At the time of surgery and till @ minutes after administration of anesthesia , there was no significant difference in pain between the @ groups ( p = @ and @ respectively ) .


Group A had better akinesia as compared to group B ( p = @ ) .


There was a greater rise in mean intraocular pressure just after injection in group B as compared to group A ( p < @ ) ; in both groups , the intraocular pressure declined to its base level @ minutes after the injection ( p = @ ) .


Subtenon anesthesia is less painful at the time of its administration , provides better akinesia and leads to smaller rise in intraocular pressure just after the injection than peribulbar anesthesia .


The objective of this study was to compare the backfill standard voiding trial ( SVT ) that relies on the assessment of voided volume to subjective patients ' evaluation of their voiding based on the assessment of the force of stream ( FOS ) after an outpatient midurethral sling surgery .


This double-blinded randomized trial included patients undergoing an outpatient midurethral sling surgery without any other concomitant surgery .


Participants were randomized to either the SVT group or to the FOS group .


The primary outcome was the rate of catheterization any time up to @ weeks after surgery .


Both groups underwent the same backfill voiding trial protocol postoperatively .


Measurements of the voided amount , postvoid residual , and the response to the FOS visual analog scale were collected .


The criteria for passing the voiding trial in the SVT group was voiding at least two-thirds of the instilled amount ; while the criteria for passing the trial in the FOS group was assessment of FOS at least @ % of the baseline , regardless of the voided volume .


Participants were interviewed preoperatively and @-@ days , @-@ days , and @ weeks postoperatively .


All postoperative interviews included assessments of pain , tolerance of physical activity , urinary FOS , as well as satisfaction with the surgery .


Validated questionnaires ( Incontinence Severity Index and Urinary Distress Inventory , short form ) before the surgery and @ weeks after were used to evaluate urinary symptoms .


A total of @ patients were enrolled and randomized , and @-week follow-up data were available for @ participants ( FOS @ , SVT @ ) .


The @ groups were similar with respect to demographic characteristics and urinary symptoms .


The incidence of catheterization was also similar between the groups ( FOS @ -LSB- @ % -RSB- , SVT @ -LSB- @ % -RSB- ; P = @ ) .


Amount voided had a moderate correlation with FOS assessment ( Spearman rho @ ; P < @ ) .


There was no significant difference in mean catheter days , pain scores , Incontinence Severity Index , and Urinary Distress Inventory , short form scores between the @ groups .


Of the patients who were discharged home without a catheter in either group none required catheter reinsertion within @ weeks after the surgery .


Patient 's subjective assessment of the urinary FOS correlated well with the measured voided amount and no difference in catheterization days was noted between the subjective and objective assessment of voiding .


Thus subjective evaluation of the FOS is a reliable and safe method to use after outpatient midurethral surgery .


To examine the effects of whole-body periodic acceleration ( pGz ) on exercise-induced-muscle-damage ( EIMD ) - related symptoms induced by unaccustomed eccentric arm exercise .


Seventeen active young men ( @ @ y ) made @ visits to the research facility over a @-wk period .


On day @ , subjects performed a @-repetition-maximum ( @RM ) elbow-flexion test and were randomly assigned to the pGz ( n = @ ) or control group ( n = @ ) .


Criterion measurements were taken on day @ , before and immediately after performance of the eccentric-exercise protocol ( @ sets , @ repetitions using @ % @RM ) and after the recovery period .


During subsequent sessions ( @ , @ , @ , and @ h ) these data were collected before pGz or passive recovery .


Measurements included isometric strength ( maximal voluntary contraction -LSB- MVC -RSB- ) , blood markers ( creatine kinase , myoglobin , IL-@ , TNF - , TBARS , PGF@ , protein carbonyls , uric acid , and nitrites ) , soreness , pain , circumference , and range of motion ( ROM ) .


Significantly higher MVC values were seen for pGz throughout the recovery period .


Within-group differences were seen in myoglobin , IL-@ , IL-@ , protein carbonyls , soreness , pain , circumference , and ROM showing small negative responses and rapid recovery for the pGz condition .


Our results demonstrate that pGz can be an effective tool for the reduction of EIMD and may contribute to the training-adaptation cycle by speeding up the recovery of the body due to its performance-loss-lessening effect .


Most patients with anxiety disorders receive treatment in primary care settings .


Limited moderator data are available to inform clinicians of likely prognostic outcomes for individual patients .


We identify baseline characteristics associated with outcome in adults seeking treatment for anxiety disorders .


We conducted an exploratory moderator analysis from the Coordinated Anxiety Learning and Management ( CALM ) trial .


In the CALM trial , @,@ adults who met DSM-IV criteria for generalized anxiety disorder ( GAD ) , panic disorder , social anxiety disorder , and/or posttraumatic stress disorder ( PTSD ) were randomized to usual care ( UC ) or a collaborative care intervention ( ITV ) of cognitive-behavioral therapy and/or pharmacotherapy between June @ and April @ .


Logistic regression was used to examine baseline characteristics associated with remission and response overall and by treatment condition .


Receiver operating curve ( ROC ) analyses identified subgroups associated with similar likelihood of response and remission of global anxiety symptoms .


Remission was defined as score < @ on the @-item Brief Symptom Inventory ( BSI-@ ) anxiety and somatization subscales .


Response was defined as at least @ % reduction on BSI-@ , or meeting remission criteria .


Randomization to ITV over UC was often the strongest predictor of outcome .


Several baseline patient characteristics were associated with poor treatment outcome including comorbid depression , increased severity of underlying anxiety disorder ( s ) ( P < @ ) , low socioeconomic status ( perceived -LSB- P < @ -RSB- and actual -LSB- P < @ -RSB- ) , and limited social support ( P < @ ) .


Patient characteristics associated with particular benefit from ITV were being female ( P < @ ) , increased depression ( P < @ ) / GAD severity ( P < @ ) , and low socioeconomic status ( P < @ ) .


ROC analysis demonstrated prognostic subgroups with large differences in response likelihood .


Further research should focus on the effectiveness of implementing the ITV intervention of CALM in community treatment centers where patients typically are of low socioeconomic status and may particularly benefit from ITV .


Muscle spindles endings are extremely sensitive to externally applied vibrations , and under such circumstances they convey proprioceptive inflows to the central nervous system that modulate the spinal reflexes excitability or the muscle responses elicited by postural perturbations .


The aim of this pilot study is to test the feasibility and effectiveness of a balance training program in association with a wearable proprioceptive stabilizer ( Equistasi ) that emits focal mechanical vibrations in patients with PD .


Forty patients with PD were randomly divided in two groups wearing an active or inactive device .


All the patients received a @-month intensive program of balance training .


Assessments were performed at baseline , after the rehabilitation period ( T@ ) , and two more months after ( T@ ) .


Posturographic measures were used as primary endpoint ; secondary measures of outcome included the number of falls and several clinical scales for balance and quality of life .


Both groups improved at the end of the rehabilitation period and we did not find significant between-group differences in any of the principal posturographic measures with the exception of higher sway area and limit of stability on the instrumental functional reach test during visual deprivation at T@ in the Equistasi group .


As for the secondary outcome , we found an overall better outcome in patients enrolled in the Equistasi group : @ ) significant improvement at T@ on Berg Balance Scale ( +@ % , p = @ ) , Activities-specific Balance Confidence ( +@ , p = @ ) , Falls Efficacy Scale ( -@ % , p = @ ) and PDQ-@ ( -@ % , p = @ ) ; @ ) sustained improvement at T@ in terms of UPDRS-III , Berg Balance Scales , Time Up and Go and PDQ-@ ; @ ) significant and sustained reduction of the falls rate .


This pilot trial shows that a physiotherapy program for training balance in association with focal mechanical vibration exerted by a wearable proprioceptive stabilizer might be superior than rehabilitation alone in improving patients ' balance .


To compare the effectiveness of limbal relaxing incisions ( LRI ) with that of toric intraocular lens ( IOL ) implantation for the treatment of astigmatism during phacoemulsification using nonvectorial ( predictability , safety , and efficacy ) and vectorial analyses .


This longitudinal observational case series assessed @ eyes of @ consecutive cataract patients with preoperative corneal astigmatism of @-@ @ diopters ( D ) in both eyes .


Patients were randomly assigned to @ groups : a toric IOL group , which received toric IOLs in both eyes , and an LRI group , which received spherical IOLs associated with LRI placement in both eyes .


All patients were evaluated at @ , @ , and @ months after surgery , when refractive astigmatism analysis was performed using both nonvectorial and Alpins vectorial methods .


Outcomes were assessed within each group and compared between groups .


The proportion of eyes within @ D of the intended correction at @ and @ months after surgery was @ % and @ % , respectively , in the LRI group and @ % and @ % , respectively , in the toric IOL group .


In the remaining period , the proportion was greater in the toric IOL group .


The safety index showed no difference at any time point .


The efficacy index at @ and @ months after surgery was significantly higher in the toric IOL group ( @ and @ , respectively ) than in the LRI group ( @ and @ , respectively ) .


At @ months after surgery , the status of eyes in the LRI group was as follows : @ % were undercorrected , @ % achieved the intended correction , and @ % were overcorrected .


In the toric IOL group , @ % eyes were undercorrected , @ % achieved the intended correction , and @ % were overcorrected .


The success rates for astigmatic surgery , astigmatism reduction at the intended axis , and astigmatism corrected were @ % , @ % , and @ % , respectively , in the LRI group and @ % , @ % , and @ % , respectively , in the toric IOL group .


Our results suggest that the use of toric IOLs may be advantageous over the use of LRIs for the treatment of astigmatism during phacoemulsification .


Although such advantages seem subtle in nonvectorial analyses , they are highlighted in vectorial analyses .


To ensure vaccines safety , given the weaknesses of the national pharmacovigilance system in Cameroon , there is a need to identify effective interventions that can contribute to improving AEFI reporting .


To assess the effect of : ( i ) sending weekly SMS , or ( ii ) weekly supervisory visits on AEFI reporting rate during a meningitis immunization campaign conducted in Cameroon in @ using the meningitis A conjugate vaccine ( MenAfriVac ) .


Health facilities that met the inclusion criteria were randomly assigned to receive : ( i ) a weekly standardized SMS , ( ii ) a weekly standardized supervisory visits or ( iii ) no intervention .


The primary outcome was the reported AEFI incidence rate from week @ to @ after the immunization campaign .


Poisson regression model was used to estimate the effect of interventions after adjusting for health region , type of health facility , type and position of health workers as well as the cumulative number of AEFI reported from weeks @ to @ .


A total of @ ( @ % ) of @ health facility were included , and @ assigned to each of three groups .


The incidence rate of reported AEFI per @ health facility per week was @ ( @-@ @ ) in the SMS group , @ ( @-@ @ ) in supervision group and @ ( @-@ @ ) in the control group .


Supervision led to a significant increase of AEFI reporting rate compared to SMS -LSB- adjusted RR = @ ( @-@ @ ) ; p < @ -RSB- and control -LSB- RR = @ ( @-@ @ ) ; p < @ ) -RSB- groups .


The effect of SMS led to some increase in AEFI reporting rate compared to the control group , but the difference was not statistically significant -LSB- RR = @ ( @-@ @ ) ; p = @ ) -RSB- .


