Furthermore , there was significantly greater change in high-calorie ratings than in low-calorie ratings in the active group ( P = @ ) .


Active IP effects extended to high-calorie foods not specifically included in the intervention , which suggested an effect generalization .


Moreover , a greater change in high-calorie ratings than in low-calorie ratings persisted @-@ d after active IP ( P < @ ) , which suggested lasting effects .


This study provides initial evidence that IP can be used to alter high-calorie food preferences , which could promote healthier eating habits .


To compare @-year outcomes and complications of the Ahmed FP@ Glaucoma Valve ( AGV ) ( New World Medical , Cucamonga , CA ) and the Baerveldt Glaucoma Implant ( BGI ) @-@ ( Abbott Medical Optics , Abbott Park , IL ) for the treatment of refractory glaucoma .


Multicenter , randomized , controlled clinical trial .


A total of @ patients : @ in the AGV group and @ in the BGI group .


Patients aged @ to @ years with refractory glaucoma and intraocular pressures ( IOPs ) @ mmHg in whom an aqueous shunt was planned were randomized to an AGV or a BGI .


The IOP , visual acuity ( VA ) , supplemental medical therapy , complications , and failure ( IOP > @ mmHg or not reduced by @ % from baseline , IOP < @ mmHg , reoperation for glaucoma or removal of implant , or loss of light perception vision ) .


At @ years , IOP ( mean standard deviation ) was @ @ mmHg ( AGV group ) and @ @ mmHg ( BGI group ) ( P = @ ) on @ @ and @ @ glaucoma medications , respectively ( P = @ ) .


The cumulative probabilities of failure were @ % ( standard error -LSB- SE -RSB- , @ % ) ( AGV ) and @ % ( @ % ) ( BGI ) ( P = @ ) .


Postoperative complications associated with reoperation or vision loss of > @ Snellen lines occurred in @ patients ( @ % ) ( AGV ) and @ patients ( @ % ) ( BGI ) ( P = @ ) .


The mean change in the logarithm of the minimum angle of resolution VA at @ years was similar ( AGV : @ @ , BGI : @ @ ) in the @ treatment groups at @ years ( P = @ ) .


The cumulative proportion of patients ( SE ) undergoing reoperation for glaucoma before the @-year postoperative time point was @ % ( @ % ) in the AGV group compared with @ % ( @ % ) in the BGI group ( P = @ , log rank ) .


The relative risk of reoperation for glaucoma in the AGV group was @ times that of the BGI group ( @ % confidence interval , @-@ @ ; P = @ , Cox proportional hazards regression ) .


Implantation of the AGV was associated with the need for significantly greater adjunctive medication to achieve equal success relative to implantation of the BGI and resulted in a greater relative risk of reoperation for glaucoma .


More subjects experienced serious postoperative complications in the BGI group than in the AGV group .


A new treatable venous disorder , chronic cerebrospinal venous insufficiency ( CCSVI ) , has been proposed in patients with multiple sclerosis .


The natural course of CCSVI has not been examined yet .


This is crucial given the fact that surgical procedures are increasingly offered to MS patients to treat venous stenosis .


To document the natural course of venous haemodynamics we performed extra - and transcranial echo colour Doppler ( ECD ) in @ multiple sclerosis patients and @ healthy controls ( HC ) and re-examined this group after a median period of @ weeks .


The reexamination was done being blinded to the initial findings and the patients did not undergo any intervention .


The ECD examination at baseline showed CCSVI in @ ( @ % ) of the @ multiple sclerosis patients and @ HC ( P = @ ) .


At follow-up the diagnosis CCSVI could not be reconfirmed in @ out of @ patients at follow-up , while @ new CCSVI-positive multiple sclerosis patients were detected .


ECD examination shows a fluctuating natural course of the extracranial venous haemodynamics , which makes determination of CCSVI by ECD examination unreliable .


To explore the effective method of the prevention and treatment of procedural pain in dressing changes of burn wounds .


Ninety patients of burn injury were randomized into @ groups , @ cases in each one .


In the group A , fentanyl citrate injection was used at corresponding injury area , jiaogan ( AH@a , sympathetic nerve ) , fei ( CO@ , lung ) , neifenmi ( CO@ , endocrine ) on ear , @ mL at each point .


In the group B , fentanyl citrate injection was applied subcutaneously in the deltoid muscle , @ mL .


In the group C , @ % sodium chloride injection was applied subcutaneously in the deltoid muscle , @ mL .


The visual analogue scale ( VAS ) was used to evaluate the analgesic effect before , during and @ min after dressing change in the patients of the three groups separately .


It was not different in VAS score before dressing change among the three groups ( P > @ ) .


Compared with that before dressing change , the pain was not significant and VAS score was not different during and after dressing change in the patients of the group A ( both P > @ ) , but the score in the patients of the group B and C was different significantly ( all P < @ ) .


The VAS score during and after dressing change in the group A was lower than that in the group B and C ( all P < @ ) , and the score in the group B was lower than that in the group C ( P < @ ) .


Fentanyl injection of small dose at auricular points achieves definite analgesic effect on procedural pain in dressing changes of burn wounds , superior to subcutaneous injection of fentanyl .


In insulin-requiring type @ diabetes patients , current insulin therapy approaches such as basal-alone or basal-bolus multiple daily injections ( MDI ) have not consistently provided achievement of optimal glycemic control .


Previous studies have suggested a potential benefit of continuous subcutaneous insulin infusion ( CSII ) in these patients .


The OpT@mise study is a multicenter , randomized , trial comparing CSII with MDI in a large cohort of subjects with evidence of persistent hyperglycemia despite previous MDI therapy .


Subjects were enrolled into a run-in period for optimization of their MDI insulin regimen .


Subjects showing persistent hyperglycemia ( glycated hemoglobin -LSB- HbA@c -RSB- @ % and @ % ) were then randomly assigned to CSII or continuing an MDI regimen for a @-month phase followed by a single crossover of the MDI arm , switching to CSII .


The primary end point is the between-group difference in mean change in HbA@c from baseline to @ months .


Secondary end points include change in mean @-h glucose values , area under the curve and time spent in hypoglycemia and hyperglycemia , measures of glycemic excursions , change in postprandial hyperglycemia , and evaluation of treatment satisfaction .


Safety end points include hypoglycemia , hospital admissions , and emergency room visits .


When subject enrollment was completed in May @ , @ subjects had been enrolled in the study .


The study completion for the primary end point is expected in January @ .


OpT@mise will represent the largest studied homogeneous cohort of type @ diabetes patients with persistent hyperglycemia despite optimized MDI therapy .


OpT@mise will help define the role of CSII in insulin intensification and define its safety , rate of hypoglycemia , patient adherence , and patient satisfaction .


To explore the effect of autologous cytokine-induced killer cells on the quality of life in patient with breast cancer who have already finished the adjuvant chemotherapy .


One hundred and twenty-eight postoperative patients with breast cancer who underwent anthracycline-based adjuvant chemotherapy were enrolled in this prospective study , and they were randomized into @ groups , i.e. , treatment group , which received the therapy of CIK cells transfusion , and control group , which was given regular follow-up .


Meanwhile , patients with positive hormone receptor in the two groups were given endocrine therapy , and the patients with positive axillary lymph nodes were given radiotherapy to the chest wall and regional lymph nodes .


The difference of quality of life between the two groups was analyzed according to the EORTC QLQ-BR@ quality of life questionnaire , and the adverse reactions were monitored .


As regarding the functional evaluation , the physical function scores of patients of the treatment group were ( @ @ ) and ( @ @ ) at @ and @ months after the CIK cell therapy , respectively , significantly higher than the baseline value -LSB- ( @ @ ) , P < @ ) -RSB- .


Global health status/QOL scores were ( @ @ ) and ( @ @ ) , significantly higher than the baseline value -LSB- ( @ @ ) , P < @ -RSB- .


As regarding symptoms , the scores of fatigue , nausea , vomiting and loss of appetite of patients in the treatment group were higher than the baseline value , with significant differences ( P < @ ) .


The nausea and vomiting scores in the control group at @ and @ months of followed-up were ( @ @ ) and ( @ @ ) , significantly lower than the baseline values -LSB- ( @ @ ) , P < @ -RSB- .


The scores of worrying about the future in the patients of treatment group were ( @ @ ) and ( @ @ ) after @ and @ months , significantly better than the baseline value -LSB- ( @ @ ) , P < @ -RSB- .


The systematic therapy side effects scores were ( @ @ ) and ( @ @ ) , significantly better than the baseline value -LSB- ( @ @ ) , P < @ -RSB- .


The scores of arm edema were ( @ @ ) and ( @ @ ) , significantly milder than the baseline value -LSB- ( @ @ ) , P < @ -RSB- .


In the control group , the scores of arm edema were ( @ @ ) and ( @ @ ) , significantly lower than the baseline values -LSB- ( @ @ ) points , P < @ -RSB- .


Alopecia scores were ( @ @ ) and ( @ @ ) , significantly lower than the baseline values -LSB- ( @ @ ) , P < @ -RSB- .


In the treatment group , the patients ' physical function , social function and global health status/QOL , fatigue , insomnia , and worrying about the future rates were significantly higher than that of the control group ( P < @ for all ) .


Three patients after CIK reinfusion had transient fever , and @ cases felt pain in the lower limb , but the symptoms were relieved after symptomatic treatment .


Therapy of autologous CIK cells transfusion can significantly improve the quality of life of breast cancer patients , and the adverse reactions during the treatment can be alleviated by symptomatic treatment .


In this partially randomised intervention study , we assessed the effect of social networks on the improvement of type @ diabetes management in a largely African-American population in Baltimore .


Patients in the intervention group ( n = @ ) were asked to recruit peers , form small groups , and attend monthly diabetes education sessions , emphasising peer support .


Patients in the control group ( n = @ ) were recruited individually to attend standard diabetes education sessions .


The primary outcomes were changes in haemoglobin A@C ( HbA@c ) and blood glucose .


Secondary outcomes included blood pressure , weight , functional status , self-efficacy , perceived cohesion , social network connectedness and diabetes knowledge .


General linear mixed models were built to assess mean absolute changes in primary and secondary outcomes at @ and @ months .


At @ months from baseline , the social network intervention group achieved a larger reduction in HbA@c of -@ % ( p < @ ) and blood glucose of -@ mg/dL , ( p < @ ) compared to the control group .


In analyses of secondary endpoints , the intervention group had more favourable outcomes over time for weight , quality of life , self-efficacy , social network scores and diabetes knowledge , compared to the control group .


While blood pressure decreased , and perceived cohesion increased in both groups over the duration of the study , the difference between groups was not statistically significant .


The social networks intervention showed improved integration of patients within their existing networks leading to a greater reduction in HbA@c and blood glucose , as well as improved behaviour mediating outcomes .


While there is a dose-response relationship between physical activity ( PA ) and health benefit , little is known about the effectiveness of different PA prescriptions on total daily PA. .


To test , under real-life conditions and using an objective , non-invasive measurement technique ( accelerometry ) , the effect of prescribing additional physical activity ( walking only ) of different durations ( @ , @ and @ min/day ) on compliance ( to the activity prescribed ) and compensation ( to total daily PA ) .


