Used Encephalofluctuograph Technology ( ET ) and Hamilton Depression Scale ( HAMD ) to measure the changes of cerebral neurotransmitters and scale scores in both groups at baseline time , @ , @ and @ months later to evaluate the effects of Bushen Huoxue Herbs .


In the treatment group , @-hydroxytryptamine ( @-HT ) , noradrenaline ( NE ) and dopamine ( DA ) levels were increased significantly when compared with pretreatment ( P < @ ) , especially of @-HT and DA levels ( P < @ ) ; Compared with the control group , @-HT and DA levels were increased significantly ( P < @ ) .


After treatment , the scores of the HAMD scale was significantly decreased ( P < @ ) .


No adverse effects were found in this trial .


Bushen Huoxue Herbs can improve depression of PD patients by increasing the levels of @-HT , NE and DA in the brain and decreasing the scores of the HAMD scale with reliable effects .


Acute acquired hypofibrinogenemia in children undergoing cardiac surgery is a major concern because it often results in perioperative bleeding and high rates of allogeneic blood transfusion .


Fibrinogen concentrate has been proposed as an alternative to cryoprecipitate ( the gold standard therapy ) , with minimal infectious and immunologic risks .


Our objective was to investigate the efficacy and safety of fibrinogen concentrate in children undergoing cardiac surgery .


In this randomized pilot study , patients were allocated to receive fibrinogen concentrate ( @ mg/kg ) or cryoprecipitate ( @ mL/kg ) if bleeding was associated with fibrinogen levels < @ g/dL after cardiopulmonary bypass weaning .


The primary outcome was postoperative blood losses during the @ hours after surgery .


A total of @ patients were included in the study , @ in the fibrinogen concentrate group and @ in the cryoprecipitate group .


The median @-hour blood loss was not significantly different between the @ groups ( @ mL -LSB- interquartile range , @-@ -RSB- vs @ mL -LSB- interquartile range , @-@ -RSB- , respectively ; P = @ ) .


After treatment , plasma fibrinogen concentration increased similarly following administration of both products .


There were no differences in allogeneic blood transfusion after intervention treatment .


A large trial comparing fibrinogen concentrate and cryoprecipitate in the management of children with acute acquired hypofibrinogenemia during heart surgery is feasible .


The preliminary results of our study showed that the use of fibrinogen concentrate was as efficient and safe as cryoprecipitate in the management of bleeding children undergoing cardiac surgery .


Sleep problems are common and persistent during adolescence and can have negative effects on adolescents ' mood .


To date , studies that investigate the effects of sleep extension on adolescents ' sleep and depressive symptoms are still lacking .


This study aims to investigate the effects of gradual sleep extension combined with sleep hygiene advice in adolescents with chronic sleep reduction on objectively measured sleep , self-reported sleep problems and depressive symptoms .


Fifty-five adolescents with chronic sleep reduction ( mean age : @ years ; @ % females ) were included in the study .


Participants were randomly assigned to either a sleep extension group ( gradual sleep extension by advancing bedtimes in the evening and receiving sleep hygiene advice ) or to a control group ( no instruction ) .


Sleep was measured with actigraphy during threeweeks , the first week was the baseline week , and the last twoweeks were the experimental weeks during which sleep was extended .


Other outcome variables were self-reported sleep problems ( daytime sleepiness , symptoms of insomnia and circadian rhythm sleep disorder ) and depressive symptoms , which were assessed before and after the experimental manipulation .


During the third week of the experiment , adolescents in the sleep extension group had earlier bedtimes , earlier sleep onsets , spent more time in bed and slept longer than adolescents in the control group .


Their chronic sleep reduction , insomnia symptoms and depressive symptoms diminished significantly .


In addition , there was a trend of improved circadian rhythm sleep disorder symptoms and sleep quality .


Gradual sleep extension combined with sleep hygiene advice seems to have beneficial effects on sleep , self-reported sleep problems and depressive symptoms of adolescents with chronic sleep reduction .


Although we can not distinguish between the effects of sleep extension and sleep hygiene advice , the results suggest that advancing bedtimes can extend sleep and improve depressive symptoms .


Bruxism is a parafunctional habit characterized by grinding and/or clenching of the teeth .


It may happen while awake ( awake bruxism ) or while sleeping ( sleep bruxism ) .


In adults , the prevalence is @ % for the awake bruxism and @ % for the sleep bruxism .


Peripheral , central , and psychosocial factors influence the disorder , which may predispose to pain in the masticatory muscles and neck , headache , decreased pain thresholds in the masticatory and cervical muscles , limitation mandibular range of motion , sleep disorders , stress , anxiety , depression , and overall impairment of oral health .


The aim of this study is to compare two distinct physical therapy interventions with dental treatment in pain , mandibular range of motion , sleep quality , anxiety , stress , depression , and oral health in individuals with bruxism .


Participants will be randomized into one of three groups : Group @ ( n = @ ) intervention will consist of massage and stretching exercises ; Group @ ( n = @ ) will consist of relaxation and imagination therapies ; and Group @ ( n = @ ) will receive dental treatment .


The evaluations will be performed at baseline , immediately after treatment , and at @-month follow-up .


Pain intensity will be assessed using the visual analogical scale , while pain thresholds will be determined using dolorimetry .


Mandibular range of motion will be assessed using digital pachymeter .


Sleep quality will be assessed by the Pittsburgh Sleep Quality Index , anxiety by the State-Trait Anxiety Inventory , stress by the Perceived Stress Scale-@ , depression by the Beck Depression Inventory , and oral health will be assessed using the Oral Health Impact Profile -- @ .


Significance level will be determined at the @ % level .


This project describes the randomization method that will be used to compare two physical therapy interventions with dental treatment in the management of pain , mandibular range of motion , sleep quality , anxiety , stress , depression , and oral health in individuals with bruxism .


The study will support the practice of evidence-based physical therapy for individuals with bruxism .


Data will be published after study is completed .


Vatreptacog alfa , a recombinant factor VIIa ( rFVIIa ) analog with three amino acid substitutions and @ % identity to native FVIIa , was developed to improve the treatment of hemophilic patients with inhibitors .


To confirm the safety and assess the efficacy of vatreptacog alfa in treating bleeding episodes in hemophilic patients with inhibitors .


In this international , multicenter , randomized , double-blind , active-controlled , crossover , confirmatory phase III trial ( adept ( ) @ ) in patients with hemophilia A or B and inhibitors , bleeds were randomized @ : @ to treatment with vatreptacog alfa ( one to three doses at @ g kg ( -@ ) ) or rFVIIa ( one to three doses at @ g kg ( -@ ) ) .


Treatment failures after three doses of trial product ( TP ) were managed according to the local standard of care .


In the @ patients enrolled , @ bleeds were treated with TP .


Both vatreptacog alfa and rFVIIa gave @ % effective bleeding control at @ h. Vatreptacog alfa was superior to rFVIIa in secondary efficacy outcomes , including the number of doses used to treat a bleed and sustained bleeding control @-@ h after the first dose .


Eight patients ( @ % ) developed antibodies against vatreptacog alfa , including four with cross-reactivity against rFVIIa and one with an in vitro neutralizing effect to vatreptacog alfa .


This large randomized controlled trial confirmed the well-established efficacy and safety profile of rFVIIa , and showed that vatreptacog alfa had similar or better efficacy than rFVIIa .


However , because of the development of anti-drug antibodies , a positive benefit-risk profile is unlikely to be achieved with vatreptacog alfa .


Prucalopride is a high-affinity @-HT@ receptor agonist for the treatment of chronic constipation .


The aims of this study were to investigate the relationship between health-related quality of life ( HRQoL ) and symptoms of constipation , and to assess the response of HRQoL to treatment using integrated data from three phase III trials of prucalopride .


This was an integrated analysis of data from three pivotal multicenter , double-blind , randomized , placebo-controlled , parallel-group trials ( ClinicalTrials.gov Identifiers : NCT@ , NCT@ and NCT@ ) .


Relationships were investigated between Patient Assessment of Constipation Quality of Life ( PAC-QOL ) scores , Patient Assessment of Constipation Symptoms ( PAC-SYM ) scores , bowel movement frequency ( assessed using daily diaries ) , and treatment .


Patients treated with prucalopride @ mg ( n = @ ) and placebo ( n = @ ) were included in the analysis .


An improvement in PAC-SYM scores correlated well with an improvement in PAC-QOL overall score ( r = @ ) and satisfaction subscale score ( r = @ ) .


After @ weeks , PAC-QOL overall score and satisfaction subscale score significantly ( p < @ ) improved by @ point ( clinically relevant ) in @ % and @ % of patients treated with prucalopride , compared with @ % and @ % with placebo respectively .


Moreover , @ % of patients with an improvement in satisfaction of @ point achieved @ spontaneous complete bowel movements/week , compared with @ % of those with no improvement in satisfaction ( < @ point ) .


Improvements in PAC-QOL overall score and satisfaction score were associated with improvements in symptoms of chronic constipation .


Compared with placebo , treatment with prucalopride significantly improved HRQoL .


Combined treatment with cyclosporine microemulsion preconcentrate ( CyA MEPC ) and steroids has been widely used for idiopathic membranous nephropathy ( IMN ) associated with steroid-resistant nephrotic syndrome ( SRNS ) .


Recent studies have shown that once-a-day and preprandial administration of CyA MEPC is more advantageous than the conventional twice-a-day administration in achieving the target blood CyA concentration at @ h post dose ( C@ ) .


We designed a randomized trial to compare these administrations .


IMN patients with SRNS ( age @-@ years ) were divided prospectively and randomly into @ groups .


In group @ ( n = @ ) , @-@ mg/kg body weight ( BW ) CyA MEPC was given orally once a day before breakfast .


In group @ ( n = @ ) , @ mg/kg BW CyA MEPC was given twice a day before meals .


CyA + prednisolone was continued for @ weeks .


Group @ showed a significantly higher cumulative complete remission ( CR ) rate ( p = @ ) , but not when incomplete remission @ ( ICR@ ; urine protein @-@ @ g/day ) was added ( p = @ ) .


Because a C@ of @ ng/mL was determined as the best cut-off point , groups @ and @ were further divided into subgroups A ( C@ @ ng/mL ) and B ( C@ < @ ng/mL ) .


Groups @A and @A revealed significantly higher cumulative remission ( CR + ICR@ ) ( p = @ ) and CR-alone ( p = @ ) rates .


On the other hand , @ patients with high CyA levels ( C@ > @ ng/mL ) in Group @A were withdrawn from the study because of complications .


CyA + prednisolone treatment is effective for IMN with associated SRNS at a C@ of @ ng/mL .


To achieve remission , preprandial once-a-day administration of CyA at @-@ mg/kg BW may be the most appropriate option .


