackle a range of interdisciplinary science questions , including examining ambient exposures among the regional population , assessing how those exposures might change with different technologies and behaviors , and estimating the comparative impact of local behavior and technological changes versus regional climate variability and change on local air quality and health outcomes .


REACCTING is well-poised to generate useful data on the impact of a cookstove intervention on a wide range of outcomes .


By comparing different technologies side by side and employing an interdisciplinary approach to study this issue from multiple perspectives , this study may help to inform future efforts to improve health and quality of life for populations currently relying on open fires for their cooking needs .


The mean follow-up in the clinical trials of antiplatelet drugs in the secondary prevention of ischemic atherothrombotic stroke ranges from @ to @ years .


Thus , the safety and efficacy of these drugs in the very long term is not totally documented .


We have assessed the safety and effectiveness of triflusal and aspirin for a very long-term period in the secondary prevention of patients with ischemic atherothrombotic stroke .


Patients with atherothrombotic ischemic stroke , including TIA , who participated in randomized clinical trials of triflusal versus aspirin were included in the study .


The period of recruitment was between @ and @ .


After finishing their participation in the clinical trials , patients were followed up in the Neurology Department of our hospital .


All patients were treated with aspirin or triflusal during a mean period of @ years .


Groups were comparable with respect to sex , age , risk factor and etiology of the stroke .


Adverse events and vascular events ( including stroke recurrence , ischemic heart disease and vascular death ) that appeared throughout the study were registered .


Statistical analysis was performed using the statistical package SPSS @ for Windows .


Kaplan-Meier curves and the log-rank test were used to compare treatments .


A total of @ patients ( @ men ) with a mean age ( SD ) of @ years were included in the study ; @ patients ( @ % ) were treated with triflusal and @ with aspirin .


There were no statistically significant differences between aspirin and triflusal concerning new vascular events ( @ vs. @ % ; p = @ ) , stroke recurrence ( @ vs. @ % ; p = @ ) , ischemic heart events ( @ vs. @ % ; p = @ ) , vascular death ( @ vs. @ % ; p = @ ) and global mortality ( @ vs. @ % ; p = @ ) .


The incidence of serious bleeding ( upper digestive tract hemorrhage and cerebral hemorrhage ) was @ % in aspirin-treated patients and @ % in triflusal-treated patients ( p < @ ) .


In reference to other adverse events , no significant differences were found between aspirin and triflusal .


In the secondary prevention of ischemic stroke , very long-term treatment with triflusal or aspirin seems to have a similar efficacy , but triflusal is safer with a lower hemorrhagic risk .


Triflusal may be an alternative therapy , particularly in patients who present aspirin resistance .


Low caste adolescent girls living in rural northern Karnataka are at increased risk of school drop-out , child marriage , and entry into sex-work , which enhances their vulnerability to HIV , early pregnancy and adverse maternal and child health outcomes .


This protocol describes the evaluation of Samata , a comprehensive , multi-level intervention designed to address these structural drivers of HIV risk and vulnerability .


The Samata study is a cluster randomised controlled trial that will be conducted in eighty village clusters ( @ intervention ; @ control ) in Bijapur and Bagalkot districts in northern Karnataka .


The intervention seeks to reach low caste girls and their families ; adolescent boys ; village communities ; high school teachers and school governing committees ; and local government officials .


All low caste ( scheduled caste/tribe ) adolescent girls attending @th standard ( final year of primary school ) will be recruited into the study in two consecutive waves , one year apart .


Girls ( n = @ ) , their families ( n = @ ) and school teachers ( n = @ ) will be interviewed at baseline and at endline .


The study is designed to assess the impact of the intervention on four primary outcomes : the proportion of low caste girls who ( i ) enter into secondary school ; ( ii ) complete secondary school ; ( iii ) marry before age @ ; and ( iv ) engage in sex before age @ .


Observers assessing the outcomes will be blinded to group assignment .


The primary outcome will be an adjusted , cluster-level intention to treat analysis , comparing outcomes in intervention and control villages at follow-up .


We will also conduct survival analyses for the following secondary outcomes : marriage , sexual debut , pregnancy and entry into sex work .


Complementary monitoring and evaluation , qualitative and economic research will be used to explore and describe intervention implementation , the pathways through which change occurs , and the cost-effectiveness of the intervention .


This is an innovative trial of a comprehensive intervention to improve the quality of life and reduce HIV vulnerability among marginalised girls in northern Karnataka .