Participants in each group were prescribed @ sessions of walking per week over @ weeks .


@ normal-weight and overweight women ( mean BMI @ @ kg/m ( @ ) , height @ @ cm , weight @ @ kg and mean age @ @ years ) were randomly assigned to @ prescription groups : @ , @ or @ min/day PA. .


Walking duration resulted in an almost linear increase in the number of steps per day during the prescription period from an average of about @,@ steps per day for the @-min prescription to about @,@ for the @-min prescription .


Compliance was excellent for the @-min prescription but decreased significantly with @-min and @-min prescriptions .


In parallel , degree of compensation subsequent to exercise increased progressively as length of prescription increased .


A @-min prescription of extra walking @ times per week was well tolerated .


However , in order to increase total PA further , much more than @ min of walking may need to be prescribed in the majority of individuals .


While total exercise ` volume ' increased with prescriptions longer than @ min , compliance to the prescription decreased and greater compensation was evident .


Many national colorectal cancer screening campaigns have a similar structure .


First , individuals are invited to take a noninvasive screening test , and , second , in the case of a positive screening test result , they are advised to undergo a more invasive follow-up test .


The objective of this study was to investigate how much individuals ' participation decision in noninvasive screening is affected by the presence or absence of detailed information about invasive follow-up testing and how this effect varies over screening tests .


We used a labeled discrete choice experiment of three noninvasive colorectal cancer screening types with two versions that did or did not present respondents with detailed information about the possible invasive follow-up test ( i.e. , colonoscopy ) and its procedure .


We used data from @ Dutch respondents aged @ to @ years .


Each respondent received only one of the two versions ( N = @ for the invasive follow-up test information specification version , and N = @ for the no-information specification version ) .


Mixed logit model results show that detailed information about the invasive follow-up test negatively affects screening participation decisions .


This effect can be explained mainly by a decrease in choice shares for the most preferred screening test ( a combined stool and blood sample test ) .


Choice share simulations based on the discrete choice experiment indicated that presenting invasive follow-up test information decreases screening participation by @ % .


Detailed information about the invasive follow-up test has a negative effect on individuals ' screening participation decisions in noninvasive colorectal cancer screening campaigns .


This result poses new challenges for policymakers who aim not only to increase uptake but also to provide full disclosure to potential screening participants .


The purpose of this study was to examine the influence of instrument assisted soft tissue techniques ( IASTT ) on myofascial trigger points ( MTrP ) .


Randomized , controlled study with the researcher assessing the MTrP sensitivity blinded to the treatment rendered .


Phase @ = @ ; Phase @ = @ .


MTrPs were identified in the upper back .


In phase @ , two MTrPs ( right & left ) were identified .


One was treated with IASTT , the other was a control .


In phase @ , one MTrP was identified in a treatment and a control group .


In each phase , the treatment groups received six treatments of IASTT .


Sensitivity threshold of the MTrP was assessed with a dolorimeter .


There was a significant improvement in both groups over time but there was no difference between the treatment and control groups .


The use of a pressure dolorimeter may have served as a form of ischemic compression treatment .


This assessment tool may have been a mitigating factor in the over-shadowing any potential influence of the IASTT on the MTrP .


Thus , another assessment tool needs to be identified for MTrP assessment .


Until that technique is identified , the effect of IASTT on MTrPs in inconclusive .


Nowadays , advanced irradiation techniques make it possible to escalate safely the dose in prostate cancer .


We studied the effect of a higher dose on tumor control in a randomized trial with a median follow-up of @ months .


Patients with T@b-T@N@ prostate cancer ( n = @ ) were randomized between @ Gy and @ Gy .


Primary endpoint was biochemical and/or clinical failure ( BCF ) according to the American Society for Therapeutic Radiology and Oncology ( ASTRO ) guidelines ( @ consecutive rises ) , and to Phoenix ( nadir plus @ g/L ) .


Secondary endpoints were clinical failure ( CF ) , local failure ( LF ) , prostate cancer death ( PCD ) , and overall survival ( OS ) .


Explorative subgroup analyses were performed .


BCF rate ( HR = @ ; @ % less events ) and LF rate ( HR = @ ; @ % less events ) were significantly lower in the @ Gy arm ( p < @ ) .


CF , PCD and OS were similar in both arms .


A significant heterogeneity of treatment effect was found for PSA cutoffs between @ and @ g/L .


We observed significantly less BCF and LF in the high-dose arm .


This suggests improvement of the therapeutic ratio .


However , we observed similar rates of CF and PCD at the current update .


More follow-up is needed to investigate which patients benefit in terms of prolonged OS .


Breast cancer is characterized by great molecular heterogeneity demonstrated , e.g. by the intrinsic subtypes .


Administration of post-mastectomy radiotherapy ( PMRT ) does , however , not reflect this heterogeneity .


A gene profile ( DBCG-RT profile ) has recently been developed and validated , and has shown prognostic impact in terms of loco-regional failure and predictive impact for PMRT .


Reports have also shown predictive value in terms of benefit of PMRT from intrinsic subtypes and derived approximations .


The aim of this study was to examine : @ ) the agreement between various methods for determining the intrinsic subtypes ; and @ ) the relationship between the prognostic and predictive impact of the DBCG-RT profile and the intrinsic subtypes .


Intrinsic subtypes and the DBCG-RT profile was determined from microarray analysis based on fresh frozen tissue from @ patients included in the Danish Breast Cancer Cooperative Group ( DBCG ) @bc trial .


Corresponding formalin-fixed , paraffin-embedded tissue was available from @ of these patients and from another @ DBCG@bc patients .


Estrogen receptor , progesterone receptor , HER@ , CK@/@ , Ki-@ and EGFR were combined into immunohistochemical approximations of the intrinsic subtypes .


Endpoint considered was loco-regional recurrence ( LRR ) .


The DBCG-RT profile identified a group of patients with low risk of LRR and no additional benefit from PMRT among all subtypes .


Combining six immunohistochemical markers identified a subgroup of triple negative patients with high risk of LRR and significant benefit from PMRT .


Agreement in the different assignments of tumors to the subtypes was suboptimal , and the clinical outcome and predicted benefit from PMRT varied according to the method used for assignment .


The prognostic and predictive information obtained from the DBCG-RT profile can not be substituted by any approximation of the tumors intrinsic subtype .


The predictive value of the intrinsic subtypes in terms of PMRT was influenced by the method used for assignment to the intrinsic subtypes .


Investigate the effect of ankle taping on plantar-flexion strength , angle matching and force matching .


Single group , repeated measures .


Laboratory of an educational institution .


Twenty uninjured females ( @ years ) .


Tape was applied to the ankle using a conventional hindfoot technique .


Angle and force matching , and plantar-flexor strength were assessed using the purpose built dual ankle dynamometer , and measures were taken prior to and following taping .


Angle matching was assessed passively and actively at @ , @ and @ of plantar-flexion .


Participants were required to match the angle of the reference leg with the contralateral leg .


Force matching was assessed at @ of plantar-flexion and participants matched the torque of the reference leg with the contralateral leg .


Taping had no effect on absolute errors during active or passive angle matching .


Regardless of taping , the ankle angle tested had a significant effect on passive angle matching ( p < @ ) ; subjects were most accurate at matching a plantar-flexion angle of @ .


Ankle taping had no effect on force matching .


Taping significantly improved peak plantar-flexion strength by @ % ( p = @ ) .


Ankle taping has little effect on contralateral force and angle matching , but it can enhance peak plantar-flexion strength .


Dexmedetomidine , a potent selective @-adrenergic agonist , produces sedation and analgesia .


This study was conducted to assess the effect of dexmedetomidine infusion on sevoflurane requirements , recovery profiles , and emergence agitation in children undergoing ambulatory surgery .


Forty children undergoing ambulatory hernioplasty or orchiopexy were randomized into two groups .


The dexmedetomidine group ( Group D , n = @ ) received dexmedetomidine @ g/kg , followed by @ g/kg/h until the end of surgery , whereas the saline group ( Group S , n = @ ) received volume-matched normal saline .


Sevoflurane was used for induction and maintenance of anesthesia and caudal block was performed in all children .


End-tidal sevoflurane concentration ( ET-sevo ) , the incidence of emergence agitation , pain scores , and sedation scores were recorded .


Hemodynamic changes and other adverse effects were assessed in the perioperative period .


ET-sevo of Group D was significantly reduced in @-@ % compared to Group S during surgery .


The incidence of emergence agitation was lower in Group D than in Group S ( @ % vs. @ % , p = @ ) .


Postoperative pain was comparable , and discharge time was not different between the groups .


Mean arterial pressure and heart rate were significantly lower in Group D during surgery .


Intraoperative infusion of dexmedetomidine reduced sevoflurane requirements and decreased emergence agitation without delaying discharge in children undergoing ambulatory surgery .


However , caution should be taken in regard to bradycardia and hypotension .


To investigate the effects of oxytocin on high-intensity focused ultrasound ( HIFU ) ablation for the treatment of adenomyosis .


Eighty-six patients with adenomyosis from three hospitals were randomly assigned to the oxytocin group or control group for HIFU treatment .


During HIFU treatment , @ units of oxytocin was added in @ml of @ % normal saline running at the rate of @ml/min ( @ U/min ) in the oxytocin group , while @ % normal saline was used in the control group .


Both patients and HIFU operators were blinded to oxytocin or saline application .


Treatment results , adverse effects were compared .


When using oxytocin , the non-perfused volume ( NPV ) ratio was @ % , the energy-efficiency factor ( EEF ) was @ J/mm ( @ ) , and the sonication time required to ablate @cm ( @ ) was @ s/cm ( @ ) .


When not using oxytocin , the non-perfused volume ratio was @ % , the EEF was @ J/mm ( @ ) , and the sonication time required to ablate @cm ( @ ) was @ S/cm ( @ ) .


Significant difference in the NPV ratio , EEF , and the sonication time required to ablate @cm ( @ ) between the two groups was observed .


No oxytocin related adverse effects occurred .


Oxytocin could significantly decrease the energy for ablating adenomyosis with HIFU , safely enhance the treatment efficiency .


To assess agreement between meter and diary self monitoring of blood glucose ( SMBG ) records , over a year , in a sample of patients with type @ diabetes .


Meter and diary records were available , for @ individuals , who took part in the Efficacy of self monitoring of blood glucose in patients with newly diagnosed type @ diabetes study .


Pearson 's correlation coefficient was used to explore the relationships between the types of error .


Maximum likelihood estimation was used to explore changes over time through a structural equation modelling approach .


Paired samples t-tests were used to determine if the presence of errors led to a significant difference between the mean diary and meter SMBG concentrations or coefficients of variation .


Multiple regression was used to explore possible predictors of the error indices .


Mean over-reporting , under-reporting , concordance and overall reliability were @ % , @ % , @ % and @ % , respectively .


The first week of monitoring had significantly more under-reporting , over-reporting and less concordance and overall reliability than subsequent weeks .


The majority of concordance errors were not clinically significant .


Those that were , tended to occur during the first three months of monitoring .


Participants ' at one trial site were significantly more likely to have recording errors than those at the largest site .