However , we should adjust the dosage of CyA by therapeutic drug monitoring to avoid complications .


The optimal surgical approach for treatment of oesophagogastric junction ( OGJ ) cancer is controversial .


A randomized clinical trial ( JCOG@ ) comparing transhiatal ( TH ) and left thoracoabdominal ( LTA ) approaches was stopped after the first interim analysis owing to limited efficacy for LTA resections .


Complete @-year follow-up data are now available .


Patients with histologically proven adenocarcinoma of the OGJ or gastric cardia with oesophageal invasion of @cm or less were randomized to a TH or LTA approach .


Both groups underwent total gastrectomy and splenectomy with D@ nodal dissection plus para-aortic lymphadenectomy above the left renal vein .


For LTA , a thorough mediastinal lymphadenectomy below the left inferior pulmonary vein was also mandatory .


The primary endpoint was overall survival .


A total of @ patients ( @ TH , @ LTA ) were enrolled .


The @-year overall survival rate was @ ( @ per cent c.i. @ to @ ) per cent for the TH approach and @ ( @ to @ ) per cent for the LTA technique ( P = @ ) .


The hazard ratio for death was @ ( @ to @ ) for the LTA technique .


Subgroup analysis based on the Siewert classification indicated non-significant survival advantages in favour of the TH approach .


LTA resections should be avoided in the treatment of adenocarcinoma of the OGJ or gastric cardia .


Infections are the most common noncardiac complication after cardiac surgery , but their incidence across a broad range of operations , as well as the management factors that shape infection risk , remain unknown .


This study sought to prospectively examine the frequency of post-operative infections and associated mortality , and modifiable management practices predictive of infections within @ days from cardiac surgery .


This study enrolled @,@ patients and analyzed independently adjudicated infections using a competing risk model ( with death as the competing event ) .


Nearly @ % of patients experienced major infections .


Baseline characteristics associated with increased infection risk included chronic lung disease ( hazard ratio -LSB- HR -RSB- : @ ; @ % confidence interval -LSB- CI -RSB- : @ to @ ) , heart failure ( HR : @ ; @ % CI : @ to @ ) , and longer surgery ( HR : @ ; @ % CI : @ to @ ) .


Practices associated with reduced infection risk included prophylaxis with second-generation cephalosporins ( HR : @ ; @ % CI : @ to @ ) , whereas post-operative antibiotic duration > @ h ( HR : @ ; @ % CI : @ to @ ) , stress hyperglycemia ( HR : @ ; @ % CI : @ to @ ) ; intubation time of @ to @ h ( HR : @ ; @ % CI : @ to @ ) ; and ventilation > @ h ( HR : @ ; @ % CI : @ to @ ) were associated with increased risk .


HRs for infection were similar with either < @ h or < @ h of antibiotic prophylaxis .


There was a significant but differential effect of transfusion by surgery type ( excluding left ventricular assist device procedures/transplant ) ( HR : @ ; @ % CI : @ to @ ) .


Major infections substantially increased mortality ( HR : @ ; @ % CI : @ to @ ) .


Major infections dramatically affect survival and readmissions .


Second-generation cephalosporins were strongly associated with reduced major infection risk , but optimal duration of antibiotic prophylaxis requires further study .


Given practice variations , considerable opportunities exist for improving outcomes and preventing readmissions .


( Management Practices and Risk of Infection Following Cardiac Surgery ; NCT@ ) .


To evaluate the outcome of resistive home exercise and its possible longterm influence on health , disability , and disease activity in patients with active polymyositis ( PM ) or dermatomyositis ( DM ) .


Nineteen patients with recent-onset PM/DM were included after introduction of high-dose prednisolone .


They were assessed by independent assessors as to perceived health , muscle performance , aerobic capacity , and serum creatine phosphokinase ( CPK ) at baseline and after @ weeks , including repeated muscle biopsies at @ weeks ( single-blinded randomized controlled study ) , and in an open-label followup at @ , @ , and @ weeks .


Patients were randomized to @ weeks , @ days/week resistive home exercise with telephone support and encouragement for another @ weeks of twice-a-week home or gym exercise ( EG , n = @ ) or to @ weeks , @ days/week range of motion exercise ( CG , n = @ ) .


Patients in the CG group without inflammatory infiltrates in muscle biopsies at @ weeks were invited to the @-week resistive home exercises .


At baseline , the EG had poorer perceived health , but otherwise the groups were comparable .


At @ weeks , both groups improved in muscle performance and aerobic capacity ( p < @ to < @ ) with no signs of increased inflammation assessed by CPK levels or muscle biopsies .


Both groups improved in muscle performance and aerobic capacity up to @ weeks ( p < @ ) lasting to @ weeks in the EG ( p < @ ) and presented minor improvements in perceived health .


Our study supports the safety of resistive exercise in patients with active PM/DM but did not reveal any between-group differences in exercise effects .


An individually adapted physical therapist-supervised home exercise program might be recommended in early active PM/DM , with regular evaluation of muscle performance and health .


Dapagliflozin is a highly selective , orally active inhibitor of renal sodium-glucose cotransporter @ that reduces hyperglycemia by increasing urinary glucose excretion .


The goal of this study was to evaluate dapagliflozin as monotherapy in drug-naive Asian patients with type @ diabetes whose disease was inadequately controlled with diet and exercise .


In this Phase III , multicenter , parallel-group , double-blind study , drug-naive patients with glycosylated hemoglobin ( HbA@c ) levels @ % to @ % ( @-@ mmol/mol ) were randomized ( by using an interactive voice response system ) to receive placebo ( n = @ ) , dapagliflozin @ mg ( n = @ ) , or dapagliflozin @ mg ( n = @ ) .


The primary end point was mean change from baseline in HbA@c level at week @ ( last-observation-carried-forward ) .


Secondary end points included changes in fasting plasma glucose , @-hour postprandial glucose , body weight , and other glycemic parameters .


Baseline characteristics were balanced across groups .


Most patients ( @ % ) were Chinese , median disease duration was @ year , and mean HbA@c level was @ % .


Most patients ( @ % ) completed the study .


At week @ , mean reductions in HbA@c were -@ % for placebo versus -@ % and -@ % for dapagliflozin @ and @ mg , respectively ( P < @ for both doses ) .


Changes in fasting plasma glucose were @ , -@ , and -@ mg/dL ( @ , -@ , and -@ mmol/L ) for placebo , dapagliflozin @ mg , and dapagliflozin @ mg .


Changes in @-hour postprandial glucose were @ , -@ , and -@ mg/dL ( @ , -@ , and -@ mmol/L ) .


Reductions in body weight were -@ , -@ , and -@ kg .


Proportions of patients achieving HbA@c levels < @ % ( @ mmol/mol ) were @ % , @ % , and @ % .


Adverse events ( AEs ) occurred in @ % , @ % , and @ % of patients , and serious AEs occurred in @ % , @ % , and @ % of patients .


No deaths occurred .


Hypoglycemia was uncommon ( @ % , @ % , and @ % ) ; no hypoglycemic event led to discontinuation .


Genital infections occurred in @ % , @ % , and @ % of patients and urinary tract infections in @ % , @ % , and @ % of patients .


No AEs of renal infection or pyelonephritis were reported .


No changes in renal function or AEs of renal failure occurred .


Compared with placebo , dapagliflozin @ and @ mg demonstrated clinically and statistically significant improvements in HbA@c levels after @ weeks of treatment .


Dose-dependent , statistically significant reductions in fasting plasma glucose , postprandial glucose , and weight were also observed for both doses compared with placebo .


AEs and serious AEs were balanced across groups , with low rates of hypoglycemia and no increase in renal events .


Genital infections and urinary tract infections were more common with dapagliflozin .


Dapagliflozin as monotherapy in these drug-naive Asian patients was well tolerated , significantly improving glycemic control with the additional benefit of weight loss .


Correcting volumetric measurements of brain structures for intracranial volume ( ICV ) is important in comparing volumes across subjects with different ICV .


The aim of this study was to investigate whether intracranial area ( ICA ) reliably predicts actual ICV in a healthy pediatric cohort and in children with convulsive status epilepticus ( CSE ) .


T@-weighted volumetric MRI was performed on @ healthy children ( control group ) , @ with CSE with structurally normal MRI ( CSE/MR - ) , and @ with CSE with structurally abnormal MRI ( CSE/MR + ) .


ICA , using a mid-sagittal slice , and the actual ICV were measured .


A high Spearman correlation was found between the ICA and ICV measurements in the control ( r = @ ; P < @ ) , CSE/MR - ( r = @ ; P = @ ) , and CSE/MR + ( r = @ ; P < @ ) groups .


On comparison of predicted and actual ICV , there was no significant difference in the CSE/MR - group ( P = @ ) .


However , the comparison between predicted and actual ICV was significantly different in the CSE/MR + ( P = @ ) group .


Our Bland-Altman plot showed that the ICA method consistently overestimated ICV in children in the CSE/MR + group , especially in those with small ICV or widespread structural abnormalities .


After further validation , ICA measurement may be a reliable alternative to measuring actual ICV when correcting volume measurements for ICV , even in children with localized MRI abnormalities .


Caution should be applied when the method is used in children with small ICV and those with multilobar brain pathology .


The role of zoledronic acid ( ZA ) when added to the neoadjuvant treatment of breast cancer ( BC ) in enhancing the clinical and pathological response of tumors is unclear .


The effect of ZA on the antitumor effect of neoadjuvant chemotherapy has not prospectively been studied before .


NEOZOTAC is a national , multicenter , randomized study comparing the efficacy of TAC ( docetaxel , adriamycin and cyclophosphamide i.v. ) followed by granulocyte colony-stimulating factor on day @ with or without ZA @ mg i.v. q @ weeks inpatients withstage II/III , HER@-negative BC .


We present data on the pathological complete response ( pCR in breast and axilla ) , on clinical response using MRI , and toxicity .


Post hoc subgroup analyses were undertaken to address the predictive value of menopausal status .


Addition of ZA to chemotherapy did not improve pCR rates ( @ % for TAC+ZA versus @ % for TAC ) .


Postmenopausal women ( N = @ ) had a numerical benefit from ZA treatment ( pCR @ % for TAC+ZA versus @ % for TAC , P = @ ) .


Clinical objective response did not differ between treatment arms ( @ % versus @ % ) .


There was no difference in grade III/IV toxicity between treatment arms .


Addition of ZA to neoadjuvant chemotherapy did not improve pathological or clinical response to chemotherapy .


Further investigations are warranted in postmenopausal women with BC , since this subgroup might benefit from ZA treatment .


To evaluate the effect of an exercise training program combining low-impact dance aerobic , resistance and stretching exercise on physical fitness , hormone and lipid levels of postpartum , primiparous , lactating women .


