Topiramate is one of the promising medications with reported reductions in cocaine use and craving in former studies .


The present study evaluated the acceptance and effectiveness of topiramate as an add-on to cognitive behavioral therapy ( CBT ) in crack-cocaine dependent patients .


Seventy-four crack-cocaine dependent outpatients participated in an open-label , randomized feasibility trial .


They were randomized to receive either @-week CBT plus topiramate ( @mg/day ) or @-week CBT only .


The primary outcome measure was treatment retention .


Secondary outcomes included medication adherence , safety , cocaine and other substance use , health , social functioning , and patient satisfaction .


Adherence to topiramate treatment was low .


In the intent-to-treat analyses , topiramate neither improved treatment retention nor reduced cocaine and other substance use .


Post hoc , exploratory analyses suggested a moderation effect of comorbid opioid dependence , with a significant effect of topiramate on cocaine use reduction only in crack-cocaine dependent patients with comorbid opioid dependence .


Topiramate was safe and well-tolerated in this sample of crack-cocaine dependent patients , but efficacy was not supported probably due to low acceptance of the treatment .


Given the equivocal results of previous studies and the negative findings in our study , the potential of topiramate in the treatment of cocaine dependence seems limited .


Food portion size is an important determinant of intake in children .


It remains unknown if children 's weight status and relative reinforcing value of food ( RRVF ) interact with portion size to affect intake .


In a randomized crossover design , @ normal-weight and @ obese children , ages @-@ years , consumed dinner once a week for @ weeks .


At each dinner , the same meal was served , but the portion size of all foods ( chicken nuggets , hash browns , ketchup , green beans , brownies ) and a sugar-sweetened beverage ( fruit punch ) varied across conditions ( @ , @ , and @ % ) .


Children 's RRVF was assessed using a behavioral choice task .


There was a significant main effect of portion size condition ( P = @ ) and weight status ( P = @ ) and a nonsignificant trend for a portion size-by-weight status interaction ( P = @ ) on intake .


Mean intakes across conditions ( @ , @ , and @ % ) were @ , @ , and @ kcal for normal-weight children and @ , @ , and @ kcal for obese children , respectively .


Neither the main effect of RRVF status nor the condition-by-RRVF status interaction was significant ( P > @ ) .


Environments that offer large portions of palatable foods affect all children 's intake irrespective of their weight status or how reinforcing they find food to be .


To examine the efficacy of a brief intervention delivered by a therapist ( TBI ) or a computer ( CBI ) in preventing cannabis use among adolescents in urban primary care clinics .


A randomized controlled trial comparing : CBI and TBI versus control .


Urban primary care clinics in the United States .


Research staff recruited @ adolescents ( aged @-@ years ) who reported no life-time cannabis use on a screening survey for this study , which included a baseline survey , randomization ( stratified by gender and grade ) to conditions ( control ; CBI ; TBI ) and @ - , @ - and @-month assessments .


Using an intent-to-treat approach , primary outcomes were cannabis use ( any , frequency ) ; secondary outcomes included frequency of other drug use , severity of alcohol use and frequency of delinquency ( among @ % completing follow-ups ) .


Compared with controls , CBI participants had significantly lower rates of any cannabis use over @ months ( @ % , @ % , respectively , P < @ ) , frequency of cannabis use at @ and @ months ( P < @ ) and other drug use at @ months ( P < @ ) .


Compared with controls , TBI participants did not differ in cannabis use or frequency , but had significantly less other drug use at @ months ( P < @ ) , alcohol use at @ months ( P < @ ) and delinquency at @ months ( P < @ ) .


Among adolescents in urban primary care in the United States , a computer brief intervention appeared to prevent and reduce cannabis use .


Both computer and therapist delivered brief interventions appeared to have small effects in reducing other risk behaviors , but these dissipated over time .


Glycoprotein NMB ( gpNMB ) , a negative prognostic marker , is overexpressed in multiple tumor types .


Glembatumumab vedotin is a gpNMB-specific monoclonal antibody conjugated to the potent cytotoxin monomethyl auristatin E.


This phase II study investigated the activity of glembatumumab vedotin in advanced breast cancer by gpNMB expression .


Patients ( n = @ ) with refractory breast cancer that expressed gpNMB in @ % of epithelial or stromal cells by central immunohistochemistry were stratified by gpNMB expression ( tumor , low stromal intensity , high stromal intensity ) and were randomly assigned @:@ to glembatumumab vedotin ( n = @ ) or investigator 's choice ( IC ) chemotherapy ( n = @ ) .


The study was powered to detect overall objective response rate ( ORR ) in the glembatumumab vedotin arm between @ % ( null ) and @ % ( alternative hypothesis ) with preplanned investigation of activity by gpNMB distribution and/or intensity ( Stratum @ to Stratum @ ) .


Glembatumumab vedotin was well tolerated as compared with IC chemotherapy ( less hematologic toxicity ; more rash , pruritus , neuropathy , and alopecia ) .


ORR was @ % ( five of @ ) for glembatumumab vedotin versus @ % ( three of @ ) for IC , without significant intertreatment differences for predefined strata .


Secondary end point revealed ORR of @ % ( @ of @ ) versus @ % ( five of @ ) overall , and @ % ( seven of @ ) versus @ % ( one of @ ) for gpNMB overexpression ( @ % of tumor cells ) .


Unplanned analysis showed ORR of @ % ( five of @ ) versus @ % ( @ of @ ) in patients with triple-negative breast cancer ( TNBC ) , and @ % ( four of @ ) versus @ % ( zero of six ) in gpNMB-overexpressing TNBC .


Glembatumumab vedotin is well tolerated in heavily pretreated patients with breast cancer .


Although the primary end point in advanced gpNMB-expressing breast cancer was not met for all enrolled patients ( median tumor gpNMB expression , @ % ) , activity may be enhanced in patients with gpNMB-overexpressing tumors and/or TNBC .


A pivotal phase II trial ( METRIC -LSB- Metastatic Triple-Negative Breast Cancer -RSB- ) is underway .


Assess effectiveness of the Expanded Food and Nutrition Education Program on nutrition behaviors post-education and longitudinally .


Switching replications randomized experimental design .


Participants randomly assigned to immediate education ( IE ) or delayed education ( DE ) .


Participants in IE received intervention the first @ weeks , and those in DE the second @ weeks , with no intervention during alternate periods .


Data were collected in @ repeated measures .


Parents ( n = @ randomized ; n = @ completed ) of children in @ Head Start and @ low-income schools .


Eight weekly workshops , based on Eating Right is Basic-Enhanced adapted to incorporate dialogue approach with experiential learning .


Ten-item self-reported behavior checklist on nutrition , food resource management , food safety , and food security ; responses on a @-point scale reporting frequency of behavior .


Chi-square , analysis of variance , and multiple regression .


Groups were demographically similar .


Both groups reported improved behaviors pre - to post-education ( P < @ ) .


There was no significant difference between groups at Time @ ( T@ ) or DE control period ( T@ vs T@ ) .


Changed IE behavior was retained T@ to T@ .


A multiple regression model of overall change , controlling for T@ score and educator , showed significant improvement ( n = @ , = @ , P < @ ) .


Positive outcomes were supported by this experimental study in a usual program context , with reported behavior changes retained at least @ months .


Healthcare worker attitudes toward obese individuals facilitate discrimination and contribute to poor health outcomes .


Previous studies have demonstrated medical student bias toward obese individuals , but few have examined effects of the educational environment on these prejudicial beliefs .


We sought to determine whether an innovative educational intervention ( reading a play about obesity ) could diminish obesity prejudice relative to a standard medical lecture .


We conducted a randomized , controlled trial enrolling medical students ( n = @ ) from three universities .


Students were assigned to play-reading or a standard lecture .


Explicit attitudes and implicit bias toward obese individuals were assessed prior to intervention and after four months .


At baseline , students demonstrated moderate explicit and implicit bias toward obese people despite high scores on empathy .


Students randomized to the play-reading group had significantly decreased explicit fat bias ( P = @ ) at follow-up , while students in the lecture group showed increased endorsement of a prescriptive model of care at the expense of a patient-centered approach ( P = @ ) .


There was a significant increase in empathy for those in both the theater ( P = @ ) and lecture group ( P = @ ) .


The intervention had no significant effect on implicit bias or regard for obesity as a civil rights issue .


Dramatic reading may be superior to traditional medical lectures for showcasing patient rights and preferences .


The present study demonstrates for the first time that play-reading diminishes conscious obesity bias .


Further research should determine whether nontraditional methods of instruction promote improved understanding of and care for obese patients .


To compare the thrombosis rate , ease of insertion , bleeding rate , and complications of a nontapered peripherally inserted central catheter ( PICC ) versus a reverse tapered PICC .


This was a prospective randomized , controlled trial conducted in single center .


All patients @-@ years old requiring PICC insertion were considered for the study .


All patients were followed until PICC removal .


Ultrasound examination of the arm was performed at PICC removal or at @ days .


There were @ patients randomly assigned -- @ to the nontapered PICC group and @ to the reverse tapered PICC group .


The overall thrombosis rate was @ % .


The thrombosis rate was @ % in the nontapered PICC group and @ % in the reverse tapered PICC group ( P = @ ) .


The symptomatic thrombosis rate was @ % in the nontapered PICC group and @ % in the reverse tapered PICC group ( P = @ ) .


The complete thrombosis rate was @ % in the nontapered PICC group compared with @ % in the reverse tapered PICC group ( P = @ ) .


There was a statistically significantly higher thrombosis rate in patients with cancer ( @ % vs @ % , P = @ ) .


This study showed a high incidence of thrombosis of peripheral veins used for PICC insertion .


The implication of this thrombosis is significant in light of the morbidity and potential mortality associated with this condition .


A difference in thrombosis rate between devices could not be detected in this study .


Four-layer bandaging is the standard treatment for venous leg ulcers but is bulky and can restrict mobility .


Two-layer compression stockings have recently been marketed but their clinical and cost effectiveness were unknown .


To compare the clinical and cost effectiveness of four-layer bandaging with two-layer compression stockings .


In a pragmatic , open , randomised controlled trial @ participants were randomly allocated two-layer compression stockings or four-layer bandages and followed for up to @ months after healing .


The median time to ulcer healing was almost identical ( stockings group : @ days , bandaging group : @ days ) .


More patients allocated stockings changed treatment but ulcer recurrence rates were higher in the bandaging group .


Stockings cost @ sterling pounds less per participant per year and had more than @ % probability of being the most cost-effective treatment .


Two-layer compression stockings are a viable , cost-effective alternative to four-layer bandaging but may not be suitable for all patients .


The approved use of onabotulinumtoxinA for prophylaxis of headaches in patients with chronic migraine ( CM ) involves treatment every @weeks .


It is currently unknown whether patients who fail to respond to the first onabotulinumtoxinA treatment cycle will respond to subsequent treatment cycles .