Error levels were similar to those described previously in type @ diabetes and there was a suggestion of an initial learning curve for record keeping .


For some individuals diary records would not be considered acceptable if held to the same standards as blood glucose meters .


Secukinumab , a fully human anti-interleukin-@A monoclonal antibody , demonstrated efficacy and safety in moderate-to-severe plaque psoriasis when administered via subcutaneous injection .


Self-administration by pre-filled syringe ( PFS ) can offer patients clinical benefits of a drug , with increased convenience .


To assess efficacy , safety and usability of secukinumab administration via PFS in subjects with moderate-to-severe plaque psoriasis .


Subjects in this phase @ trial were randomized @:@:@ to secukinumab @ or @mg or matching placebo .


Results to week @ are presented here .


Each treatment was delivered using a PFS once weekly to week @ , and again at week @ .


Co-primary endpoints were secukinumab superiority over placebo for week @ PASI @ ( @ % reduction in Psoriasis Area and Severity Index ) and IGA mod @ ( @ modified Investigator 's Global Assessment ) @/@ response rates .


Secondary endpoints included PFS usability , determined by observer rating of successful , hazard-free self-injection and subject rating of acceptability by the Self-Injection Assessment Questionnaire ( SIAQ ) .


Co-primary endpoints were met , with demonstration of superiority for each secukinumab dose vs. placebo at week @ ( PASI @ : @ % , @ % and @ % for secukinumab @mg , @mg and placebo ; IGA mod @@/@ : @ % , @ % and @ % , respectively ; P < @ for all comparisons vs. placebo ) .


PFS usability was high : @ % of subjects successfully self-administered treatment at week @ , and subjects reported high SIAQ-assessed acceptability of the PFS throughout the trial .


No new/unexpected safety signals were observed .


Secukinumab administration by PFS was effective , with an acceptable safety profile and high usability .


The PFS provides a reliable , convenient form of secukinumab administration in subjects with moderate-to-severe plaque psoriasis .


Exercise is an essential component of contemporary cardiac rehabilitation programs for the secondary prevention of coronary heart disease .


Despite the benefits associated with regular exercise , adherence with supervised exercise-based cardiac rehabilitation remains low .


Increasingly powerful mobile technologies , such as smartphones and wireless physiological sensors , may extend the capability of exercise-based cardiac rehabilitation by enabling real-time exercise monitoring for those with coronary heart disease .


This study compares the effectiveness of technology-assisted , home-based , remote monitored exercise-based cardiac rehabilitation ( REMOTE ) to standard supervised exercise-based cardiac rehabilitation in New Zealand adults with a diagnosis of coronary heart disease .


A two-arm , parallel , non-inferiority , randomised controlled trial will be conducted at two sites in New Zealand .


One hundred and sixty two participants will be randomised at a @:@ ratio to receive a @-week program of technology-assisted , home-based , remote monitored exercise-based cardiac rehabilitation ( intervention ) , or an @-@ program of standard supervised exercise-based cardiac rehabilitation ( control ) .


The primary outcome is post-treatment maximal oxygen uptake ( VO@max ) .


Secondary outcomes include cardiovascular risk factors ( blood lipid and glucose concentrations , blood pressure , anthropometry ) , self-efficacy , intentions and motivation to be active , objectively measured physical activity , self-reported leisure time exercise and health-related quality of life .


Cost information will also be collected to compare the two modes of delivery .


All outcomes are assessed at baseline , post-treatment , and @ months , except for VO@max , blood lipid and glucose concentrations , which are assessed at baseline and post-treatment only .


This novel study will compare the effectiveness of technology-supported exercise-based cardiac rehabilitation to a traditional supervised approach .


If the REMOTE program proves to be as effective as traditional cardiac rehabilitation , it has potential to augment current practice by increasing access for those who can not utilise existing services .


Acute pain after open abdominal hysterectomy limits the function of patients in the postoperative period , but data regarding the analgesic efficacy of a low dose of pregabalin ( @ or @ mg ) have been conflicting .


This study was performed to determine if a low dose of pregabalin could decrease postoperative opioid use following abdominal hysterectomy when compared with placebo .


American Society of Anesthesiologists I-II patients older than @ yr and scheduled for open elective abdominal hysterectomy were recruited for participation and randomized to one of three groups : pregabalin @ mg ( P@ ) , pregabalin @ mg ( P@ ) , or placebo .


The study drug was administered two hours prior to surgery and @ hr following the initial dose .


Anesthetic technique and postoperative analgesia were standardized .


Postoperative pain was managed using patient-controlled analgesia with morphine .


Pain at rest and movement as well as nausea were assessed with an @-point numeric rating scale .


One hundred and one patients were recruited , and @ patients completed the study .


Mean ( SD ) cumulative morphine consumption at @ hr postoperatively was @ ( @ ) mg for the placebo group , @ ( @ ) mg for the P@ group , and @ ( @ ) mg for the P@ group .


Independent Student 's t tests indicated no difference between the placebo group and either the P@ group ( @ % confidence interval -LSB- CI -RSB- : -@ to @ ; P = @ ) or the P@ group ( @ % CI : -@ to @ ; P = @ ) .


At the doses used in this study , pregabalin treatment may not be effective in reducing opioid use up to @ hr postoperatively following abdominal hysterectomy .


This trial was registered at www.ClinicalTrials.gov : NCT@ .


To investigate the effect of workplace neck/shoulder strength training with and without regular supervision on neck/shoulder pain and headache among office workers .


A @-week cluster randomized controlled trial among @ office workers was randomized into three groups : two training groups with the same total amount of planned exercises three times per week ( @ ) with supervision ( @WS ) throughout the intervention period , ( @ ) with minimal supervision ( @MS ) only initially , and ( @ ) a reference group ( REF ) .


Main outcome is self-reported pain intensity in neck and shoulder ( scale @-@ ) and headache ( scale @-@ ) .


Intention-to-treat analyses showed a significant decrease in neck pain intensity the last @ days in @MS compared with REF : -@ @ ( P < @ ) and a tendency for @WS versus REF : -@ @ ( P < @ ) .


Intensity of headache the last month decreased in both training groups : @WS versus REF : -@ @ ( P < @ ) and @MS versus REF : -@ @ ( P < @ ) .


Additionally , days of headache decreased @ @ in @WS and @ @ in @MS versus REF .


There were no differences between the two training groups for any of the variables .


Neck/shoulder training at the workplace reduced neck pain and headache among office workers independently of the extent of supervision .


This finding has important practical implications for future workplace interventions .


Preclinical data indicate anti-invasive activity of APG@ , a CD@ ligand ( CD@L ) - binding fusion protein , in glioblastoma .


Patients ( N = @ ) with glioblastoma at first or second progression were randomized @:@ between second radiotherapy ( rRT ; @ Gy ; five times @ Gy per week ) or rRT + APG@ ( @ mg weekly i.v. ) .


Patient characteristics -LSB- N = @ ( @ patients rRT , @ patients rRT + APG@ ) -RSB- were balanced .


Progression-free survival at @ months ( PFS-@ ) rates were @ % -LSB- @ % confidence interval ( CI ) , @-@ @ -RSB- for rRT and @ % ( @ % CI , @-@ @ ) for rRT + APG@ ( P = @ ) .


Median PFS was @ ( @ % CI , @-@ @ ) months and @ ( @ % CI , @-@ @ ) months with a hazard ratio ( HR ) of @ ( @ % CI , @-@ @ ; P = @ ) adjusted for tumor size .


Cox regression analysis adjusted for tumor size revealed a HR of @ ( @ % CI , @-@ @ ; P = @ ) for rRT + APG@ for death of any cause .


Lower methylation levels at CpG@ in the CD@L promoter in the tumor conferred a stronger risk reduction ( HR , @ ; @ % CI , @-@ @ ) for treatment with APG@ , suggesting a potential biomarker .


CD@ pathway inhibition in combination with rRT is an innovative concept with clinical efficacy .


It warrants further clinical development .


CD@L promoter methylation in the tumor may be developed as a biomarker .


Epidural glucocorticoid injections are widely used to treat symptoms of lumbar spinal stenosis , a common cause of pain and disability in older adults .


However , rigorous data are lacking regarding the effectiveness and safety of these injections .


In a double-blind , multisite trial , we randomly assigned @ patients who had lumbar central spinal stenosis and moderate-to-severe leg pain and disability to receive epidural injections of glucocorticoids plus lidocaine or lidocaine alone .


The patients received one or two injections before the primary outcome evaluation , performed @ weeks after randomization and the first injection .


The primary outcomes were the score on the Roland-Morris Disability Questionnaire ( RMDQ , in which scores range from @ to @ , with higher scores indicating greater physical disability ) and the rating of the intensity of leg pain ( on a scale from @ to @ , with @ indicating no pain and @ indicating `` pain as bad as you can imagine '' ) .


At @ weeks , there were no significant between-group differences in the RMDQ score ( adjusted difference in the average treatment effect between the glucocorticoid-lidocaine group and the lidocaine-alone group , -@ points ; @ % confidence interval -LSB- CI -RSB- , -@ to @ ; P = @ ) or the intensity of leg pain ( adjusted difference in the average treatment effect , -@ points ; @ % CI , -@ to @ ; P = @ ) .


A prespecified secondary subgroup analysis with stratification according to type of injection ( interlaminar vs. transforaminal ) likewise showed no significant differences at @ weeks .


In the treatment of lumbar spinal stenosis , epidural injection of glucocorticoids plus lidocaine offered minimal or no short-term benefit as compared with epidural injection of lidocaine alone .


( Funded by the Agency for Healthcare Research and Quality ; ClinicalTrials.gov number , NCT@ . )


GC@ , a hybrid Fc-fused erythropoietin , is a novel erythropoiesis-stimulating agent that is expected to have an extended duration of action .


The preclinical data showed that the hemoglobin increase lasted longer following GC@ administration than it did following the administration of darbepoetin alfa ( NESP ) .


This study aimed to investigate the pharmacodynamic and pharmacokinetic characteristics and tolerability profiles of GC@ in humans after single intravenous or subcutaneous administration and to compare the results with those for darbepoetin alfa .


A dose-block randomized , placebo - and active-controlled , dose-escalation phase I clinical trial was conducted in @ healthy volunteers .


Blood samples were collected before and up to @ h after drug administration and the serum erythropoietin concentration following the GC@ or darbepoetin alfa administration was measured by an ELISA .


The reticulocyte counts were measured for pharmacodynamic assessments .


Pharmacokinetic and pharmacodynamic parameters were determined using non-compartmental methods .


The reticulocyte count-time profiles in the intravenous GC@ @-@ g/kg groups were comparable with those of the darbepoetin alfa @ g group .


After subcutaneous administration of GC@ , reticulocyte count peaked later and decreased more slowly than it did following darbepoetin alfa administration .


GC@ ( @-@ g/kg intravenous , @-@ g/kg subcutaneous ) was well-tolerated in the volunteers , and no immunogenicity was observed .


GC@ was tolerated and effective in the studied dose range ; these findings could be applied to further clinical studies with patients .