Thirty seven primiparous , lactating women were randomly assigned at @-@ weeks postpartum to either follow an exercise training program of @-@ min aerobic , strengthening and stretching exercise , @ days a week , for @ weeks ( interventional group ; n = @ ) or no training program at all ( control group ; n = @ ) .


The following parameters were measured at baseline and @ weeks later : ( @ ) for evaluation of physical fitness : VO@max , muscular endurance , joint mobility and body fat ; ( @ ) for evaluation of the lipidemic profile : triglyceride , total cholesterol , HDL and LDL levels , and ( @ ) levels of hormones associated with lactation : prolactin , estradiol , cortisol , TSH , fT@ and fT@ .


After completion of the exercise training program , comparisons between the interventional and the control group showed statistically significant mean changes in VO@max ( p = @ ) , muscular endurance of the upper extremities ( p < @ ) , and the abdomen ( p < @ ) , flexibility ( p = @ ) , and body fat ( p = @ ) .


There were no significant differences between the two groups in mean changes of lipid and hormone levels .


Implementation of a low-impact exercise training program appears to improve physical fitness of postpartum women , while it does not seem to affect lipid levels and lactation-associated hormone levels .


Hence , implementation of an exercise training program combining low-impact dance aerobic , resistance and stretching exercise is feasible in postpartum , primiparous , lactating women .


To investigate the effects of intensive blood pressure ( BP ) lowering according to baseline BP levels and optimal achieved BP levels in patients with acute intracerebral hemorrhage ( ICH ) .


INTERACT@ was an open , blinded endpoint , randomized controlled trial in @,@ patients with ICH within @ hours of onset and elevated systolic BP ( SBP ) ( @-@ mm Hg ) who were allocated to receive intensive ( target SBP < @ mm Hg within @ hour , with lower limit of @ mm Hg for treatment cessation ) or guideline-recommended ( target SBP < @ mm Hg ) BP-lowering treatment .


Outcome was physical function across all @ levels of the modified Rankin Scale at @ days .


Analysis of the randomized comparisons showed that intensive BP lowering produced comparable benefits on physical function at @ days in @ subgroups defined by baseline SBP of < @ , @-@ , @-@ , @-@ , and @ mm Hg ( p homogeneity = @ ) .


Analyses of achieved BP showed linear increases in the risk of physical dysfunction for achieved SBP above @ mm Hg for both hyperacute ( @-@ hours ) and acute ( @-@ days ) phases while modest increases were also observed for achieved SBP below @ mm Hg .


Intensive BP lowering appears beneficial across a wide range of baseline SBP levels , and target SBP level of @-@ mm Hg is likely to provide maximum benefit in acute ICH .


This study provides Class I evidence that the effect of intensive BP lowering on physical function is not influenced by baseline BP .


To observe the effect of Qiju Dihuang Pill ( QDP ) on changes of Chinese medical syndrome types in pregnant women of Gan-Shen yin deficiency syndrome ( GSYDS ) , and to explore the correlation between imbalanced cytokine levels and GSYDS .


This was a random controlled trail .


A total of @ pregnant women of GSYDS at @ -@ gestational weeks were randomly allocated into the experimental group ( @ cases ) and the control group ( @ cases ) .


Patients in the experimental group took QDP for @ -@ weeks .


Changes of Chinese medical syndrome types and serum interferon-gamma ( IFN-gamma ) and interleukin-@ ( IL-@ ) levels were observed and compared between the two groups before and after treatment .


( @ ) Totally @ patients ( @ % ) in the experimental group were transformed to normal Chinese medical syndrome type .


In the same period of the follow-ups , @ patients ( @ % ) in the control group were transformed to normal Chinese medical syndrome type , showing statistical difference ( P < @ ) .


( @ ) In the experimental group , the serum level of IFN-gamma and the ratio of IFN-gamma/IL -@ in the peripheral blood were obviously lower after treatment than before treatment ( P < @ ) , and obviously lower than those in the control group ( P < @ ) .


The level of IL-@ after treatment in the experimental group was higher than that before treatment , and also higher than that in the control group , but with no statistical difference .


These results indicated that there was imbalanced IFN-gamma/IL -@ ratio in the peripheral blood of pregnant women of GSYDS .


QDP might play a role in immunoregulation by affecting the IFN-gamma level .


The aim of this study was to compare the effect of two energy-restricted , differing with regard to protein content , on the inflammation state of obese individuals with features of metabolic syndrome .


Ninety-six participants completed an @-wk randomized intervention trial that compared the RESMENA diet ( -@ % energy , with @ % energy from protein ) with a control diet ( -@ % energy , with @ % energy from protein ) that was based on American Heart Association criteria .


The mean body weight losses were @ @ kg and @ @ kg , respectively , with no differences seen between the groups .


The endpoint inflammation score-which was based on high-sensitivity C-reactive protein , interleukin-@ , tumor necrosis factor - , and plasminogen activator inhibitor-@ levels-was significantly lower ( P = @ ) in the low-protein group ( @ @ versus @ @ ) .


The linear regression analyses revealed that total protein intake was positively associated with inflammation ( P = @ ) as well as with animal protein ( P = @ ) and meat protein ( P = @ ) , but neither vegetable - nor fish-derived proteins were found to influence inflammatory status .


Our results suggest that the type of protein consumed ( more than the total protein consumed ) within an energy-restricted diet influences the inflammation status associated with obesity-related comorbidities .


Loneliness enhances risk for episodic memory declines over time .


Omega-@ supplementation can improve cognitive function for people experiencing mild cognitive difficulties .


Accordingly , we explored whether omega-@ supplementation would attenuate loneliness-related episodic memory problems .


Participants ( n = @ ) from a parent randomized controlled trial were randomized to the placebo , @ grams/d of omega-@ , or @ grams/d of omega-@ conditions for a @-month period .


They completed a baseline loneliness questionnaire and a battery of cognitive tests both at baseline and at the end of the randomized controlled trial .


After adjustment for baseline verbal episodic memory scores , lonelier people within the placebo condition had poorer verbal episodic memory postsupplementation , as measured by immediate ( b = -@ , t ( @ ) = -@ , p = @ ) and long-delay ( b = -@ , t ( @ ) = -@ , p = @ ) free recall , than their less lonely counterparts .


This effect was not observed in the @ - and @-grams / d supplementation groups ( all p values > @ ) .


The plasma omega-@ : omega-@ ratio data mirrored these results .


There were no loneliness-related effects of omega-@ supplementation on short-delay recall or the other cognitive tests ( all p values > @ ) .


These results suggest that omega-@ supplementation attenuates loneliness-related verbal episodic memory declines over time and support the use of exploring novel interventions for treating episodic memory problems among lonely people .


To evaluate the effect of surgical factors on postoperative astigmatism in infants undergoing cataract extraction with or without intraocular lens ( IOL ) implantation .


The Infant Aphakia Treatment Study is a multicenter clinical trial in which @ infants with unilateral congenital cataracts were randomized to undergo cataract extraction with IOL placement or contact lens aphakic correction .


Surgical videos were reviewed with regard to incision type and location , whether the incision was extended , the number of sutures placed , and technique of closure .


Corneal astigmatism was measured using a handheld keratometer prior to surgery and at @ year of age .


Corneal astigmatism decreased from a mean of @ D at baseline to @ D at age @ year in the contact lens group but remained almost unchanged from @ D to @ D in the IOL group ( P = @ ) .


There was no statistical difference between the amount of corneal astigmatism with regard to incision type ( P = @ ) and no increase in astigmatism with extension of the incision to facilitate IOL placement ( P = @ ) at @ year .


The number of sutures and technique of closure did not influence the amount of astigmatism at @ year .


At the age of @ year following cataract extraction in infants , contact lens correction and the lack of IOL placement are associated with a significant decrease in postoperative corneal astigmatism compared to IOL placement .


No other surgical factors considered in this study had a statistically significant effect on corneal astigmatism .


This study assessed the efficacy of a @-hour communication skills training program designed to train a multidisciplinary radiotherapy team .


Four radiotherapy teams were randomly assigned to a training program or a waiting list .


Assessments were scheduled at baseline and after training for the training group and at baseline and @ months later for the waiting list group .


Assessments included an audio recording of a radiotherapy planning session to assess team members ' communication skills and expression of concerns of patients with breast cancer ( analyzed with content analysis software ) and an adapted European Organisation for Research and Treatment of Cancer satisfaction with care questionnaire completed by patients at the end of radiotherapy .


Two hundred thirty-seven radiotherapy planning sessions were recorded .


Compared with members of the untrained teams , members of the trained teams acquired , over time , more assessment skills ( P = @ ) and more supportive skills ( P = @ ) and provided more setting information ( P = @ ) .


Over time , patients interacting with members of the trained teams asked more open questions ( P = @ ) , expressed more emotional words ( P = @ ) , and exhibited a higher satisfaction level regarding nurses ' interventions ( P = @ ) .


The @-hour training program facilitated transfer of team member learned communication skills to the clinical practice and improved patients ' satisfaction with care .


Although selective serotonin reuptake inhibitors are now established as first-line pharmacotherapy for social anxiety disorder ( SAD ) , other agents with different mechanisms have shown promise in treating SAD .


The aim of this study was to examine the efficacy and safety of tandospirone in treating adolescents with SAD .


Adolescent patients meeting the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition ( DSM-IV ) criteria for SAD were randomly assigned ( @:@ ) to open-label treatment with either tandospirone or sertraline for @weeks .


The primary outcome measures were changes from baseline in the Hamilton Anxiety ( HAM-A ) scale and response using the Clinical Global Impression of Improvement ( CGI-I ) scale .


The adjusted mean change in HAM-A scores from baseline was indicating a significant improvement over baseline in both treatment arms ( p < @ ) .


The mean CGI-I scale score at week was with no significant difference between the two arms ( p = @ ) .


Rates of response were @ % for tandospirone and @ % for sertraline using the CGI-I .


Response rates were @ % for tandospirone and @ % for sertraline using a HAM-A response criterion ( @ % reduction ) .


The adjusted mean change in Social Phobia Inventory scores from baseline was indicating a significant improvement over baseline in both treatment arms ( p < @ ) .


Tandospirone is safe and effective and appears non-inferior to sertraline for SAD in youths .


The CAREvent Public Access Resuscitator ( PAR ) is an electronic , oxygen-driven cardiopulmonary resuscitation ( CPR ) device allowing volume-controlled ventilation with a face mask and guiding the rescuer through the resuscitation with voice prompts and visual indications .


We hypothesized that @ year after initial training , the efficacy of ventilation skills ( primary outcome ) and compression skills ( secondary outcome ) by first responders using the PAR would be superior compared with CPR with only a face mask .


Seventy-one first responders were randomized to a group using the PAR ( n = @ ) and a control group using only a face mask ( n = @ ) .