To help inform decisions about treating non-responders , we examined the probability of treatment cycle @ non-responders responding in cycle @ , and cycle @ and @ non-responders responding in cycle @ .


Pooled PREEMPT data ( two studies : a @-week , @-cycle , double-blind , randomised ( @:@ ) , placebo-controlled , parallel-group phase , followed by a @-week , @-cycle , open-label phase ) evaluated onabotulinumtoxinA ( @-@U ) for prophylaxis of headaches in persons with CM ( @days/month with headache @h/day ) .


End points of interest included the proportion of study patients who first achieved a @ % reduction in headache days , moderate/severe headache days , total cumulative hours of headache on headache days , or a @-point improvement in Headache Impact Test ( HIT ) -@ .


For treatment cycle @ , all eligible participants were included .


For subsequent cycles , responders in a previous cycle were no longer considered first responders .


Among onabotulinumtoxinA-treated patients ( n = @ ) @ % had a @ % reduction in headache-day frequency during treatment cycle @ , with @ % and @ % of patients first responding during cycles @ and @ , respectively .


@ % , @ % and @ % of patients first responded with a @ % reduction in cumulative hours of headache , and @ % , @ % and @ % of patients first responded with a @-point improvement in total HIT-@ during treatment cycles @ , @ and @ , respectively .


A meaningful proportion of patients with CM treated with onabotulinumtoxinA who did not respond to the first treatment cycle responded in the second and third cycles of treatment .


Unhealthy lifestyles contribute to the development of cardiovascular risk factors , whose incidence is increasing among children and adolescents .


The Program SI !


is a long-term , multi-target behavioral intervention to promote healthy lifestyle habits in children through the school environment .


The objective of the study is to evaluate the efficacy of this intervention in its first phase , preschoolers .


Cluster-randomized controlled trial in public schools in the city of Madrid , Spain .


A total @ schools , including @ children ( @-@ years ) , @ families , and @ teachers participated in the study .


Schools were assigned to their usual school curriculum or to engage in an additional multi-component intervention ( Program SI ! )


The primary outcome of this trial is @-school year changes from baseline in scores for children 's knowledge , attitudes and habits ( KAH ) .


Secondary outcomes are @-school year changes from baseline in scores for knowledge , attitudes , and habits among parents , teachers , and the school environment .


After @-school year , our results indicate that the Program SI !


intervention increases children 's KAH scores , both overall ( @ , @ % CI , @-@ @ ) and component-specific ( Diet : @ , @ % CI , @-@ @ ; Physical activity : @ , @ % CI , @-@ @ ; Human body : @ , @ % CI , @-@ @ ) score .


is demonstrated as an effective and feasible strategy for increasing knowledge and improving lifestyle attitudes and habits among very young children .


The Juglans regia L. leaf has been traditionally used for treatment of diabetes mellitus in Iran .


But yet , no controlled human study has determined its efficacy in diabetic patients .


The present study was designed to investigate the effects of the Juglans regia leaf extract on hyperglycemia and lipid profiles in type II diabetic patients .


Total @ patients , suffering from type II diabetes with fasting blood glucose ( FBG ) between @ and @mg/dL , glycated hemoglobin ( HbA@c ) between @ % and @ % and aged between @ and @ years were selected , and randomly divided in to two groups of Juglans regia and placebo .


First group received @mg Juglans regia leaf extract in capsules form two times a day for @ months and other group received @mg placebo capsule with the same dosage .


The standard anti-diabetic therapy ( metformin and glibenclamide , and nutritional regimen ) was continued in both groups .


At the baseline and after three months the FBG , insulin , HbA@c , cholesterol , triglyceride , HDL , LDL and liver and renal function tests were determined .


In addition general satisfaction with the treatment was identified using health questionnaires .


The results indicated that FBG , HbA@c , total cholesterol and triglyceride levels in Juglans regia treated patients significantly decreased compared with the baseline and with placebo group .


Patients in Juglans regia group were significantly satisfied with Juglans regia treatment compared with the placebo group .


No liver , kidney and other side effects were observed in the groups , except more GI events ( specially a mild diarrhea ) associated with extract treatment at the beginning of the study .


In conclusion , treatment of type II diabetic patients with @mg Juglans regia leaf extract two times a day for three months improves lipid profile and glycemic control without any tangible adverse effects .


The use of tissue adhesives for the closure of surgical incisions is increasing .


Few studies directly compare tissue adhesives to one another or focus on the difference in wound closure time between tissue adhesives .


We compared the use of N-butyl-@ cyanoacrylate ( Histoacryl ) , octyl cyanoacrylate ( Dermabond ) , or subcuticular suture in incisions resulting from reduction mammoplasty , mastopexy , panniculectomy , and abdominoplasty .


A @-armed prospective randomized controlled trial was performed .


Part @ compared closure of surgical incisions with N-butyl-@ cyanoacrylate and octyl cyanoacrylate .


Part @ compared the closure of surgical incisions with N-butyl-@ cyanoacrylate and subcuticular suture .


End points were closure time , scar width , and satisfaction ratings .


Both study arms revealed significantly faster closer times with N-butyl-@ cyanoacrylate -LSB- @/@ in part @ ( P = @ ) and @/@ in part @ ( P = @ ) -RSB- .


Scar width difference did not reach statistical significance , and there was no difference in surgeon , independent reviewer , or patient satisfaction among the materials .


Our results demonstrate a decreased time required for wound closure using N-butyl-@ cyanoacrylate compared to both suture and octyl cyanoacrylate regardless of incision type with no significant difference in scar width or satisfaction ratings .


To evaluate the effect of burn rehabilitation massage therapy on hypertrophic scar after burn .


One hundred and forty-six burn patients with hypertrophic scar ( s ) were randomly divided into an experimental group and a control group .


All patients received standard rehabilitation therapy for hypertrophic scars and @ patients ( massage group ) additionally received burn scar rehabilitation massage therapy .


Both before and after the treatment , we determined the scores of visual analog scale ( VAS ) and itching scale and assessed the scar characteristics of thickness , melanin , erythema , transepidermal water loss ( TEWL ) , sebum , and elasticity by using ultrasonography , Mexameter ( ) , Tewameter ( ) , Sebumeter ( ) , and Cutometer ( ) , respectively .


The scores of both VAS and itching scale decreased significantly in both groups , indicating a significant intragroup difference .


With regard to the scar characteristics , the massage group showed a significant decrease after treatment in scar thickness , melanin , erythema , TEWL and a significant intergroup difference .


In terms of scar elasticity , a significant intergroup difference was noted in immediate distension and gross skin elasticity , while the massage group significant improvement in skin distensibility , immediate distension , immediate retraction , and delayed distension .


Our results suggest that burn rehabilitation massage therapy is effective in improving pain , pruritus , and scar characteristics in hypertrophic scars after burn .


This study examined how well students estimate their overall drinker type and the relation between the accuracy of this estimation with alcohol-related consequences .


The study also explored the association between psychosocial alcohol variables and underestimation or overestimation of drinker type .


College students ( n = @,@ ) completed questionnaires at baseline ( precollege matriculation ) assessing self-reported drinker types ( SI ) , protective and risky drinking behaviors , drinking expectancies , attitudes , and norms .


Postbaseline assessment occurred during the fall semester sophomore year and included the number and type of alcohol consequences experienced during the previous year .


Students ' SIs were coded as accurate , overestimated , or underestimated relative to their empirically derived latent class analytic drinker class .


The association between drinker type accuracy and consequences and membership in the high-risk Multiple and Repeated Consequence group was assessed , as was the relationship between the psychosocial alcohol variables and accuracy .


Eighteen percent of students underestimated and @ % overestimated their drinker type .


Students who under - or overestimated their drinker type reported experiencing more consequences , even after controlling for drinking .


Increases in positive alcohol expectancies , protective and risky drinking behaviors , and descriptive peer norms were positively associated with underestimation of drinker type .


Only protective and risky drinking behaviors were associated with overestimation .


This study underscores the importance of accurate estimation of drinker type and the risk of experiencing alcohol consequences .


Future research and intervention strategies are discussed .


Detection of clinically relevant pain relief in cats with degenerative joint disease ( DJD ) is complicated by a lack of validated outcome measures and a placebo effect .


To evaluate a novel approach for detection of pain relief in cats with DJD .


Fifty-eight client-owned cats .


Prospective , double-masked , placebo-controlled , stratified , randomized , clinical study .


Enrolled cats were @-@years of age , with owner-observed mobility impairment , evidence of pain in at least @ joints during orthopedic examination , and overlapping radiographic evidence of DJD , and underwent a @-week baseline period , @-week treatment period with placebo or meloxicam , and @-week masked washout period .


Outcome measures were evaluated at days @ , @ , @ , and @ .


Both groups significantly improved after the treatment period ( day @ ) on client-specific outcome measures ( CSOM ) and feline musculoskeletal pain index ( FMPI ) ( P < @ for both ) ; there was no difference between the groups on CSOM or FMPI score improvement .


After the masked washout period , more cats that received meloxicam during the treatment period had a clinically relevant decrease in CSOM score ( P = @ ) and FMPI score ( P = @ ) than cats that received placebo .


Using both a client-specific and a general clinical metrology instrument , owners of cats with DJD were able to detect evident recurrence of clinical signs after withdrawal of active medication than after withdrawal of placebo , and that this study design might be a novel and useful way to circumvent the placebo effect and detect the efficacy of pain-relieving medications .


To evaluate the efficacy of continuous wound infusion of ropivacaine for postoperative pain relief after open hepatectomy .


From May @ to December @ , @ patients undergoing open hepatectomy were randomized into normal saline continuous infusion group ( n = @ ) and @ % ropivacaine continuous infusion group ( n = @ ) .


The following variables were recorded for the @ hours postoperatively : pain scores at rest and sedation score every @ hours , total sufentanil consumption , first postoperative bowel movement , length of hospitalization , nausea and vomiting score , liver function change and other adverse events were also recorded .


Pain scores at rest were lower for the ropivacaine group and reached significance after @ h ( all P < @ ) .


The values of sufentanil consumption ( ( @ @ ) vs ( @ @ ) g , P < @ ) , time to bowel recovery ( ( @ @ ) vs ( @ @ ) days , P < @ ) and mean length of hospitalization ( ( @ @ ) vs ( @ @ ) days , P < @ ) decreased significantly .


Sedation score and liver function recovery were better in ropivacaine group .


No surgical wound infection occurred in either group .


Surgical wound infusion with ropivacaine is safe and effective .


And it improves postoperative pain relief and accelerates patients recovery and discharge with less damage to liver function .


Preliminary findings suggest that Web-based interventions may be effective in achieving significant smoking cessation .


To date , very few findings are available for primary care patients , and especially for the involvement of general practitioners .