The findings will be of interest to programme implementers , policy makers and evaluation researchers working in the development , education , and sexual and reproductive health fields .


Individuals with serious mental illness have high rates of obesity and a need for specialized weight loss intervention programs .


This study examines the efficacy of the RENEW weight loss intervention and examines the impact of the intervention setting on outcomes .


@ individuals with serious mental illness from @ different settings were randomly assigned to receive the RENEW weight loss intervention or a control condition of treatment as usual .


The RENEW intervention is a one year program that includes an intensive , maintenance and intermittent supports phase .


The intervention group experienced a modest weight loss of @ lbs at @ months , @ lbs at @ months and a slight weight gain of @ lbs at @ months .


The control group gained a total of @ lbs at @ months .


However when settings were examined separately the responder sites had a weight loss of @ lbs at @ months , @ lbs at @ months and @ lbs at @ months .


These results suggest that the settings in which individuals receive services may act as a support or hindrance toward response to weight loss interventions .


The concept of the obesogenic environment deserves further examination as a factor in the success of weight loss programs .


To observe the impacts of different frequencies of electroacupuncture ( EA ) on post-operative cognitive function and the change in serum S-@beta protein under the compound anesthesia of acupuncture and drugs .


One hundred and twenty-four patients of abdominal operation at selective time were randomized into a routine drug anesthesia group ( group A , @ cases ) , a meridian point @ Hz group ( group B , @ cases ) , a me ridian point @ Hz/@ Hz group ( group C , @ cases ) , a meridian point @ Hz group ( group D , @ cases ) and a transcutaneous acupoint electric stimulation @ Hz/@ Hz group ( group E , @ cases ) .


In group A , the endotrachea-lgeneral anesthesia was applied .


In the rest groups , the acupuncture anesthesia was induced for @ min before the endotracheal general anesthesia , at Baihui ( GV @ ) , Yintang ( GV @ ) and Neiguan ( PC @ ) , with G@-@ electric acupuncture apparatus used .


In group B , the continuous wave and @Hz in frequency were selected .


In group C , the disperse-dense wave and @ Hz/@ Hz in frequency were selected .


In group D , the continuous wave and @ Hz in frequency were selected .


In group E , the disperse-dense wave and @ Hz/@ Hz in frequency were selected , and the electrode pads were stick on the acupoints and connected with the electric stimulation till the end of operation .


Mini-mental state examination ( MMSE ) was adopted to evaluate and record the changes in cognitive function @ day before operation and on the @rd day after operation .


The conditions of post-operative cognitive dysfunction ( POCD ) in the patients and the changes in serum S-@beta protein were monitored before and at the end of operation .


The incidence rate of POCD on the @rd day after operation was @ % ( @/@ ) in group A.


The incidence rates of POCD were @ % ( @/@ ) , @ % ( @/@ ) , @ % ( @/@ ) and @ % ( @/@ ) in group B , C , D and E separately .


Compared with group A , the incidence rate of PCOD in group B , C , D and E were reduced ( all P < @ ) , the incidence rate in group C and E were lower than that in groups B and D ( all P < @ ) .


At the end of operation , the level of serumS-@beta protein was ( @ + / - @ ) microg/L in group A , the levels were ( @ + / - @ ) microg/L , ( @ + / - @ ) microg/L , ( @ + / - @ ) microg/L and ( @ + / - @ ) microg/L in group B , C , D and E separately .


The levels of serum S-@beta protein in group B , C , D and E were lower than that in group A separately ( all P < @ ) .


The general anesthesia assisted with EA at different frequencies reduces the incidence of cognitive dysfunctionand , decreases the level of serum S-@beta protein after intestinal cancer resection .


The effects of the meridian point electric stimulation at @ Hz/@ Hz and the transcutaneous electric stimulation at @ Hz/@ Hz are the best .


Hence , these two approaches of anesthesia deserve to be recommended practically .


Many features can influence the choice of a supraglottic airway device ( SAD ) , including ease of insertion , adequate ventilation pressures and lack of adverse effects .


The goal of this randomized prospective trial was to compare the performance of the i-gel with that of the LMA-Supreme .


One hundred adult patients ( American Society of Anesthesiologists I-III ) scheduled to undergo elective surgery under general anesthesia were randomized to either an i-gel ( n = @ ) or an LMA-Supreme ( n = @ ) .


The primary objective was to compare ventilation pressures .


Secondary objectives included time and number of attempts needed to introduce the device , adverse effects , and repositioning .


