During a @-month period , @ patients were referred to LDCT ( @ / @ adults on GP list/month ) .


Half of the patients needed further diagnostic work-up , and @ ( @ % , @ % CI : @-@ @ % ) of the patients had lung cancer ; @ % ( @ % CI : @-@ @ % ) in a localised stage .


The GP referral rate was @ % higher for CME participants compared to non-participants .


Of all patients referred to LDCT , @ % were diagnosed with lung cancer with a favourable stage distribution .


Half of the referred patients needed additional diagnostic work-up .


There was an association between participation in CME and use of CT scan .


The proportion of cancers diagnosed through the usual fast-track evaluation was @ times higher in the group of CME-participating GPs .


The question remains if primary care case-finding with LDCT is a better option for patients having signs and symptoms indicating lung cancer than a screening program .


Whether open access to LDCT may provide earlier diagnosis of lung cancer is yet unknown and a randomised trial is required to assess any effect on outcome .


Many patients with advanced type @ diabetes do not meet their glycated haemoglobin targets and randomised controlled studies comparing the efficacy of pump treatment and multiple daily injections for lowering glucose in insulin-treated patients have yielded inconclusive results .


We aimed to resolve this uncertainty with a randomised controlled trial ( OpT@mise ) .


We did this multicentre , controlled trial at @ hospitals , tertiary care centres , and referal centres in Canada , Europe , Israel , South Africa , and the USA .


Patients with type @ diabetes who had poor glycaemic control despite multiple daily injections with insulin analogues were enrolled into a @-month dose-optimisation run-in period .


After the run-in period , patients with glycated haemoglobin of @-@ % ( @-@ mmol/mol ) were randomly assigned ( @:@ ) by a computer-generated randomisation sequence ( block size @ with probability @ and size @ with probability @ ) to pump treatment or to continue with multiple daily injections .


Neither patients nor investigators were masked to treatment allocation .


The primary endpoint was change in mean glycated haemoglobin between baseline and end of the randomised phase for the intention-to-treat population .


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


@ of @ screened patients entered the run-in phase and @ were randomised ( @ to pump treatment , @ to multiple daily injections ) .


Mean glycated haemoglobin at baseline was @ % ( @ mmol/mol ) in both groups .


At @ months , mean glycated haemoglobin had decreased by @ % ( SD @ ; @ mmol/mol , SD @ ) in the pump treatment group and @ % ( SD @ ; @ mmol/mol , SD @ ) in the multiple daily injection group , resulting in a between-group treatment difference of -@ % ( @ % CI -@ to -@ ; -@ mmol/mol , @ % CI -@ to -@ , p < @ ) .


At the end of the study , the mean total daily insulin dose was @ units ( SD @ ) with pump treatment versus @ units ( SD @ ) for multiple daily injections ( p < @ ) , with no significant difference in bodyweight change between the two groups ( @ kg -LSB- SD @ -RSB- vs @ kg -LSB- @ -RSB- , p = @ ) .


Two diabetes-related serious adverse events ( hyperglycaemia or ketosis without acidosis ) resulting in hospital admission occurred in the pump treatment group compared with one in the multiple daily injection group .


No ketoacidosis occurred in either group and one episode of severe hypoglycaemia occurred in the multiple daily injection group .


In patients with poorly controlled type @ diabetes despite using multiple daily injections of insulin , pump treatment can be considered as a safe and valuable treatment option .


Colchicine is effective for the treatment of acute pericarditis and first recurrences .


However , conclusive data are lacking for the efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis .


We did this multicentre , double-blind trial at four general hospitals in northern Italy .


Adult patients with multiple recurrences of pericarditis ( two ) were randomly assigned ( @:@ ) to placebo or colchicine ( @ mg twice daily for @ months for patients weighing more than @ kg or @ mg once daily for patients weighing @ kg or less ) in addition to conventional anti-inflammatory treatment with aspirin , ibuprofen , or indometacin .