Our goal was to examine the short-term effectiveness of a fully automated Web-based coaching program in combination with accompanied telephone counseling in smoking cessation in a primary care setting .


The study was an unblinded cluster-randomized trial with an observation period of @ weeks .


Individuals recruited by general practitioners randomized to the intervention group participated in a Web-based coaching program based on education , motivation , exercise guidance , daily short message service ( SMS ) reminding , weekly feedback through Internet , and active monitoring by general practitioners .


All components of the program are fully automated .


Participants in the control group received usual care and advice from their practitioner without the Web-based coaching program .


The main outcome was the biochemically confirmed smoking status after @ weeks .


We recruited @ participants ( @ intervention group , @ control group ) into the study .


For @ participants from the intervention group and @ participants from the control group , follow-up data were available both at baseline and @ weeks .


Very few patients ( @ % , @/@ ) from the intervention group and from the control group ( @ % , @/@ ) successfully managed smoking cessation ( OR @ , @ % CI @-@ @ ; P = @ ) .


Similar results were found within the intent-to-treat analysis : @ % ( @/@ ) of the intervention group and @ % ( @/@ ) of the control group ( OR @ , @ % CI @-@ @ ; P = @ ) .


The number of smoked cigarettes per day decreased on average by @ in the intervention group and by @ in the control group ( @ mean difference ; @ % CI -@ to -@ ; P = @ ) .


After adjustment for the baseline value , age , gender , and height , this significance decreases ( mean difference @ ; @ % CI -@ to @ ; P = @ ) .


This trial did not show that the tested Web-based intervention was effective for achieving smoking cessation compared to usual care .


The limited statistical power and the high drop-out rate may have reduced the study 's ability to detect significant differences between the groups .


Further randomized controlled trials are needed in larger populations and to investigate the long-term outcome .


To propose a random forest normal tissue complication probability ( RF-NTCP ) model to predict late rectal toxicity following prostate cancer radiation therapy , and to compare its performance to that of classic NTCP models .


Clinical data and dose-volume histograms ( DVH ) were collected from @ patients who received @-dimensional conformal radiation therapy for prostate cancer with at least @ years of follow-up .


The series was split @ times into training and validation cohorts .


A RF was trained to predict the risk of @-year overall rectal toxicity and bleeding .


Parameters of the Lyman-Kutcher-Burman ( LKB ) model were identified and a logistic regression model was fit .


The performance of all the models was assessed by computing the area under the receiving operating characteristic curve ( AUC ) .


The @-year grade @ overall rectal toxicity and grade @ and grade @ rectal bleeding rates were @ % , @ % , and @ % , respectively .


Predictive capabilities were obtained using the RF-NTCP model for all @ toxicity endpoints , including both the training and validation cohorts .


The age and use of anticoagulants were found to be predictors of rectal bleeding .


The AUC for RF-NTCP ranged from @ to @ , depending on the toxicity endpoint .


The AUC values for the LKB-NTCP were statistically significantly inferior , ranging from @ to @ .


The RF-NTCP model may be a useful new tool in predicting late rectal toxicity , including variables other than DVH , and thus appears as a strong competitor to classic NTCP models .


A randomized clinical trial was designed to compare the efficacy , success rate and surgical complications of percutaneous nephrolithotomy ( PCNL ) and laparoscopic pyelolithotomy ( LP ) .


Sixty patients with renal pelvic stones larger than @ cm were randomly divided into two groups of LP and PCNL .


All patients were followed up to three months after surgery using renal diethylenetriamine?pentaaceticacid ( DTPA ) scan and determining the glomerular filtration rate ( GFR ) .


Mean operation time ( @ ?


@ vs. @ ?


@ min ) and mean hospital stay ( @ vs. @ days ) were significantly higher in LP , but mean hemoglobin drop ( @ vs. @ g/dL ) and the rate of blood transfusion were significantly lower .


Stone free rate was @ % and @ % for LP and PCNL , respectively ( P = @ ) , while the changes in GFR were not statistically significant @ days after surgery between two groups .


Those in LP group showed better improvement in GFR at three months postoperatively .


Improvement of the affected split kidney function was significantly higher in LP group ( P = @ ) .


No major complications were observed in both groups according to Clavien grading system .


PCNL remains the gold standard treatment for most large kidney stones , nevertheless , laparoscopic pyelolithotomy can be considered for selected cases especially in whom maximal preservation of renal function is ?


necessary .


To examine the long-term prevalence and predictors of weekly urinary incontinence in the Diabetes Prevention Program Outcomes Study , a follow-up study of the Diabetes Prevention Program randomized clinical trial of overweight adults with impaired glucose tolerance .


This analysis included @ female participants of the Diabetes Prevention Program Outcomes Study who had been randomly assigned during the Diabetes Prevention Program to intensive lifestyle intervention ( n = @ ) , metformin ( n = @ ) or placebo ( n = @ ) .


The study participants completed semi-annual assessments after the final Diabetes Prevention Program visit and for @years until October @ .


At the study entry , the prevalence of weekly urinary incontinence was lower in the intensive lifestyle intervention group compared with the metformin and placebo groups ( @ % vs @ % , @ % urinary incontinence/week , P = @ ) ; during the @-year follow-up period , these lower rates in intensive lifestyle intervention were maintained ( @ % , @ % , @ % urinary incontinence/week ; P = @ ) .


Statistically adjusting for urinary incontinence prevalence at the end of the Diabetes Prevention Program , the treatment arm no longer had a significant impact on urinary incontinence during the Diabetes Prevention Program Outcomes Study .


Independent predictors of lower urinary incontinence during the Diabetes Prevention Program Outcomes Study included lower body mass index ( odds ratio @ , @ % confidence interval @-@ @ ) and greater physical activity ( odds ratio @ , @ % confidence interval @-@ @ ) at the Diabetes Prevention Program Outcomes Study entry , and greater reductions in body mass index ( odds ratio @ , @ % confidence interval @-@ @ ) and waist circumference ( odds ratio @ , @ % confidence interval @-@ @ ) during the Diabetes Prevention Program Outcomes Study .


Diabetes was not significantly related to urinary incontinence .


Intensive lifestyle intervention has a modest positive and enduring impact on urinary incontinence , and should be considered for the long-term prevention and treatment of urinary incontinence in overweight/obese women with glucose intolerance .


Motor impairment is a major consequence of spinal cord injury ( SCI ) .


Earlier studies have shown that robotic gait orthosis ( e.g. , Lokomat ) can improve an SCI individual 's walking capacity .


However , little is known about the differential responses among different individuals with SCI .


The present longitudinal study sought to characterize the distinct recovery patterns of gait impairment for SCI subjects receiving Lokomat training , and to identify significant predictors for these patterns .


Forty SCI subjects with spastic hypertonia at their ankles were randomly allocated to either control or intervention groups .


Subjects in the intervention group participated in twelve @-hour Lokomat trainings over one month , while control subjects received no interventions .


Walking capacity was evaluated in terms of walking speed , functional mobility , and endurance four times , i.e. baseline , @ , @ , and @ weeks after training , using the @-Meter-Walking , Timed-Up-and-Go , and @-Minute-Walking tests .


Growth Mixture Modeling , an analytical framework for stratifying subjects based on longitudinal changes , was used to classify subjects , based on their gait impairment recovery patterns , and to identify the effects of Lokomat training on these improvements .


Two recovery classes ( low and high walking capacity ) were identified for each clinical evaluation from both the control and intervention groups .


Subjects with initial high walking capacity ( i.e. shorter Timed-Up-and-Go time , higher @-Meter-Walking speed and longer @-Minute-Walking distance ) displayed significant improvements in speed and functional mobility ( @ m/s/week and-@ @ s/week respectively ) ; however no significant change in endurance was observed .


Subjects with low walking capacity exhibited no significant improvement .


The membership in these two classes-and thus prediction of the subject 's gait improvement trajectory over time-could be determined by the subject 's maximum voluntary torque at the ankle under both plantar-and dorsi-flexion contractions determined prior to any training .


Our findings demonstrate that subjects responded to Lokomat training non-uniformly , and should potentially be grouped based on their likely recovery patterns using objective criteria .


Further , we found that the subject 's ankle torque can predict whether he/she would benefit most from Lokomat training prior to the therapy .


These findings are clinically significant as they can help individualize therapeutic programs that maximize patient recovery while minimizing unnecessary efforts and costs .


This study was to develop a breastfeeding promotion program and to test effects of the program on levels of breast discomfort , breast size , sodium in breast milk , and type of feeding in mothers with breast engorgement following cesarean birth .


A non-synchronized non-equivalent control group pretest-posttest design was used in this study .


The participants were @ postpartum mothers who were admitted to a postpartum care center and experienced breast engorgement following cesarean birth .


The planned nursing intervention was the breastfeeding promotion program consisting of breast massage and @:@ breastfeeding education , counseling , and support focusing on individualized problem solving provided for @ days .


Fifty-three women completed the program ( experimental group @ , control group , @ ) .


Measurements were level of breast discomfort , breast size , sodium in breast milk and type of feeding at pre and posttest .


Women who participated in the program experienced lower scores for breast discomfort , greater decrease in breast size , lower levels of sodium in breast milk , and practiced breastfeeding more than those in the control group .


Results indicate that this breastfeeding promotion program is effective in reducing breast engorgement and improving breastfeeding practices , and is therefore recommended to enhance breastfeeding promotion practice in postpartum care centers .


The purpose of this study was to evaluate the @-year clinical outcomes of more complex XIENCE V USA real-world patients with small versus nonsmall vessel lesions .


Patients with small vessel lesions undergoing coronary stent placement are at higher risk of major adverse cardiac events .


Improved safety and efficacy of XIENCE V everolimus eluting stents ( EES ) have been previously demonstrated in selected low-risk small vessel populations in randomized clinical trials .


The XIENCE V USA study was a condition of approval , single-arm study in unselected real-world patients .


Baseline and @-year clinical outcomes were compared between XIENCE V USA patients who received a single @ mm stent ( small vessel group , N = @ ) and patients implanted with a single > @ mm stent ( non-small vessel group , N = @,@ ) .


Mean reference vessel diameter was @ and @ mm in the small and non-small vessel groups , respectively ( P < @ ) .


Small vessel group had more females , presented with a higher rate of diabetes , and had more complex lesion characteristics .


The definite or probable ST rates analyzed using Kaplan-Meier method were low and not significantly different between the groups at @ and @ % for the small and nonsmall vessel group ( P = @ ) , respectively .


The composite rate of cardiac death or MI was comparable at @ % for the small and @ % for the non-small vessel @ groups ( P = @ ) .


The @-year target lesion revascularization rate was also comparable in the small vessel group ( @ % vs. @ % , P = @ ) .


Despite gender difference , higher prevalence of diabetes and more complex lesions in the small vessel groups , the @-year clinical outcomes were similar in both small and nonsmall vessel groups .