To evaluate the efficacy and safety of antiretroviral simplification from a ritonavir-boosted protease inhibitor-based regimen -LSB- protease inhibitor + RTV + two nucleos ( t ) ide reverse transcriptase inhibitors ( NRTIs ) ; @ months of exposure prior to study entry with no prior treatment failure -RSB- to the single-tablet regimen ( STR ) rilpivirine/emtricitabine/tenofovir disoproxil fumarate ( RPV/FTC/TDF ) in virologically suppressed , HIV-@-infected participants .


Phase @b , randomized , open-label , international , @-week switch study .


Participants were randomized @:@ to switch to RPV/FTC/TDF immediately or stay on their baseline protease inhibitor + RTV +@ NRTIs regimen with a delayed switch to RPV/FTC/TDF at week @ .


The primary endpoint was noninferiority ( @ % margin ) of RPV/FTC/TDF compared with protease inhibitor + RTV + two NRTIs in maintaining plasma HIV-@ RNA less than @copies/ml at week @ by Snapshot analysis .


A total of @ participants were randomized and received at least one dose of study drug .


Demographics and baseline characteristics were similar between arms .


The primary objective of noninferiority at week @ was met : HIV-@ RNA less than @copies/ml by Snapshot analysis , @ % of RPV/FTC/TDF versus @ % of protease inhibitor + RTV + two NRTIs ( difference @ % , @ % confidence interval -@ to @ % ) .


Through week @ , @ % of participants in the immediate switch group maintained virologic suppression .


High rates of suppression were maintained with RPV/FTC/TDF regardless of participant 's pre-antiretroviral HIV-@ RNA level .


Overall development of resistance mutations after switching to RPV/FTC/TDF was low .


Decreases in total cholesterol , low-density lipoprotein ( LDL ) , and triglycerides were significantly greater among RPV/FTC/TDF recipients than those in the protease inhibitor + RTV + two NRTIs group .


Switching to the STR RPV/FTC/TDF from an RTV-boosted protease inhibitor regimen in virologically suppressed , HIV-@-infected participants maintained virologic suppression with a low risk of virologic failure , while improving total cholesterol , LDL , and triglycerides .


Chronic pain caused by myofascial pain syndrome ( MPS ) results in generalized and debilitating conditions .


Trigger-point injection ( TPI ) is the mainstay of MPS management to reduce acute and localized pain .


Other adjunctive intervention to modulate the central pain pathway might be helpful if they are combined with TPI .


Transcranial direct-current stimulation ( tDCS ) , which is a form of neurostimulation , has been reported to be safe and effective in treating chronic pain by changing cortical excitability .


To determine whether there is an additional effect of tDCS and TPI to reduce pain in patients with MPS .


Twenty-one patients with newly diagnosed MPS of shoulder girdle muscles .


Patients were randomly assigned into @ of @ groups ( @ active and @ sham stimulation groups ) and received TPI .


Immediately after TPI , tDCS ( @ mA for @ minutes on @ consecutive days ) was administered .


For the active stimulation groups , tDCS was applied over @ different locations ( primary motor cortex and dorsolateral prefrontal cortex -LSB- DLPFC -RSB- ) .


Visual analogue scale ( VAS ) , Pain Threshold Test , and short form of the McGill Pain Questionnaire were measured before and immediately after stimulation for @ consecutive days .


The mean VAS values were decreased in all three groups after @ days .


There was a significant change between before and after stimulation only in the DLPFC group .


The significant change in the mean VAS value was shown from after the second stimulation session ( p = @ ) , and this remained significant until the last stimulation session ( p = @ ) .


This study suggests that tDCS over DLPFC may have additional effects with TPI to reduce pain in patients with MPS .


tDCS over DLPFC can be used to reverse central pain pathway by modulating cortical plasticity .


Docetaxel or AA are therapeutic options for mCRPC .


We retrospectively analyzed clinical outcomes with subsequent docetaxel in patients with mCRPC after disease progression ( DP ) with AA to evaluate cross resistance between these therapies .


Patients with chemotherapy-naive mCRPC who were treated with AA in previously reported phase I to III trials , who had DP , and were subsequently treated ( not on study ) with docetaxel , were included .


Acquired AA resistance was defined as : PSA decline > @ % from baseline or radiographically stable disease for @ months , with subsequent DP .


All other patients were defined as having primary AA resistance .


Efficacy outcomes after docetaxel therapy were analyzed .


We identified @ patients who were treated with docetaxel after DP with AA , including @ ( @ % ) with acquired and @ ( @ % ) with primary AA resistance .


Median duration between discontinuation of AA and docetaxel initiation was @ months ( range , @-@ @ months ) .


Subsequent docetaxel therapy led to @ % PSA decline in @ patients ( @ % ) and @ % PSA decline in @ patients ( @ % ) .


Median OS from date of first docetaxel dose was @ months ( @ % confidence interval , @-@ @ ) .


Patients with previous primary versus acquired AA resistance had similar outcomes with subsequent docetaxel therapy .


In this retrospective analysis , the type of AA resistance did not appear to affect outcomes with subsequent docetaxel .


The PSA response rates observed suggest a lack of cross-resistance between docetaxel and AA , but prospective studies are needed to evaluate for potential cross-resistance and optimize sequences of therapy in patients with mCRPC .


Interferon-containing regimens for the treatment of hepatitis C virus ( HCV ) infection are associated with increased toxic effects in patients who also have cirrhosis .


We evaluated the interferon-free combination of the protease inhibitor ABT-@ with ritonavir ( ABT-@ / r ) , the NS@A inhibitor ombitasvir ( ABT-@ ) , the nonnucleoside polymerase inhibitor dasabuvir ( ABT-@ ) , and ribavirin in an open-label phase @ trial involving previously untreated and previously treated adults with HCV genotype @ infection and compensated cirrhosis .


We randomly assigned @ patients with Child-Pugh class A cirrhosis to receive either @ or @ weeks of treatment with ABT-@ / r-ombitasvir ( at a once-daily dose of @ mg of ABT-@ , @ mg of ritonavir , and @ mg of ombitasvir ) , dasabuvir ( @ mg twice daily ) , and ribavirin administered according to body weight .


The primary efficacy end point was a sustained virologic response @ weeks after the end of treatment .


The rate of sustained virologic response in each group was compared with the estimated rate with a telaprevir-based regimen ( @ % ; @ % confidence interval -LSB- CI -RSB- , @ to @ ) .


A noninferiority margin of @ percentage points established @ % as the noninferiority threshold ; the superiority threshold was @ % .


A total of @ of @ patients who received @ weeks of treatment had a sustained virologic response at post-treatment week @ , for a rate of @ % ( @ % CI , @ to @ ) .


These rates were superior to the historical control rate .


The three most common adverse events were fatigue ( in @ % of patients in the @-week group and @ % of patients in the @-week group ) , headache ( in @ % and @ % , respectively ) , and nausea ( in @ % and @ % , respectively ) .


The hemoglobin level was less than @ g per deciliter in @ % and @ % of patients in the respective groups .


Overall , @ % of patients discontinued treatment owing to adverse events .


In this phase @ trial of an oral , interferon-free regimen evaluated exclusively in patients with HCV genotype @ infection and cirrhosis , multitargeted therapy with the use of three new antiviral agents and ribavirin resulted in high rates of sustained virologic response .


Drug discontinuations due to adverse events were infrequent .


( Funded by AbbVie ; TURQUOISE-II ClinicalTrials.gov number , NCT@ . )


The role played by T helper cytokines under chronic , low grade inflammation as seen in type-@ Diabetes Mellitus ( T@DM ) and Coronary Artery Disease ( CAD ) co-morbidity is less well studied .


In the present study , we measured the serum levels of both Th@ and Th@ cytokines and correlated it with clinical risk factors for T@DM ( Insulin Resistance ( IR ) , Glycated haemoglobin ( HbA@c ) ) and CAD ( C-Reactive Protein ( CRP ) , Intima Media Thickness ( IMT ) and Augmentation index ( AGI ) ) in T@DM subjects with/without CAD .


The study subjects were recruited from Chennai Urban Rural Epidemiology Study ( CURES ) .


Serum cytokine profile was determined by multiplex cytokine assay in Control ( n = @ ) , T@DM ( n = @ ) , CAD ( n = @ ) and T@DM-CAD ( n = @ ) subjects .


T@DM subjects showed a mixed Th@-Th@ profile .


CAD subjects presented a Th@ profile with modest Th@ suppression while T@DM-CAD subjects showed enhanced Th@ profile with strong suppression of Th@ cytokines .


Both Th@ and Th@ cytokines showed a positive correlation with FPG , HbA@c , hsCRP , IMT and AGI .


Logistic regression analysis revealed a significant association of IL-@ ( OR = @ ; @ % CI = @-@ @ ; p = @ ) , IFN - ( OR = @ ; @ % CI = @-@ @ , p = @ ) , IL-@ ( OR = @ ; @ % CI @-@ @ , p = @ ) , IL-@ ( OR = @ ; @ % CI = @-@ @ ; p = @ ) and IL-@ ( OR = @ ; @ % CI = @-@ @ ; p = @ ) with T@DM-CAD .


In conclusion , from the present study it appears that transition from T@DM or CAD to T@DM-CAD co-morbidity is associated with strong down regulation of Th@ cytokines and enhancement of Th@ responses .


We aimed to investigate the effects of metoclopramide and ondansetrone on mivacurium neuromuscular blockade .


Seventy five , ASA I-II patients , aged @-@ and scheduled for elective surgery requiring tracheal intubation were included in the study .


The patients received metoclopramide @ mg , ondansetrone @ mg or normal saline @ mL ; group M , group O , group NS ( n = @ ) , respectively .


Before anesthesia study drugs were administered in a volume of @ mL .


The level of plasma cholinesterase were obtained before and @ minutes after the administration of study drugs and @ minutes after the administration of mivacurium .


Onset time , T@ , T@ , T@-@ , T@ levels were compared with each other and differences between each patients were investigated .


After recording T@ , the study was terminated and surgery was started .


Onset time was significantly shorter in group M , than the other two groups .


Onset time in group O was significantly shorter than in group NS .


In Group M T@ , T@ , T@ and recovery indices were significantly greater than in Group NS ( p < @ ) .


In Group O T@ , T@ were greater than Group NS ( p < @ and p < @ , respectively ) .


In Group M T@ , T@ and emergence indices were significantly higher than Group O ( p < @ , p < @ , p < @ , respectively ) .


In Groups M and O , plasma cholinesterase levels decreased significantly ( p < @ ) after administration of study drugs and mivacurium .


Plasma cholinesterase also was reduced in Group NS @ minutes after the administration of mivacurium ( p < @ ) .


Ondansetrone is believed to be more reliable agent than metoclopramide when used with mivacurium .


Our previous randomized , clinical trial showed that postoperative tight glycemic control ( TGC ) for children undergoing cardiac surgery did not reduce the rate of health care-associated infections compared with standard care ( STD ) .


Heterogeneity of treatment effect may exist within this population .


We performed a post hoc exploratory analysis of @ children from birth to @ months of age at the time of cardiac surgery who were randomized to postoperative TGC or STD in the intensive care unit .