CPR skills were assessed immediately after training and after @ , @ and @ months using a Skill Reporter manikin .


Differences between groups over time and the interaction between time and groups were assessed using repeated measures models .


Results are reported as mean values and number of participants with good ventilation or compression skills .


Twelve months after training , there were more PAR users with adequate tidal volume than face mask users .


Other ventilations skills did not differ between groups .


There were more PAR users with an adequate number of compressions and with good hand position .


Skill decay over @ months did not differ between groups , except for hand position , where no decline was observed in the PAR group .


Compared with the face mask , PAR improved tidal volume , compressions per minute and hand position in a manikin setting .


Metatarsus adductus is a common pediatric foot deformity related to intrauterine molding .


It is usually a mild deformity that responds well to simple observation or minimal treatment with a home program of stretching .


Resistant cases may need a more aggressive approach such as serial casting or special bracing to avoid the need for surgical intervention .


We compared clinical outcomes using serial casting with orthoses for resistant metatarsus adductus .


We prospectively treated @ infants ( @ feet ) between the ages @ and @ months who failed home stretching treatment .


Patients were randomized to either serial plaster casting or Bebax orthoses .


Footprints and simulated weight-bearing anteroposterior and lateral view radiographs were made at entry and follow-up .


There was no statistical difference between casting and Bebax for the following parameters : age at study entry , length of treatment , number of clinic visits , follow-up , and follow-up maintenance treatments .


Both groups showed improvement in footprint and radiographic measurements post-treatment , without worsening of heel valgus .


The Bebax group had greater improvement in the footprint heel bisector measurement than the casting group .


The Bebax treatment requires more active parental cooperation .


A simulated cost analysis of materials and office visit charges , however , revealed that Bebax treatment was significantly less expensive , about half the cost of casting .


Because of the cost savings and virtually identical clinical results , we recommend the Bebax orthosis for resistant metatarsus in pre-walking infants with parents who are compliant .


Other considerations include specific insurance plans , which may pay for casts but not orthoses .


The aim was to compare the hemodynamic parameters , intubation times , upper airway trauma and postoperative sore throat scores of the patients with normal airway anatomy , intubated with the Airtraq , Macintosh laryngoscope and fiberoptic bronchoscope , by experienced anesthesiologists .


Ninety patients , scheduled to undergo elective surgery under general anesthesia were randomly divided into three groups ( n = @ ) : Group A : Airtraq laryngoscope , Group M : Macintosh laryngoscope and Group FB : fiberoptic bronchoscope .


The time to intubation and success rates were recorded .


The hemodynamic parameters before and one minute after the anesthesia induction were recorded and the measurements were repeated @ , @ and @ minutes after the endotracheal intubation .


The postoperative sore throat scores and signs of any trauma were also recorded .


Mean arterial blood pressure and heart rate were not significantly different between the three groups .


The mean intubation time interval did not differ between groups .


Highest postoperative sore throat scores were recorded at the @th hour post extubation .


The scores were @ + / - @ in Group A , @ + / - @ in Group M and @ + / - @ in Group FB .


The scores in Group A were significantly higher compared to other groups .


The number of patients requiring additional analgesia to relieve sore throat was also significantly higher in Group A.


The Airtraq laryngoscope seems to be a more traumatic airway device in the routine endotracheal intubation compared to Macintosh laryngoscope and fiberoptic bronchoscope , when used by experienced anesthesiologists .


It also does not offer advantage over the first-attempt success rates , the intubation times and hemodynamic parameters .


Oncostatin M ( OSM ) has been implicated in the pathophysiology of rheumatoid arthritis ( RA ) through its effect on inflammation and joint damage .


GSK@ is a humanised anti-OSM Immunoglobulin G@ ( IgG@ ) monoclonal antibody ( mAb ) .


This @-part study examines the safety , tolerability and efficacy of GSK@ in patients with active RA .


This was a @-part ( Parts A , B and C ) , multicenter study .


Part A and Part B were randomised , double-blind , placebo-controlled , Bayesian adaptive dose finding studies to investigate the safety , tolerability , efficacy , pharmacokinetics and pharmacodynamics of single ( Part A ) and @ repeat ( Part B ) intravenous infusions of GSK@ in patients with active RA on a background of methotrexate ( MTX ) .


Part C was a single dose , randomised , single-blind , placebo-controlled study to assess subcutaneously administered GSK@ to patients with active RA on a background of MTX .


The primary endpoint of the study was mean change in DAS@ at Day @ in Part A and Day @ in Part B and C. All patients receiving at least one dose of GSK@ were included in safety analysis .


In Part A , there were statistically significant differences in DAS@ between @ mg/kg and placebo at Day @ , @ and @ .


There was also a statistically significant difference in DAS@ between @ mg/kg , @ mg/kg and @ mg/kg , as compared to placebo , at Day @ .


Although these changes were small and occurred late , they supported progression to Part B and C to determine the therapeutic potential of GSK@ .


For Part B , no significant difference was observed between @ mg/kg and placebo .


For Part C , a statistically significant difference in DAS@ was observed at Day @ , Day @ and Day @ between the @ mg subcutaneous group , as compared to placebo .


No significant findings were observed at any of the time points for EULAR response criteria , ACR@ , ACR@ or ACR@ .


An exploratory analysis of clinical , pharmacokinetic and pharmacodynamics data suggests the lack of efficacy may be due to moderate binding affinity and rapid off-rate of GSK@ as compared to the higher affinity OSM receptor causing a protein carrier effect prolonging the half life of OSM due to accumulation of the OSM/antibody complex in the serum and synovial fluid .


Our data highlighted the importance of binding affinity and off-rate effect of a mAb to fully neutralize the target and how this may influence its efficacy and potentially worsen disease activity .


Using an anti-OSM mAb with high affinity should test this hypothesis and examine the potential of OSM as a therapeutic target in RA .


Screening can reduce colorectal cancer ( CRC ) incidence and mortality .


However , screening is underutilized in vulnerable patient populations , particularly among Latinos .


Patient-directed decision aids can increase CRC screening knowledge , self-efficacy , and intent ; however , their effect on actual screening test completion tends to be modest .


This is probably because decision aids do not address some of the patient-specific barriers that prevent successful completion of CRC screening in these populations .


These individual barriers might be addressed though patient navigation interventions .


This study will test a combined decision aid and patient navigator intervention on screening completion in diverse populations of vulnerable primary care patients .


We will conduct a multisite , randomized controlled trial with patient-level randomization .


Planned enrollment is @ patients aged @ to @years at average CRC risk presenting for appointments at two primary clinics in North Carolina and New Mexico .


Intervention participants will view a video decision aid immediately before the clinic visit .


The @ to @minute video presents information about fecal occult blood tests and colonoscopy and will be viewed on a portable computer tablet in English or Spanish .


Clinic-based patient navigators are bilingual and bicultural and will provide both face-to-face and telephone-based navigation .


Control participants will view an unrelated food safety video and receive usual care .


The primary outcome is completion of a CRC screening test at six months .


Planned subgroup analyses include examining intervention effectiveness in Latinos , who will be oversampled .


Secondarily , the trial will evaluate the intervention effects on knowledge of CRC screening , self-efficacy , intent , and patient-provider communication .


The study will also examine whether patient ethnicity , acculturation , language preference , or health insurance status moderate the intervention effect on CRC screening .


This pragmatic randomized controlled trial will test a combined decision aid and patient navigator intervention targeting CRC screening completion .


Findings from this trial may inform future interventions and implementation policies designed to promote CRC screening in vulnerable patient populations and to reduce screening disparities .


Diarrhoea and pneumonia contribute @ % of deaths in children under @ in Pakistan .


Pakistan 's Lady Health Workers Programme ( LHW-P ) covers about @ % of the population but has had little impact in reducing morbidity and mortality related to these major childhood killers .


An external evaluation of the LHW-P suggests that lack of supportive supervision of LHWs by lady health supervisors ( LHSs ) is a key determinant of this problem .


Project NIGRAAN aims to improve knowledge and skills of LHWs and community caregivers through supervisory strategies employed by LHSs .


Ultimately , community case management ( CCM ) of childhood pneumonia and diarrhoea will improve .


NIGRAAN is a cluster-randomised trial in District Badin , Pakistan .


There are approximately @ LHWs supervised by @ LHSs in Badin .


For this study , each LHS serves as a cluster .


All LHSs working permanently in Badin who regularly conduct and report field visits are eligible .


Thirty-four LHSs have been allocated to either intervention or control arms in a ratio of @:@ through computer-generated simple randomisation technique .


Five LHWs from each LHSs are also randomly picked .


All @ LHSs and @ LHWs will be actively monitored .


The intervention consists of training to build LHS knowledge and skills , clinical mentorship and written feedback to LHWs .


Pre - and post-intervention assessments of LHSs , LHWs and community caregivers will be conducted via focus group discussions , in-depth interviews , knowledge assessment questionnaires , skill assessment scorecards and household surveys .


Primary outcome is improvement in CCM practices of childhood diarrhoea and pneumonia and will be assessed at the cluster level .


NIGRAAN takes a novel approach to implementation research and explores whether training of LHSs in supervisory skills results in improving the CCM practices of childhood diarrhoea and pneumonia .


No significant harm to participants is anticipated .


The enablers and barriers towards improved CCM would provide recommendations to policymakers for scale up of this intervention nationally and regionally .


To evaluate and compare peri-implant health , marginal bone loss and success of immediate and delayed implant placement for rehabilitation with full-arch fixed prostheses .


The present study was a prospective , randomized , single-blind , clinical preliminary trial .


Patients were randomized into two treatment groups .


In Group A implants were placed immediately post-extraction and in Group B six months after extraction .


The following control time-points were established : one week , six months and twelve months after loading .


Measurements were taken of peri-implant crevicular fluid volume , plaque index , gingival retraction , keratinized mucosa , probing depth , modified gingival index and presence of mucositis .


Implant success rates were evaluated for the two groups .


The study sample included fifteen patients ( nine women and six men ) with a mean average age of @ years .


One hundred and forty-four implants were placed : @ placed in healed sites and @ placed immediately .


At the moment of prosthetic loading , keratinized mucosa width and probing depth were higher in immediate implants than delayed implants , with statistically significant differences .


However , after six and twelve months , differences between groups had disappeared .


Bone loss was @ @ mm for immediate implants and @ @ mm for delayed implants ( p = @ ) .


No implants failed in either group .


The present study with a short follow-up and a small sample yielded no statistically significant differences in implant success and peri-implant marginal bone loss between immediate and delayed implants with fixed full-arch prostheses .


Peri-implant health showed no statistically significant differences for any of the studied parameters ( crevicular fluid volume , plaque index , gingival retraction , keratinized mucosa , probing depth , modified gingival index and presence of mucositis ) at the twelve-month follow-up .