These results demonstrate the therapeutic benefit of XIENCE V EES in a real-world all inclusive patient population with small vessel disease .


This pilot study examined whether the addition of a normal protein ( NP ) vs. high protein ( HP ) breakfast leads to alterations in food cravings and plasma homovanillic acid ( HVA ) , which is an index of central dopamine production , in overweight/obese ` breakfast skipping ' late-adolescent young women .


A randomized crossover design was incorporated in which @ girls ( age @ y ; BMI @ kg/m@ ) consumed @kcal NP ( @g protein ) breakfast meals , @kcal HP ( @g protein ) breakfast meals , or continued breakfast skipping ( BS ) for @ consecutive days/pattern .


On day @ of each pattern , a @h testing day was completed including the consumption of breakfast ( or no breakfast ) followed by food craving questionnaires and blood sampling for HVA concentrations throughout the morning .


Both breakfast meals reduced post-meal cravings for sweet and savory foods and increased HVA concentrations vs. BS ( all , p < @ ) .


Between breakfast meals , the HP breakfast tended to elicit greater reductions in post-meal savory cravings vs. NP ( p = @ ) and tended to elicit sustained increases in HVA concentrations prior to lunch vs. NP ( p = @ ) .


Lastly , HVA concentrations were positively correlated with the protein content at breakfast ( r : @ ; p < @ ) .


Collectively , these findings suggest that the addition of breakfast reduces post-meal food cravings and increases homovanillic acid concentrations in overweight/obese young people with higher protein versions eliciting greater responses .


Deep brain stimulation ( DBS ) is an effective treatment for patients with advanced Parkinson 's disease ( PD ) and motor symptom complications .


Recently , attention has been focused on whether offering DBS earlier in the course of PD is beneficial .


The purpose of this study was to determine the effects of DBS on neuropsychological functioning in subjects with early stage PD .


Thirty subjects with early PD ( Hoehn & Yahr Stage II off medication ) were randomized to optimal drug therapy ( ODT ) ( n = @ ) or bilateral subthalamic nucleus ( STN ) DBS+ODT ( n = @ ) after completing an expanded informed consent process specially designed for the study and administered by a medical ethicist and the study team .


Comprehensive neuropsychological testing was completed in the treatment-withdrawn state at baseline and at @ month and @ month follow-ups .


Two serious adverse events occurred in the DBS+ODT group .


One subject experienced a stroke and another developed infected hardware that contributed to specific declines in cognitive functioning .


However , compared to the ODT group , the remaining subjects in the DBS+ODT group exhibited modest reductions on a few measures of attention , executive function , and word fluency at @ months .


These differences were largely diminished at @ months , especially when those with the adverse events were excluded .


The results of this trial provide novel data regarding the effects of DBS on cognitive function in early PD .


We believe that the findings and insights from this trial can help guide the safety analysis and risk-benefit evaluations in future discussions of DBS in early stage PD .


The literature suggests that people delay too long prior to attending emergency departments with acute coronary syndrome ( ACS ) symptoms .


This delay is referred to as prehospital delay .


Patient decision delay contributes most significantly to prehospital delay .


Using a randomized controlled trial , we tested an educational intervention to reduce patient prehospital delay in ACS and promote appropriate responses to symptoms .


Eligible patients who were admitted across five emergency departments ( EDs ) in Dublin were recruited to the study ( n = @ ; control : @ , intervention : @ ) .


Median baseline prehospital delay times did not differ significantly between the groups at baseline ( Mann-Whitney U , p = @ ) ( CONTROL : @ h , @ ( th ) percentile = @ , @ ( th ) percentile = @ ; Intervention @ h , @ ( th ) percentile = @ , @ ( th ) percentile = @ ) .


Both groups received usual in-hospital care .


In addition , patients randomized to the intervention group received a @-min individualized education session using motivational techniques .


This was reinforced @ month later by telephone .


Of the @ , @ ( @ % ) were readmitted with ACS symptoms : @ ( @ % ) and @ ( @ % ) of the intervention and control groups , respectively .


Prehospital delay times were again measured .


Median delay time was significantly lower in the intervention compared to the control group ( @ h vs. @ h ; p @ ) .


Appropriately , those in the intervention group reported their symptoms more promptly to another person ( p = @ ) and fewer consulted a general practitioner ( p = @ ) .


There was no significant difference in ambulance use ( p = @ ) or nitrate use ( p = @ ) between the groups .


It is possible to reduce prehospital delay time in ACS , but the need for renewed emphasis on ambulance use is important .


Central disinhibition is a mechanism involved in the physiopathology of fibromyalgia .


Melatonin can improve sleep quality , pain and pain threshold .


We hypothesized that treatment with melatonin alone or in combination with amitriptyline would be superior to amitriptyline alone in modifying the endogenous pain-modulating system ( PMS ) as quantified by conditional pain modulation ( CPM ) , and this change in CPM could be associated with serum brain-derived neurotrophic factor ( BDNF ) .


We also tested whether melatonin improves the clinical symptoms of pain , pain threshold and sleep quality .


Sixty-three females , aged @ to @ , were randomized to receive bedtime amitriptyline ( @ mg ) ( n = @ ) , melatonin ( @ mg ) ( n = @ ) or melatonin ( @ mg ) + amitriptyline ( @ mg ) ( n = @ ) for a period of six weeks .


The descending PMS was assessed with the CPM-TASK .


It was assessed the pain score on the Visual Analog Scale ( VAS @-@ mm ) , the score on Fibromyalgia Impact Questionnaire ( FIQ ) , heat pain threshold ( HPT ) , sleep quality and BDNF serum .


Delta values ( post - minus pre-treatment ) were used to compare the treatment effect .


The outcomes variables were collected before , one and six weeks after initiating treatment .


Melatonin alone or in combination with amitriptyline reduced significantly pain on the VAS compared with amitriptyline alone ( P < @ ) .


The delta values on the VAS scores were-@ @ ( @ ) , -@ ( @ ) and-@ @ ( @ ) in the amitriptyline , melatonin and melatonin + amitriptyline groups , respectively .


Melatonin alone and in combination increased the inhibitory PMS as assessed by the Numerical Pain Scale -LSB- NPS ( @-@ ) -RSB- reduction during the CPM-TASK : -@ ( @ ) melatonin + amitriptyline,-@ @ ( @ ) melatonin , and-@ @ ( @ ) amitriptyline , ( P < @ ) .


Melatonin + amitriptyline treated displayed better results than melatonin and amitriptyline alone in terms of FIQ and PPT improvement ( P < @ , fort both ) .


Melatonin increased the inhibitory endogenous pain-modulating system as assessed by the reduction on NPS ( @-@ ) during the CPM-TASK .


Melatonin alone or associated with amitriptyline was better than amitriptyline alone in improving pain on the VAS , whereas its association with amitriptyline produced only marginal additional clinical effects on FIQ and PPT .


Results of a study to determine potential cost benefits of substituting an alternative electrolyte solution for @ % sodium chloride injection for the initial fluid resuscitation of trauma patients are presented .


Using data from a randomized clinical trial that compared @-hour fluid resuscitation outcomes in critically injured trauma patients treated with @ % sodium chloride injection and those who received a balanced electrolyte solution ( Plasma-Lyte A , Baxter Healthcare ) , a cost-minimization analysis was performed at a large medical center .


The outcomes evaluated included fluid and drug acquisition costs , materials and nurse labor costs , and costs associated with electrolyte replacement .


The use of Plasma-Lyte A was associated with a relatively higher fluid acquisition cost but a reduced need for magnesium replacement .


During the first @ hours of hospitalization , @ of @ patients ( @ % ) treated with @ % sodium chloride injection and none of the patients who received the comparator product ( n = @ ) required supplemental magnesium .


Patients treated with @ % sodium chloride injection received a median of @ g of magnesium ( interquartile range -LSB- IQR -RSB- , @-@ @ g ) , compared with a median of @ g ( IQR @-@ g ) in the comparator group .


Taking into account the costs of consumable supplies and nursing labor , the cost-minimization analysis indicated a @-hour cost differential of $ @ in favor of Plasma-Lyte A.


Substitution of Plasma-Lyte A for @ % sodium chloride injection for fluid resuscitation during the first @ hours after traumatic injury was associated with decreased magnesium replacement requirements and a net cost benefit to the institution .


Persons with low back pain fail to show the same transition as healthy individuals from in-phase to anti-phase rotation of the thorax and pelvis as walking speed increases .


The purpose of this study was to determine if the relative phase of the thorax and pelvis during walking was a reliable ( within day test-retest ) and valid measure for persons with thoracic pain .


The time series motion of the spine over C@ , T@ and sacrum were measured at five treadmill walking speeds ( @ , @ , @ , @ , @ m/s ) in @ persons with thoracic spine pain and @ healthy control subjects .


After a @minute rest , all tests were repeated .


The average relative phases of the transverse plane rotation between C@-T@ , C@-sacrum and T@-sacrum during a one-minute walk were calculated .


The standard error of measurement ( SEM ) and the intra-class correlation coefficient ( ICC ) were used to estimate test-retest reliability .


Three-way repeated measures analyses of variance were performed to determine the influence of group , walking speed and session on the relative phases .


The minimum transverse plane motion amplitudes , across all participants and speeds , for the C@-T@ , C@-sacrum , and T@-sacrum were @ , @ and @ degrees , respectively .


The C@-T@ relative phase changed little with speed .


The C@-sacrum and T@-sacrum relative phases showed increases as subjects walked faster , but both groups had similar patterns of change .


Only the C@-T@ relative phase at @ and @ m/s exhibited good reliability ( ICC > @ , SEM @-@ @ , no significant time effects ) for both groups .


The C@-T@ and T@-sacrum relative phases demonstrated significant group by speed effects .


The C@-T@ relative phase showed reasonable reliability and some discrimination between groups , but changes in response to walking speed were small .


The T@-sacrum relative phase showed some discriminative ability , but reliability was not adequate .


Urinary incontinence ( UI ) affects half of patients hospitalised after stroke and is often poorly managed .


Cochrane systematic reviews have shown some positive impact of conservative interventions ( such as bladder training ) in reducing UI , but their effectiveness has not been demonstrated with stroke patients .


We conducted a cluster randomised controlled feasibility trial of a systematic voiding programme ( SVP ) for the management of UI after stroke .


Stroke services were randomised to receive SVP ( n = @ ) , SVP plus supported implementation ( SVP + , n = @ ) , or usual care ( UC , n = @ ) .


Feasibility outcomes were participant recruitment and retention .


The main effectiveness outcome was presence or absence of UI at six and @ weeks post-stroke .


Additional effectiveness outcomes included were the effect of the intervention on different types of UI , continence status at discharge , UI severity , functional ability , quality of life , and death .


It was possible to recruit patients ( @ ; @ SVP , @ SVP + , and @ UC ) and participant retention was acceptable ( @ % and @ % at six and @ weeks , respectively ) .