Supervision was more effective than SMS or routine surveillance in improving AEFI reporting rate .


It should be part of any AEFI surveillance system .


SMS could be useful in improving AEFI reporting rates but strategies need to be found to improve its effectiveness , and thus maximize its benefits .


The aims of this study were to evaluate the effect of left ventricular ( LV ) dysfunction on clinical outcomes after transcatheter aortic valve replacement ( TAVR ) and standard therapy for severe aortic stenosis ( AS ) and to assess LV ejection fraction ( LVEF ) recovery and its impact on subsequent clinical outcomes .


Cohort B of the Placement of AoRtic TraNscathetER Valves trial randomised @ inoperable patients with severe AS to TAVR or standard therapy .


We defined LV dysfunction as an LVEF < @ % and LVEF improvement as an absolute increase in LVEF @ % at @days .


Baseline LV dysfunction did not affect survival after TAVR but was associated with increased cardiac mortality at @ year with standard therapy ( @ % vs @ % with normal LVEF ; HR = @ ( @ % CI @ to @ ) ; p = @ ) .


In those with LV dysfunction , LVEF improvement occurred in @ % and @ % of TAVR and standard therapy patients , respectively ( p = @ ) , and was independently predicted by relative wall thickness and receipt of TAVR .


LVEF improvement with standard therapy portended reduced all-cause mortality at @year ( @ % vs @ % without LVEF improvement ; HR = @ ( @ % CI @ to @ ) ; p = @ ) but not at @years .


In inoperable patients with severe AS , mild-to-moderate LV dysfunction is associated with higher cardiac mortality with standard therapy but not TAVR .


A subset of patients undergoing standard therapy with LV dysfunction demonstrates LVEF improvement and favourable @-year but not @-year survival .


TAVR improves survival and should be considered the standard of care for inoperable patients with AS and LVEF > @ % .


Recent symptoms stand as a major determinant of stroke risk in patients with carotid stenosis , likely reflective of atherosclerotic plaque destabilization .


In view of emerging links between vascular and adipose biology , we hypothesized that human perivascular adipose characteristics associate with carotid disease symptom status .


Clinical history , carotid plaques , blood , and subcutaneous and perivascular adipose tissues were prospectively collected from patients undergoing carotid endarterectomy .


Nine adipose-associated biological mediators were assayed and compared in patients with symptomatic ( n = @ ) versus asymptomatic ( n = @ ) disease .


Bonferroni correction was performed for multiple testing ( / @ = @ ) .


Symptomatic patients had @-fold higher perivascular adiponectin levels ( P = @ ) .


Other circulating , subcutaneous , and perivascular biomarkers , as well as microscopic plaque characteristics , did not differ between symptomatic and asymptomatic patients .


Symptomatic and asymptomatic carotid endarterectomy patients display a tissue-specific difference in perivascular adipose adiponectin .


This difference , which was not seen in plasma or subcutaneous compartments , supports a potential local paracrine relationship with vascular disease processes that may be related to stroke mechanisms .


We conducted a phase III randomized controlled trial ( RCT ) to investigate the efficacy of postsurgical adjuvant immunotherapy combined with chemotherapy .


The immunotherapy targets were residual micrometastases and clones resistant to chemotherapy .


Between April @ and July @ , @ postsurgical non-small cell lung cancer patients were randomly assigned to receive either chemo-immunotherapy ( group A ) or chemotherapy ( group B ) .


The immunotherapy consisted of the adoptive transfer of autologous activated killer T cells and dendritic cells obtained from the lung cancer patients ' own regional lymph nodes .


The @-year overall survival rates in groups A and B were @ and @ % , and the @-year rates were @ and @ % , respectively .


The differences were statistically significantly better in group A.


The hazard ratio ( HR ) was @ ( p = @ ) .


The @ - and @-year recurrence-free survival rates were @ , @ and @ , @ % in groups A and B , respectively .


Those differences were also statistically significant ( log-rank test p = @ ) .


The HR was @ ( p = @ ) in favor of group A.


As for adverse reactions to immunotherapy , of a total of @ courses , @ ( @ % ) were accompanied with chills and shivering , and @ ( @ % ) , with fever ( > @ C ) .


Immunotherapy has the potential to improve the postsurgical prognosis of lung cancer patients , but a large-scale multi-institutional RCT is awaited for further confirmation of this study .


To assess the clinical performance of Systane Ultra lubricant eye drops in daily disposable soft contact lens wearers who experience contact lens-related dryness .


In this randomized , investigator-masked study , daily disposable lens wearers with symptoms of dryness were randomized to use Systane Ultra lubricant eye drops or to no treatment .


The lubricant regimen was applied twice a day , @ minutes before lens insertion and after lens removal , for the @-week study period .


Subjective comfort , wear time , and visual acuity were assessed at baseline and after @ weeks .


A total of @ daily disposable lens wearers were randomly assigned to the Systane Ultra group ( n = @ ) or the control group ( n = @ ) .


Two weeks of Systane Ultra lubricant eye drop use resulted in a significant increase in comfortable lens wear time when compared with baseline assessment ( P = @ ) and a trend toward significant improvement compared with the control group ( P = @ ) .


End-of-the-day comfort was significantly improved in the Systane Ultra group compared with the control group ( P = @ ) .


A significant reduction in the overall dryness ( P < @ ) and end-of-day dryness ( P = @ ) was observed in subjects using the Systane Ultra lubricant eye drops compared with the control group .


The study demonstrates that Systane Ultra lubricant eye drops applied before and after contact lens wear is an effective artificial tear for alleviating symptoms of contact lens-related dry eye .


The teaching of medicine has varied and has continued to develop until today .


Most courses rely on the lecture although it may bring less benefit to students .


Another teaching technique , the open group discussion , may not be the most effective , but is widely accepted as a teaching development especially for its overall improvement of student skills .


Basically , the teaching of surgery has more limitations than other subjects because patients with critical conditions are required .


The present study was designed to compare the effectiveness of these two teaching methods , the lecture and the open group discussion , in the Department of Surgery , Rajavithi Hospital .


Fifth year medical students enrolled from @-@ BE ( AD @-@ ) were recruited in the study and randomly divided in groups by the Office of Administration , College of Medicine , Rangsit University .


A colorectal surgeon taught the subject , common anorectal disease , throughout the study year .


The drawing method was used to randomize the members grouped by teaching methods .


The assessment comprised multiple choice questions ( MCQ ) and multiple essay questions ( MEQ ) .


Seventy-three students ( @ females , @ males ) were recruited .


Students ' basic characteristic showed no association between groups of teaching methods .


Higher mean MEQ scores were found in the open discussion group ( @ % ) compared with those taught by lecture ( @ % ) , exhibiting significant difference ( p < @ ) .


With respect to MCQ@ and MCQ@ , students in the open discussion group had higher scores than those in the lecture group ) , was also with statistical significance ( p = @ ) .


Teaching medicine differs from other disciplines .


To achieve the most effective teaching performance , teaching methods may be limited in some subjects .


This study was a partial project for teaching in the Department of Surgery .


It was shown that students in the open discussion group had better MCQ and MEQ scores than those in the lecture group .


In developing student skills , giving open discussion provided greater interaction between instructors and students .


Importantly , the instructor should manage and facilitate questioning techniques to more effectively transfer course content .


Sublingual immunotherapy ( SLIT ) is recommended for allergic diseases .


However , clinical studies containing evidence-based data of this treatment in young children , which is rarely reported in the literature , are needed .


This study was designed to assess the efficacy and safety of SLIT in children , including very young children .


Two hundred sixty-four children aged @-@ years old ( @ children , @-@ years old ) with Dermatophagoides farinae-induced allergic rhinitis with or without asthma treated by standard pharmacotherapy had randomly received either SLIT ( SLIT group ) or no SLIT ( control group ) for @ months .


Symptoms , medications , visual analog scale ( VAS ) and presence of adverse events ( AEs ) were assessed at monthly visits .


Skin-prick test and Dermatophagoides farinae-specific IgE and IgG@ were measured before and after treatment .


Both treatments were effective in the global clinical scores during the first seven visits when compared with baseline ( all , p < @ ) , and SLIT showed lower symptoms scores and VAS scores throughout this period ( all , p < @ ) .


These improvements continued until the later visits only in the SLIT group .


Also , the asthma medication consumption was decreased by SLIT treatment only at the end of study ( p < @ ) .


The specific IgG@ was significantly increased after SLIT treatment when compared with the control group , but no significant change of specific IgE was observed in either groups .


In the SLIT group , there was no significant difference between children less than or more than @ years old in terms of clinical efficacy , onset of action , immunologic parameters , and safety .


No severe systemic AEs were reported .


SLIT is effective and well-tolerated in children with allergic rhinitis @-@ years old .


This study was performed to prospectively and independently validate the Global Antiphospholipid Syndrome Score ( GAPSS ) , a system derived from the combination of independent risk factors for thrombosis , including antiphospholipid antibodies ( aPL ) and conventional cardiovascular risk factors .


The GAPSS was applied to @ consecutive systemic lupus erythematosus patients , all positive for aPL and prospectively followed up for mean SD @ @ months .


Of them , @ were women with a mean SD age of @ @ years at entry .


The GAPSS was calculated yearly for each patient by adding together the points corresponding to the risk factors .


An increase in the GAPSS ( entry versus last visit ) was seen in patients who experienced vascular events ( n = @ , mean SD @ @ versus @ @ ; P = @ ) .


No changes were observed in those without thrombosis ( n = @ , mean SD @ @ versus @ @ ; P = @ ) .


An increase in the GAPSS during the followup was associated with a higher risk of vascular events ( relative risk @ -LSB- @ % confidence interval ( @ % CI ) @-@ @ -RSB- , P = @ ) , and an increase of more than @ points showed the best risk accuracy for vascular events ( hazard ratio @ -LSB- @ % CI @-@ @ -RSB- , P = @ ) .


The cumulative proportion of thrombosis-free individuals was lower in patients whose GAPSS was increased by @ or more points ( P = @ ) .


We have prospectively demonstrated that GAPSS is a valid tool for accurate prediction of vascular events in SLE patients with aPL .


Among patients infected with human immunodeficiency virus ( HIV ) , visceral adiposity is associated with metabolic dysregulation and ectopic fat accumulation .


Tesamorelin , a growth hormone-releasing hormone analog , specifically targets visceral fat reduction but its effects on liver fat are unknown .


To investigate the effect of tesamorelin on visceral and liver fat .


Double-blind , randomized , placebo-controlled trial conducted among @ antiretroviral-treated HIV-infected men and women with abdominal fat accumulation at Massachusetts General Hospital in Boston .


The first patient was enrolled on January @ , @ ; for the final patient , the @-month study visit was completed on September @ , @ .


Participants were randomized to receive tesamorelin , @ mg ( n = @ ) , or placebo ( n = @ ) , subcutaneously daily for @ months .


Primary end points were changes in visceral adipose tissue and liver fat .


Secondary end points included glucose levels and other metabolic end points .


Forty-eight patients received treatment with study drug .