To observe the effect of postoperative analgesia with dexmedetomidine on the survival rate of amputated finger replantation .


@ cases , who was going to receive amputated finger replantation , were randomly divided into group A ( n = @ ) and B ( n = @ ) .


PCIA ( patient-controlled intravenous analgesia ) was set immediately after operation in group A ( fentanyl @ mg + tropisetron @ mg + @ mg + dexmedetomidine @ microg + saline @ ml ) and group B ( same as group A except dexmedetomidine ) .


Background infusion is @ ml/h with a bolous of @ ml and lockout time is @ min .


postoperative VAS score , Ramsay score , condition of replanted fingers and other adverse events at the @-@ h , @-@ h , @-@ h and @-@ h were recorded and analyzed .


The age , sex , height , weight , amputated time ( Ts ) , revascularized time ( Tt ) in the two groups were not statistically different ( P > @ ) .


Postoperative VAS score in the two groups was significantly different at the @-@ h , @-@ h , @-@ h and @-@ h ( P < @ ) , but Ramsay score was not ( P > @ ) .


The highest and lowest postoperative VAS score and Ramsay score were markedly different between two groups ( P < @ ) .


@ of the @ fingers in group A experienced vascular crisis and @ underwent vascular explore surgery .


@ of @ fingers in group B occurred vascular crisis , and @ underwent vascular explore surgery , showing significant difference between the two groups ( P < @ ) .


PCIA adverse reactions showed no difference between the two groups ( P > @ ) .


Bradycardia and hypotension did n't happen in any patients in the two groups .


@ weeks after surgery , the survival rate was @ % ( @/@ ) in group A , and @ % ( @/@ ) in group B ( P < @ ) .


Postoperative analgesia with dexmedetomidine as an adjuvant can increase the survival rate of replantation fingers with high safety .


Trabectedin binds to the minor groove of DNA and blocks DNA repair machinery .


Preclinical data have shown that trabectedin also modulates the transcription of the oncogenic fusion proteins of translocation-related sarcomas .


We aimed to assess the efficacy and safety of trabectedin as second-line therapy or later for patients with advanced translocation-related sarcoma .


We did a multicentre randomised open-label study in Japan .


Eligible patients had pathological diagnosis of translocation-related sarcoma , were aged @ years or older , were unresponsive or intolerant to standard chemotherapy regimens , no more than four previous chemotherapy regimens , Eastern Cooperative Oncology Group performance status @ or @ , adequate bone marrow reserve , renal and liver functions , and had measurable lesions .


Patients were randomly assigned ( @:@ ) by the minimisation method to receive either trabectedin ( @ mg/m ( @ ) given via a central venous line over @ h on day @ of a @ day treatment cycle ) or best supportive care , which was adjusted centrally by pathological subtype .


Investigators , patients , and the sponsor were unmasked to the treatment assignment .


Progression-free survival and objective responses were assessed by a masked central radiology imaging review .


Efficacy was assessed by masked central radiology imaging review .


The primary endpoint was progression-free survival for the full analysis set population .


Follow-up is ongoing for the patients under study treatment .


The study is registered with Japan Pharmaceutical Information Center , number JapicCTI-@ .


Between July @ , @ , and Jan @ , @ , @ patients were enrolled and allocated to receive either trabectedin ( n = @ ) or best supportive care ( n = @ ) .


After central review to confirm pathological subtypes , @ patients ( @ in the trabectedin group and @ in the best supportive care group ) were included in the primary efficacy analysis .


Median progression-free survival of the trabectedin group was @ months ( @ % CI @-@ ) and the best supportive care group was @ months ( @-@ ) .


The hazard ratio ( HR ) for progression-free survival of trabectedin versus best supportive care was @ ( @ % CI @-@ and @ % CI @-@ ) by a Cox proportional hazards model ( p < @ ) .


The most common drug-related adverse events for patients treated with trabectedin were nausea ( @ -LSB- @ % -RSB- of @ ) , decreased appetite ( @ -LSB- @ % -RSB- ) , decreased neutrophil count ( @ -LSB- @ % -RSB- ) , increased alanine aminotransferase ( @ -LSB- @ % -RSB- ) , and decreased white blood cell count ( @ -LSB- @ % -RSB- ) .


Trabectedin significantly reduced the risk of disease progression and death in patients with advanced translocation-related sarcoma after standard chemotherapy such as doxorubicin , and should be considered as a new therapeutic treatment option for this patient population .


Marked activation of the sympathetic nervous system occurs during and after noncardiac surgery .


Low-dose clonidine , which blunts central sympathetic outflow , may prevent perioperative myocardial infarction and death without inducing hemodynamic instability .


We performed a blinded , randomized trial with a @-by-@ factorial design to allow separate evaluation of low-dose clonidine versus placebo and low-dose aspirin versus placebo in patients with , or at risk for , atherosclerotic disease who were undergoing noncardiac surgery .


A total of @,@ patients at @ centers in @ countries were enrolled .


For the comparison of clonidine with placebo , patients were randomly assigned to receive clonidine ( @ mg per day ) or placebo just before surgery , with the study drug continued until @ hours after surgery .


The primary outcome was a composite of death or nonfatal myocardial infarction at @ days .


Clonidine , as compared with placebo , did not reduce the number of primary-outcome events ( @ and @ , respectively ; hazard ratio with clonidine , @ ; @ % confidence interval -LSB- CI -RSB- , @ to @ ; P = @ ) .


Myocardial infarction occurred in @ patients ( @ % ) assigned to clonidine and in @ patients ( @ % ) assigned to placebo ( hazard ratio , @ ; @ % CI , @ to @ ; P = @ ) .


Significantly more patients in the clonidine group than in the placebo group had clinically important hypotension ( @ patients -LSB- @ % -RSB- vs. @ patients -LSB- @ % -RSB- ; hazard ratio @ ; @ % CI , @ to @ ; P < @ ) .


Clonidine , as compared with placebo , was associated with an increased rate of nonfatal cardiac arrest ( @ % -LSB- @ patients -RSB- vs. @ % -LSB- @ patients -RSB- ; hazard ratio , @ ; @ % CI , @ to @ ; P = @ ) .


Administration of low-dose clonidine in patients undergoing noncardiac surgery did not reduce the rate of the composite outcome of death or nonfatal myocardial infarction ; it did , however , increase the risk of clinically important hypotension and nonfatal cardiac arrest .


( Funded by the Canadian Institutes of Health Research and others ; POISE-@ ClinicalTrials.gov number , NCT@ . )


Right ventricular ( RV ) outflow tract obstruction ( RVOTO ) might protect the RV from adverse remodeling caused by significant pulmonary regurgitation ( PR ) in patients with repaired tetralogy of Fallot ( rTOF ) , but the underlying mechanisms and influences on exercise tolerance remain unclear .


This study sought to investigate the impacts from mild RVOTO on ventricular remodeling and exercise capacity in rTOF .


Eighty-five rTOF patients with a PR fraction @ % were assessed with cardiac magnetic resonance , cardiopulmonary exercise test , and echocardiography .


Patients with a peak RVOT pressure gradient @-@ mmHg were considered to have mild RVOTO ( n = @ ) , while those with a gradient < @ mmHg had isolated PR ( n = @ ) .


Comparing to patients with isolated PR , patients with combined PR and mild RVOTO had smaller RV and RVOT dimension , better RV and left ventricular ( LV ) ejection fraction ( EF ) , and superior exercise capacity .


PR severity and RV mass/volume ratio were similar between these @ groups .


LVEF coupled with RVEF only in patients with isolated PR .


In multivariate analysis , smaller RVOT dimension was independently related to smaller RV dimension ( P < @ ) and higher RVEF ( P = @ ) .


Furthermore , mild RVOTO was independently associated with higher peak oxygen consumption ( P = @ ) and oxygen uptake efficiency slope ( P = @ ) .


Patients with combined PR and mild RVOTO had better RV remodeling and exercise capacity compared to those with isolated PR .


Our findings confirm the benefits from mild residual RVOTO support a policy of conservative RVOTO relief at repair .


Muscle mitochondrial function can vary during fasting , but is lower during hyperinsulinaemia in insulin-resistant humans .


Ageing and hyperlipidaemia may be the culprits , but the mechanisms remain unclear .


We hypothesised that ( @ ) insulin would fail to increase mitochondrial oxidative capacity in non-diabetic insulin-resistant young obese humans and in elderly patients with type @ diabetes and ( @ ) reducing NEFA levels would improve insulin sensitivity by raising oxidative capacity and lowering oxidative stress .


Before and after insulin ( @ , @ , @ nmol/l ) stimulation , mitochondrial oxidative capacity was measured in permeabilised fibres and isolated mitochondria using high-resolution respirometry , and H@O@ production was assessed fluorimetrically .


Tissue-specific insulin sensitivity was measured with hyperinsulinaemic-euglycaemic clamps combined with stable isotopes .


To test the second hypothesis , in a @-day randomised , crossover study , @ patients with type @ diabetes recruited via local advertisement were assessed for eligibility .


Nine patients fulfilled the inclusion criteria ( BMI < @ kg/m ( @ ) ; age < @ years ) and were allocated to and completed the intervention , including oral administration of @ mg placebo or acipimox .


Blinded randomisation was performed by the pharmacy ; all participants , researchers performing the measurements and those assessing study outcomes were blinded .


The main outcome measures were insulin sensitivity , oxidative capacity and oxidative stress .


Insulin sensitivity and mitochondrial oxidative capacity were ~ @ % and ~ @ % lower in the obese groups than in the lean group .


The obese participants also exhibited blunted substrate oxidation upon insulin stimulation .


In the patients with type @ diabetes , acipimox improved insulin sensitivity by ~ @ % and reduced H@O@ production by ~ @ % , but did not improve basal or insulin-stimulated mitochondrial oxidative capacity .


No harmful treatment side effects occurred .


Decreased mitochondrial oxidative capacity can also occur independently of age in insulin-resistant young obese humans .


Insulin resistance is present at the muscle mitochondrial level , and is not affected by reducing circulating NEFAs in type @ diabetes .


Thus , impaired plasticity of mitochondrial function is an intrinsic phenomenon that probably occurs independently of lipotoxicity and reduced glucose uptake .


Hereditary angioedema ( HAE ) , caused by C@ inhibitor ( C@INH ) deficiency or dysfunction , is characterized by recurrent attacks of tissue swelling affecting multiple anatomic locations .


Recombinant human C@INH ( rhC@INH ) has been shown effective for acute treatment of HAE attacks .


To evaluate the efficacy and safety of rhC@INH ( @ IU/kg to maximum @,@ IU/treatment ) vs placebo in a larger HAE population .