There was no suggestion of a beneficial effect on the main outcome at six ( SVP versus UC : odds ratio ( OR ) @ , @ % CI : @ to @ ; SVP + versus UC : OR : @ , @ % CI : @ to @ ) or @ weeks ( SVP versus UC : OR : @ , @ % CI : @ to @ ; SVP + versus UC : OR : @ , @ % CI : @ to @ ) .


No secondary outcomes showed a strong suggestion of clinically meaningful improvement in SVP and/or SVP + arms relative to UC at six or @ weeks .


However , at @ weeks both intervention arms had higher estimated odds of continence than UC for patients with urge incontinence .


The trial has met feasibility outcomes of participant recruitment and retention .


It was not powered to demonstrate effectiveness , but there is some evidence of a potential reduction in the odds of specific types of incontinence .


A full trial should now be considered .


The solubility of valsartan is dependent on pH and thus may cause patient variability in drug absorption and failure in bioequivalence studies ; thus , increasing the solubility and release of valsartan at low pH has been suggested for a more favorable pharmacokinetic profile .


However , due to this pH dependence , the change in the formulation process could alter the disintegration and/or dissolution profile of the drug , possibly making the results of bioequivalence studies misleading .


The aim of this study was to assess the bioavailability and tolerability of a newly developed oral formulation of valsartan @ mg ( wet-granulation tablet ) in healthy Korean male volunteers .


This study was performed with the subjects under fasted conditions , using a randomized , single-dose , @-period crossover design .


Subjects were assigned to receive , in randomized order , a single dose of the test formulation and a reference formulation ( valsartan @-mg dry-granulation tablet ) , with a washout period of @ days between the administrations .


Blood samples were collected up to @ hours after dosing , and pharmacokinetic parameters were determined after the plasma valsartan concentration was analyzed using UPLC-MS/MS .


The dissolution studies of both formulations were conducted using USP apparatus @ at @ rpm with @ mL of phosphate buffer solution ( pH , @ ) at @C @ C. Bioequivalence was defined per Korean Food and Drug Administration 's regulatory criteria as @ % CIs of the geometric mean test/reference ratios of AUC@-t and Cmax within the range of @ to @ .


Tolerability was assessed using physical examination and subject interviews .


Sixty subjects were enrolled ( mean -LSB- SD -RSB- age -LSB- range -RSB- , @ -LSB- @ -RSB- years -LSB- @-@ -RSB- ; height , @ -LSB- @ -RSB- cm -LSB- @-@ -RSB- ; and weight , @ -LSB- @ -RSB- kg -LSB- @-@ -RSB- ) .


The mean AUC@ - values with the test and reference tablets were @,@ ( @,@ ) and @,@ ( @,@ ) ng h/mL , respectively ; Cmax , @ ( @ ) and @ ( @ ) ng/mL ; Tmax , @ ( @ ) and @ ( @ ) hours .


The @ % CIs for the geometric mean test/reference ratios of AUC@-t and Cmax were @ to @ and @ to @ , respectively , which met the criteria for bioequivalence .


The most frequently reported adverse event was dizziness after blank blood sampling , recorded in @ subjects , @ cases each with the test and reference formulations .


In this study in healthy Korean male volunteers , the test and reference formulations of @-mg valsartan met the Korean Food and Drug Administration 's regulatory criteria for bioequivalence despite the difference in formulation ( wet granulation vs dry granulation ) .


Both formulations were well tolerated , with no serious adverse events reported .


As the influenza A H@N@ pandemic emerged in @ , children were found to experience high morbidity and mortality and were prioritized for vaccination .


This multicenter , randomized , double-blind , age-stratified trial assessed the safety and immunogenicity of inactivated influenza A ( H@N@ ) pdm@ vaccine in healthy children aged @ months to @ years .


Children received @ doses of approximately @ or @ g hemagglutin antigen @ days apart .


Reactogenicity was assessed for @ days after each dose , adverse events through day @ , and serious adverse events or new-onset chronic illnesses through day @ .


Serum hemagglutination inhibition titers were measured on days @ ( prevaccination ) , @ , @ , @ and @ .


A total of @ children received the first dose and @ received the second dose of vaccine .


Vaccinations were generally well-tolerated and no related serious adverse events were observed .


The @ g dosage elicited a seroprotective hemagglutination inhibition ( @:@ ) in @ % , @ % and @ % of children in the @-@ month , @-@ year and @-@ year age strata @ days after dose @ and in @ % , @ % and @ % of children @ days after dose @ , respectively .


The @ g vaccine dosage induced similar responses .


The inactivated influenza A ( H@N@ ) pdm@ vaccine exhibited a favorable safety profile at both dosage levels .


While a single @ or @ g dose induced seroprotective antibody responses in most children @-@ years of age , younger children required @ doses , even when receiving dosages @ - to @-fold higher than recommended .


Well-tolerated vaccines are needed that induce immunity after a single dose for use in young children during influenza pandemics .


To observe the difference in clinical efficacy on focal vitiligo treated with heat-sensitive moxibustion in comparison with medication , and discuss its effect mechanism .


Sixty-eight cases were randomized into a moxibustion group ( @ cases ) and a medication group ( @ cases ) .


Additionally , @ healthy persons were selected randomly as a normal group .


In the moxibustion group , the heat-sensitive moxibustion was applied to Hegu ( LI @ ) , Quchi ( LI @ ) , Yanglingquan ( GB @ ) , Zusanli ( ST @ ) , Xuehai ( SP @ ) and the others , once a day .


In the medication group , triamcinolone acetonide cream was used externally and locally , twice a day .


In the two groups , the treatment of @ days made one session .


The efficacy was observed after continuous treatment for @ sessions .


The hemorheology test was done in all of the subjects .


The radioimmunoassay was adopted to determine the levels of Interleukin @ ( IL-@ ) , Interleukin @ ( IL-@ ) , Interleukin @ ( IL-@ ) and tumor necrosis factor ( TNF-alpha ) before and after treatment .


The levels of IL-@ , IL-@ and TNF-alpha in vitiligo patients were higher significantly than those in the normal group ( P < @ , P < @ ) , the level of IL-@ was lower significantly than that in the normal group ( P < @ ) before treatment .


After @ sessions treatment , IL-@ level was increased significantly in the moxibustion group and the levels of IL-@ , IL-@ and TNF-alpha were reduced , without significant differences as compared with the normal group ( all P > @ ) .


But the differences were significant as compared with those in the medication group ( all P < @ ) .


The curative and remarkably effective rate was @ % ( @/@ ) after treatment in the moxibustion group , which was higher significantly than @ % ( @/@ , P < @ ) in the medication group .


Heat-sensitive moxibustion achieves very good clinical efficacy on focal vitiligo , which is probably via promoting blood circulation and regulating the levels of IL-@ , IL-@ and TNF-alpha .


Epoprostenol sodium with arginine-mannitol excipients ( epoprostenol AM ; Veletri -LSB- Actelion Pharmaceuticals Ltd , Allschwil , Switzerland -RSB- ) and epoprostenol sodium with glycine-mannitol excipients ( epoprostenol GM ; Flolan -LSB- GlaxoSmithKline , Triangle Park , NC -RSB- ) are intravenous treatments for pulmonary arterial hypertension ( PAH ) .


Epoprostenol AM contains different inactive excipients , resulting in greater stability at room temperature compared with epoprostenol GM .


In this prospective , multicenter , open-label , randomized , phase IV exploratory study , epoprostenol-nave patients in need of injectable prostanoid therapy were randomized @:@ to open-label epoprostenol AM or epoprostenol GM .


The study period was @ days , followed by a @-day safety follow-up .


Study aims were to descriptively compare the safety , tolerability , drug metabolite levels , and treatment effects of epoprostenol AM and epoprostenol GM in PAH .


Statistical analysis was descriptive only because of the exploratory nature of the study .


Thirty patients with PAH ( @-@ years , @ women , @ idiopathic PAH ) were randomized to epoprostenol AM ( n = @ ) or epoprostenol GM ( n = @ ) .


Most frequently reported adverse events included jaw pain , headache , nausea , and flushing .


Two deaths occurred during the study period , and @ death occurred during the @-day safety follow-up period , all in patients receiving epoprostenol AM .


All deaths were classified by the treating physician as unrelated to epoprostenol AM .


The median ( range ) change from baseline to day @ in @-minute walk distance was @ m ( -@ to @ m ) and @ m ( -@ to @ m ) for the epoprostenol AM and epoprostenol GM groups , respectively .


In this randomized clinical study of epoprostenol AM in PAH , use of this novel preparation with greater room temperature stability was well tolerated .


Internet addiction is one of the most common problems among adolescents and effective treatment is needed .


This research aims to test the effectiveness and underlying mechanism of multi-family group therapy ( MFGT ) to reduce Internet addiction among adolescents .


A total of @ participants consisting of @ adolescents with Internet addiction , aged @-@years , and @ their parents , aged @-@years , were assigned to the experimental group ( six-session MFGT intervention ) or a waiting-list control .


Structured questionnaires were administered at pre-intervention ( T@ ) , post-intervention ( T@ ) and a three-month follow-up ( T@ ) .


There was a significant difference in the decline both in the average score and proportion of adolescents with Internet addiction in MFGT group at post-intervention ( MT@ = @ , MT@ = @ , p < @ ; @ versus @ % , p < @ ) maintained for three months ( MT@ = @ , p < @ ; @ versus @ % , p < @ ) .


Reports from both adolescents and parents were significantly better than those in the control group .


Further explorations of the underlying mechanisms of effectiveness based on the changed values of measured variables showed that the improvement in adolescent Internet use was partially explained by the satisfaction of their psychological needs and improved parent-adolescent communication and closeness .


The six-session multi-family group therapy was effective in reducing Internet addiction behaviors among adolescents and could be implemented as part of routine primary care clinic services in similar populations .


As family support system is critical in maintaining the intervention effect , fostering positive parent-adolescent interaction and addressing adolescents ' psychological needs should be included in preventive programs for Internet addiction in the future .


To investigate the potential effect of sugammadex on anti-Xa anticoagulantactivity of enoxaparin and the activated partial thromboplastin time ( APTT ) of unfractionated heparin ( UFH ) .


This two-part , randomized , double-blind , placebocontrolled , four-period cross-over study was performed in healthy males ( @ - @ years ) .


In each period , subjects received @ mg enoxaparin ( in part @ ) , @,@ units UFH ( in part @ ) , or placebo followed by @ or @ mg/kg sugammadex , or placebo .


Treatments were separated by @ days .


Primary endpoints were anti-Xa activity and APTT both time-averaged from @ to @ minutes post-dose .


Geometric mean ratios ( GMRs ) and their two-sided @ % confidence limits were calculated for anticoagulant plus sugammadex ( @ or @ mg/kg ) vs. anticoagulant plus placebo .