Tesamorelin significantly reduced visceral adipose tissue ( mean change , -@ cm@ -LSB- @ % CI , -@ to -@ cm@ -RSB- with tesamorelin vs @ cm@ -LSB- @ % CI , -@ to @ cm@ -RSB- with placebo ; treatment effect , -@ cm@ -LSB- @ % CI , -@ to -@ cm@ -RSB- ; P = @ ) and liver fat ( median change in lipid to water percentage , -@ % -LSB- interquartile range -LCB- IQR -RCB- , -@ % to @ % -RSB- with tesamorelin vs @ % -LSB- IQR , -@ % to @ % -RSB- with placebo ; P = @ ) over @ months , for a net treatment effect of -@ % in lipid to water percentage .


Fasting glucose increased in the tesamorelin group at @ weeks ( mean change , @ mg/dL -LSB- @ % CI , @-@ mg/dL -RSB- vs @ mg/dL -LSB- @ % CI , -@ to @ mg/dL -RSB- in the placebo group ; treatment effect , @ mg/dL -LSB- @ % CI , @-@ mg/dL -RSB- ; P = @ ) , but changes at @ months in fasting glucose ( mean change , @ mg/dL -LSB- @ % CI , -@ to @ mg/dL -RSB- with tesamorelin vs @ mg/dL -LSB- @ % CI , -@ to @ mg/dL -RSB- with placebo ; treatment effect , @ mg/dL -LSB- @ % CI , -@ to @ mg/dL -RSB- ; P = @ overall across time points ) and @-hour glucose ( mean change , -@ mg/dL -LSB- @ % CI , -@ to @ mg/dL -RSB- vs -@ mg/dL -LSB- @ % CI , -@ to @ mg/dL -RSB- , respectively ; treatment effect , @ mg/dL -LSB- @ % CI , -@ to @ mg/dL -RSB- ; P = @ overall across time points ) were not significant .


In this preliminary study of HIV-infected patients with abdominal fat accumulation , tesamorelin administered for @ months was associated with reductions in visceral fat and additionally with modest reductions in liver fat .


Further studies are needed to determine the clinical importance and long-term consequences of these findings .


The phase III Zostavax Efficacy and Safety Trial of @ dose of licensed zoster vaccine ( ZV ; Zostavax ; Merck ) in @-@-year-olds showed approximately @ % vaccine efficacy ( VE ) to reduce the incidence of herpes zoster ( HZ ) .


An objective of the trial was to assess immune response biomarkers measuring antibodies to varicella zoster virus ( VZV ) by glycoprotein-based enzyme-linked immunosorbent assay as correlates of protection ( CoPs ) against HZ .


The principal stratification vaccine efficacy curve framework for statistically evaluating immune response biomarkers as CoPs was applied .


The VE curve describes how VE against the clinical end point ( HZ ) varies across participant subgroups defined by biomarker readout measuring vaccine-induced immune response .


The VE curve was estimated using several subgroup definitions .


The fold rise in VZV antibody titers from the time before immunization to @ weeks after immunization was an excellent CoP , with VE increasing sharply with fold rise : VE was estimated at @ % for the subgroup with no rise and at @ % for the subgroup with @-fold rise .


In contrast , VZV antibody titers measured @ weeks after immunization did not predict VE , with similar estimated VEs across titer subgroups .


The analysis illustrates the value of the VE curve framework for assessing immune response biomarkers as CoPs in vaccine efficacy trials .


Immunogenicity and safety of the HPV-@ / @ AS@-adjuvanted vaccine were evaluated up to @ years postvaccination ( month @ ) in preteen/adolescent girls .


Participants , who had received @ HPV-@ / @ AS@-adjuvanted vaccine doses at @-@ years of age in an initial controlled , observer-blinded , randomized study ( NCT@ ) and participated in the open @-year follow-up ( NCT@ ) , were invited to continue the follow-up for up to @ years postvaccination ( NCT@ ) .


Anti-HPV-@ and -@ antibody titers were measured by enzyme-linked immunosorbent assays at yearly visits and were used to fit the modified power-law and piecewise models , predicting long-term immunogenicity .


Serious adverse events ( SAEs ) and pregnancy information were recorded .


In the according-to-protocol immunogenicity cohort , all participants ( N = @ ) with data available remained seropositive for anti-HPV-@ and -@ antibodies at month @ .


In initially seronegative participants , anti-HPV-@ and -@ antibody geometric mean titers were @ - and @-fold higher than those associated with natural infection ( NCT@ ) and @ - and @-fold higher than those measured at month @-@ in a study demonstrating vaccine efficacy in women aged @-@ years ( NCT@ ) .


Exploratory antibody modeling , based on the @-year data , predicted that vaccine-induced population anti-HPV-@ and -@ antibody geometric mean titers would remain above those associated with natural infection for at least @ years postvaccination .


The HPV-@ / @ AS@-adjuvanted vaccine safety profile was clinically acceptable .


In preteen/adolescent girls , the HPV-@ / @ AS@-adjuvanted vaccine induced high anti-HPV-@ and -@ antibody levels up to @ years postvaccination , which were predicted to remain above those induced by natural infection for at least @ years .


The currently recommended duration of dual antiplatelet therapy ( DAPT ) in drug-eluting stent ( DES ) recipients is @ months to reduce the risk of late stent thrombosis , particularly in those with acute coronary syndrome ( ACS ) .


This study hypothesized that antiplatelet treatment with DAPT for @ months may be noninferior to @-month DAPT in aspirin-sensitive patients .


A multicenter , randomized study assigned patients undergoing implantation of everolimus-eluting stents with confirmed nonresistance to aspirin to receive @ - or @-month DAPT .


The primary endpoint was a composite of death , myocardial infarction , urgent target vessel revascularization , stroke , and major bleeding at @ months post-stenting .


A total of @,@ patients were enrolled in @ European and Middle Eastern centers .


The trial was prematurely terminated due to recruitment problems , leaving @ patients randomized to @-month DAPT and @ to @-month DAPT .


The @ treatment groups had similar baseline and procedural characteristics .


There was no significant difference in the primary endpoint ( @-month : @ % vs. @-month : @ % ; p = @ ) .


Noninferiority was demonstrated for @ - versus @-month DAPT , with an absolute risk difference of @ % ( @ % confidence interval : -@ % to @ % ; p for noninferiority = @ ) .


There were no significant differences in stent thrombosis or bleeding complications .


In the @ ( @ % ) high-risk patients with ACS , primary and secondary endpoints did not significantly differ ( hazard ratio : @ -LSB- @ % confidence interval : @ to @ ; p = @ -RSB- ) .


Rates of bleeding and thrombotic events were not significantly different according to @ - versus @-month DAPT after PCI with new-generation DES in good aspirin responders .


( Is There A LIfe for DES After Discontinuation of Clopidogrel -LSB- ITALICplus -RSB- ; NCT@ ) .


Arthroscopic subacromial decompression may cause substantial postoperative pain .


We undertook a randomized controlled trial to examine whether adding dexmedetomidine to the local anesthetic in an interscalene brachial plexus block and subsequent patient-controlled interscalene analgesia ( PCIA ) regime improved postoperative pain scores , patient satisfaction , rescue analgesic requirement , and local anesthetic consumption .


A total of @ patients aged between @ and @ years undergoing arthroscopic subacromial decompression were enrolled and randomized into @ of the @ groups .


Group L ( n = @ ) received levobupivacaine and epinephrine , whereas Group LD ( n = @ ) received levobupivacaine , epinephrine , and dexmedetomidine through an interscalene catheter .


Four hours after surgery , a PCIA regime was commenced .


In Group L patients were administered levobupivacaine and in Group LD levobupivacaine and dexmedetomidine .


Demographic and hemodynamic data , duration of motor and sensory blocks , pain VAS , side effects , PCIA demand and delivery values , consumption of lornoxicam as a rescue analgesic , and patient satisfaction were recorded for @ hours after surgery .


PCIA demand and delivery , and pain VAS values were significantly lower , and patient satisfaction was significantly higher in the dexmedetomidine group ( P = @ , @ , @ , and @ , respectively ) .


The side effect profile was similar between the groups .


Levobupivacaine consumption was significantly lower in Group LD ( P = @ ) .


In the first @ postoperative hours , Group LD consumed significantly less lornoxicam ( P = @ ) .


Addition of dexmedetomidine to levobupivacaine for interscalene brachial plexus block decreases pain scores and increases patient satisfaction after arthroscopic subacromial decompression .


Iron-deficient erythropoiesis results in excess formation of zinc protoporphyrin ( ZPP ) , which can be measured instantly and at low assay cost using portable haematofluorometers .


ZPP is used as a screening marker of iron deficiency in individual pregnant women and children , but also to assess population iron status in combination with haemoglobin concentration .


We examined associations between ZPP and disorders that are common in Africa .


In addition , we assessed the diagnostic utility of ZPP ( measured in whole blood and erythrocytes ) , alone or in combination with haemoglobin concentration , in detecting iron deficiency ( plasma ferritin concentration < @ g/L ) .


Single blood samples were collected from a population sample of @ rural Kenyan women with singleton pregnancies , gestational age @ to @ weeks , and haemoglobin concentration @ g/L .


We used linear regression analysis to assess associations between ZPP and iron markers ( including anaemia ) , factors known or suspected to be associated with iron status , inflammation markers ( plasma concentrations of C-reactive protein and @-acid glycoprotein ) , infections ( Plasmodium infection , HIV infection ) , and other disorders ( ( + ) - thalassaemia , plasma concentrations of total bilirubin , and lactate dehydrogenase ) .


Subsequently , in those without inflammation , Plasmodium infection , or HIV infection , we used logistic discriminant analysis and examined receiver operating characteristics curves with corresponding area-under-the-curve to assess diagnostic performance of ZPP , alone and in combination with haemoglobin concentration .


Individually , whole blood ZPP , erythrocyte ZPP , and erythrocyte protoporphyrin had limited ability to discriminate between women with and without iron deficiency .


Combining each of these markers with haemoglobin concentration had no additional diagnostic value .


Conventional cut off points for whole blood ZPP ( > @ mol/mol haem ) resulted in gross overestimates of the prevalence of iron deficiency .


Erythrocyte ZPP has limited value to rule out iron deficiency when used for screening in conditions with a low prevalence ( e.g. , @ % ) .


ZPP is of unreliable diagnostic utility when discriminating between pregnant women with and without iron deficiency .


Based on these findings , guidelines on the use of ZPP to assess iron status in individuals or populations of pregnant women need review .


To evaluate hepatic fat fraction on dual - and triple-echo gradient-recalled echo MRI sequences in healthy children .


We retrospectively reviewed the records of children in a medical check-up clinic from May @ to November @ .


We excluded children with abnormal laboratory findings or those who were overweight .


Hepatic fat fraction was measured on dual - and triple-echo sequences using @T MRI .


We compared fat fractions using the Wilcoxon signed rank test and the Bland-Altman @ % limits of agreement .


The correlation between fat fractions and clinical and laboratory findings was evaluated using Spearman 's correlation test , and the cut-off values of fat fractions for diagnosing fatty liver were obtained from reference intervals .


In @ children ( M : F = @:@ ; @-@ years ; mean @ years ) , the dual fat fraction ( @-@ @ % ; median @ % ) was not different from the triple fat fraction ( @-@ @ % ; median @ % ) ( p = @ ) .