Seventy-five patients experiencing peripheral , abdominal , facial , and/or oropharyngeal laryngeal attacks were randomized ( @:@ ) to rhC@INH ( n = @ ) or placebo ( saline ; n = @ ) .


Efficacy was assessed bypatient responses on a Treatment Effect Questionnaire ( TEQ ) and visual analog scale ( VAS ) .


Safety also was evaluated .


Median ( @ % confidence interval ) time to beginning of symptom relief at the primary attack location was @ minutes ( @-@ ) in rhC@INH-treated patients vs @ minutes ( @ , not estimable ) in placebo-treated patients ( P = @ ) based on the TEQ and @ minutes ( @-@ ) vs @ minutes ( @-@ , P = @ ) based on a VAS decrease of at least @ mm .


Median time to minimal symptoms was @ minutes ( @-@ ) in rhC@INH-treated patients vs @ minutes ( @-@ ,@ ) in placebo-treated patients based on the TEQ ( P = @ ) and @ minutes ( @-@ ) vs @ minutes ( @ , not estimable ; P = @ ) , based on an overall VAS less than @ mm .


Overall , rhC@INH was safe and well tolerated ; no thromboembolic events , anaphylaxis , or neutralizing antibodies were observed .


Relief of symptoms of HAE attacks was achieved faster with rhC@INH compared with placebo as assessed by the TEQ and VAS , with a positive safety profile .


Results are consistent with previous studies showing efficacy and safety of rhC@INH in patients with HAE .


Surgical interns are often not well prepared and have high anxiety about the execution of basic technical skills .


This study investigates whether a short preclinical course focusing on laparoscopic camera-navigating skills is useful in the preparation for internship .


Through randomization , an experimental group who attended a short laparoscopic training session and a control group were created .


Students ' interest for this training and their confidence for laparoscopic exposure during surgical internship were inquired .


During internship , camera-navigating skills were assessed by the operating surgeons ( using a validated global rating scale ) as well as by the students themselves ( using a @-points Likert scale ) .


All research was performed in the Center for Surgical Technologies , Leuven , Belgium .


A total of @ fifth-year medical students at the University of Leuven , Belgium .


Of the control group students , @ % were interested in attending the training session .


There was no difference in confidence between experimental and control group .


According to the surgeons and students , there was a significant improvement in clinical performance from the first ( scores on global rating and Likert scales @ % ) to the last procedure ( scores @ % ) for both groups .


However , there was no difference in performance between groups .


Students are very interested in attending a preclinical laparoscopic training session .


However , trained students did not display higher confidence or better clinical performance during internship .


Even without previous training , students are fast to acquire the necessary skills during surgical internship .


The study was designed to investigate the effects of drenching with propylene glycol ( PG ) on body condition , serum metabolites and milk production during the transition period of dairy buffaloes .


Animals were randomly allocated to a control group ( n = @ ) and a PG group of @ buffaloes that were drenched with @ ml of propylene glycol once daily from @ ( @ ) days prepartum until @ weeks postpartum .


Ultrasound measurements of backfat thickness ( BFT ) were performed weekly , while blood samples were taken at -@ , -@ , @ , @ , @ , and @ weeks from parturition for estimation of hematological and biochemical metabolites .


At -@ , -@ , and -@ weeks from calving , BFT did not differ between the two groups , but decreased after calving and was higher for the control group than the PG group at weeks -@ and @ .


Hematological analysis revealed insignificant changes between the two groups .


Serum concentrations of non-esterified fatty acids ( NEFA ) , - hydroxybutyric acid ( BHBA ) and glucose did not differ between the two groups before parturition .


At @ and @ weeks from parturition , NEFA was higher for the control group than the PG group .


Serum concentrations of BHBA were higher at @ , @ , @ , and @ weeks in control animals than in treated buffaloes .


In contrast , the glucose level was significantly increased in PG group when compared to the control group at week @ postpartum ( p < @ ) .


Serum concentrations of total cholesterol , triglycerides , total proteins , albumin , and globulins did not differ significantly between the two groups ( p > @ ) .


Serum enzyme activities of aspartate aminotransferase and - glutamyl transferase were significantly higher in the control than in the PG group .


In treated buffaloes significantly ( p < @ ) higher average @-day milk yields were recorded ( @ vs. @ kg/day ) .


Milk composition did not differ between the two groups .


Drenching of dairy buffaloes with propylene glycol may reduce the risk of ketosis , improve the metabolic status , and increase the milk yield .


Spinal bone metastases are commonly diagnosed in cancer patients .


The consequences are pain both at rest and under exercise , impairment of activities of daily life ( ADL ) , reduced clinical performance , the risk of pathological fractures , and neurological deficits .


The aim of this randomized , controlled pilot trial was to investigate the feasibility of muscle-training exercises in patients with spinal bone metastases under radiotherapy .


Secondary endpoints were local control , pain response and survival .


This study was a prospective , randomized , monocentre , controlled explorative intervention trial to determine the multidimensional effects of exercises for strengthening the paravertebral muscles .


On the days of radiation treatment , patients in the control group were physically treated in form of respiratory therapy .


Sixty patients were randomized between September @ and March @ into one of the two groups : differentiated resistance training or physical measure with thirty patients in each group .


The resistance training of the paravertebral muscles was feasible in @ % of patients ( n = @ ) .


Five patients died during the first three months .


The exercise group experienced no measurable side effects .


`` Chair stand test '' in the intervention group was significant enhanced with additionally improved analgesic efficiency .


Patients in intervention group improved in pain score ( VAS , @-@ ) over the course ( p < @ ) , and was significant better between groups ( p = @ ) after @ months .


The overall pain response showed no significant difference between groups ( p = @ ) There was no significant difference in overall and bone survival ( survival from first diagnosed bone metastases to death ) .


Our trial demonstrated safety and feasibility of an isometric resistance training in patients with spinal bone metastases .


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


N-acetylcysteine ( NAC ) or sodium bicarbonate ( NaHCO@ ) , singly or combined , inconsistently prevent patients exposed to radiographic contrast media from developing contrast-induced acute kidney injury ( CI-AKI ) .


We asked whether intravenous isotonic saline and either NaHCO@ in @ % dextrose or else a high dose of NAC in @ % dextrose prevent CI-AKI in outpatients exposed to high-osmolal iodinated contrast medium more than does saline alone .


This completed prospective , parallel , superiority , open-label , controlled , computer-randomized , single-center , Brazilian trial ( NCT@ ) hydrated @ adult outpatients ( @ at high risk of developing CI-AKI ) exposed to ioxitalamate during elective coronary angiography and ventriculography .


From @ hour before through @ hours after exposure , @ patients ( group @ ) received a high dose of NAC and saline , @ ( group @ ) received NaHCO@ and saline , @ ( group @ ) received both treatments , and @ ( group @ ) received only saline .


Groups were similar with respect to age , gender , weight , pre-existing renal dysfunction , hypertension , medication , and baseline serum creatinine and serum cystatin C , but diabetes mellitus was significantly less prevalent in group @ .


CI-AKI incidence @ hours after exposure to contrast medium was @ % ( @/@ ) , measured as serum creatinine > ( baseline +@ mg/dL ) and/or serum cystatin C > ( @ baseline ) , and @ % ( @/@ ) , measured as both serum creatinine and serum cystatin C > ( baseline +@ mg/dL ) or > ( @ baseline ) .


CI-AKI incidence measured less sensitively was similar among groups .


Measured more sensitively , incidence in group @ was significantly ( p < @ ) lower than in groups @ and @ but not group @ ; adjustment for confounding by infused volume equalized incidence in groups @ and @ .


We found no evidence that intravenous isotonic saline and either NaHCO@ or else a high dose of NAC prevent CI-AKI in outpatients exposed to high osmolal iodinated contrast medium more than does saline alone .


The purpose of this study was to examine the relative effectiveness of @ forms of physical education instruction on students ' skill and technical performance , as well as content knowledge in @ track and field events .


Students from @ classes in @ Portuguese schools completed @-min units conducted under the auspices of sport education or a more traditional teacher-directed format .


Classes were randomly assigned to these conditions within each school .


Although both groups improved significantly from pretest to posttest , the sport education classes outperformed the traditional classes in both technique and skill execution .


Only the sport education group made significant improvements in content knowledge .


When the students in the traditional group were tested at the point in time where they would usually complete a unit of physical education ( @ min ) , there were no significant improvements in any of the study 's variables .


The explanation given for the superior performance outcomes of the sport education classes lies in the nature of formal competition and team affiliation , which are cornerstones of this pedagogical model .


That is , students take their learning experiences more seriously than in traditional and often inauthentic classes .


In terms of content knowledge , the fact that sport education has a level of content-embedded accountability that holds students accountable for their officiating duties is postulated as a significant contributor to their increased understanding of rules and protocols of athletic events .


Obesity is a disorder often accompanied by a heightened state of systemic inflammation and immunoactivation .


The present randomized crossover trial aimed to investigate the efficacy of curcumin , a bioactive polyphenol with established anti-inflammatory and immunomodulatory effects , on the serum levels of a panel of cytokines and mediators in obese individuals .


Thirty obese individuals were randomized to receive curcumin at a daily dose of @ g or a matched placebo for @ weeks .


Following a @-week wash-out period , each group was assigned to the alternate treatment regimen for another @ weeks .


Serum samples were collected at the start and end of each study period .


Serum levels of IL-@ , IL-@ , IL-@ , IL-@ , IL-@ , IL-@ , IL-@ , VEGF , IFN , EGF , MCP-@ , and TNF were measured using a multiplex Biochip Array Technology based method .


Mean serum IL-@ ( P = @ ) , IL-@ ( P = @ ) , and VEGF ( P = @ ) were found to be significantly reduced by curcumin therapy .


In contrast , no significant difference was observed in the concentrations of IL-@ , IL-@ , IL-@ , IL-@ , IFN , EGF , and MCP-@ .


The findings of the present trial suggested that curcumin may exert immunomodulatory effects via altering the circulating concentrations of IL-@ , IL-@ , and VEGF .


To explore the feasibility of subserosal injection of carbon nanoparticle via venous infusion needle to label lymph node and its application value in laparoscopic radical gastrectomy .


Forty patients with gastric cancer were randomly divided into two groups ( carbon nanoparticle group and control group ) .


Subserosal injection of carbon nanoparticle around the tumor was performed via venous infusion needle laparoscopically at the beginning of surgery in carbon nanoparticles group , while the patients routinely underwent laparoscopic radical gastrectomy in control group .


Results of harvested lymph nodes were compared between the two groups .


The perioperative complications and the side effect of carbon nanoparticle were also evaluated .


The average number of harvested lymph node in carbon nanoparticle group ( @ ) was significantly higher than that in control group ( @ , P < @ ) .