Significant interactions were observed between treatment group and both neonate ( age @ days ; P = @ ) and intraoperative glucocorticoid exposure ( P = @ ) on the risk of infection .


The rate and incidence of infections in subjects @ days old were significantly increased in the TGC compared with the STD group ( rate : @ versus @ infections per @ cardiac intensive care unit days , P = @ ; incidence : @ % versus @ % , P = @ ) , whereas infections among those > @ days of age were significantly reduced in the TGC compared with the STD group ( rate : @ versus @ infections per @ cardiac intensive care unit days , P = @ ; incidence : @ % versus @ % , P = @ ) ; the interaction of treatment group by age subgroup was highly significant ( P = @ ) .


Multivariable logistic regression controlling for the main effects revealed that previous cardiac surgery , chromosomal anomaly , and delayed sternal closure were independently associated with increased risk of infection .


This exploratory analysis demonstrated that TGC may lower the risk of infection in children > @ days of age at the time of cardiac surgery compared with children receiving STD .


Meta-analyses of past and ongoing clinical trials are necessary to confirm these findings before clinical practice is altered .


Recent studies have shown a decline in glomerular filtration rate and increased renal vasoconstriction after administration of normal saline when compared with IV solutions with less chloride .


In this study , we investigated the impact of normal saline versus a chloride-reduced , acetate-buffered crystalloid on the incidence of hyperkalemia during cadaveric renal transplantation .


The incidence of metabolic acidosis and kidney function were secondary aims .


In this prospective randomized controlled trial , @ patients received normal saline or an acetate-buffered balanced crystalloid during and after cadaveric renal transplantation .


Venous blood gases were obtained at the start of anesthesia and every @ minutes until discharge from the postoperative surveillance unit .


Serum creatinine and @-hour urine output were obtained on postoperative days @ , @ , and @ .


Patients received a similar amount of fluid ( median : @mL -LSB- interquartile range : @ to @ -RSB- vs @ mL -LSB- @ to @ -RSB- , P = @ ) .


Hyperkalemia , defined as serum potassium > @ mmol/L , occurred in @ patients ( @ % ) in the saline and @ ( @ % ) in the balanced group ( P = @ ; difference between proportions -@ -LSB- -@ % to @ % -RSB- ) .


Minimum base excess was lower in the saline group compared with the balanced regimen ( -@ mmol/L -LSB- -@ to -@ -RSB- vs -@ mmol/L -LSB- -@ to -@ -RSB- , P < @ ) and maximum chloride was significantly higher in the saline group ( @ mmol/L -LSB- @ to @ -RSB- vs @ mmol/L -LSB- @ to @ -RSB- , P < @ ) .


No difference in creatinine or urine output was seen postoperatively .


Significantly more patients needed catecholamines in the saline group ( @ % vs @ % , P = @ ) .


The incidence of hyperkalemia differed by less than @ % between groups .


Use of balanced crystalloid resulted in less hyperchloremia and metabolic acidosis .


Significantly more patients in the saline group required administration of catecholamines for circulatory support .


To examine changes in intake across food groups during a weight loss trial that produced significant and sustainable weight loss in lactating women receiving dietary treatment .


At @-@ wk postpartum , @ overweight and obese lactating Swedish women were randomized to a @-wk dietary ( D ) , exercise ( E ) , combined ( DE ) , or control ( C ) treatment .


Food intake was assessed by @-d weighed diet records which were used to examine changes in intake across seven food groups from baseline to @ wk and @ y after randomization .


Differences in changes in food choice between women receiving dietary treatment ( D+DE ) and no dietary treatment ( E+C ) were examined using multivariate linear regression .


At baseline , sweets and salty snacks contributed to @ percent of total energy intake ( E % ) .


During the intervention period , women receiving dietary treatment reduced their E % from sweets and salty snacks and caloric drinks and increased their E % from vegetables more than did women not receiving dietary treatment ( all P < @ ) .


At @ y , the increased E % from vegetables was maintained significantly higher among women receiving dietary treatment ( P = @ ) .


Lactating women receiving dietary treatment achieved sustainable weight loss through changes in food choice in line with current dietary guidelines .


Suspected coronary artery disease ( CAD ) is one of the most common , potentially life-threatening diagnostic problems clinicians encounter .


However , no large outcome-based randomized trials have been performed to guide the selection of diagnostic strategies for these patients .


The PROMISE study is a prospective , randomized trial comparing the effectiveness of @ initial diagnostic strategies in patients with symptoms suspicious for CAD .


Patients are randomized to either ( @ ) functional testing ( exercise electrocardiogram , stress nuclear imaging , or stress echocardiogram ) or ( @ ) anatomical testing with @-slice multidetector coronary computed tomographic angiography .


Tests are interpreted locally in real time by subspecialty certified physicians , and all subsequent care decisions are made by the clinical care team .


Sites are provided results of central core laboratory quality and completeness assessment .


All subjects are followed up for @ year .


The primary end point is the time to occurrence of the composite of death , myocardial infarction , major procedural complications ( stroke , major bleeding , anaphylaxis , and renal failure ) , or hospitalization for unstable angina .


More than @,@ symptomatic subjects were randomized in @ years at @ US and Canadian cardiology , radiology , primary care , urgent care , and anesthesiology sites .


Multispecialty community practice enrollment into a large pragmatic trial of diagnostic testing strategies is both feasible and efficient .


The PROMISE trial will compare the clinical effectiveness of an initial strategy of functional testing against an initial strategy of anatomical testing in symptomatic patients with suspected CAD .


Quality of life , resource use , cost-effectiveness , and radiation exposure will be assessed .


Tolvaptan is a selective vasopressin receptor antagonist ( V@R ) that increases free water excretion .


We wanted to test the hypotheses that tolvaptan changes both renal handling of water and sodium and systemic hemodynamics during basal conditions and during nitric oxide ( NO ) - inhibition with L-NG-monomethyl-arginine ( L-NMMA ) .


Nineteen healthy subjects were enrolled in a randomized , placebo-controlled , double-blind , crossover study of two examination days .


Tolvaptan @ mg or placebo was given in the morning .


L-NMMA was given as a bolus followed by continuous infusion during @ minutes .


We measured urine output ( UO ) , free water clearance ( CH@O ) , fractional excretion of sodium ( FENa ) , urinary aquaporin-@ channels ( u-AQP@ ) and epithelial sodium channels ( u-ENaC ) , plasma vasopressin ( p-AVP ) , central and brachial blood pressure ( cBP , bBP ) .


During baseline conditions , tolvaptan caused a significant increase in UO , CH@O and p-AVP , and FENa was unchanged .


During L-NMMA infusion , UO and CH@O decreased more pronounced after tolvaptan than after placebo ( -@ vs.-@ % and -@ vs.-@ % respectively ) .


U-AQP@ decreased during both treatments , whereas u-ENaC decreased after placebo and increased after tolvaptan .


CBP and bBP were unchanged .


During baseline conditions , tolvaptan increased renal water excretion .


During NO-inhibition , the more pronounced reduction in renal water excretion after tolvaptan indicates that NO promotes water excretion in the principal cells , at least partly , via an AVP-dependent mechanism .


The lack of decrease in u-AQP@ by tolvaptan could be explained by a counteracting effect of increased plasma vasopressin .


The antagonizing effect of NO-inhibition on u-ENaC suggests that NO interferes with the transport via ENaC by an AVP-dependent mechanism .


To assess whether shared medical appointments ( SMAs ) for neuromuscular patients represent a way of using clinicians ' time efficiently without compromising quality of care for patients .


Patients with a chronic neuromuscular disease ( NMD ) ( n = @ ) were randomly allocated to either an SMA or a regular individual annual appointment and followed up for a period of @ months .


Data on resource utilization and quality of life ( EQ-@D ) were collected prospectively , using a health care perspective .


Incremental costs and changes in quality-adjusted life-years ( QALYs ) were computed using a probabilistic decision model .


Factors critical to the incremental cost-effectiveness of SMAs were explored in sensitivity analyses .


No substantial differences between SMAs and individual visits in terms of costs per QALY were found ( incremental cost-effectiveness ratio -@ ; @ % confidence interval -@,@ , +@,@ ) .


Sensitivity analyses showed that the cost-effectiveness ratio was particularly sensitive to SMA group size and proportion of patients seeing their treating neurologist .


Cost-effectiveness of SMAs did not show a significant difference vs that of individual appointments based on data from our randomized controlled trial .


On the other hand , we were able to show that a minimum of @ patients per SMA and @ % of patients attending their treating neurologist are specific conditions under which SMAs qualify as a cost-effective alternative .


This implies that SMAs may be a means to increase productivity of the physician without compromising quality of care .


This study provides Class III evidence that SMAs are not significantly more cost-effective than individual appointments for patients with NMDs .


The study lacks the precision to exclude important differences in cost-effectiveness between SMAs and individual appointments .


Non-adjuvanted seasonal influenza vaccines show only modest efficacy in young children .


This study compared the immunogenicity , reactogenicity and safety of the MF@-adjuvanted trivalent subunit vaccine ( aTIV ) with two non-adjuvanted trivalent vaccines , TIV-@ , the non-adjuvanted version of aTIV , and TIV-@ , a split virion vaccine .


@ children received two doses of aTIV ( n = @ ) , TIV-@ ( n = @ ) , or TIV-@ ( n = @ ) four weeks apart ( Days @ and @ ) .


Children aged @ to < @ months and @ to < @ months received @ mL and @ mL doses , respectively .


Immunogenicity was assessed by hemagglutination inhibition ( HI ) assay ( n = @ ) on Days @ , @ , @ and @ .


Safety was assessed up to Day @ .


After the second vaccination ( Day @ ) , the aTIV group showed significantly higher geometric mean HI titers and seroconversion rates than the TIV-@ or TIV-@ groups against all homologous and heterologous strains .


The difference was enhanced at HI titers @ .


aTIV elicited a faster , more persistent antibody response , with significantly higher titers in the aTIV group after one vaccination ( Day @ ) and after six months ( Day @ ) than in either TIV group .


aTIV was more reactogenic than were TIV-@ and TIV-@ but rates of severe adverse events were very low for all three vaccines .


In infants and young children , the MF@-adjuvanted vaccine induced substantially faster ( after one dose ) , higher , persistent HI titers than the non-adjuvanted vaccines , with consistently higher seroprotection rates at increased threshold HI titers .


This trial is registered at clinicaltrials.gov : NCT@ .


When patients with type @ diabetes start their first injectable therapy , clinicians can choose between glucagon-like peptide-@ ( GLP-@ ) receptor agonists and basal insulins .


In DURATION-@ , exenatide once weekly was compared with insulin glargine ( henceforth , glargine ) as first injectable therapy .


Here , we report the results of the final @-year follow-up .


DURATION-@ was an open-label randomised trial done between May @ , @ , and Jan @ , @ .


Patients with type @ diabetes aged @ years or older were enrolled at @ sites worldwide .


They were eligible when they had suboptimum glycaemic control ( HbA@c @-@ @ % -LSB- @-@ mmol/mol -RSB- ) despite maximum tolerated doses of metformin alone or with a sulfonylurea for at least @ months , a stable bodyweight for at least @ months , and a BMI of @-@ kg/m ( @ ) ( @-@ kg/m ( @ ) in South Korea and Taiwan ) .