The dual - and triple-echo fat fractions showed good agreement using a Bland-Altman plot ( -@ @ % ) .


Eight children ( @ % ) on dual-echo sequences and six ( @ % ) on triple-echo sequences had greater than @ % fat fraction .


From these children , six out of eight children on dual-echo sequences and four out of six children on triple-echo sequences had a @-@ % hepatic fat fraction .


When using a cut-off value of a @ % fat fraction derived from a reference interval , only @ % of children were diagnosed with fatty liver .


There was no significant correlation between clinical and laboratory findings with dual and triple-echo fat fractions .


Dual fat fraction was not different from triple fat fraction .


We suggest a cut-off value of a @ % fat fraction is more appropriate for diagnosing fatty liver on both dual - and triple-echo sequences in children .


The aim of this study was to investigate the effect of growing-up milk ( GUM ) with added short-chain galacto-oligosaccharides ( scGOS ) / long-chain fructo-oligosaccharides ( lcFOS ) ( @:@ ) ( Immunofortis ) and n-@ long-chain polyunsaturated fatty acids ( LCPUFAs ) on the occurrence of infections in healthy children attending day care centres .


In a randomised double-blind controlled , parallel , multicountry intervention study , @ healthy children , ages @ to @ months , received GUM with scGOS/lcFOS/LCPUFAs ( the active group , n = @ ) , GUM without scGOS/lcFOS/LCPUFAs ( the control group , n = @ ) , or cow 's milk ( n = @ ) for @ weeks .


The primary outcome measure was the number of episodes of upper respiratory tract infections or gastrointestinal infections based on a combination of subject 's illness symptoms reported by the parents during the intervention period .


Children in the active group compared with the control group had a decreased risk of developing at least @ infection ( @/@ -LSB- @ % -RSB- vs @/@ -LSB- @ % -RSB- , respectively , relative risk @ , @ % confidence interval -LSB- CI -RSB- @-@ @ ; logistic regression P = @ ) .


There was a trend toward a reduction ( P = @ ) in the total number of infections in the active group , which was significant when confirmed by one of the investigators ( @/@ -LSB- @ % -RSB- vs @/@ -LSB- @ % -RSB- , respectively , relative risk @ , @ % CI @-@ @ ; P = @ , post hoc ) .


More infectious episodes were observed in the cow 's milk group , when compared with both GUM groups ( @/@ -LSB- @ % -RSB- vs @/@ -LSB- @ % -RSB- , respectively , relative risk @ , @ % CI @-@ @ ) .


This is the first study in children to show a reduced risk of infection following consumption of GUM supplemented with scGOS/lcFOS/n -@ LCPUFAs .


The borderline statistical significance justifies a new study to confirm this finding .


Obesity and overweight are the fifth most fatal diseases leading to an increased rate of morbidity and mortality in global population , with its incidence increasing drastically .


Taking this into consideration we have conducted the present study in order to explore the efficacy of plant based formulation in the management of adolescent obesity and its associated biomarkers .


Randomized , double blind , placebo controlled trial was conducted in @ obese adolescent of both sexes , with BMI above @kg/m ( @ ) .


The subjects were randomly assigned into test formulation group ( TFG ) and placebo group ( PG ) .


TFG received two @mg capsule containing test formulation whereas , the PG received two @mg of cellulose powder containing capsule daily for @ months .


The parameters such as blood pressure , inflammatory cytokines , adipokines and lipid profile were assessed in all subjects pre and post treatment .


There was a considerable improvement in the levels of lipid profile , inflammatory cytokines , adipokines and blood pressure after treatment in TFG compared to PG .


The statistical difference obtained between the groups after three months of treatment for the various biomarkers are given as mean with @ % CI for BMI ( -@ ( -@ to -@ ) ) , total cholesterol mg/dl ( -@ ( -@ to -@ ) ) , triglyceride mg/dl ( -@ ( -@ to -@ ) ) , HDL-c mg/dl ( @ ( @-@ @ ) ) , IL-@ ( -@ ( -@ to -@ ) ) , hs C-reactive protein ( CRP ) mg/l ( -@ ( -@ to -@ ) ) , adiponectin g/ml ( @ ( @-@ @ ) ) , leptin ng/ml ( -@ ( -@ to -@ ) ) , diastolic blood pressure ( DBP ) mmHg ( -@ ( -@ to -@ ) ) and systolic blood pressure ( SBP ) mmHg ( -@ ( -@ to -@ ) ) .


Also , there was a statistical significance within group TFG .


The study concludes that the test formulation may prevent the future cardio vascular risk incidence in obese adolescents by reducing inflammation , overweight , lipid profile and by regulating adipokines .


Thus it may help to improve the health pattern in obese patients with least side effects .


To investigate whether ambient orange fragrance , compared with no fragrance , can reduce patient anxiety before and during surgical removal of an impacted mandibular third molar .


In the present randomized clinical trial , the patients who required extraction of an impacted mandibular third molar and fulfilled the predetermined criteria were included .


A dental anxiety scale ( DAS ) questionnaire was used to determine the anxiety level of the patients before surgery .


Only patients with moderate and high anxiety levels ( DAS scale @ to @ ) were included .


The predictor variable was fragrance exposure .


The fragrance group was exposed to orange fragrance , and the control group was exposed to no fragrance .


The outcome variables were physiologic measures related to anxiety , including the mean blood pressure , respiratory rate , and pulse rate .


The physiologic vital changes were determined before and during the surgical procedure .


The data were analyzed using the independent t test , ( @ ) test , and Mann-Whitney U test ( Statistical Package for Social Sciences , version @ ; = @ ) .


A total of @ patients fulfilled the inclusion criteria ( fragrance group , @ males and @ females ; no-fragrance group , @ males and @ females ) .


Before entering the waiting room , the patients ' vital signs were recorded twice .


No significant differences were found between the @ groups .


The mean blood pressure , pulse rate , and respiratory rate were significantly lower in the fragrance group during surgery ( from sitting in the dental chair to the end of surgery ; P < @ ) .


The results of our study have shown that orange fragrance is effective in reducing the anxiety related to surgical removal of an impacted mandibular third molar .


Many patients with acromegaly do not achieve biochemical control despite receiving high doses of the first-generation somatostatin analogues octreotide or lanreotide .


In the PAOLA trial , we aimed to assess the efficacy and safety of two different doses of the somatostatin analogue pasireotide long-acting release compared with active control ( octreotide or lanreotide ) in patients with inadequately controlled acromegaly .


In a multicentre , randomised , phase @ trial , we enrolled eligible patients aged @ years or older with acromegaly who were inadequately controlled ( @-point , @ h mean growth hormone concentration > @ g/L and insulin-like growth factor @ -LSB- IGF-@ -RSB- concentration > @ times the upper normal limit ) and had received @ mg octreotide long-acting repeatable or @ mg lanreotide ( Somatuline Autogel ; Ipsen , UK ) as monotherapy for @ months or longer .


We randomly assigned patients in a @:@:@ ratio with an interactive voice-web response system to receive @ mg pasireotide long-acting release once every @ days for @ weeks , @ mg pasireotide long-acting release once every @ days for @ weeks , or continued treatment with octreotide or lanreotide ( active control ) .


Patients were stratified according to previous treatment ( octreotide or lanreotide ) and growth hormone concentrations at screening ( @-@ g/L and > @ g/L ) .


Patients and study investigators were not masked to study drug assignment but were masked to pasireotide dose allocation .


The primary endpoint was number of patients achieving biochemical control , defined as mean growth hormone concentration less than @ g/L and normalised IGF-@ concentration .


Efficacy analyses were based on intention to treat .


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


Between Dec @ , @ , and Aug @ , @ , @ patients were enrolled and randomly assigned to pasireotide @ mg ( n = @ ) , pasireotide @ mg ( n = @ ) , or active control ( n = @ ) groups .


At @ weeks , ten ( @ % ) patients in the pasireotide @ mg group and @ ( @ % ) patients in the pasireotide @ mg group achieved biochemical control , compared with no patients in the active control group ( absolute difference from control group @ % , @ % CI @-@ , p = @ for pasireotide @ mg group , @ % , @-@ , p < @ for pasireotide @ mg group ) .


The most common adverse events were hyperglycaemia ( @ -LSB- @ % -RSB- for treatment with @ mg pasireotide , @ -LSB- @ % -RSB- with @ mg pasireotide , and nine -LSB- @ % -RSB- with active control ) , diabetes ( @ -LSB- @ % -RSB- , @ -LSB- @ % -RSB- , and five -LSB- @ % -RSB- ) , and diarrhoea ( ten -LSB- @ % -RSB- , @ -LSB- @ % -RSB- , and three -LSB- @ % -RSB- ) ; most were grade @ or @ in severity .


Serious adverse events were reported in six ( @ % ) patients in the pasireotide @ mg group , two ( @ % ) in the pasireotide @ mg group , and three ( @ % ) in the active control group .


Pasireotide provides superior efficacy compared with continued treatment with octreotide or lanreotide , and could become the new standard pituitary-directed treatment in patients with acromegaly who are inadequately controlled using first-generation somatostatin analogues .


To test efficacy and durability of a polyphenol-based prebiotic treatment for acute gastroenteritis in a @ patient double-blinded clinical study .


A two-arm randomized , double-blinded , placebo-controlled clinical study was conducted at two public health centers in Managua , Nicaragua .


Potential subjects who qualified based on inclusion and exclusion criteria were randomly assigned to one of two treatment arms .


Two thirds of the subjects ( n = @ ) received a single titrated @-@ ounce liquid dose of a novel polyphenol-based prebiotic ( Aliva ( TM ) ) diluted with @ to eight ounces of oral rehydration solution ( ORS ) .


One third of the subjects ( n = @ ) were randomized to receive two liquid ounces of a taste and color-matched placebo diluted in eight ounces of ORS .


The outcome variables measured included stool consistency , stomach discomfort , gas and bloating , and heartburn/indigestion .


The study subjects ranked their stool consistency and the severity of their subjective symptoms at specified intervals from immediately prior to treatment , to five days post treatment .


All subjects recorded their symptoms in a study diary .


The study subjects also recorded the time and consistencies of all stools in their study diary .


Stool consistency was compared to the picture and descriptions on the Bristol Stool Chart , and any stool rated greater than Type @ was considered unformed .


The clinical study team reviewed the study diaries with subjects during daily follow-up calls and close-out visits , and recorded the data in case report forms .


After receiving a single dose , Aliva treated subjects reported shorter median time to their last unformed stool ( @ h @ min ) than placebo treated subjects ( @ h @ min . )


, a statistically significant difference -LSB- @ % CI : -@ - ( -@ ) , P = @ -RSB- .


Aliva treated subjects also reported shorter median their time to last unformed stool ( TTLUS ) ( @ hrs @ min ) than placebo treated subjects ( @ h @ min ) , which was also a statistically significant difference ( P = @ ) .


The percentage of subjects recording TTLUS was greater for those who received Aliva vs placebo at @ min ( P = @ ) , @ h ( P = @ ) , @ h ( P = @ ) , @ h ( P = @ ) , @ h ( P = @ ) , and @ d ( P = @ ) post dose .


There were @ study subjects @ years old or older , which was the criteria set for reliable self-reporting of subjective symptoms .