The proportion of harvested small node ( < @ mm ) in carbon nanoparticles group ( @ % ) was higher than that in control group ( @ % , P < @ ) .


The mean harvest time in carbon nanoparticle group -LSB- ( @ ) min -RSB- was shorter than that in control group -LSB- ( @ ) min , P < @ -RSB- .


The rate of black-dyed harvested lymph node was @ % and the metastasis rate of black-dyed lymph node was @ % in carbon nanoparticle group , which were significantly higher than those without black-dyed ( @ % , P < @ ) and those in control group ( @ % , P < @ ) .


The operative time and perioperative complications were not significantly different between the two groups , and no serious side effect caused by carbon nanoparticle was observed .


Subserosal injection of carbon nanoparticle via venous infusion needle to label lymph nodes during laparoscopic radical gastrectomy is safe and feasible .


It can increase the number of harvested lymph node , especially the small node .


In patients with severe community-acquired pneumonia , treatment failure is associated with excessive inflammatory response and worse outcomes .


Corticosteroids may modulate cytokine release in these patients , but the benefit of this adjunctive therapy remains controversial .


To assess the effect of corticosteroids in patients with severe community-acquired pneumonia and high associated inflammatory response .


Multicenter , randomized , double-blind , placebo-controlled trial conducted in @ Spanish teaching hospitals involving patients with both severe community-acquired pneumonia and a high inflammatory response , which was defined as a level of C-reactive protein greater than @ mg/L at admission .


Patients were recruited and followed up from June @ through February @ .


Patients were randomized to receive either an intravenous bolus of @ mg/kg per @ hours of methylprednisolone ( n = @ ) or placebo ( n = @ ) for @ days started within @ hours of hospital admission .


The primary outcome was treatment failure ( composite outcome of early treatment failure defined as -LSB- @ -RSB- clinical deterioration indicated by development of shock , -LSB- @ -RSB- need for invasive mechanical ventilation not present at baseline , or -LSB- @ -RSB- death within @ hours of treatment ; or composite outcome of late treatment failure defined as -LSB- @ -RSB- radiographic progression , -LSB- @ -RSB- persistence of severe respiratory failure , -LSB- @ -RSB- development of shock , -LSB- @ -RSB- need for invasive mechanical ventilation not present at baseline , or -LSB- @ -RSB- death between @ hours and @ hours after treatment initiation ; or both early and late treatment failure ) .


In-hospital mortality was a secondary outcome and adverse events were assessed .


There was less treatment failure among patients from the methylprednisolone group ( @ patients -LSB- @ % -RSB- ) compared with the placebo group ( @ patients -LSB- @ % -RSB- ) ( P = @ ) , with a difference between groups of @ % ( @ % CI , @ % to @ % ) .


Corticosteroid treatment reduced the risk of treatment failure ( odds ratio , @ -LSB- @ % CI , @ to @ -RSB- ; P = @ ) .


In-hospital mortality did not differ between the @ groups ( @ patients -LSB- @ % -RSB- in the methylprednisolone group vs @ patients -LSB- @ % -RSB- in the placebo group ; P = @ ) ; the difference between groups was @ % ( @ % CI , -@ % to @ % ) .


Hyperglycemia occurred in @ patients ( @ % ) in the methylprednisolone group and in @ patients ( @ % ) in the placebo group ( P = @ ) .


Among patients with severe community-acquired pneumonia and high initial inflammatory response , the acute use of methylprednisolone compared with placebo decreased treatment failure .


If replicated , these findings would support the use of corticosteroids as adjunctive treatment in this clinical population .


To investigate whether melatonin administered intraoperatively reduced pain following laparoscopic cholecystectomy .


Randomized , placebo-controlled , double-blinded study .


Two surgical departments in Copenhagen .


@ women between @ and @ years of age , who were surgical candidates for laparoscopic cholecystectomy .


Patients were anesthetized by a standard protocol and received a standard multimodal postoperative analgesic regimen .


Patients undergoing surgery were admitted on the day of surgery and were discharged the day after surgery .


Ten mg of intravenous ( IV ) melatonin or placebo were administered at the time of surgical incision .


Pain was assessed by a set of questionnaires documenting `` pain at rest '' using a visual analog scale ( VAS ) .


The use of rescue medication was recorded .


Sleep quality and general well-being were measured on separate VAS scales .


Sleepiness was assessed by the Karolinska Sleepiness Scale .


Forty-four patients were included and randomized to the study .


Three patients did not complete the study .


No differences in VAS pain scores , sleep quality , general well-being , or sleepiness were found between the two groups in the postoperative period .


The use of postoperative rescue medication did not differ between the groups .


The use of @mg of IV melatonin administered during laparoscopic cholecystectomy did not affect postoperative pain or use of analgesic medication .


To test the hypothesis that observation with early salvage radiotherapy ( SRT ) is not inferior to ` standard ' treatment with adjuvant RT ( ART ) with respect to biochemical failure in patients with pT@ disease and/or positive surgical margins ( SMs ) after radical prostatectomy ( RP ) .


To compare the following secondary endpoints between the two arms : patient-reported outcomes , adverse events , biochemical failure-free survival , overall survival , disease-specific survival , time to distant failure , time to local failure , cost utility analysis , quality adjusted life years and time to androgen deprivation .


The Radiotherapy - Adjuvant Versus Early Salvage ( RAVES ) trial is a phase III multicentre randomised controlled trial led by the Trans Tasman Radiation Oncology Group ( TROG ) , in collaboration with the Urological Society of Australia and New Zealand ( USANZ ) , and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group ( ANZUP ) .


In all , @ patients are planned to be randomised @:@ to either ART commenced at @ months of RP ( standard of care ) or close observation with early SRT triggered by a PSA level of > @ ng/mL ( experimental arm ) .


Eligible patients have had a RP for adenocarcinoma of the prostate with at least one of the following risk factors : positive SMs extraprostatic extension seminal vesicle involvement .


The postoperative PSA level must be @ ng/mL .


Rigorous investigator credentialing and a quality assurance programme are designed to promote consistent RT delivery among patients .


Trial is currently underway , with @ patients randomised as of @ October @ .


International collaborations have developed , including a planned meta-analysis to be undertaken with the UK Medical Research Council/National Cancer Institute of Canada Clinical Trials Group RADICALS ( Radiotherapy and Androgen Deprivation In Combination with Local Surgery ) trial and an innovative psycho-oncology sub-study to investigate a patient decision aid resource .


On the current evidence available , it remains unclear if ART is equivalent or superior to observation with early SRT .


Brucellosis remains the most common zoonotic disease throughout the world and especially in Iran .


Several clinical trials have tested different therapeutic regimens for brucellosis , but few have assessed the optimal duration of treatment .


We performed a randomized controlled trial to compare a triple-drug regimen of doxycycline plus rifampicin for @ weeks and streptomycin for the first @ days with doxycycline plus rifampicin for @ weeks and streptomycin for @ days in patients with uncomplicated brucellosis in Arak , Iran .


The primary outcome measure for the treatment groups was the relapse rate measured at @ , @ , @ , @ , and @ months after cessation of therapy .


Eligible patients were randomized to one of the @ groups with @ per arm .


We found no significant difference in the relapse rate for the @-week treatment group compared to the @-week group ( @ % vs @ % ) .


There were no significant differences between the @-week and @-week groups regarding the relapse rate , period between clinical presentation and beginning of treatment , and time of relapse .


Symptom resolution was achieved in all cases at a median @ days and no cases experienced continuing symptoms after treatment .


Our trial found no significant difference between @-week and @-week regimens of doxycycline and rifampicin plus streptomycin for the first @ days .


Further comparative studies with a large sample size should be implemented to achieve a consistent therapeutic regimen for uncomplicated brucellosis , to help identify those who may benefit from longer treatment , and to minimize adverse effects and unnecessary continuation of treatment .


The purpose of this randomized controlled trial was to evaluate the efficacy of the Dynamic SpineCor brace for early idiopathic scoliosis ( @-@ ) compared to the natural evolution of the disease .


@ patients participated in this study ( @ treated and @ controls ) with at least @ years follow-up .


The inclusion criteria were : @ ) high risk of evolution : family history and/or proven progressive ; @ ) no significant pathological malformation of the spine ; @ ) initial Cobb angle between @ and @ ; @ ) risser @ , @ or @ .


Assessment of brace efficacy included the percentage of patients who have @ or less curve progression and the percentage of patients who have @ or more progression at skeletal maturity .


At five-year follow-up a correction was achieved in @ % of treated patient and only in @ % of controls , stabilization in @ % treated and @ % in controls and progression in @ % for the treated group and @ % for controls .


For the control patients we considered as a failure if the Cobb angle worsened by more then @ from the original angle and the patient then received treatment .


The results @ years after the treatment suggested that the SpineCor brace reduced the probability of the progression of early idiopathic scoliosis comparing with its natural history .


Moreover , the positive outcome appears to be maintained in the long term .


The hypothalamic-pituitary-adrenal ( HPA ) axis is a critical mediator linking stress to health .


Understanding how to modulate its reactivity could potentially help reduce the detrimental health effects of HPA axis activation .


Social evaluative threat is a potent activator of this system .


Access to control and coping responses can reduce its reactivity to pharmacological activation .


Compassionate or affiliative behaviors may also moderate stress reactivity .


Impact of these moderators on social evaluative threat is unknown .


Here , we tested the hypotheses that interventions to increase control , coping , or compassionate ( versus competitive ) goals could reduce HPA-axis response to social evaluative threat .


Healthy participants ( n = @ ) were exposed to social evaluative threat using the Trier Social Stress Test ( TSST ) .


They were randomly assigned to receive one of four different instructions prior to the stressor : Standard TSST instructions ( SI ) , standard instructions with access to `` control '' ( SI Control ) , or one of two cognitive interventions ( CI ) that ( @ ) increased familiarity and helped participants prepare coping strategies ( CI Coping ) , or ( @ ) shifted goal orientation from self-promotion to helping others ( CI Compassionate Goals ) .


ACTH and cortisol were obtained before and after stress exposure via intravenous catheter .


Control alone had no effect .


CI Compassionate Goals significantly reduced ACTH and cortisol responses to the TSST ; CI Coping raised baseline levels .


Compassionate Goals reduced hormonal responses without reducing subjective anxiety , stress or fear , while increasing expression of pro-social intentions and focus on helping others .


Brief intervention to shift focus from competitive self-promotion to a goal orientation of helping-others can reduce HPA-axis activation to a potent psychosocial stressor .


This supports the potential for developing brief interventions as inoculation tools to reduce the impact of predictable stressors and lends support to growing evidence that compassion and altruistic goals can moderate the effects of stress .