Patients were randomly assigned ( @:@ ) by computer-generated random sequence with an interactive voice-response system ( block size four , stratified by country and concomitant therapy ) to once-weekly exenatide ( @ mg subcutaneous injection ) or once-daily glargine ( titrated to target ) to be given in addition to their existing oral glucose-lowering regimens .


The primary efficacy measure at @ years was change in HbA@c from baseline in patients given at least one dose of the assigned drug ( ie , analyses by modified intention to treat ) .


Patients , investigators , and data analysts were not masked to treatment assignment .


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


@ patients underwent randomisation and received at least one dose of the assigned drug ( @ given exenatide , @ glargine ) .


At @ years , least-squares mean HbA@c change was -@ % ( SE @ ) in the exenatide group versus -@ % ( @ ) in the glargine group ( least-squares mean difference -@ % , SE @ , @ % CI -@ to -@ ; p = @ ) .


Transient gastrointestinal adverse events characteristic of GLP-@ receptor agonists were more frequent with exenatide than glargine ( nausea : @ -LSB- @ % -RSB- of @ patients vs five -LSB- @ % -RSB- of @ ; vomiting : @ -LSB- @ % -RSB- vs six -LSB- @ % -RSB- ; diarrhoea : @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , although frequency of these events did decrease after week @ in the exenatide group .


The proportion of patients who reported serious adverse events in the exenatide group ( @ patients -LSB- @ % -RSB- ) was the same as that in the glargine group ( @ -LSB- @ % -RSB- ) .


The exposure-adjusted rate of overall hypoglycaemia was three times higher in patients given glargine ( @ events per patient per year ) than in those given exenatide ( @ events per patient per year ) .


Efficacy of once-weekly exenatide is sustained for @ years .


GLP-@ receptor agonists could be a viable long-term injectable treatment option in patients with type @ diabetes who have not yet started taking insulin .


In the major trials of cardiac resynchronization therapy ( CRT ) , the survival benefit of the therapy , relative to control subjects , increases with QRS duration .


In the non-CRT heart failure population , however , a wide QRS duration is associated with a shorter survival .


Relative survival benefit from a therapy , however , is not synonymous with a longer absolute survival .


We sought to determine whether baseline QRS duration relates to the absolute survival after CRT .


In this prospective , longitudinal , observational study , @,@ consecutive patients undergoing CRT ( QRS @-@ ms @ % , QRS @-@ ms @ % , and QRS @ ms @ % ) were assessed in relation to mortality over @ years .


Overall mortality rates ( per @ patient-years ) were @ % , @ % , and @ % in the @ groups , respectively ( all P < @ ) .


Cardiac mortality rates were @ , @ , and @ per @ patient-years , respectively ( all P < @ ) .


Compared with the QRS @-@ ms group , cardiac mortality was highest in the QRS @ ms group ( hazard ratio -LSB- HR -RSB- @ -LSB- @ % CI @-@ @ -RSB- , P < @ ) , independent of age , gender , New York Heart Association class , presence of atrial fibrillation , heart failure etiology , and left ventricular ejection fraction .


Median survival after CRT was longest in patients with a width of QRS @-@ ms and shortest in patients with a QRS @ ms ( P < @ ) .


In multivariable analyses , a QRS @ ms emerged as a powerful independent predictor of both overall ( HR @ -LSB- @ % CI @-@ @ -RSB- , P = @ ) and cardiac mortality ( HR @ -LSB- @ % CI @-@ @ -RSB- , P = @ ) .


At long-term follow-up , absolute overall and cardiac survival after CRT is similar in patients with a preimplant QRS duration of @ to @ ms and @ to @ ms but markedly shorter in patients with a QRS @ ms.


To compare the clinical efficacy in the treatment of allergic rhinitis ( AR ) of lung qi deficiency and cold syndrome between Jin 's three-needle therapy and western medication .


Sixty-six patients were randomized into an acupuncture group and a western medication group , @ cases in each one .


In the acupuncture group , acupuncture was applied at three-nose points -LSB- Yingxiang ( LI @ ) , Shangyingxiang ( EX-HN @ ) and Yintang ( GV @ ) ; Cuanzhu ( BL @ ) was added for frontal headache -RSB- and three-back points -LSB- Dazhu ( BL @ ) , Fengmen ( BL @ ) and Feishu ( BL @ ) -RSB- , once every day .


Ten treatments made one session .


Two sessions of treatment were required .


In the western medication group , desloratadine oral suspension was prescribed , @ mg each time , once a day , for @ days .


The scores of the symptoms and physical signs in AR patients as well as the clinical efficacy were observed between the two groups .


The total effective rate was @ % ( @/@ ) in the acupuncture group , which was better than @ % ( @/@ ) in the western medication group ( P < @ ) .


After treatment , the scores of AR symptoms and physical signs as well as the total score were all reduced compared with those before treatment in the two groups ( all P < @ ) .


The score of every item in the acupuncture group was lower than that in the western medication group after treatment ( score of symptoms : @ + / - @ vs @ + / - @ , score of physical signs : @ + / - @ vs @ + / - +@ , total score : @ + / - @ vs @ + / - @ , all P < @ ) .


Jin 's three-needle therapy achieves superior efficacy on AR of lung-qi deficiency and cold syndrome , which is better than desloratadine oral suspension .


To assess the efficacy of a psychoeducational intervention , Wide Awake Parenting ( WAP ) , to decrease symptoms of postnatal fatigue .


A randomized controlled trial .


Local government areas within the Australian state of Victoria .


Two hundred and two mothers were randomly allocated to either the professionally-led telephone support intervention ( n = @ ) , self-directed written intervention ( n = @ ) , or waitlist control ( n = @ ) .


The professionally-led group received a workbook , home visit , and three telephone support calls .


The self-directed written group received the workbook only , and the control group received usual health care services .


Primary outcomes were symptoms of fatigue , depression , anxiety and stress , and health care beliefs and behaviors .


Mothers were followed up at @ - and @-weeks postintervention .


Mothers in the professionally-led group reported fewer symptoms of fatigue than mothers in the control condition at @ weeks postintervention .


Mothers in either intervention had more positive attitudes toward their health - and self-care behaviors at postintervention and follow-up .


Mothers in the professionally-led intervention reported fewer symptoms of depression , anxiety , and stress than mothers in the other conditions at postintervention .


Wide Awake Parenting is effective in promoting mothers ' self-efficacy to prioritize , plan for , and engage in health and self-care behaviors to promote mental health and manage fatigue .


Implications and future opportunities for WAP are discussed .


Filgrastim or methionyl-granulocyte colony-stimulating factor ( Met-G-CSF ) , is a recombinant therapeutic protein widely used to treat severe neutropenia caused by myelosuppressive drugs in patients with nonmyeloid malignancies .


In addition to its role in the regulation of granulopoiesis , treatment with G-CSF is considered the standard approach to mobilize CD@ positive ( CD@ + ) mononuclear cells for reconstituting hemopoietic ability for bone marrow transplantation .


An intended biosimilar filgrastim ( coded BK@ ) was produced in GMP conditions by E.coli fermentation according to an original recombinant process and showed physico-chemical properties and purity profile similar to Neupogen , a commercial preparation of filgrastim .


The aim of the present study was to demonstrate the comparability of BK@ to Neupogen in terms of both in vitro biological activities and in vivo toxicology , pharmacokinetics and pharmacodynamics .


Cell proliferation and radioligand binding assays were conducted in NFS-@ cells to compare the biological activity and functional interaction with the G-CSF receptor in vitro , while preclinical in vivo studies , including pharmacokinetics and pharmacodynamics after repeated dose were performed in normal and neutropenic rats .


A phase I study was carried out in healthy male volunteers treated by multiple-dose subcutaneous administration of BK@ and Neupogen to evaluate their pharmacodynamic effects as well as their pharmacokinetic and safety profile and to demonstrate their pharmacodynamic equivalence and pharmacokinetic bioequivalence .


The results reported in this work demonstrate that BK@ is comparable in terms of biological activity , efficacy and safety to Neupogen .


BK@ has the same pharmacokinetic profile , efficacy and safety as the reference commercial filgrastim Neupogen and therefore could be further developed to become a convenient option to treat neutropenia in oncological patients .


Healthcare technologies and patient care have evolved rapidly .


Healthcare communication techniques and technologies have lagged .


This pilot study was conducted at Duke University Hospital to investigate the benefits of using smartphones among healthcare team members to promote efficient and effective patient care .


This study used a pre-post implementation survey with an educational intervention .


Teams ( physicians , patient resource managers , physician assistants , and nurses ) from medicine and surgery were randomly assigned a smartphone .


A validated @-question survey was used to assess user experience ( @-point Likert scale , with @ indicating more reliable , strongly agree , and faster ) .


Participants were encouraged to attend focus groups to provide feedback on survey content and overall experience .


Facilitators used guiding questions and transcripts were used for qualitative analysis .


Eighty-nine matched pre - and postsurveys were analyzed .


Postimplementation data results declined for a majority of items , although remained favorable .


This suggests the reality of smartphone use did not live up to expectations but was still considered an improvement over the current paging system .


Differences by device and user were found , such as the iPhone being easier to use and the BlackBerry more professional ; nonphysicians were more concerned about training and the sterility of the device .


Themes elicited from focus groups included challenges of the current paging system , text message content , device ease of use and utility , service coverage , and professionalism .


Participants in this study recognized the benefit of using smartphones to reach team members in a timely and convenient manner while having access to beneficial applications .


Lessons were learned for future implementations with more favorable experiences for participants .


Perhaps most striking was the shared acknowledgment that the current system does n't work well and an understanding of why .


Cold hypersensitivity in the hands and feet ( CHHF ) is one of the most common complaints among Asians , especially in women .


Korean red ginseng ( KRG ) , which is a steamed form of Panax ginseng , has vasodilating action in the peripheral vessels and increases blood flow under cold stress .


However , few studies have evaluated the effect of KRG on cold hypersensitivity .


This trial is a randomized , double-blind , placebo-controlled trial in @ CHHF patients .


The trial will be implemented at Kyung Hee University Hospital at Gangdong in Seoul , Korea .


The participants will take KRG or a placebo for eight weeks , after which they will be followed-up for four weeks .


During the administration period , six capsules of @ mg KRG or placebo will be provided twice a day .


The primary outcome is change of skin temperature in the hands between baseline and after treatment .


The secondary outcomes include the visual analogue scale scores of cold hypersensitivity in the hands , change of skin temperature and the VAS scores of cold hypersensitivity in the feet , the recovery rate of the skin temperature by the cold stress test of the hands , the distal-dorsal difference of the hands , power variables of heart rate variability , and the @-item short form health survey .


This study is the first trial to evaluate the efficacy of KRG on CHHF by using infrared thermography .


Our study will provide basic evidence regarding CHHF .


Studies relating to the cardiovascular effects of glucagon-like peptide-@ ( GLP-@ ) and its agonists , which slow gastric emptying , have not discriminated between fasting and postprandial , blood pressure ( BP ) and heart rate ( HR ) .