Of those @ subjects , @ reported stomach pain and discomfort during screening .


From @ minutes -LSB- @ % CI : -@ - ( -@ ) , P = @ -RSB- through @ d -LSB- @ % CI : -@ - ( -@ ) , P = @ ) , the subjects treated with Aliva experienced significantly less stomach pain and discomfort than those who received placebo .


Of those same @ participants , @ subjects reported gas and bloating during screening .


Similarly , subjects who received Aliva experienced significantly less gas and bloating from @ h -LSB- @ % CI : -@ - ( -@ ) , P = @ -RSB- through @ d ( @ % CI : -@ -@ , P = @ ) compared with the placebo arm .


In this double-blind , randomized clinical study , subjects with acute gastroenteritis receiving Aliva prebiotic showed significant and sustained improvement of multiple symptoms vs those receiving placebo .


Recent studies have demonstrated that mesenchymal stem cells ( MSCs ) modulate the immune response and reduce lung injury in animal models .


Currently , no clinical studies of the effects of MSCs in acute respiratory distress syndrome ( ARDS ) exist .


The objectives of this study were first to examine the possible adverse events after systemic administration of allogeneic adipose-derived MSCs in ARDS patients and second to determine potential efficacy of MSCs on ARDS .


Twelve adult patients meeting the Berlin definition of acute respiratory distress syndrome with a PaO@/FiO@ ratio of < @ were randomized to receive allogeneic adipose-derived MSCs or placebo in a @:@ fashion .


Patients received one intravenous dose of @ @ cells/kg of body weight or saline .


Possible side effects were monitored after treatment .


Acute lung injury biomarkers , including IL-@ , IL-@ and surfactant protein D ( SP-D ) , were examined to determine the effects of MSCs on lung injury and inflammation .


There were no infusion toxicities or serious adverse events related to MSCs administration and there were no significant differences in the overall number of adverse events between the two groups .


Length of hospital stay , ventilator-free days and ICU-free days at day @ after treatment were similar .


There were no changes in biomarkers examined in the placebo group .


In the MSCs group , serum SP-D levels at day @ were significantly lower than those at day @ ( p = @ ) while the changes in IL-@ levels were not significant .


The IL-@ levels at day @ showed a trend towards lower levels as compared with day @ , but this trend was not statistically significant ( p = @ ) .


Administration of allogeneic adipose-derived MSCs appears to be safe and feasible in the treatment of ARDS .


However , the clinical effect with the doses of MSCs used is weak , and further optimization of this strategy will probably be required to reach the goal of reduced alveolar epithelial injury in ARDS .


Research in health communication has shown that narratives contribute more positively to changing health behaviors than informational messages .


The main purposes of this study were to examine and to compare the effects of two messages promoting physical activity , one narrative and the other informational , on the perceptions and behavioral intentions of cancer patients .


A total of @ women with breast cancer , undergoing chemotherapy and sedentary , were assigned to read the testimony of a breast cancer survivor who had been physically active during and after treatment ( TE group ) , a content-equivalent message composed of expert recommendations about physical activity in breast cancer patients ( RE group ) , or no message ( control group ) .


Source trust was higher in TE group than RE group ( p < @ ) .


Exercise self-efficacy and exercise intention were higher in TE group than RE and control groups ( p < @ ) .


However , scores in RE group were higher than those of TE group for beliefs about exercise benefits ( p < @ ) and lower than those of TE and control groups for beliefs about exercise risks ( p < @ ) .


Source trust , exercise self-efficacy , and beliefs about exercise benefits and risks mediated the relationship between the message and exercise intention .


The results suggest that narratives may be more effective in improving perceived physical abilities and involvement in physical activity , whereas informational messages seem to be more appropriate to convey the benefits and the absence of risks related to physical activity .


The aim of this study was to investigate etomidate administration with or without flumazenil in autistic children who underwent intrathecal transplantation of stem cells by lumbar puncture .


Forty autistic children aged @-@ , who were scheduled for stem cell transplantation via lumbar puncture under anesthesia , were randomized for a double-blind study .


The children were randomly assigned to two groups : the flumazenil group ( group F , n = @ ) and the etomidate group ( group E , n = @ ) .


All children received @ mg/kg of etomidate .


In the case of inadequate anesthesia , patients received repeated doses of @ mg/kg of etomidate until reaching deep sedation .


After operation , children in group F were given flumazenil ( @ mg/kg ) and children in group E received placebo .


Heart rate ( HR ) , mean arterial pressure , oxygen saturation , respiratory rate , the Ramsay sedation score ( RSS ) , and recovery time of all children were continuously monitored and recorded during the entire procedure .


After anesthesia , blood pressure and HR measurements were not significantly changed in both groups compared with the baseline .


There were no respiratory depression , bradycardia , hypotension , nausea , and vomiting .


Five patients complained of pain on the site of injection .


Myoclonus occurred in seven patients .


Recovery time in group F was significantly shorter than in group E ( p < @ ) , and after the injection of flumazenil , RSS in group F significantly decreased than in group E.


There were no significant differences in operation time .


Physician satisfaction in both groups was similar .


Etomidate resulted in stable hemodynamic responses and relatively less adverse effects , and flumazenil antagonized the anesthetic effect of etomidate ; thus , etomidate with flumazenil is suitable for performing stem cell transplantation in autistic children .


To evaluate the effects of heated humidified ventilation on mucociliary function during general anaesthesia .


Male patients ( ASA physical status @ or @ ) , scheduled for elective radical retropubic prostatectomy , were allocated to receive sevoflurane general anaesthesia with conventional or heated humidified ventilation .


Bronchial mucus transport velocity was assessed via fibreoptic bronchoscope and methylene blue dye at @h after induction of anaesthesia .


Median ( SE ) bronchial mucus transport velocity was significantly higher in the heated humidified group ( n = @ ) than the conventional ventilation group ( n = @ ) ( @ -LSB- @ -RSB- mm/min vs @ -LSB- @ -RSB- mm/min ) .


Heated humidified ventilation effectively maintains mucociliary clearance of patients during sevoflurane general anaesthesia .


Babies born after midtrimester preterm prelabour rupture of membranes ( PPROM ) are at risk to develop neonatal pulmonary hypoplasia .


Perinatal mortality and morbidity after this complication is high .


Oligohydramnios in the midtrimester following PPROM is considered to cause a delay in lung development .


Repeated transabdominal amnioinfusion with the objective to alleviate oligohydramnios might prevent this complication and might improve neonatal outcome .


Women with PPROM and persisting oligohydramnios between @ and @ weeks gestational age will be asked to participate in a multi-centre randomised controlled trial .


random allocation to ( repeated ) abdominal amnioinfusion ( intervention ) or expectant management ( control ) .


The primary outcome is perinatal mortality .


Secondary outcomes are lethal pulmonary hypoplasia , non-lethal pulmonary hypoplasia , survival till discharge from NICU , neonatal mortality , chronic lung disease ( CLD ) , number of days ventilatory support , necrotizing enterocolitis ( NEC ) , periventricular leucomalacia ( PVL ) more than grade I , severe intraventricular hemorrhage ( IVH ) more than grade II , proven neonatal sepsis , gestational age at delivery , time to delivery , indication for delivery , successful amnioinfusion , placental abruption , cord prolapse , chorioamnionitis , fetal trauma due to puncture .


The study will be evaluated according to intention to treat .


To show a decrease in perinatal mortality from @ % to @ % , we need to randomise two groups of @ women ( two sided test , - error @ and - error @ ) .


This study will answer the question if ( repeated ) abdominal amnioinfusion after midtrimester PPROM with associated oligohydramnios improves perinatal survival and prevents pulmonary hypoplasia and other neonatal morbidities .


Moreover , it will assess the risks associated with this procedure .


Aiming at partly controlled asthma ( PCa ) instead of controlled asthma ( Ca ) might decrease asthma medication use .


Biomarkers , such as the fraction of exhaled nitric oxide ( Feno ) , allow further tailoring of treatment .


We sought to assess the cost-effectiveness and clinical effectiveness of pursuing PCa , Ca , or Feno-driven controlled asthma ( FCa ) .


In a nonblind , pragmatic , cluster-randomized trial in primary care , adults ( @-@ years of age ) with a doctor 's diagnosis of asthma who were prescribed inhaled corticosteroids were allocated to one of @ treatment strategies : ( @ ) aiming at PCa ( Asthma Control Questionnaire -LSB- ACQ -RSB- score < @ ) ; ( @ ) aiming at Ca ( ACQ score < @ ) ; and ( @ ) aiming at FCa ( ACQ score < @ and Feno value < @ ppb ) .


During @ months ' follow-up , treatment was adjusted every @ months by using an online decision support tool .


Outcomes were incremental cost per quality-adjusted life year gained , asthma control ( ACQ score ) , quality of life ( Asthma Quality of Life Questionnaire score ) , asthma medication use , and severe exacerbation rate .


Six hundred eleven participants were allocated to the PCa ( n = @ ) , Ca ( n = @ ) , or FCa ( n = @ ) strategies .


The FCa strategy improved asthma control compared with the PCa strategy ( P < @ ) .


There were no differences in quality of life ( P @ ) .


Asthma medication use was significantly lower for the PCa and FCa strategies compared with the Ca strategy ( medication costs : PCa , $ @ ; Ca , $ @ ; and FCa , $ @ ; P @ ) .


The FCa strategy had the highest probability of cost-effectiveness at a willingness to pay of $ @,@ / quality-adjusted life year ( @ % ; PCa , @ % ; Ca , @ % ) .


There were no differences in severe exacerbation rate .


A symptom - plus Feno-driven strategy reduces asthma medication use while sustaining asthma control and quality of life and is the preferred strategy for adult asthmatic patients in primary care .


To determine the feasibility of a novel low-barrier-to-entry image guidance system .


Initially a randomized crossover study was performed to establish the interface ( iPad or @-dimensional mouse ) that minimized both the amount of time required to perform a manual image registration and the error of that registration .


A subsequent clinical feasibility study was undertaken on @ patients undergoing robot-assisted partial nephrectomy .


Randomized crossover study primary outcomes were time to task completion , NASA-Task Load Index score , and alignment error ( translational and rotational ) .


The Mann-Whitney U test was used to compare groups .


Surgeon feedback was sought when assessing the system in a clinical setting .


In the initial randomized crossover study , the iPad-based system was able to achieve adequate alignment accuracy ( Frobenius norm of @ ; total error of @ mm ) in significantly less time ( @ seconds ; P < @ ) than the @-dimensional mouse interface .


The platform received good feedback from the operating surgeon in all instances with the surgeon commenting particularly on the improved appreciation of hilar vascular anatomy .


In this study , we have demonstrated the feasibility of a `` low-barrier-to-entry '' image guidance system in a clinical setting .


The system was able to achieve swift and sufficiently accurate alignment , with little impact on the surgical workflow .


BMS-@ is a novel antidepressant that selectively inhibits the reuptake of serotonin , norepinephrine , and dopamine .


This Phase I study assessed safety , tolerability , and pharmacokinetics of multiple daily doses of BMS-@ in healthy subjects .