The pre-specified threshold for a potential effect of clinical relevance was a @ % upper confidence limit ( UCL ) > @ .


In part @ ( n = @ ) , the @ % UCLs were @ and @ for GMRs of anti-Xa activity after dosing with @ and @ mg/kg sugammadex , respectively .


In part @ ( n = @ ) , the @ % UCLs for GMRs of APTT were @ and @ .


Neither sugammadex dose produced a treatment effect that met the pre-specified criterion for potential clinical relevance .


Treatments were generally well tolerated .


In healthy subjects , treatment with @ mg/kg and @ mg/kg sugammadex did not change either anti-Xa activity or APTT to a clinically meaningful extent following pretreatments with enoxaparin or UFH .


Hypertension is associated with cognitive deficits , particularly executive function , and decreased cerebral microvascular responsiveness to CO@ ( CO@ vasoreactivity ) .


The relation between CO@ vasoreactivity and executive function is not known .


Protocols to assess CO@ vasoreactivity are cumbersome and require inhaling a CO@-enriched gas .


We explored the ability to measure CO@ vasoreactivity using end-tidal CO@ fluctuations during normal breathing and the association of this measure with cognitive function in hypertension .


Executive function ( Trail-Making Test parts A/B ) , memory , attention and blood flow velocity ( BFV ) in the middle cerebral artery using transcranial Doppler were measured in hypertensive subjects who were tapered off their treatment for @ weeks .


BFV was measured while sitting and normally breathing for @ min , followed by breathing @ % CO@ gas and hyperventilation for @ min each .


We calculated CO@ vasoreactivity as the rate of BFV change from hypoventilation to hyperventilation , and as a model-derived measure using the normal breathing data .


The latter was derived using nonlinear principal dynamic modes ( PDM ) , which modelled the dynamic effect of fluctuations in end-tidal CO@ and blood pressure upon BFV during normal room-air respiration .


Multiple regression analyses were used to correlate cerebral hemodynamics with cognitive measures .


Data were collected from @ individuals with hypertension ( mean age @ years , @ % African Americans , @ % women , off antihypertensive therapy ) .


Lower CO@ vasoreactivity was associated with a worse executive function test score using both calculation methods : p value using the hyper/hypoventilation data was @ and from the PDM analysis was @ .


PDM calculations showed a stronger correlation with executive function ( @ vs. @ using the hyper/hypoventilation data ) .


There were no associations with memory or attention measures .


There was a weak but statistically significant correlation between the two calculation methods of CO@ vasoreactivity ( R ( @ ) = @ % , p = @ ) .


This study suggests that the decrease in CO@ vasoreactivity in hypertension is associated with lower executive function .


This may offer new insight into the vascular underpinning of cognitive decline in hypertension .


We demonstrate that calculating CO@ vasoreactivity is possible during normal breathing .


If replicated in future studies , this may offer a more convenient clinical way to assess CO@ vasoreactivity in hypertension and cognitive disorders .


Obsessive-compulsive disorder ( OCD ) is a highly prevalent and devastating psychiatric condition .


Repetitive transcranial magnetic stimulation ( rTMS ) is a potential and non-invasive treatment for OCD .


Diverse efficacies of rTMS have been reported in different locations or frequencies of the stimulation .


The main objective of this study was to assess the treatment effect for OCD with alpha electroencephalogram ( EEG ) - guided TMS over dorsal lateral prefrontal cortex bilaterally .


There were @ OCD patients in the TMS treatment group and @ OCD patients in the sham control group .


Each subject received @ daily treatment sessions ( @ days a week ) .


The TMS group had significant reduction in scores of Yale-Brown Obsessive Compulsive Scale and Hamilton Rating Scale for Anxiety ( HAMA ) compared with the control group at the end of @-week treatment and @-week follow-up .


Analysis of variance with repeated measures was used to test the effects between the two groups .


Significant difference in scores of obsession and HAMA were found between the two groups after treatment .


No significant difference in scores of Hamilton Rating Scale for Depression was found between the two groups after the treatment , but statistical significance was shown at the end of @-week follow-up .


EEG-guided TMS may be an effective treatment for OCD and related anxiety .


Delayed response to TMS in depression suggests that it might be secondary to the improvement of primary response in OCD and anxiety .


Dopamine is an intermediate product in the biosynthesis of melanin pigment , which is absent or reduced in albinism .


Animal research has shown that supplying a precursor to dopamine , levodopa , may improve visual acuity in albinism by enhancing neural networks .


This study examines the safety and effectiveness of levodopa on best-corrected visual acuity in human subjects with albinism .


Prospective , randomized , placebo-controlled , double-masked clinical trial conducted at the University of Minnesota .


Forty-five subjects with albinism .


Subjects with albinism were randomly assigned to one of three treatment arms : levodopa @ mg/kg with @ % carbidopa , levodopa @ mg/kg with @ % carbidopa , or placebo and followed for @ weeks , with best-corrected visual acuity measured at enrollment , and at weeks @ , @ , @ , and @ after enrollment .


Side-effects were recorded with a symptom survey .


Blood was drawn for genotyping .


Side-effects and best-corrected visual acuity @ weeks after enrolment .


All subjects had at least one mutation found in a gene known to cause albinism .


Mean age was @ years ( range : @ to @ years ) .


Follow up was @ % and compliance was good .


Minor side-effects were reported ; there were no serious adverse events .


There was no statistically significant improvement in best-corrected visual acuity after @ weeks with either dose of levodopa .


Levodopa , in the doses used in this trial and for the time course of administration , did not improve visual acuity in subjects with albinism .


To compare tensile strength , failure location , and histologic features after acute repeat celiotomy through a ventral median ( RVM ) or a right ventral paramedian ( RVP ) celiotomy in horses .


Ex vivo experimental study .


Adult horses ( N = @ ) .


Twelve adult horses had original ventral median ( OVM ) celiotomy .


Repeat celiotomy was performed @hours postoperatively through the original ventral median ( RVM , N = @ ) or a RVP ( N = @ ) celiotomy .


Celiotomies were scored daily for edema , drainage , and dehiscence .


Fourteen days after repeat celiotomy , horses were euthanatized and abdominal wall containing celiotomy ( ies ) were collected for biomechanical and histological evaluation .


The abdominal wall of control horses ( N = @ ; no celiotomy ) was collected for biomechanical testing .


Vital sign variables , incisional edema , and histologic scores were compared using a Wilcoxon signed-rank test .


Incisional fibrotic depth and tensile strength per unit length ( N/cm ) was compared using repeated measures ANOVA .


RVM and RVP horses had significantly less tensile strength compared to control horses , but no differences were observed between RVM and RVP horses .


No differences in healing , inflammation , infection , or necrosis of repeat celiotomies was observed , but RVP horses accumulated more fibrin and hemorrhage within the incision .


RVP horses had significantly greater incisional edema scores , but incisional drainage was more frequent in RVM horses .


Acute repeat celiotomy through a RVM incision results in similar incisional healing and tensile strength compared with repeat celiotomy through a RVP incision .


To test the hypothesis that supplementation with the long chain polyunsaturated fatty acids docosahexaenoic acid ( DHA ) and arachidonic acid ( AA ) to very low birth weight ( VLBW ) infants would improve long-term cognitive functions and influence neuroanatomical volumes and cerebral cortex measured by MRI .


The current study is a follow-up of a randomized , double-blinded , placebo-controlled study of supplementation with high-dose DHA ( @ % ) and AA ( @ % ) to @ VLBW infants fed human milk .


Ninety-eight children participated at @ years follow-up and completed a broad battery of cognitive tests .


Eighty-one children had cerebral MRI scans of acceptable quality .


There were no significant differences between the intervention group and the control group on any of the cognitive measures .


Equally , MRI data on segmental brain volumes and cerebral cortex volume , area , and thickness suggested no overall group effect .


This study is the first long-term follow-up of a randomized controlled trial with supplementation of DHA and AA to human milk fed VLBW infants investigating both cognitive functions and brain macrostructure measured by MRI .


No cognitive or neuroanatomical effects of the supplementation were detected at @ years of age .


Water extract from Malvastrum coromandelianum ( Linn . )


Garcke ( MC ) has been shown to have glucose lowering effect , short - and long-term safety in animal studies .


A preliminary study in human reveals safety and its potential use as an adjunctive treatment to antihyperglycemic medications .


To investigate the glycemic-lowering efficacy ofMC in type @ diabetes subjects .


A multicenter randomized , double-blind , placebo-controlled trial was conducted .


Seventy-one diabetes subjects , who were treated with either diet control or single oral anti-diabetic drug ( sulphonylurea or biguanide ) with HbA@C between @-@ % , were recruited .


Subjects were randomized to take MC tablets in a total dose of @,@ mg/day or placebo for @ weeks .


Clinical parameters , glycemic control , HOMA-IR and HOMA - were assessed .


Both MC ( n = @ ) and placebo ( n = @ ) groups had comparable baseline characteristics with a mean baseline HbA@C of @ @ vs. @ @ % , respectively .


During the study , HbA@C did not differ statistically after @ , @ and @ weeks of treatment ( @ @ vs. @ @ , @ @ vs. @ @ and @ @ vs. @ @ % , respectively ) .


The body weight , insulin resistance and insulin secretion were also similar between groups ( p > @ ) .


No episode of hypoglycemia was reported .


MC in a dosage of @,@ mg/day does not have glucose lowering efficacy in type @ diabetes .


This randomized Phase III trial will evaluate whether the methylene blue-assisted technique is efficient for harvesting lymph nodes after radical surgery for gastric cancer .


Patients that undergo distal or total gastrectomy with radical nodal dissection will be randomly assigned to Group A : the standard group , the lymph nodes ( LNs ) will be harvested from the fresh specimen immediately after surgery , or Group B : the methylene blue-assisted group , where the LNs will be harvested from specimens fixed with @ % buffered formalin with methylene blue for @ hours after surgery .


The primary endpoint is the ratio of the number of the harvested LNs per time ( minute ) .


The secondary endpoint is the number of harvested LNs .


A @ % reduction in the ratio of harvested lymph-node/time ( minute ) was determined to be necessary for this test treatment , considering the balance between the cost and benefit .


Retrospective data was used to estimate the ratio of the number of the harvested LNs per time ( minute ) to be @/@ minutes in Group A.


A @ % risk reduction and a rate of @/@ @ minutes is expected in Group B. Therefore , the sample size required ensuring a two-sided alpha error of @ % and statistical power of @ % is @ patients , with @ patients per arm .


The number of patients to be accrued was set at @ in total , due to the likelihood of enrolling ineligible patients .


Perforated colonic diverticulitis usually requires surgical resection , which is associated with significant morbidity .


Cohort studies have suggested that laparoscopic lavage may treat perforated diverticulitis with less morbidity than resection procedures .