To determine whether exogenous GLP-@ modulates the effects of an intraduodenal ( ID ) glucose infusion on BP , HR , and splanchnic blood flow in healthy older subjects .


A double-blind randomized trial was conducted .


Community-dwelling residents attended a clinical research laboratory .


Ten healthy `` older '' subjects ( @ male , @ female ; age @ @ y ) were studied .


Intravenous infusion of GLP-@ ( @ pmol/kg/min ) , or saline ( @ % ) for @ min ( t = -@ -@ min ) .


Between t = @-@ min , ID glucose was infused at @ kcal/min .


BP , HR , superior mesenteric artery ( SMA ) flow , blood glucose , and serum insulin were measured .


During the fasting period ( t = -@ -@ min ) , GLP-@ had no effect on BP or HR .


In response to ID glucose ( t = @-@ min ) , systolic BP decreased ( P < @ ) , and both HR ( P < @ ) and SMA flow ( P < @ ) increased , on both days .


GLP-@ attenuated the maximum decrease in systolic BP ( P < @ ) , tended to increase HR ( P = @ ) , and increased SMA flow ( P < @ ) .


GLP-@ diminished the glycemic response ( P < @ ) .


In healthy older subjects , acute administration of GLP-@ attenuates the hypotensive response to ID glucose , and potentiates the increase in SMA flow .


The objective of the paper is to understand leadership in an online community , specifically , Wikipedia .


Wikipedia successfully aggregates millions of volunteers ' efforts to create the largest encyclopedia in human history .


Without formal employment contracts and monetary incentives , one significant question for Wikipedia is how it organizes individual members with differing goals , experience , and commitment to achieve a collective outcome .


Rather than focusing on the role of the small set of people occupying a core leadership position , we propose a shared leadership model to explain the leadership in Wikipedia .


Members mutually influence one another by exercising leadership behaviors , including rewarding , regulating , directing , and socializing one another .


We conducted a two-phase study to investigate how distinct types of leadership behaviors ( transactional , aversive , directive , and person-focused ) , the legitimacy of the people who deliver the leadership , and the experience of the people who receive the leadership influence the effectiveness of shared leadership in Wikipedia .


Our results highlight the importance of shared leadership in Wikipedia and identify trade-offs in the effectiveness of different types of leadership behaviors .


Aversive and directive leadership increased contribution to the focal task , whereas transactional and person-focused leadership increased general motivation .


We also found important differences in how newcomers and experienced members responded to leadership behaviors from peers .


These findings extend shared leadership theories , contribute new insight into the important underlying mechanisms in Wikipedia , and have implications for practitioners who wish to design more effective and successful online communities .


The study objective was to assess the effectiveness of a turmeric - and sandal wood oil-containing cream -LSB- Vicco ( ) turmeric cream ( VTC ) ; Vicco Laboratories , Parel , India -RSB- on radiodermatitis in patients with head and neck cancer undergoing radiotherapy .


A total of @ patients with head and neck cancer requiring > @ Gy of curative radiotherapy/chemoradiotherapy were enrolled in the study .


The volunteers were randomly divided into two groups of @ patients .


Group @ was assigned to a topical application of Johnson 's ( ) baby oil ( Johnson & Johnson Ltd , Baddi , India ) and Group @ for VTC .


Prophylactic application of the cream was initiated on Day @ and continued every day until @ weeks after the end of treatment .


Both agents were symmetrically applied within the irradiated field five times a day , and the acute skin reactions were assessed twice weekly in accordance with the Radiation Therapy Oncology Group scores by an investigator who was unaware of the details .


The incidence of radiodermatitis increased with the exposure to radiation and was the highest in both groups at Week @ .


However , a significant reduction in grades of dermatitis were seen in cohorts applying VTC at all time points , including @ weeks post radiotherapy ( p < @ to p < @ ) .


The occurrence of Grade @ dermatitis was lower in the cohorts using VTC and was statistically significant ( p < @ ) .


Additionally , follow-up observations @ weeks after the completion of radiotherapy also showed a reduced degree of radiodermatitis in cohorts applying VTC , which was significant ( p = @ ) .


VTC is shown to be effective in preventing radiodermatitis and needs to be validated in larger double-blind trials .


For the first time , this study shows that the turmeric - and sandal oil-based cream was effective in preventing radiation-induced dermatitis .


Pemetrexed and erlotinib have been approved as second-line monotherapy for locally advanced or metastatic non-small cell lung cancer ( NSCLC ) .


This multicentre , randomised , open-label , parallel phase II study assessed efficacy and safety of pemetrexed versus pemetrexed + erlotinib in patients with advanced non-squamous NSCLC .


NSCLC stage III-IV patients who failed one prior platinum-based chemotherapy regimen , @ measurable lesion by Response Evaluation Criteria in Solid Tumors , and Eastern Cooperative Oncology Group performance status @ were eligible .


Patients received pemetrexed @ mg/m ( @ ) with vitamin B@ and folic acid q@w alone or combined with erlotinib @ mg daily .


The primary end-point was progression-free survival ( PFS ) .


Secondary end-points were overall survival ( OS ) , time-to-treatment failure ( TTTF ) , response and toxicity .


Of @ randomised non-squamous patients , @ were treated ( pemetrexed : @ ; pemetrexed + erlotinib : @ ) .


The median PFS ( months ; @ % CI ) was @ ( @ , @ ) for pemetrexed versus @ ( @ , @ ) for pemetrexed + erlotinib ( hazard ratio -LSB- HR -RSB- @ ; @ % CI : ( @ , @ ) ; P = @ ) .


The median OS ( months ; @ % CI ) was @ ( @ , @ ) for pemetrexed versus @ ( @ , @ ) for pemetrexed + erlotinib ( HR : @ ; @ % CI : @ , @ ; P = @ ) .


The median TTTF ( months : @ % CI ) was @ ( @ , @ ) for pemetrexed versus @ ( @ , @ ) for pemetrexed + erlotinib ( HR @ ; @ % CI : @ , @ ; P = @ ) .


One patient died in pemetrexed + erlotinib arm due to febrile neutropenia .


Grades @/@ drug-related toxicities ( in @ % of patients ) in pemetrexed/pemetrexed + erlotinib were febrile neutropenia ( @ % / @ % ) , diarrhoea ( @ % / @ % ) , rash ( @ % / @ % ) ; anaemia ( @ % / @ % ) , leukopenia ( @ % / @ % ) , neutropenia ( @ % / @ % ) , and thrombocytopenia ( @ % / @ % ) .


Pemetrexed + erlotinib treatment significantly improved PFS , OS and TTTF in @nd line non-squamous NSCLC and was associated with an increase in grade @/@ toxicities compared with pemetrexed alone .


To determine the efficacy of oral zinc for treatment of idiopathic neonatal hyperbilirubinemia in near-term and term ( @-@ weeks ) neonates .


Randomized placebo-controlled trial .


Tertiary-care teaching hospital .


Eighty newborns with idiopathic neonatal hyperbilirubinemia .


Neonates were randomized to receive either oral zinc sulfate ( @ mg/d ) or placebo for @ days .


Primary : total serum bilirubin levels at @ ( @ ) h , @ ( @ ) h and @ ( @ ) h after intervention .


Secondary : duration of phototherapy , and serum zinc and copper levels .


Baseline mean ( SD ) total serum bilirubin levels were @ ( @ ) and @ ( @ ) mg/dL in zinc and placebo groups , respectively .


No significant differences were observed in total bilirubin levels between the two groups after the intervention .


Mean ( SD ) total serum bilirubin levels in zinc and placebo groups were @ ( @ ) vs. @ ( @ ) mg/dL ( mean difference @ ; @ % CI -@ , @ , P = @ ) at @ h , @ ( @ ) vs. @ ( @ ) mg/dL ( mean difference @ ; @ % CI -@ , @ , P = @ ) at @ h and @ ( @ ) vs. @ ( @ ) mg/dL ( mean difference -@ , @ % CI -@ , @ , P = @ ) at @ h. Although the mean duration of phototherapy in the zinc group was less by @ h ( @ % CI @ , @ , P = @ ) , the difference was not significant .


Post-intervention , serum zinc levels were significantly higher in the zinc-supplemented group while serum copper levels were comparable between the two groups .


Oral zinc sulfate , in a dose of @ mg/day , is not effective in the management of idiopathic neonatal hyperbilirubinemia .


Enteral nutrition is one of the major risk factors for ventilator-associated pneumonia .


Abdominal massage is assumed to prevent the development of ventilator-associated pneumonia by reducing residual gastric volume .


To identify the effect of abdominal massage administered to critically ill patients with mechanical ventilation and continuous enteral feeding on the development of ventilator-associated pneumonia .


A randomized controlled design was used in this study .


This study was performed in a critical care unit of a university hospital in Turkey .


The sample of the study consisted of a total of @ patients , selected randomly to receive abdominal massage ( n = @ ) and a control group ( n = @ ) .


The stratified randomization was used in this study .


Patients were stratified according to age and gender .


A fifteen-minute abdominal massage was administered to the patients in the intervention group twice daily .


No intervention was administered to the patients in the control group .


At the end of monitoring days a reduction , compared to the control patients , was identified .


The amount of gastric residual volume and abdominal circumference measurement of the patients in the intervention group had decreased .


This reduction was found to be significant in the statistical analysis ( p < @ ) .


Also , although not reaching the statistical significance level , ventilator-associated pneumonia decreased in the intervention group with a ratio of @ % compared to the control group ( @ % ) ( p > @ ) .


This study revealed that abdominal massage administered to intubated and enterally fed patients reduced gastric residual volume and abdominal distension .


In addition , a decrease in the ratio of ventilator-associated pneumonia was determined .


To study the effect of case management on quality of life , caregiver strain , and perceived quality of care ( QOC ) in patients with amyotrophic lateral sclerosis ( ALS ) and their caregivers .


We conducted a multicenter cluster randomized controlled trial with the multidisciplinary ALS care team as the unit of randomization .


During @ months , patients with ALS and their caregivers received case management plus usual care or usual care alone .


Outcome measures were the @-item ALS Assessment Questionnaire ( ALSAQ-@ ) , Emotional Functioning domain ( EF ) ; the Caregiver Strain Index ( CSI ) ; and the QOC score .


These measures were assessed at baseline and at @ , @ , and @ months .


Case management resulted in no changes in ALSAQ-@ EF , CSI , or QOC from baseline to @ months .


ALSAQ-@ EF scores in both groups were similar at baseline and did not change over time ( p = @ ) .


CSI scores in both groups increased significantly ( p < @ ) .


Patients with ALS from both groups rated their perceived QOC at baseline with a median score of @ , which did not change significantly during follow-up .


Within the context of multidisciplinary ALS care teams , case management appears to confer no benefit for patients with ALS or their caregivers .


This study provides Class III evidence that case management in addition to multidisciplinary ALS care does not significantly improve health-related quality of life of patients with ALS .


Supraglottic airway devices such as the LMA-Supreme ( LMA-S ) and I-gel , which have an additional lumen for the insertion of a gastric tube , can be useful in the management of the difficult airway .