Central serotonin transporter ( SERT ) and dopamine transporter ( DAT ) occupancy were assessed using positron emission tomography and -LSB- ( @ ) C -RSB- MADAM or -LSB- ( @ ) C -RSB- PE@I , respectively .


Fifty-seven healthy volunteers were enrolled in this double-blind , placebo-controlled , ascending multiple-dose study ( ClincalTrials.gov identifier : NCT@ ) .


Eight participants in seven dose cohorts received oral doses of BMS-@ ( @-@mg ) or placebo for @days to assess safety , tolerability , and pharmacokinetics .


Additionally , SERT and DAT occupancies were evaluated in @-@ subjects per cohort at @h post-dose on Day @ and @h post-dose on Day @ at anticipated steady-state conditions .


Most adverse events were mild to moderate ; there were no serious safety concerns .


Median maximum concentrations of BMS-@ were observed at @-@ @ h post-dose ; estimated elimination half-life was @-@h .


About @ % striatal SERT occupancy was achieved after multiple doses of @ mg BMS-@ at both @ and @h post-dose .


Striatal DAT occupancy ranged between @ % and @ % at @h post-dose with a slight decline at @h post-dose .


Multiple daily doses of up to @mg BMS-@ appeared to be generally safe and well tolerated in a healthy population .


SERT and DAT occupancies were in a range associated with therapeutic efficacy of antidepressants .


Together with the pharmacokinetic profile of BMS-@ , the occupancy data support once-daily administration .


Stroke is a devastating complication of coronary artery bypass grafting ( CABG ) .


This study was carried out with the aim that the development of off pump coronary artery surgery decreases the incidence/adverse outcome due to extra corporeal circulation .


The data utilized in this study was extracted from a randomized controlled trial that was conducted from January @ to March @ at Punjab Institute of Cardiology .


One hundred patients were included in ` on pump ' group-A , and @ patients in ` off pump ' group-B .


The mean age of the patients in group-A was @ @ years and in group-B it was @ @ years .


Renal failure occurred in @ % patients of group-A as compared to @ % of group-B while Acute Myocardial Infarction occurred in significantly higher number of patients in group-B ( @ % ) as compared to group-A ( @ % ) .


Off pump was associated with significant decrease in rate of stroke @ % as compared to on pump @ % .


similarly there was decreased in the risk of deaths after stroke @ % as compared to on pump @ % mortality after stroke .


In group A @ ( @ % ) patients developed stroke where as in group-B @ ( @ % ) patients developed stroke out of these @ patients there were @ mortalities after stroke in group-A while in group-B there was no mortality after stroke within @ days postoperatively .


Off pump CABG is associated with significantly decreased rate of stroke in comparison with the on-pump CABG .


Early detection of right ventricular ( RV ) and left ventricular ( LV ) dysfunction in patients with repaired tetralogy of Fallot ( TOF ) is essential because dysfunction is correlated with a poor clinical outcome .


The aim of this study was to assess RV and LV function in asymptomatic children with repaired TOF by two-dimensional ultrasound speckle tracking echocardiography ( STE ) .


Fifty-six asymptomatic children with a preserved biventricular ejection fraction ( EF ) after repair of TOF and @ healthy control subjects were studied .


RV and LV strain and strain rate were measured by STE. RVEF and pulmonary regurgitation ( PR ) were assessed using cardiac magnetic resonance imaging .


Compared with the control subjects , RV regional longitudinal strain and strain rate and global longitudinal strain ( GLS ) and strain rate ( GLSR ) were impaired in children with repaired TOF .


Likewise , LV circumferential and radial strain and strain rate were reduced in patients with TOF .


In contrast , longitudinal strain and strain rate did not differ between the groups .


RV and LV GLSR were correlated with postoperative follow-up period ( r@ = -@ ; r@ = -@ ) .


RV GLS and GLSR were associated with RVEF ( r@ = @ ; r@ = @ ) and PR ( r@ = -@ ; r@ = -@ ) .


LV circumferential strain rate was related to PR ( r = -@ ) .


STE can identify abnormalities that may represent early impairment of RV and LV systolic function in postoperative TOF patients with a preserved EF .


PR is associated with decreased biventricular performance in repaired patients .


STE-derived strain and strain rate may be useful indices for detecting the early deterioration of biventricular performance in patients with TOF .


Although mouse brain-derived , inactivated Japanese encephalitis vaccines ( JE-MBs ) have been successfully used for a long time , potential rare neurological complications have prompted the development of a Vero cell culture-derived inactivated vaccine ( JE-VC ) .


In a phase III clinical study , we aimed to compare the safety and immunogenicity of a JE-VC , KD-@ with a JE-MB , JEV-GCC , in children .


In this multicenter , double-blinded , randomized controlled trial , the study population consisted of @ healthy Korean children aged @-@ months .


Each subject was subcutaneously vaccinated with either KD-@ or JEV-GCC twice at an interval of @weeks and then vaccinated once @months after the second vaccination .


Neutralizing antibodies were measured by the plaque reduction neutralization test using the homologous and heterologous , as a post hoc analysis , challenge virus strains .


The three-dose regimen of KD-@ showed a comparable safety profile with JEV-GCC except higher incidence of fever after the first dose ( @ % and @ % , respectively ) .


Most of the fever was mild degree ( @ % and @ % , respectively ) .


KD-@ fulfilled the non-inferiority criteria for seroconversion rate ( SCR ) and geometric mean titer ( GMT ) of the neutralizing antibody , which were the primary endpoints , at @weeks after the third vaccination ( @ % CI : -@ , @ for the SCR difference and @ , @ for the GMT ratio ) .


The SCRs of KD-@ were all @ % and the GMTs were higher in the KD-@ group than in the JEV-GCC group after the second vaccination and before and after the third vaccination ( GMT ratio : @ , @ , and @ , respectively , p < @ in all ) .


GMTs were higher in the KD-@ group in the heterologous analysis also ( GMT ratio : @ , @ , and @ , respectively , p < @ in all ) .


This study suggests that the KD-@ , a JE-VC is as safe as and may be more effective than the licensed MB-derived vaccine .


KD-@ could thus be useful as a second-generation vaccine and substitute for the current JE-MB vaccine in Korean children .


To evaluate the clinical efficacy of acupuncture combined single photon emission computed tomography ( SPECT ) in treating coronary heart disease ( CHD ) and its effect on the myocardial ischemia/perfusion and the recovery of heart functions .


Totally fifty-nine patients with confirmed CHD were randomly assigned to two groups , the acupuncture group ( @ cases ) and the nitroglycerine group ( @ cases ) .


Patients in the acupuncture group were electro-acupunctured at bilateral Neiguan ( PC@ ) and Xinshu ( BL@ ) for @ min with the frequency of @/@ Hz and the current strength @ - @ mA after myocardial imaging induced by routine exercises or drug load .


@mTc-MIBI @ MBq was injected @ min after needling .


The myocardial perfusion imaging was performed immediately after needling .


@mTc-MIBI@ MBq was injected to those in the nitroglycerine group during routine exercises or drug load .


The myocardial perfusion imaging was performed @ min after injection .


Patients were asked to sublingual administration of nitroglycerine @ mg after the myocardial perfusion imaging was completed .


@mTc-MIBI @ MBq was intravenously injected @ min later , and myocardial perfusion imaging was performed @ min after injection .


There was statistical difference in changes of radioactive uptake between before and after treatment in the two groups ( P < @ , P < @ ) .


Both acupuncture and buccal administration of nitroglycerine could increase the blood perfusion of ischemic myocardium .


But there was no statistical difference in the improvement of ischemic myocardial cells ( t = @ , P > @ ) .


Using SPECT could clearly display therapeutic effects of acupuncture on CHD , thus providing a new visible research method for CHD studies .


It is unknown if disposable electrocardiographic lead wires ( ECG-LWs ) reduce infection rates compared with cleaned , reusable lead wires .


To compare infection rates in intensive care unit ( ICU ) patients receiving disposable versus reusable ECG-LWs .


Matched adult ICUs were randomly assigned to disposable or reusable ECG-LWs .


Outcomes were bloodstream infection , ventilator-associated pneumonia , and chest surgical site infections .


Patients ' characteristics and infections were collected from hospital databases .


Event rates were described by using total counts and rates per @ patient days and were compared between groups by using generalized linear mixed-effect models weighted by patients ' ICU length of stay .


Overall , @ patients from @ ICUs received disposable and @ patients from @ ICUs received reusable ECG-LWs .


The characteristics of the @ groups were similar , except patients receiving disposable ECG-LWs were less likely to be discharged home ( P = @ ) and had more comorbid conditions ( P = @ ) .


Overall infection rates did not differ between ECG-LW groups , between groups in matched ICUs , between groups by infection type , or when only patients with ICU stays longer than @ hours were considered ( @ cases ) .


In multivariate analyses , infection rates did not differ between all patients in ECG-LW groups or for patients with ICU stays beyond @ hours ( both P = @ ) .


No difference was observed in infection rates of ICU patients receiving disposable versus reusable ECG-LWs .


The safety and efficacy of dexmedetomidine during laser in situ keratomileusis ( LASIK ) in stressed patients under topical anesthesia has not been fully investigated .


We randomized @ adult patients with ametropia , with a Self-Rating Anxiety Scale score greater than @ , who were undergoing LASIK to receive dexmedetomidine ( DEX group ) , propofol ( P group ) , or placebo .


No differences in baseline characteristics were observed between the groups .


In the DEX group , dexmedetomidine was loaded ( @ g/kg ) before superficial anesthesia for eye surgery .


Mean arterial pressure , heart rate ( HR ) , oxygen saturation ( SpO@ ) , bispectral index ( BIS ) monitoring , and end-tidal CO@ were recorded before infusion ( baseline ) and every @ minutes after loading of the study drugs .


The degree of sedation was evaluated using the Ramsay Sedation Scale by an anesthesiologist who was unaware of the type of sedative used .


The satisfaction of the patients and surgeon was assessed immediately after surgery using a @-point Likert-like verbal rating scale .


Significantly lower HR was observed over time in the DEX group compared with the P group .


No significant differences in SpO@ were observed between the groups .


Bispectral index scores decreased at @ , @ , and @ minutes after infusion .


The surgeon 's satisfaction scores were higher in the DEX group than in the P group .


Recovery times were longer in DEX group than in the P group .


Dexmedetomidine in conjunction with topical anesthesia offered better conscious sedation for nervous patients during LASIK , but these patients required a longer recovery period .


To measure serum levels of bevacizumab and to compare serum levels of free vascular endothelial growth factor ( VEGF ) and insulin-like growth factor-@ ( IGF-@ ) in infants who were treated with either intravitreal injection of bevacizumab ( IVB ) or laser for type @ retinopathy of prematurity ( ROP ) .


Twenty-four infants with type @ ROP were randomized into three treatment groups : IVB at @ mg per eye per dose , IVB at @ mg per eye per dose , and laser .


Blood samples were collected prior to treatment and on posttreatment days @ , @ , @ , and @ .


Weekly body weights were documented from birth until @ days post treatment .


Serum levels of bevacizumab , free VEGF , and IGF-@ were measured with enzyme-linked immunosorbent assay ( ELISA ) .


Serum bevacizumab was detected @ days after the injection , peaked at @ days , and persisted for up to @ days with half-life of @ days .