To compare the outcomes from laparoscopic lavage with those for colon resection for perforated diverticulitis .


Multicenter , randomized clinical superiority trial recruiting participants from @ centers in Sweden and Norway from February @ to June @ .


The last patient follow-up was in December @ and final review and verification of the medical records was assessed in March @ .


Patients with suspected perforated diverticulitis , a clinical indication for emergency surgery , and free air on an abdominal computed tomography scan were eligible .


Of @ patients screened , @ were eligible and @ were enrolled .


Patients were assigned to undergo laparoscopic peritoneal lavage ( n = @ ) or colon resection ( n = @ ) based on a computer-generated , center-stratified block randomization .


All patients with fecal peritonitis ( @ patients in the laparoscopic peritoneal lavage group vs @ in the colon resection group ) underwent colon resection .


Patients with a pathology requiring treatment beyond that necessary for perforated diverticulitis ( @ in the laparoscopic lavage group vs @ in the colon resection group ) were also excluded from the protocol operations and treated as required for the pathology encountered .


The primary outcome was severe postoperative complications ( Clavien-Dindo score > IIIa ) within @ days .


Secondary outcomes included other postoperative complications , reoperations , length of operating time , length of postoperative hospital stay , and quality of life .


The primary outcome was observed in @ of @ patients ( @ % ) in the laparoscopic lavage group and @ of @ patients ( @ % ) in the colon resection group ( difference , @ % -LSB- @ % CI , -@ % to @ % -RSB- ; P = @ ) .


Mortality at @ days did not significantly differ between the laparoscopic lavage group ( @ patients -LSB- @ % -RSB- ) and the colon resection group ( @ patients -LSB- @ % -RSB- ; difference , @ % -LSB- @ % CI , -@ % to @ % -RSB- ; P = @ ) .


The reoperation rate was significantly higher in the laparoscopic lavage group ( @ of @ patients -LSB- @ % -RSB- ) than in the colon resection group ( @ of @ patients -LSB- @ % -RSB- ; difference , @ % -LSB- @ % CI , @ % to @ % -RSB- ; P = @ ) for patients who did not have fecal peritonitis .


The length of operating time was significantly shorter in the laparoscopic lavage group ; whereas , length of postoperative hospital stay and quality of life did not differ significantly between groups .


Four sigmoid carcinomas were missed with laparoscopic lavage .


Among patients with likely perforated diverticulitis and undergoing emergency surgery , the use of laparoscopic lavage vs primary resection did not reduce severe postoperative complications and led to worse outcomes in secondary end points .


These findings do not support laparoscopic lavage for treatment of perforated diverticulitis .


We conducted a randomized trial among overweight long-distance drivers to study the effects of structured lifestyle counseling on body weight and cardiometabolic risk factors .


Men with waist circumference > @ cm were randomized into a lifestyle counseling ( LIFE , N = @ ) and a reference ( REF , N = @ ) group .


The LIFE group participated in monthly counseling on nutrition , physical activity , and sleep for @ months aiming at @ % weight loss .


After @ months , the REF group participated in @-month counseling .


Assessments took place at @ , @ , and @ months .


Between-group differences in changes were analyzed by generalized linear modeling .


Metabolic risk ( Z score ) was calculated from components of metabolic syndrome .


The mean body weight change after @ months was -@ kg in LIFE ( N = @ ) and @ kg in REF ( N = @ ) -LSB- net difference -@ kg , @ % confidence interval ( @ % CI ) -@ - -@ -RSB- .


Six men in LIFE reduced body weight by @ % .


Changes in waist circumference were -@ cm in LIFE and -@ cm in REF ( net -@ cm , @ % CI -@ - -@ ) .


Metabolic risk decreased more in the LIFE than REF group ( net -@ points , @ % CI -@ - -@ ) .


After @ months follow-up , there were no between-group differences in changes in body weight ( net -@ kg , @ % CI -@ -@ ) or metabolic risk score ( net @ points ; @ % CI -@ -@ ) compared to baseline .


Weight reduction and decreases in cardiometabolic risk factors were clinically meaningful after @ months of counseling .


To observe the therapeutic effects of Pegasys ( pegylated interferon alpha-@a ) in chronic hepatitis B ( CHB ) patients with low-level alanine transaminase ( ALT ) < @ x upper limit of normal ( ULN ) .


One hundred and seven CHB patients were randomized enrolled including @ with ALT < @ x ULN and liver tissues inflammation activity > or = G@ as observational group and @ with ALT > @ x ULN as control group .


All the enrolled patients received pegasys treatment for @ weeks and the responses between two groups were compared .


Measurement data were analyzed using t test and numeration data were analyzed using chi square test .


The reductions of HBV DNA in observational group at different time points were all less than control group ( all P < @ ) .


At the end of treatment , the HBV DNA negative rate , HBeAg seroconversion rate and HBsAg loss rate in the observational group were @ % , @ % and @ % , respectively , which were all lower than control group ( @ % , @ % and @ % , respectivley ) ( all P < @ ) .


The ALT normalization rates of two groups were @ % and @ % ( P > @ ) .


Pegasys is efficient for CHB patients with ALT < @ x ULN and liver tissues inflammation activity > or = G@ , while it is still inferior to those with ALT > @ x ULN .


Adverse events associated with @-fluorouracil ( @FU ) based adjuvant therapy in colorectal cancer ( CRC ) patients may predict survival .


We studied whether haematological ( leucopenia , neutropenia , thrombocytopenia ) or non-haematological ( mucositis , diarrhoea , nausea/vomiting , hand-foot syndrome or other toxicity ) adverse events were associated with disease-free survival ( DFS ) or overall survival ( OS ) in a large patient material treated with @-fluorouracil based adjuvant chemotherapy .


Data from two prospective randomised adjuvant trials were combined to achieve a dataset of @ radically operated stage II and III CRC patients treated with either monthly @FU and leucovorin ( LV ) as bolus injections ( Mayo or modified Mayo ) or bi-monthly with bolus and continuous infusion ( LV@FU@ or simplified LV@FU@ ) .


Toxicities were recorded at each treatment cycle according to NCI-C CTC ( the Common Toxicity Criteria of the National Cancer Institute of Canada ) .


The worst toxicity grade was taken into account .


The median follow-up time of patients was @ years .


@ % of patients developed neutropenia , @ % nausea/vomiting and @ % mucositis .


Any grade neutropenia was associated with improved DFS ( hazard ratio ( HR ) @ ) , any grade nausea/vomiting with improved DFS ( HR @ ) and OS ( HR @ ) and mucositis with improved DFS ( HR @ ) and OS ( HR @ ) .


Patients experiencing no predefined toxicity had the worst outcome .


Specific adverse events related to adjuvant fluorouracil chemotherapy are associated with improved DFS and OS in early stage CRC patients .


Intimate partner violence ( IPV ) violates women 's human rights , and it is a serious public health concern associated with increased HIV risk .


SASA !


, a phased community mobilization intervention , engages communities to prevent IPV and promote gender equity .


The SASA !


study assessed the community-level impact of SASA !


on reported HIV-related risk behaviours and relationship dynamics .


Data were collected as part of a cluster randomized controlled trial conducted between @ and @ in eight communities in Kampala .


An adjusted cluster-level intention to treat analysis , compares secondary outcomes in intervention and control communities at follow-up .


The qualitative evaluation explored participants ' subjective experience of SASA !


A total of @ in-depth interviews were audio recorded at follow-up , transcribed verbatim and analyzed using thematic analysis .


Men in intervention communities were significantly more likely than controls to report a broad range of HIV-protective behaviours , including higher levels of condom use ( aRR @ , @ % CI @-@ @ ) , HIV testing ( aRR @ , @ % CI @-@ @ ) and fewer concurrent partners ( aRR @ , @ % CI @-@ @ ) .


They were also more likely to report increased joint decision-making ( aRR @ , @ % CI @-@ @ ) , greater male participation in household tasks ( aRR @ , @ % CI @-@ @ ) , more open communication and greater appreciation of their partner 's work inside ( aRR @ , @ % CI @-@ @ ) and outside ( aRR @ , @ % CI @-@ @ ) the home .


For women , all outcomes were in the hypothesized direction , but effect sizes were smaller .


Only some achieved statistical significance .


Women in intervention communities were significantly more likely to report being able to refuse sex with their partners ( aRR @ , @ % CI @-@ @ ) , joint decision-making ( aRR @ , @ % CI @-@ @ ) and more open communication on a number of indicators .


Qualitative interviews suggest that shifts operated through broader improvements in relationships , including increased trust and cooperation , participants ' greater awareness of the connections between HIV and IPV and their resultant desire to improve their relationships .


Barriers to change include partial uptake of SASA !


, partner resistance , fear and entrenched previous beliefs .


SASA !


impacted positively on reported HIV-related risk behaviours and relationship dynamics at a community level , especially among men .


Social change programmes focusing on IPV and gender equity could play an important role in HIV prevention efforts .


Ceftriaxone with or without a macrolide antibiotic is a recommended treatment for patients with community-acquired pneumonia requiring hospital admission and intravenous antibiotic treatment .


We aimed to assess the efficacy and safety of ceftaroline fosamil compared with ceftriaxone in the treatment of Asian patients admitted to hospital with community-acquired pneumonia .


In this international , randomised , controlled , double-blind , phase @ , non-inferiority with nested superiority trial , adult Asian patients with Pneumonia Outcomes Research Team ( PORT ) risk class III-IV acute community-acquired pneumonia were randomly assigned ( @:@ ) to receive intravenous ceftaroline fosamil ( @ mg every @ h ) or ceftriaxone ( @ g every @ h ) for @-@ days .


Patients were randomly assigned via centralised telephone and web-based system ; patients and treating clinicians were masked to treatment allocation .


Investigators who did study assessments remained masked to treatment allocation until completion of the study .


The primary endpoint was clinical cure at the test-of-cure visit ( @-@ days after last dose of study drug ) in the clinically evaluable population .


Non-inferiority of ceftaroline fosamil was defined as a lower limit of the two-sided @ % CI for the difference in the proportion of patients clinically cured of -@ % or higher ; if non-inferiority was achieved , superiority was to be concluded if the lower limit of the @ % CI was greater than @ % .


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


Between Dec @ , @ , and April @ , @ , @ patients were enrolled at @ centres in China , India , South Korea , Taiwan , and Vietnam , of whom @ were randomly assigned and @ received study treatment .


In the clinically evaluable population ( n = @ ) @ ( @ % ) of @ patients in the ceftaroline fosamil group and @ ( @ % ) of @ patients in the ceftriaxone group were clinically cured at the test-of-cure visit ( difference @ % , @ % CI @-@ ) .


The superiority of ceftaroline fosamil was consistent across all preplanned patient subgroup analyses ( split by age @ years , age @ years , sex , PORT risk class , and previous antibiotic use ) apart from patients younger than @ years .