The endoscopic view of the glottic aperture and the position of the drain tubes in relation to the esophagus were also evaluated .


The devices were inserted successfully in @ ( @ % ) patients in both groups .


There was no significant difference in the -LSB- mean ( SD ) -RSB- leak pressure -LSB- i-gel : @ ( @ ) cm H@O vs LMA-Supreme : @ ( @ ) cm H@O ; P = @ -RSB- or peak inspiratory pressure between both devices .


Insertion time was shorter with the i-gel than with the LMA-Supreme -LSB- @ ( @ ) sec vs @ ( @ ) sec , respectively ; P = @ -RSB- .


The vocal cords were completely visualized more often through the i-gel ( @ % ) than through the LMA-Supreme ( @ % ) ( P = @ ) .


Esophageal mucosa was easily visualized through the drain port in all but four patients , two patients in each group .


There was no difference between groups regarding preoperative or postoperative complications .


Postoperative patient discomfort was generally mild and comparable between both devices .


Both the LMA-Supreme and the i-gel offer similar performance for positive pressure ventilation in paralyzed patients during general anesthesia .


The i-gel was associated with a slightly faster insertion time and better fibrescopic visualization of the glottis .


This trial was registered at Clinicaltrials.gov : NCT@ .


To test the efficacy of probiotic and prebiotic , alone or combined ( synbiotic ) , on the prevention of necrotizing enterocolitis ( NEC ) in very low birth weight ( VLBW ) infants .


A prospective , randomized , controlled trial was conducted at @ neonatal intensive care units in Turkey .


VLBW infants ( n = @ ) were assigned to a control group and @ study groups that were given probiotic ( Bifidobacterium lactis ) , prebiotic ( inulin ) , or synbiotic ( Bifidobacterium lactis plus inulin ) added to breastmilk or formula for a maximum of @ weeks before discharge or death .


The primary outcome was NEC ( Bell stage @ ) .


The rate of NEC was lower in probiotic ( @ % ) and synbiotic ( @ % ) groups compared with prebiotic ( @ % ) and placebo ( @ % ) groups ( P < @ ) .


The times to reach full enteral feeding were faster ( P < @ ) , the rates of clinical nosocomial sepsis were lower ( P = @ ) , stays in the neonatal intensive care unit were shorter , ( P = @ ) , and mortality rates were lower ( P = @ ) for infants receiving probiotics , prebiotics , or synbiotic than controls .


The use of antenatal steroid ( OR @ , @ % CI @-@ @ ) and postnatal probiotic ( alone or in synbiotic ) ( OR @ , @ % CI @-@ @ ) decreased the risk of NEC , and maternal antibiotic exposure increased this risk ( OR @ , @ % CI @-@ @ ) .


In VLBW infants , probiotic ( Bifidobacterium lactis ) and synbiotic ( Bifidobacterium lactis plus inulin ) but not prebiotic ( inulin ) alone decrease NEC .


To examine whether behavioural strategies designed to improve children 's sleep problems could also improve the symptoms , behaviour , daily functioning , and working memory of children with attention deficit hyperactivity disorder ( ADHD ) and the mental health of their parents .


Randomised controlled trial .


@ general paediatric practices in Victoria , Australia .


@ children aged @-@ years with ADHD attending the practices between @ and @ .


Sleep hygiene practices and standardised behavioural strategies delivered by trained psychologists or trainee paediatricians during two fortnightly consultations and a follow-up telephone call .


Children in the control group received usual clinical care .


At three and six months after randomisation : severity of ADHD symptoms ( parent and teacher ADHD rating scale IV-primary outcome ) , sleep problems ( parent reported severity , children 's sleep habits questionnaire , actigraphy ) , behaviour ( strengths and difficulties questionnaire ) , quality of life ( pediatric quality of life inventory @ ) , daily functioning ( daily parent rating of evening and morning behavior ) , working memory ( working memory test battery for children , six months only ) , and parent mental health ( depression anxiety stress scales ) .


Intervention compared with control families reported a greater decrease in ADHD symptoms at three and six months ( adjusted mean difference for change in symptom severity -@ , @ % confidence interval -@ to -@ , P = @ , effect size -@ , and -@ , -@ to -@ , P = @ , effect size -@ , respectively ) .


Compared with control children , intervention children had fewer moderate-severe sleep problems at three months ( @ % v @ % ; adjusted odds ratio @ , @ % confidence interval @ to @ ; P < @ ) and six months ( @ % v @ % ; @ , @ to @ ; P = @ ) .