Area under the curve ( AUC ) analysis showed that systemic exposure to bevacizumab was variable among the subjects and was dose dependent .


Serum free VEGF levels decreased in all three subgroups @ days post treatment , with more significant reductions found in both IVB-treated groups , P = @ .


Serum IGF-@ levels were lower in both IVB-treated groups .


Clearance of bevacizumab from the bloodstream in premature infants takes at least @ months .


Although serum free VEGF levels decreased following either laser or bevacizumab treatment , the reductions were more significant in the IVB-treated groups .


Potential long-term effects of systemic exposure to bevacizumab in infants need to be studied further .


Hypotension during spinal anesthesia is a serious complication in elderly patients .


We evaluated the effect of glycopyrrolate on hypotensive responses in elderly patients undergoing spinal anesthesia .


Sixty-six patients older than @ yr of age scheduled for elective surgery with spinal anesthesia were included in the study .


They received either glycopyrrolate @ mg ( group G ) or normal saline ( group C ) intramuscularly @ min before spinal anesthesia .


The following outcomes were evaluated after the induction of spinal anesthesia : the incidence of hypotension and bradycardia , the ephedrine requirement , mean arterial pressure , heart rate , and the incidence of nausea and vomiting .


Twenty-three of @ ( @ % ) patients in group C experienced hypotension compared with nine of @ ( @ % ) patients in group G ( difference = @ % ; @ % confidence interval -LSB- CI -RSB- : @ to @ ; P = @ ) .


The median -LSB- interquartile range -RSB- amount of ephedrine required was @ -LSB- @-@ -RSB- mg in group C compared with @ -LSB- @-@ -RSB- mg in group G ( difference = @ mg ; @ % CI : @ to @ ; P = @ ) .


Nine ( @ % ) patients in group C experienced nausea and vomiting compared with @ ( @ % ) in group G ( difference = @ % ; @ % CI : @ to @ ; P = @ ) .


Three ( @ % ) patients in group C experienced bradycardia compared with @ ( @ % ) patient in group G ( difference = @ % ; @ % CI : -@ to @ ; P = @ ) .


Prophylactic intramuscular glycopyrrolate reduced the occurrence and severity of hypotensive responses , the requirement for ephedrine , and the incidence of nausea and vomiting in elderly patients undergoing spinal anesthesia .


The trial was registered at the Clinical Research Information Service , Republic of Korea ( KCT@ ) .


Studies have shown that bisphosphonates may have antitumor and antimetastatic properties .


Recently , observational studies have suggested a possible protective effect of bisphosphonates on breast cancer , but the effect of bisphosphonate use on risk of breast cancer has not been tested in randomized trials .


To assess the relationship of postmenopausal breast cancer incidence and bisphosphonate use using data from @ randomized ( @:@ ) , double-blind , placebo-controlled trials .


The Fracture Intervention Trial ( FIT ) randomly assigned @ women aged @ to @ years to alendronate or placebo for a mean follow-up of @ years .


The Health Outcomes and Reduced Incidence With Zoledronic Acid Once Yearly-Pivotal Fracture Trial ( HORIZON-PFT ) randomly assigned @ women aged @ to @ years to annual intravenous zoledronic acid or placebo for a mean follow-up of @ years .


Data were collected at clinical centers in the United States ( FIT and HORIZON-PFT ) and in Asia and the Pacific , Europe , North America , and South America ( HORIZON-PFT ) .


Women , in either study , with recurrent breast cancer or who reported a history of breast cancer were excluded from analyses .


In each trial , a blinded review was conducted of each cancer adverse event report to verify incident invasive breast cancer cases .


The primary analysis compared events in the active vs placebo group using a log-rank test .


Alendronate vs placebo ( FIT ) or zoledronic acid vs placebo ( HORIZON-PFT ) .


Hazard ratio for incident breast cancer in the bisphosphonate treatment group compared to the placebo group .


There was no significant difference in the rate of breast cancer in FIT : @ % ( n = @ ) in the placebo group and @ % ( n = @ ) in the alendronate group ( hazard ratio -LSB- HR -RSB- , @ -LSB- @ % CI , @-@ @ -RSB- ) .


In HORIZON-PFT , there was also no significant difference : @ % ( n = @ ) in the placebo group and @ % ( n = @ ) in the zoledronic acid group ( HR , @ -LSB- @ % CI , @-@ @ -RSB- ) .


There was also no significant difference when the data from FIT and HORIZON-PFT were pooled ( HR , @ -LSB- @ % CI , @-@ @ -RSB- ) .


These @ randomized clinical trials do not support the findings from observational research .


Contrary to the results from observational studies , we found that @ to @ years of bisphosphonate treatment did not decrease the risk of invasive postmenopausal breast cancer .


To evaluate pazopanib eye drops in subjects with active subfoveal choroidal neovascularization ( CNV ) secondary to age-related macular degeneration ( AMD ) .


Multicountry , randomized , parallel-group , double-masked , active and placebo-controlled , dose-ranging study of eye drops .


A total of @ subjects ( @ % white ; @ % female ; mean age , @ years ) whose AMD was previously managed by anti-vascular endothelial growth factor intravitreal injections .


Treatments administered for @ weeks included placebo eye drops instilled @ times daily ( n = @ ) ; pazopanib @ mg/ml instilled @ ( n = @ ) or @ times daily ( n = @ ) ; pazopanib @ mg/ml instilled @ ( n = @ ) , @ ( n = @ ) , or @ times daily ( n = @ ) ; or ranibizumab injection administered once every @ weeks ( n = @ ) .


In addition , for all eye drop treatment groups , open-label ranibizumab was administered as needed .


The main outcome measures were best-corrected visual acuity ( BCVA ) and injection frequency assessed at week @ .


Safety was assessed every @ weeks and pazopanib plasma concentrations were determined at weeks @ and @ .


At week @ , pazopanib , with allowance for as-needed ranibizumab injections , was noninferior to monthly ranibizumab as well as to as-needed ranibizumab administered with placebo eye drops in maintaining BCVA ( estimated BCVA gains of @-@ @ vs. @ vs. @ letters , respectively ) .


Pazopanib treatment did not reduce as-needed ranibizumab injections by @ % ( prespecified efficacy criterion ) .


At week @ , there were no clinically meaningful changes from baseline in retinal thickness or morphology , CNV size , or lesion characteristics on optical coherence tomography or fluorescein angiography .


Complement factor H genotype had no effect on the responses to pazopanib and/or ranibizumab ( BCVA , injection rate , or optical coherence tomography/fluorescein angiography changes ) .


Steady-state concentrations of pazopanib in plasma seemed to be reached by week @ .


The most common ocular adverse events related to pazopanib and ranibizumab were application site pain ( @ % ) and injection site hemorrhage ( @ % ) , respectively .


No treatment-related serious adverse events were reported .


Pazopanib was well tolerated .


Daily pazopanib eye drops in neovascular AMD subjects did not result in therapeutic benefit beyond that obtained with ranibizumab alone .


Evaluate the effect on the application of low level laser therapy , in patients that have been previously intervened with a sagittal ramus split osteotomy and present neurosensory impairment due to this surgery , compared with placebo .


This preliminary study is a randomized clinical trial , with an experimental group ( n = @ ) which received laser light and a control group ( n = @ ) , placebo .


All participants received laser applications , divided after surgery in days @ , @ , @ , @ , @ , @ , @ and @ .


Neurosensory impairment was evaluated clinically with @ tests ; visual analog scale ( VAS ) for pain and sensitivity , directional and @ point discrimination , thermal discrimination , each one of them performed before and after surgery on day @ , and @ , @ and @ months .


Participants and results evaluator were blinded to intervention .


Variables were described with absolute frequencies , percentages and medians .


Ordinal and dichotomous variables were compared with Mann Whitney 's and Fisher 's test respectively .


RESULTS demonstrate clinical improvement in time , as well as in magnitude of neurosensory return for laser group ; VAS for sensitivity reached @ ( normal ) , @ participants recovered initial values for @ point discrimination ( @,@ % ) and @,@ % recovered directional discrimination at @ months after surgery .


General VAS for sensitivity showed @,@ % for laser group , compared with placebo @,@ % ( p-value = ( @ ) ) .


Left side sensitivity ( VAS ) showed @ and @ medians for placebo and laser at @ months , respectively ( p-value = ( @ ) ) .


Low-level laser therapy was beneficial for this group of patients on recovery of neurosensory impairment of mandibular nerve , compared to a placebo .


The aim of this study was to explore the influence of a half-course tourniquet strategy on the peri-operative blood loss and early functional recovery in primary total knee arthroplasty .


A prospective clinical randomised controlled study was carried out in which @ patients were equally divided into two groups : half-course group and whole-course group .


A series of indicators were observed and recorded .


These included operation time , peri-operative blood loss , visual analogue scale ( VAS ) score of the thigh or knee , limb swelling index , rehabilitation progress and occurrence of deep venous thrombosis cases .


There was no significant difference in operation time between the two groups .


The intra-operative blood loss was slightly more in the half-course group , while the difference was not significant .


The post-operative blood loss and calculated blood loss were less in the half-course group and the difference was significant .


The thigh VAS score , limb swelling and time intervals required for patients to achieve straight leg raises and @ of knee flexion in the half-course group were better than in the whole-course group .


No case of symptomatic deep venous thrombosis happened in this study , while occult incidence of deep venous thrombosis happened in both groups , but no significant difference between the groups was confirmed .


The half-course tourniquet strategy could decrease the total peri-operative blood loss in primary total knee arthroplasty .


It was beneficial in helping patients to achieve earlier functional recovery by improving the pain experience and limb swelling early in the post-operative period .


To investigate the effect of extended-release ( ER ) niacin on the metabolism of high-density lipoprotein ( HDL ) apolipoprotein A-I ( apoA-I ) in men with type @ diabetes mellitus on a background of optimal statin therapy .


Twelve men with type @ diabetes mellitus were recruited for a randomized , crossover design trial .


Patients were randomized to rosuvastatin or rosuvastatin plus ER niacin for @ weeks and then crossed over to the alternate therapy after a @-week washout period .


Metabolic studies were performed at the end of each treatment period .


HDL apoA-I kinetics were measured after a standardized liquid mixed meal and a bolus injection of d@-leucine for @ hours .


Compartmental analysis was used to model the data .


ER niacin significantly decreased plasma triglyceride , plasma cholesterol , non-HDL cholesterol , low-density lipoprotein cholesterol , and apoB ( all P < @ ) and significantly increased HDL cholesterol and apoA-I concentrations ( P < @ and P < @ , respectively ) .


ER niacin also significantly increased HDL apoA-I pool size ( @,@ @ versus @,@ @ mg ; P < @ ) , and this was attributed to a lower HDL apoA-I fractional catabolic rate ( @ @ versus @ @ pools/d ; P < @ ) , with no significant changes in HDL apoA-I production ( @ @ versus @ @ mg/kg per day ; P = @ ) .


ER niacin increases HDL apoA-I concentration in statin-treated subjects with type @ diabetes mellitus by lowering apoA-I fractional catabolic rate .


The effect on HDL metabolism was independent of the reduction in plasma triglyceride with ER niacin treatment .


Whether this finding applies to other dyslipidemic populations remains to be investigated .