The frequency of adverse events was similar between treatment groups and the safety results for ceftaroline fosamil were consistent with the cephalosporin class and previous clinical trial data .


Ceftaroline fosamil @ mg given every @ h was superior to ceftriaxone @ g given every @ h for the treatment of Asian patients with PORT III-IV community-acquired pneumonia .


These data suggest that ceftaroline fosamil should be regarded as an alternative to ceftriaxone in empirical treatment regimens for this patient population .


HIV infection is associated with a higher prevalence of low bone mineral density ( BMD ) and fractures than that found in the general population .


There are limited data in HIV-positive adults , nave to antiretroviral therapy ( ART ) , with which to estimate the relative contribution of untreated HIV infection to bone loss .


The primary objective of the Strategic Timing of AntiRetroviral Treatment ( START ) Bone Mineral Density Substudy is to compare the effect of immediate versus deferred initial ART on bone .


We evaluated traditional , demographic , HIV-related and immunological factors for their associations with baseline hip and lumbar spine BMD , measured by dual-energy X-ray absorptiometry , using multiple regression .


A total of @ ART-nave participants were enrolled at @ sites on six continents ; the mean age was @ years -LSB- standard deviation ( SD ) @ years -RSB- , @ % were nonwhite , @ % were women , and @ % had a body mass index ( BMI ) < @kg/m ( @ ) .


Mean ( SD ) Z-scores were -@ ( @ ) at the spine and -@ ( @ ) for total hip ; @ % had osteoporosis and @ % had low BMD ( hip or spine T-score < -@ ) .


Factors independently associated with lower BMD at the hip and spine were female sex , Latino/Hispanic ethnicity , lower BMI and higher estimated glomerular filtration rate .


Longer time since HIV diagnosis was associated with lower hip BMD .


Current or nadir CD@ cell count and HIV viral load were not associated with BMD .


In this geographically and racially diverse population of ART-nave adults with normal CD@ cell counts , low BMD was common , but osteoporosis was rare .


Lower BMD was significantly associated with traditional risk factors but not with CD@ cell count or viral load .


To compare the effectiveness and safety of transurethral resection of the prostate ( TURP ) and transurethral enucleative resection of the prostate ( TUERP ) in the treatment of benign prostate hyperplasia ( BPH ) .


A total of @ BPH patients with indication of surgery were randomly assigned to receive TURP ( n = @ ) and TUERP ( n = @ ) , respectively .


There were no significant differences preoperatively in age , prostate volume , International Prostate Symptom Score ( IPSS ) , and Qmax between the two groups ( P > @ ) .


The prostate resection rate , operation time , postoperative complications , and quality of life ( QOL ) of the patients were recorded and statistically analyzed .


Compared with TURP , TUERP showed a significantly higher rate of prostate resection ( -LSB- @ + / - @ -RSB- vs -LSB- @ + / - @ -RSB- % , P < @ ) , shorter operation time ( -LSB- @ + / - @ -RSB- vs -LSB- @ + / - @ -RSB- min , P < @ ) , and shorter bladder irrigation time ( -LSB- @ + / - @ -RSB- vs -LSB- @ + @ -RSB- d , P < @ ) .


Significant differences were found between the pre - and post-operative levels of serum sodium and hemoglobin in the TURP group ( -LSB- @ + / - @ -RSB- vs -LSB- @ + / - @ -RSB- mmol/L , P < @ ; -LSB- @ + / - @ -RSB- vs -LSB- @ + / - @ -RSB- g/L , P < @ ) , but not in the TUERP group .


Three months after operation , IPSS , QOL , and Qmax were all markedly improved in both groups ( P < @ ) , but with no significant differences between the two groups ( P > @ ) .


TUERP is better than TURP in the treatment of BPH for its advantages of higher resection rate of the prostate , shorter operation time and bladder irrigation time , less intraoperative blood loss , fewer postoperative complications , and faster recovery .


Eradication of helicobacter pylori is important for treatment of GU but an ideal regimen is not available .


HP is resistant to metronidazole and clarithromycin .


Clarithromycin is expensive and is not available in under developing countries .


This study aimed to compare two regimens containing clarithromycin or azithromycin .


Totally , seventy-eight patients with GU ( confirmed with endoscopy ) and infection of HP ( Confirmed by Rapid Urease Test ( RUT ) ) were allocated to one of the groups of study ( @ participants in each group ) .


Two weeks regimen of Clarithromycin ( @ mg ) + Amoxicillin ( @ gr ) + omeprazole ( @ mg ) was administered for group A of patients while group B got a @ days regimen of Azithromycin ( @ mg ) + @ days Amoxicillin ( @ gr ) + omeprazole ( @ mg ) .


At the end of the treatment course , the patients were evaluated according to the side effects of the drugs .


In addition , two months after the end of therapy , patients underwent endoscopy and biopsy to evaluate HP eradication .


After two weeks , the side effects of the drug were : Nausea @ patients in group A and @ patients in group B , Diarrhea @ patients in group A , @ patients in group B and vomiting @ patients in group A , @ patients in group B.


There were no serious side effects in any group .


Eradication rate in group A was @ % ( based on per protocol analysis ( PPA ) ) and @ % ( intention to treat ( ITT ) ) .


In group B , eradication rate was @ % ( PPA ) and @ % ( ITT ) ( P = @ ) .


Based on our study results , azithromycin can be used in HP eradication regimen because of its similar efficacy to clarithromycin but also have lower cost , side effects and resistance .


The purpose of this study was to determine whether surgery is an effective option for the treatment of stenosis of the lumbar spine and degenerative spondylolisthesis in the octogenarian population .


An as-treated analysis of patients with lumbar stenosis and degenerative spondylolisthesis enrolled in the Spine Patient Outcomes Research Trial ( SPORT ) was performed .


Patients who were at least eighty years of age ( n = @ ) were compared with those younger than eighty years ( n = @ ) .


Baseline patient and clinical characteristics were noted , and the difference in improvement from baseline between operative and nonoperative treatment was determined for each group at each follow-up time period up to four years .


There were no significant baseline differences in the primary or secondary patient-reported clinical outcome measures between the two patient age groups .


Patients at least eighty years of age had higher prevalences of multilevel stenosis , severe stenosis , and asymmetric motor weakness .


Patients at least eighty years of age also had higher prevalences of hypertension , heart disease , osteoporosis , and joint problems at baseline , but they had a lower body mass index and lower prevalences of depression and smoking .


Fifty-eight of the @ patients at least eighty years of age and @ of the @ younger patients underwent operative management .


There were no differences in the rates of intraoperative or postoperative complications , reoperation , or postoperative mortality between the older and younger groups .


Averaged over a four-year follow-up period , operatively treated patients at least eighty years of age had significantly greater improvement in all primary and secondary outcome measures compared with nonoperatively treated patients .


The treatment effects in patients at least eighty years of age were similar to those in younger patients for all primary and secondary measures except the SF-@ ( Short Form-@ ) bodily pain domain and the percentage who self-rated their progress as a major improvement , in both of which the treatment effect was significantly smaller .


Operative treatment of lumbar stenosis and degenerative spondylolisthesis offered a significant benefit over nonoperative treatment in patients at least eighty years of age ( p < @ ) .


There were no significant increases in the complication and mortality rates following surgery in this patient population compared with younger patients ( p > @ ) .


This trial investigated the effects of access to an Internet-based screening and brief intervention site for illicit drug users .


This article adds to previously published results from the @ - and @-month follow-ups by extending the follow-up period to @ months and reporting changes in substance use between the @ - and @-month follow-ups .


In total , @ Internet help-seekers with illicit drug use , @-@ years old , were randomly assigned to either an intervention group that received Internet-based screening and brief intervention via eScreen.se or to an assessment-only control group .


The primary outcome measure was the Drug Use Disorders Identification Test consumption questions ( DUDIT-C ) score , and secondary outcome measures were the DUDIT , Alcohol Use Disorders Identification Test consumption questions ( AUDIT-C ) , and AUDIT scores , as well as the proportion of drug abstainers and participants making a clinically significant change in their alcohol and other drug use .


DUDIT-C , DUDIT , AUDIT-C , and AUDIT scores remained stable between the @ - and @-month follow-ups .


However , @ months after recruitment , @ % of those who used eScreen.se had changed their alcohol use to a clinically lower level compared with the @ % of the controls .


Also , none of the eScreen.se users increased their level of alcohol use during this @-month period , whereas @ % in the control group did so .


Despite no changes in illicit drug use from the @ - to @-month follow-up for both the intervention and control group , eScreen.se seems to be more effective than assessment only for reducing alcohol use among illicit drug users over a @-month period .


We previously reported rapid mood elevation following an experimental magnetic resonance imaging procedure in depressed patients with bipolar disorder ( BPD ) .


This prompted the design , construction , and testing of a portable electromagnetic device that reproduces only the rapidly oscillating ( @ kHz , < @ V/m ) electromagnetic field of the experimental procedure , called low field magnetic stimulation ( LFMS ) .


We used a randomized , double blind , sham controlled treatment protocol to study the effects of LFMS in a large group of stably medicated , depressed patients with either BPD ( n = @ ) or major depressive disorder ( n = @ ) .


Subjects received a single , @-minute treatment .


Change in mood was assessed immediately afterward using a visual analog scale ( VAS ) , the @-item Hamilton Depression Rating Scale ( HDRS-@ ) , and the Positive and Negative Affect Schedule scales .


Substantial improvement ( > @ % of baseline ) in mood was observed following LFMS treatment relative to sham treatment for both diagnostic subgroups for our primary outcomes , the VAS and the HDRS-@ .


These differences were not statistically significant in primary analyses stratifying by diagnosis but were significant in secondary analyses combining data across the two diagnostic groups ( p = @ VAS , p = @ HDRS-@ ) .


Rapid improvement in mood was also observed using the Positive and Negative Affect Schedule scales as secondary measures ( positive affect scale p = @ BPD , p = @ combined group ) .


A finite element method calculation indicates a broad penetration of the LFMS electric field throughout the cerebral cortex .


Low field magnetic stimulation may produce rapid changes in mood using a previously unexplored range of electromagnetic fields .


Older age is associated with an increase in the incidence of cancer cases .


Diagnosis and treatment of cancer in older adults can be stressful because of health decline related to age , comorbidities and inadequate treatment for pain and other symptoms of the disease .


This survey is one of the unique studies in Jordan and in the Arab world that aimed at exploring the predictors of older adult individuals awareness towards cancer .


A stratified random sampling technique was followed to reach a representative sample of @ participants .


The questionnaire of the study consisted of parts regarding demographic variables , awareness about screening tests , and signs and symptoms of cancer .


In addition , specific questions related to factors linked to cancer were included .


Cross-sectional design was adopted with face-to-face interviews at the interviewees ' households .


The mean age of the participants was about @ years ; around @ % of them are above the age of @ years .