At three months this equated to a reduction in absolute risk of @ % ( @ % confidence interval @ % to @ % ) and an estimated number needed to treat of @ .


At six months the number needed to treat was @ .


Approximately a half to one third of the beneficial effect of the intervention on ADHD symptoms was mediated through improved sleep , at three and six months , respectively .


Intervention families reported greater improvements in all other child and family outcomes except parental mental health .


Teachers reported improved behaviour of the children at three and six months .


Working memory ( backwards digit recall ) was higher in the intervention children compared with control children at six months .


Daily sleep duration measured by actigraphy tended to be higher in the intervention children at three months ( mean difference @ minutes , @ % confidence interval -@ to @ minutes , effect size @ ) and six months ( @ minutes , -@ to @ minutes , effect size @ ) ; however , this measure was only completed by a subset of children ( n = @ at three months and n = @ at six months ) .


A brief behavioural sleep intervention modestly improves the severity of ADHD symptoms in a community sample of children with ADHD , most of whom were taking stimulant medications .


The intervention also improved the children 's sleep , behaviour , quality of life , and functioning , with most benefits sustained to six months post-intervention .


The intervention may be suitable for use in primary and secondary care.Trial registration Current Controlled Trials ISRCTN@ .


The physical and mental health of college students tends to continuously decline around the world .


Since they are in a significant transition period which presents opportunities and challenges in health promotion , it is important to improve their health in this period .


As a traditional Chinese exercise form which combines movements with breath and mind , Baduanjin may be one of the selectable effective exercises .


However , evidence of Baduanjin exercise for college students has not been completely established .


The primary aim of this trial is to evaluate the effectiveness and safety of Baduanjin exercise for physical and mental health of college students through a rigorous randomization , parallel-controlled design .


We will conduct a randomized , single-blind , parallel-controlled trial .


A total of @ college students from Fujian University of Traditional Chinese Medicine who meet the eligibility criteria will be recruited and randomly allocated into Baduanjin training or usual exercise control group .


Baduanjin training will last @ weeks ( @ h per day , @ days per week ) .


The physical and psychological outcomes , including lumbar muscle strength , lumbar proprioception function , physical fitness , as well as self-reported symptom intensity , stress , self-esteem , mood , quality of life , quality of sleep , and adverse events , will be evaluated by blinded outcome assessors at baseline , @ weeks ( at the end of intervention ) , and @ weeks ( after the @-week follow-up period ) .


This protocol presents an objective design of a randomized , single-blind trial that aims to evaluate the effectiveness and safety of Baduanjin exercise for physical and mental health of college students .


If the outcome is positive , the results will provide higher-quality evidence to better inform the college students regarding their selection about whether to receive such exercise .


Methamphetamine use has been previously associated with poor medication adherence , but , to date , there have been no studies that have conducted event-level analyses on correlates of medication adherence in studies of pharmacologic agents for methamphetamine dependence .


We pooled data from two previous , randomized controlled trials ( using bupropion and mirtazapine , respectively ) for methamphetamine dependence and used a mixed effects logistic model to examine correlates of daily opening of the medication event monitoring system ( MEMS ) cap as a repeated measure .


We explored whether periods of observed methamphetamine use via urine testing were associated with study medication adherence based on MEMS cap openings .


We found a significant negative association between methamphetamine-urine positivity and event-level study medication adherence as measured by MEMS cap openings ( AOR : @ ; @ % CI : @-@ @ ) .


In addition , age ( AOR : @ ; @ % CI : @-@ @ ) and depressive symptoms ( AOR : @ ; @ % CI : @-@ @ ) were significantly associated with adherence .


Finally , participants were more likely to open their study medication bottles on days when they presented for in-person urine testing .


Our event-level analysis shows that methamphetamine use can be associated with reduced medication adherence as measured by MEMS cap openings in pharmacologic trials , which corroborates prior research .


These findings may suggest that medication adherence support in pharmacologic trials among methamphetamine users may be needed to improve study compliance and could be targeted towards periods of time when there are more likely to not open their study medication pill bottles .


Chronic venous disease is a group of symptoms caused by functional and structural defects of the venous vessels .


One of the most common aspects of this disease is the occurrence of varicose veins .


There are many ways of prevention and treatment of varicose veins , but in Poland the leading one is still surgery .


As in every medical procedure there is the possibility of some complications .


One of them is deep vein thrombosis ( DVT ) .