The weaning period is critical for stress-related diseases and infections .


Currently , large amounts of therapeutic antimicrobials are used to treat infections in the livestock production , especially in piglets .


Phytogenic feed additives could provide a useful alternative .


We hypothesize , that components in agrimonia species which have been used successfully in humans to treat gastrointestinal infections could also improve the health of piglets .


We investigated the effects of Agrimonia procera ( AP ) on the growth performance of piglets and cytokine expression in isolated porcine peripheral blood mononuclear cells ( PBMC ) .


Here we show that piglets that received a diet with @ g/kg AP for @ weeks tended to ingest more food ( +@ % ; P < @ ) , and were characterized by a higher nitrogen retention ( +@ % , P < @ ) than the control group without AP treatment .


Data from a second experiment reveal that piglets fed a diet with @ g/kg AP for @ weeks had an improved food conversion ratio ( @ @ ) compared to those that received none ( @ @ ) or @ g/kg AP ( @ @ ) with their diets ( P < @ ) .


However , the food intake , daily weight gain and dry matter of feces were not affected by the AP treatment .


Treatment of PBMC for @ and @ h with AP extract ( APE ) reduced the mRNA abundance of tumor necrosis factor ( TNF ) ?


in cells challenged with lipopolysaccharides ( LPS ) but not in cells without LPS stimulation ( P < @ ) .


The lower mRNA expression of TNF ?


was accompanied by a trend towards a lower release of TNF ?


from these cells ( P ?


After the treatment of PBMC with APE for @ h , the relative mRNA concentration of interleukin ( IL ) -@ ?


declined ( P < @ ) , whereas that of IL-@ remained unchanged .


Treatment of LPS-challenged PBMC for @ h with varying concentrations of APE did not reveal any effect on cytokine expression and TNF ?


release .


The results indicate that low dosages of AP may improve the growth performance of piglets and seem to exert antiinflammatory effects in porcine immune cells challenged with LPS .


Forty-one percent of shift workers report dozing while driving .


This study tested whether armodafinil improves driving simulator performance in subjects with shift work disorder ( SWD ) .


A primary outcome was performance late in the shift when workers are typically driving home .


Randomized , double-blind , crossover .


During each @-h test session ( @:@ -@:@ ) , subjects were kept awake except for multiple sleep latency testing ( MSLT : @:@ , @:@ , @:@ , and @:@ ) .


Subjective sleepiness ( Karolinska Sleepiness Scale , KSS ) , driving performance , and cognitive performance ( digit symbol substitution test and creativity on the Remote Associates Test , RAT ) were evaluated during the night shift and commute home times .


Hospital-based sleep research laboratory .


Twenty night workers ( age : @ @ y , @ F ) with excessive sleepiness ( @ on the Epworth Sleepiness Scale ) , meeting International Classification of Sleep Disorders , Second Edition ( ICSD-@ ) criteria for SWD , and having no other medical conditions .


Armodafinil ( @ mg ) or placebo at ( @:@ h ) on counterbalanced nights separated by @-@ days .


Primary endpoints were driving simulator performance ( standard deviation of lateral position ( SDLP ) and off-road deviations ) with four sessions starting @ h after drug administration , objective sleepiness ( MSLT ; @ to @ h post-drug ) , and creativity ( @ h post-drug ) .


Significant effects of drug were observed for each driving measure ( P < @ ) .


Armodafinil significantly improved SDLP for simulator sessions at @:@ , @:@ , and @:@ , and off-road deviations at @ h , @ min and @ h , @ min post-drug ( P < @ ) .


Armodafinil also improved objective sleepiness from @ @ min to @ @ min ( P < @ ) and RAT score from @ @ to @ @ ( P < @ ) .


Armodafinil @ mg early in the night shift improves driving simulator performance in SWD .


Effects on sleepiness , cognition , and driving were found up to @ h post-ingestion , during the critical time when many night workers are driving home .


Postinfectious cough is common in primary care , but has no proven effective treatments .


Cysteinyl leukotrienes are involved in the pathogenesis of postinfectious cough and whooping cough ( pertussis ) .


We investigated the effectiveness of montelukast , a cysteinyl leukotriene receptor antagonist , in the treatment of postinfectious cough .


In this randomised , placebo-controlled trial , non-smoking adults aged @-@ years with postinfectious cough of @-@ weeks ' duration were recruited from @ general practices in England .


Patients were tested for pertussis ( oral fluid anti-pertussis toxin IgG ) and randomly assigned ( @:@ ) to montelukast @ mg daily or image-matched placebo for @ weeks .


Patients chose whether to continue study drug for another @ weeks .


The randomisation sequence was computer-generated and stratified by general practice .


Patients , health-care professionals , and researchers were masked to treatment allocation .


Effectiveness was assessed with the Leicester Cough Questionnaire to measure changes in cough-specific quality of life ; the primary outcomes were changes in total score between baseline and two follow-up stages ( @ weeks and @ weeks ) .


The primary analysis was by intention to treat with imputation by last observation carried forward .


Recruitment closed on Sept @ , @ , and follow-up has been completed .


This trial is registered with EudraCT ( @-@-@ ) , UKCRN Portfolio ( ID @ ) , and ClinicalTrials.gov ( NCT@ ) .


From April @ , @ , to Sept @ , @ , we randomly assigned @ patients to montelukast ( n = @ ) or placebo ( n = @ ) .


@ ( @ % ) patients had laboratory-confirmed pertussis .


Improvements in cough-specific quality of life occurred in both groups after @ weeks ( montelukast : mean @ , @ % CI @-@ ; placebo : @ , @-@ ) , but the difference between groups did not meet the minimum clinically important difference of @ ( mean difference -@ , -@ to -@ , p = @ ) .


This difference was not statistically significant in any sensitivity analyses .


After @ weeks , @ of @ participants from whom data were available elected to continue study drug ( @ -LSB- @ % -RSB- of @ participants on montelukast ; @ -LSB- @ % -RSB- of @ on placebo ) .


After @ weeks , there were no significant between-group differences in cough-specific quality of life improvement ( montelukast : @ , @-@ ; placebo : @ , @-@ ; mean difference -@ , -@ to @ , p = @ ) or adverse event rates ( @ ( @ % ) of @ patients on montelukast reported one or more adverse events ; @ ( @ % ) of @ on placebo ; p = @ ) .


The most common adverse events reported were increased mucus production ( montelukast , n = @ ; placebo , n = @ ) , gastrointestinal disturbance ( montelukast , n = @ ; placebo , n = @ ) , and headache ( montelukast , n = @ ; placebo , n = @ ) .


One serious adverse event was reported ( placebo , n = @ ) , which was unrelated to study drug ( shortness of breath and throat tightness after severe coughing bouts ) .


Montelukast is not an effective treatment for postinfectious cough .


However , the burden of postinfectious cough in primary care is high , making it an ideal setting for future antitussive treatment trials .


Compare the feasibility and patient tolerance to either a clear fluid ( CF ) or low residue diet ( LRD ) started on postoperative day ( POD ) @ after elective colorectal surgery .


Diet advancement after surgery traditionally starts gradually with liquids , on the basis of fears that early solid intake may increase nausea , vomiting , and overall complications .


A randomized controlled trial comparing LRD and CF on POD @ was performed .


@ elective colorectal surgery patients were randomized to CF ( n = @ ) or LRD ( n = @ ) .


The primary end point was vomiting on POD @ .


Secondary endpoints included nausea score , days to flatus , length of hospital stay ( LOS ) , and postoperative morbidity .


Patient characteristics , surgical technique , intraoperative characteristics , and postoperative opioid use were similar between study arms .


CF versus LRD results were as follows : POD@ vomiting ( @ % vs @ % ; P = @ ) , and significant increase in mean nausea score ( @ vs @ ; P = @ ) , days to flatus ( @ vs @ days ; P = @ ) , and LOS ( @ vs @ days ; P = @ ) .


LOS remained significantly shorter even after adjusting for significant covariates ( laparoscopic technique , surgical site , postoperative comorbidity , stoma , and nasogastric tube ) with LRD patients having an adjusted @-day decrease in LOS ( P < @ ) .


There was no significant difference in postoperative morbidity between study arms .


Multivariate analysis of all secondary endpoints confirmed an overall significant improvement in outcomes for LRD vs CF ( P < @ ) .


LRD , rather than CF , on POD@ after colorectal surgery is associated with less nausea , faster return of bowel function , and a shorter hospital stay without increasing postoperative morbidity .


Skeletal muscle wasting in chronic kidney disease ( CKD ) is associated with morbidity and mortality .


Resistance exercise results in muscle hypertrophy in the healthy population , but is underinvestigated in CKD .


We aimed to determine the feasibility of delivering a supervised progressive resistance exercise program in CKD , with secondary aims to investigate effects on muscle size , strength , and physical functioning .


Parallel randomized controlled feasibility study .


Patients with CKD stages @b to @ were randomly assigned to the exercise ( n = @ ; @ men ; median age , @ -LSB- IQR , @-@ -RSB- years ; median estimated glomerular filtration rate , @ -LSB- IQR , @-@ @ -RSB- mL/min/@ @ m ( @ ) ) or nonexercise control ( n = @ ; @ men ; median age , @ -LSB- IQR , @-@ -RSB- years ; estimated glomerular filtration rate , @ -LSB- IQR , @-@ @ -RSB- mL/min/@ @ m ( @ ) ) group .


Patients in the exercise group undertook an @-week progressive resistance exercise program consisting of @ sets of @ to @ leg extensions at @ % of estimated @-repetition maximum thrice weekly .


Patients in the control group continued with usual physical activity .


Primary outcomes were related to study feasibility : eligibility , recruitment , retention , and adherence rates .


Secondary outcomes were muscle anatomical cross-sectional area , muscle volume , pennation angle , knee extensor strength , and exercise capacity .


Two - and @-dimensional ultrasonography of skeletal muscle , dynamometry , and shuttle walk tests at baseline and @ weeks .


Of @,@ patients screened , @ were identified as eligible and @ enrolled in the study .


@ ( @ % ) completed the study , and those in the exercise group attended @ % of training sessions .


No changes were seen in controls for any parameter .


Progressive resistance exercise increased muscle anatomical cross-sectional area , muscle volume , knee extensor strength , and exercise capacity .


No blinded assessors , magnetic resonance imaging not used to assess muscle mass , lack of a healthy control group .


This type of exercise is well tolerated by patients with CKD and confers important clinical benefits ; however , low recruitment rates suggest that a supervised outpatient-based program is not the most practical implementation strategy .


Clinical practice guidelines have been widely developed and disseminated with the aim of improving healthcare processes and patient outcomes but the uptake of evidence-based practice remains haphazard .


There is a need to develop effective implementation methods to achieve large-scale adoption of proven innovations and recommended care .


Clinical networks are increasingly being viewed as a vehicle through which evidence-based care can be embedded into healthcare systems using a collegial approach to agree on and implement a range of strategies within hospitals .


In Australia , the provision of evidence-based care for men with prostate cancer has been identified as a high priority .


Clinical audits have shown that fewer than @ % of patients in New South Wales ( NSW ) Australia at high risk of recurrence after radical prostatectomy receive guideline recommended radiation treatment following surgery .