To test the performance of these two devices in the difficult paediatric airway .


Randomised double-blind study .


Anaesthesia department , university hospital .


Sixty American Society of Anesthesiologists ( ASA ) I-II children undergoing elective surgery .


After obtaining ethical approval and written informed consent from the parents , we compared the size @ LMA-S with the I-gel in a simulated airway scenario made more difficult by using a cervical collar to limit mouth opening and neck movement .


The primary aim was to compare the oropharyngeal leak pressure of the LMA-S and the I-gel .


The secondary aims were to compare success rate , insertion time , time to pass a gastric tube and fibreoptic view of the larynx .


Oropharyngeal leak pressure ( meanSD ) for the LMA-S was significantly higher than with the I-gel ( @ versus @ cmH@O , P = @ ) .


First attempt success rate for the LMA-S was @ and @ % for the I-gel ( P > @ ) .


Insertion time of the LMA-S was shorter than I-gel ( @ versus @ s , P = @ ) .


Gastric tube placement was possible in all patients .


The mean insertion time of the gastric tube was shorter with the LMA-S than with the I-gel ( @ versus @ s , P = @ ) .


Fibreoptic laryngeal views were similar in both groups .


In the simulated difficult airway in children , both airway devices provided effective ventilation .


Paediatric size @ LMA-S sustained a higher airway pressure before leaking and was quicker to insert than the I-gel equivalent .


These differences may not be clinically significant .


Little evidence exists for the effectiveness of therapy for children with receptive language difficulties , particularly those whose difficulties are severe and persistent .


To establish the effectiveness of explicit speech and language therapy with visual support for secondary school-aged children with language impairments focusing on comprehension of coordinating conjunctions in a randomized control trial with an assessor blind to group status .


Fourteen participants ( aged @ ; @-@ ; @ ) with severe RELI ( mean standard scores : CELF@ ELS = @ , CELF@ RLS = @ and TROG-@ = @ ) , but higher non-verbal ( Matrices = @ ) and visual perceptual skills ( Test of Visual Perceptual Skills ( TVPS ) = @ ) were randomly assigned to two groups : therapy versus waiting controls .


In Phase @ , the therapy group received eight @-min individual sessions of explicit teaching with visual support ( Shape Coding ) with their usual SLT .


In Phase @ , the waiting controls received the same therapy .


The participants ' comprehension was tested pre - , post-Phase @ and post-Phase @ therapy on ( @ ) a specific test of the targeted conjunctions , ( @ ) the TROG-@ and ( @ ) a test of passives .


After Phase @ , the therapy group showed significantly more progress than the waiting controls on the targeted conjunctions ( d = @ ) and overall TROG-@ standard score ( d = @ ) .


The two groups did not differ on the passives test .


After Phase @ , the waiting controls made similar progress to those in the original therapy group , who maintained their previous progress .


Neither group showed progress on passives .


When the two groups were combined , significant progress was found on the specific conjunctions ( d = @ ) and TROG-@ raw ( d = @ ) and standard scores ( d = @ ) .


Correlations showed no measures taken ( including Matrices and TVPS ) correlated significantly with progress on the targeted conjunctions or the TROG-@ .


Four hours of Shape Coding therapy led to significant gains on comprehension of coordinating conjunctions which were maintained after @ months .


Given the significant progress at a group level and the lack of reliable predictors of progress , this approach could be offered to other children with similar difficulties to the participants .


However , the intervention was delivered one-to-one by speech and language therapists , thus the effectiveness of this therapy method with other methods of delivery remains to be evaluated .


Few studies have used biomarkers of whole-grain intake to study its relation to glucose metabolism .


We aimed to investigate the association between plasma alkylresorcinols ( AR ) , a biomarker of whole-grain rye and wheat intake , and glucose metabolism in individuals with metabolic syndrome ( MetS ) .


Participants were @-@ years of age , with body mass index @-@ kg/m ( @ ) and had MetS without diabetes .


Individuals were recruited through six centers in the Nordic countries and randomized to a healthy Nordic diet ( ND , n = @ ) , rich in whole-grain rye and wheat , or a control diet ( n = @ ) , for @-@ weeks .


In addition , associations between total plasma AR concentration and C@ :@ / C@ :@ homolog ratio as an indication of the relative whole-grain rye intake , and glucose metabolism measures from oral glucose tolerance tests were investigated in pooled ( ND + control ) regression analyses at @/@ weeks .


ND did not improve glucose metabolism compared with control diet , but the AR C@ :@ / C@ :@ ratio was inversely associated with fasting insulin concentrations ( P = @ ) and positively associated with the insulin sensitivity indices Matsuda ISI ( P = @ ) and disposition index ( P = @ ) in pooled analyses at @/@ weeks , even after adjustment for confounders .


The AR C@ :@ / C@ :@ ratio was not significantly associated with insulin secretion indices .


Total plasma AR concentration was not related to fasting plasma glucose or fasting insulin at @/@ weeks .


The AR C@ :@ / C@ :@ ratio , an indicator of relative whole-grain rye intake , is associated with increased insulin sensitivity in a population with MetS .


To discuss the drug intervention in diversity changes of TCRVbeta gene in AIDS patients with incomplete immune reconstitution .


PBMCs were isolated from @ cases of AIDS patients failure to immune reconstitution before and after treatment with Immune @ and @ cases of HIV negative healthy donors .


The human gene TCRVbeta CDR@ diversity quantitative detection reagent box were used , and mapped the distribution of gene scanning and calculated different CDR@ fragme of each Vbeta family size .


( @ ) Gaussian distribution of TCRVbeta families in patients with incomplete immune reconstitution after one year of HAART , had been broken with the occurrence of the offset TCR lineage .


After six months of treatment of traditional Chinese medicine combined HAART , the TCR lineage has been partially restored .


( @ ) Evaluated by the D ( distance ) value calculated by a quantitative analysis software which the kit provides , there were no significant difference in D value change between the two groups , but with traditional Chinese medicine can reduce the data variability .


( @ ) CD@ + T cell counts had a significant correlation ( r = -@ , P = @ ) with TCRVbeta genetic diversity .


Study of the mechanism showed oligoclonal of TCRVbeta family can get recovery in some degrees after treated by Immune @ plus HAART , suggesting that the medicine may promote T-cell receptor gene rearrangement , helping immune cells to effectively identify the virus to reduce T-cell apoptosis .


Studies examining the efficacy of a single preoperative dose of gabapentin for analgesia after cesarean delivery ( CD ) have been inconclusive .


The authors hypothesized that a perioperative course of gabapentin would improve analgesia after CD .


This single-center , randomized , double-blind , placebo-controlled , parallel-group , superiority trial was designed to determine the analgesic efficacy of a perioperative course of gabapentin when added to a multimodal analgesic regimen .


Women scheduled for elective CD during spinal anesthesia were randomized to receive a perioperative oral course of either gabapentin ( @mg preoperatively followed by @mg every @h for @ days ) or placebo .


Postoperative pain was measured at @ and @h , at rest and on movement , on a visual analogue scale ( VAS , @ to @mm ) .


The primary outcome was pain on movement at @h .


Neonatal outcomes , opiate consumption , VAS satisfaction ( @ to @mm ) , adverse effects , and persistent pain were also assessed .


Baseline characteristics were similar between groups .


There was a statistically significant but small reduction in VAS pain score ( mean -LSB- @ % CI -RSB- ) on `` movement '' ( @mm -LSB- @ to @ -RSB- vs. @mm -LSB- @ to @ -RSB- ; difference , -@ mm -LSB- -@ to @ -RSB- ; P = @ ) at @h in the gabapentin ( n = @ ) compared with control group ( n = @ ) .


There was more sedation in the gabapentin group at @h ( @ vs. @ % , P = @ ) but greater patient VAS satisfaction ( @ vs. @mm , P = @ ) .


A perioperative course of gabapentin produces a clinically insignificant improvement in analgesia after CD and is associated with a higher incidence of sedation .


To evaluate the performance of the first years since the beginning of a mammographic population-based screening program .


Women aged @-@ were invited biennially for two-view film-screen mammography and double reading without arbitration was performed .


Interval cancers ( ICs ) from @ to @ were identified using screening archives , local pathology archives , and hospital discharge records .


The proportional incidence of IC was determined considering breast cancers expected without screening .


Three offsite radiologists experienced in breast cancer screening blindly evaluated mammograms prior to diagnosis , randomly mixed with negative mammograms ( @:@ ratio ) .


Cases unrecalled at review were considered as true ICs , those recalled by only one reviewer as minimal signs , and those recalled by two or three reviewers as missed cancers .


T and N stage of the reviewed ICs were evaluated and compared .


A total of @,@ first level mammograms were performed .


Mean recall rate was @ % at first and @ % at repeat screening .


We had @ screen-detected cancers and @ ICs ( @ of them ductal carcinomas in situ ) .


Absolute incidence was @ per @,@ screening examinations .


Invasive proportional incidence was @ % ( @/@ ) in the first year , @ % ( @/@ ) in the second year , and @ % ( @/@ ) in the two-year interval .


Of @ ICs , @ ( @ % ) were reviewed mixed with @ negative controls : @ % ( @/@ ) resulted to be true ICs , @ % ( @/@ ) minimal signs , and @ % ( @/@ ) missed cancers .


The rate of ICs diagnosed in the first year interval was @ % ( @/@ ) for true ICs , @ % ( @/@ ) for missed cancers , and @ % ( @/@ ) for minimal signs , with a significant difference of true ICs rate compared to missed cancers rate ( p = @ ) .


A higher rate of T@ and T@ stages was found for missed cancers ( @ % , @/@ ) compared to minimal signs ( @ % , @/@ ) or true ICs ( @ % , @/@ ) , while the rate of N@ and N@ stage for both minimal signs ( @ % , @/@ ) or missed cancers ( @ % , @/@ ) was higher than that for true ICs ( @ % , @/@ ) , although all these differences were not significant ( p @ ) .


These results showed the possibility to comply with European Community standards in the first years of a screening program implementation .


Proponents of single-incision laparoscopic surgery ( SILS ) claim patients have less pain , faster recovery , and better long-term cosmetic results than patients who undergo multiport laparoscopy .


However , randomized comparisons are lacking .


This study presents the results of a prospective randomized trial of SILS or @-port laparoscopic appendectomy .


Adults with uncomplicated acute appendicitis were randomized @:@ to either SILS or @-port laparoscopic appendectomy .


The primary end point was early postoperative pain ( measured by opiate usage and pain score in the first @ hours ) .


Secondary end points were operative time , complication rate ( including conversions ) , and recovery time ( days of oral opiate usage and return to work ) .


After @ months , body image and cosmetic appearance were assessed using a validated survey .


The trial was planned for @ patients , but was halted after @ patients when planned interim analysis showed that SILS patients had more postoperative pain ( pain score : @ @ vs @ @ ; p = @ ) and higher inpatient opiate usage ( hydromorphone use : @ @ mg vs @ @ mg ; p = @ ) than @-port laparoscopy .


Operative time for SILS averaged @ % longer ( @ @ minutes vs @ @ minutes ; p < @ ) .


Only @ SILS case was converted to @-port .