The aim of the study was to establish the efficacy of anti VEGF ( Vascular Endothelial Growing Factor ) drugs in the treatment of wet form ARMD ( Age-Related Macular Degeneration ) in everyday clinical practice in the Department of Ophthalmology , Faculty Hospital , Hradec Krlov , Czech Republic , E.U. , in patients registered in the Czech national registry AMADEUS .


Retrospective study with @ months follow-up period .


In the group were evaluated @ eyes of @ patients , out of them were @ women ( @ % ) , of average age @ ( @ - @ ) years , and @ men ( @ % ) of average age @ ( @ - @ ) years .


All of the patients were completely examined before the beginning of the treatment ; during the treatment were , except the standardized eye examination , in patients treated with ranibizumab the color fundus photography and Optical Coherence Tomography ( OCT ) with measuring of the central retinal thickness performed every three months at least .


The patients treated by pegaptanib were examined every six weeks before the drug application .


The fluorescence angiography ( FA ) was performed at the beginning of the treatment to establish the type and extension of the choroidal neovascularization and during the treatment in case of necessity to establish the activity of the choroidal neovascular membrane ( CNV ) .


The treatment by ranibizumab was in the regimen PRN ( pro re nata ) , and pegaptanib was applied every six months during the first year with the follow-up evaluation of the findings .


The treatment evaluations were performed at @ and @ months .


During the two years follow - up period , the authors noticed in patients treated with ranibizumab loss of @ letters of ETDRS optotypes in case of mostly classical CNV , in occult CNV loss of @ letters , and in minimally classical CNV loss of @ letters .


In three evaluated eyes with classical CNV in patients treated with pegaptanib we noticed after @ years loss of @ letters , in eleven eyes with occult CNV we established loss of @ letters , and in two eyes with minimally classical CNV the average best-corrected visual acuity ( BCVA ) remained unchanged .


The pegaptanib treatment results may be influenced by small number of evaluated patients .


The visual acuity changes during the two years treatment were not statistically significant .


We noticed the decrease of average CRT ( central retinal thickness ) in all types of CNV treated both with ranibizumab and pegaptanib after the two years follow up .


To reach these results , an average of @ applications of ranibizumab and @ applications of pegaptanib during the two years were used .


In the followed-up group we found , comparing to the natural course of neovascular form of ARMD , retarding of the BCVA decrease during the two years treatment with VEGF inhibitors in everyday clinical practice .


Better results were achieved with ranibizumab treatment , however the differences were not statistically significant .


Key words : age related macular degeneration , AMADEUS Czech national registry , ranibizumab , pegaptanib .


Acupuncture is a safe and well-tolerated treatment for pain relief .


Previous studies supported the effectiveness of several acupuncture techniques for postoperative pain .


The aim of this randomized , controlled trial was to evaluate the efficacy of acupuncture in reducing pain after thyroid surgery .


We randomized @ patients to a control group ( undergoing only standard postoperative analgesic treatment with acetaminophen ) and an acupuncture group , undergoing also either electroacupuncture ( EA ) or traditional acupuncture ( TA ) .


Pain was measured according to intraoperative remifentanil use , acetaminophen daily intake , Numeric Rating Scale ( NRS ) , and McGill Pain Questionnaire on postoperative days ( POD ) @-@ .


Acupuncture group required less acetaminophen than controls at POD @ ( P = @ ) and @ ( P = @ ) .


EA patients required less remifentanil ( P = @ ) and acetaminophen than controls at POD @ ( P = @ ) and @ ( P = @ ) .


EA patients showed a trend toward better NRS and McGill scores from POD @ to @ compared with controls .


EA patients had a lower remifentanil requirement and better NRS and McGill scores than TA patients .


No differences occurred between TA patients and controls .


Acupuncture may be effective in reducing pain after thyroid surgery .


EA is more useful ; TA achieves no significant effects .


Overweight and obesity is a significant health concern during pregnancy .


Our aim was to investigate the effect of providing antenatal dietary and lifestyle advice to women who are overweight or obese on components of maternal diet and physical activity .


We conducted a randomised controlled trial , in which pregnant women with a body mass index@ kg/m@ , and singleton gestation between @ ( +@ ) to @ ( +@ ) weeks were recruited and randomised to Lifestyle Advice ( involving a comprehensive dietary and lifestyle intervention over their pregnancy ) or Standard Care .


Within the intervention group , we conducted a nested randomised trial in which a subgroup of women were further randomised to receive access to supervised group walking sessions in addition to the standard information presented during the intervention contacts ( the Walking group ) or standard information only .


The outcome measures were maternal dietary intake , ( including food groups , macronutrient and micronutrient intake , diet quality ( using the Healthy Eating Index ; HEI ) , dietary glycaemic load , and glycaemic index ) and maternal physical activity .


Women completed the Harvard Semi-Structured Food Frequency Questionnaire , and the Short Questionnaire to Assess Health-enhancing Physical Activity ( SQUASH ) , at trial entry , @ and @ weeks ' gestational age , and @ months postpartum .


Analyses were performed on an intention-to-treat basis , using linear mixed effects models with adjustment for the stratification variables .


Women randomised to Lifestyle Advice demonstrated a statistically significant increase in the number of servings of fruit and vegetables consumed per day , as well as increased consumption of fibre , and reduced percentage energy intake from saturated fats ( P < @ for all ) .


Maternal HEI was significantly improved at both @ ( @ versus @ ; adjusted difference in means @ ; @ % CI @ to @ ; P < @ ) and @ ( @ versus @ ; adjusted difference in means @ ; @ % CI @ to @ ; P < @ ) weeks .


There were no differences in dietary glycaemic index or glycaemic load .


Women randomised to Lifestyle Advice also demonstrated greater total physical activity ( adjusted difference in means @ metabolic equivalent task units ( MET ) minutes/week ; @ % CI @ to @ ; P = @ ) compared with women receiving Standard Care .


The supervised walking group was poorly utilised .


For women who are overweight or obese , antenatal lifestyle advice improves maternal diet and physical activity during pregnancy .


Please see related articles : http://www.biomedcentral.com/@-@/@/@ and http://www.biomedcentral.com/@-@/@/@ .


Although there are various therapeutic modalities to manage patients suffering from sacrococcygeal pilonidal sinus disease , there remains controversy over a standard method to treat such patients .


In this study the postoperative outcomes after three different surgical methods of wound repair in patients with sacrococcygeal pilonidal sinus were compared .


Patients were divided randomly into three different groups .


All of the patients underwent a wide excision of their pilonidal sinus ; the subsequent surgical wound was left open in the first group ( lay open group ) whereas it was repaired with a simple primary closure and a rhomboid flap in the second and third groups .


Variables including length of hospitalisation , time for wound healing , time off work , recurrence and surgical complications were evaluated .


A total of @ patients with an average age of @ years were studied , including @ ( @ % ) men and @ ( @ % ) women .


Postoperative hospitalisation time was significantly shorter in patients who were treated using the simple primary closure method than those with the rhomboid flaps .


However , there were no differences in terms of postoperative hospitalisation time between the lay open and simple primary groups or the lay open and rhomboid groups .


The period of absence from work was significantly shorter in patients who were managed by a simple primary closure or rhomboid flap technique comparing to those whose wound was left open ( p < @ ) .


Complete wound healing had a significantly shorter course in the rhomboid flap and the simple primary closure techniques compared to those within the lay open group .


In terms of complications , postoperative infection and haemorrhage were more common in the lay open group than in the other two .


Recurrence was about @ % in patients who were treated with the lay open method in an @-month follow-up period ; however , no recurrence was observed in the other two groups .


Considering the earlier wound healing period , less days absent from work , lower complication levels and recurrence rates , the simple primary closure or rhomboid flap techniques appear to be better options to treat the subsequent wound after a wide excision of pilonidal sinus when compared to the lay open method .


The simple primary closure method causes no cosmetic disfiguration and the most promising option among the three techniques assessed .


In current literature the association between statin use and cataracts is inconsistent and controversial .


We sought to further examine the effect of statin use on the risk of cataract and need for surgical intervention in @ North American populations .


This retrospective nested case-control study derived data from the British Columbia ( BC ) Ministry of Health databases from @-@ and the IMS LifeLink database from @-@ to form @ patient cohorts .


The BC cohort was comprised of female and male patients ; @,@ patients were matched with @,@ control subjects .


The IMS LifeLink cohort was comprised of male patients aged @-@ years ; @,@ patients were matched with @,@ control subjects .


Patients with statin use for > @ year before the initial ophthalmology visit were identified .


Diagnosis and surgical management of cataract were followed .


Conditional logistic regression models were used to analyze data .


For the BC cohort , the crude rate ratio ( RR ) for use of any statin was @ , and the adjusted RR was @ ( @ % confidence interval , @-@ @ ) .


The adjusted RRs for each individual statin were all statistically significant .


For the IMS LifeLink cohort , the crude RR for use of any statin was @ , and the adjusted RR was @ ( @ % confidence interval , @-@ @ ) .


This study demonstrates that statin use is significantly associated with cataract requiring surgical intervention .


This relationship was consistent in both North American cohorts .


Further assessment of this relationship is recommended , especially because of increased statin use and the importance of acceptable vision in old age when cardiovascular disease is common .


Dental caries in young children is commonly untreated and represents a public health problem .


Dental caries in children is reported to affect their anthropometric outcomes , but the evidence is conflicting .


Some studies found no association , whereas others found that caries was associated with underweight or overweight .


The objective was to assess the relationship between dental caries status and height and weight in @ - to @-year-old Saudi children with high caries prevalence .


This study was a cross-sectional survey in schoolchildren aged @ to @ years attending military primary schools in Jeddah , Saudi Arabia .


Caries status was assessed by using the dmft ( decayed , missing , filled , teeth -LSB- primary teeth -RSB- ) index .


Height and weight were assessed by using z scores of height-for-age ( HAZ ) , weight-for-age ( WAZ ) , and BMI-for-age ( BAZ ) calculated by World Health Organization standardized procedures .


Relationships between caries and HAZ , WAZ , and BAZ were assessed by using regression models .


A total of @ of the @ eligible schoolchildren with complete data were included , with a response rate of @ % .


Their mean dmft index was @ @ .


There was an inverse linear relationship between caries status and children 's HAZ , WAZ , and BAZ and significantly lower anthropometric outcomes for children at each consecutive group with higher levels of caries .


The associations remained significant after adjusting for dental , social , and demographic variables .


The inverse linear association between dental caries and all anthropometric outcomes suggests that higher levels of untreated caries are associated with poorer growth in Saudi schoolchildren .


Inguinal hernia repair is one of the most common surgical procedures worldwide .


This procedure is increasingly performed with endoscopic techniques ( laparoscopy ) .


Many surgeons prefer to cover the hernia gap with a mesh to prevent recurrence .


The mesh must be fixed tightly , but without tension .