Permuted block randomisation ( size four ) was done with a central computer-based automated sequence .


Patients and all investigators were masked to treatment allocation .


The primary outcome was recurrent pericarditis in the intention-to-treat population .


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


@ patients were enrolled and @ were assigned to each group .


The proportion of patients who had recurrent pericarditis was @ ( @ % ) of @ in the colchicine group and @ ( @ % ) of @ in the placebo group ( relative risk @ ; @ % CI @-@ ; p = @ ; number needed to treat @ ) .


Adverse effects and discontinuation of study drug occurred in much the same proportions in each group .


The most common adverse events were gastrointestinal intolerance ( nine patients in the colchicine group vs nine in the placebo group ) and hepatotoxicity ( three vs one ) .


No serious adverse events were reported .


Colchicine added to conventional anti-inflammatory treatment significantly reduced the rate of subsequent recurrences of pericarditis in patients with multiple recurrences .


Taken together with results from other randomised controlled trials , these findings suggest that colchicine should be probably regarded as a first-line treatment for either acute or recurrent pericarditis in the absence of contraindications or specific indications .


Despite the increasing use of pre - and posthydration protocols and low-osmolar instead of high-osmolar iodine-containing contrast media , the incidence of contrast-induced nephropathy ( CIN ) is still significant .


There is evidence that contrast media cause ischemia-reperfusion injury of the medulla .


Remote ischemic preconditioning ( RIPC ) is a non-invasive , safe , and low-cost method to reduce ischemia-reperfusion injury .


The RIPCIN study is a multicenter , single-blinded , randomized controlled trial in which @ patients at risk of CIN will receive standard hydration combined with RIPC or hydration with sham preconditioning .


RIPC will be applied by four cycles of @min ischemia and @min reperfusion of the forearm by inflating a blood pressure cuff at @mmHg above the actual systolic pressure .


The primary outcome measure will be the change in serum creatinine from baseline to @ to @h after contrast administration .


A recent pilot study reported that RIPC reduced the incidence of CIN after coronary angioplasty .


The unusual high incidence of CIN in this study is of concern and limits its generalizability .


Therefore , we propose a randomized controlled trial to study whether RIPC reduces contrast-induced kidney injury in patients at risk for CIN according to the Dutch guidelines .


To assess the long-term effects of nilvadipine on the progression of central visual field defect in retinitis pigmentosa ( RP ) .


Patients with RP were randomly divided into a treated group receiving oral nilvadipine and a control group .


Progression of RP was evaluated with MD slope and the average sensitivity of the central @ ( CENT@ ) .


The mean MD slopes were -@ / -@ ( right/left eyes , n = @ ) dB/year in the treated group and -@ / -@ ( right/left eyes , n = @ ) dB/year in the control group ( P = @ / @ , resp . )


In both eyes , however , no statistical difference was observed between the two groups for the CENT@ values .


Although we confirmed that nilvadipine significantly retarded the progression of the average of MD value defects in the central @ , it was not specific for the central @ of the visual field in RP .


In Japan , combination therapy with high doses of antipsychotic drugs is common , but as a consequence , many patients with schizophrenia report extrapyramidal and autonomic nervous system side effects .


To resolve this , we proposed a method of safety correction of high dose antipsychotic polypharmacy ( the SCAP method ) , in which the initial total dose of all antipsychotic drugs is calculated and converted to a chlorpromazine equivalent ( expressed as milligrams of chlorpromazine , mg CP ) .


The doses of low-potency antipsychotic drugs are then reduced by @ mg CP/week , and the doses of high-potency antipsychotics are decreased at a rate of @ mg CP/week .


Although a randomized , case-controlled comparative study has demonstrated the safety of this method , the number of participants was relatively small and its results required further validation .


In this study of the SCAP method , we aimed to substantially increase the number of participants .


The participants were in - or outpatients treated with two or more antipsychotics at doses of @-@ ,@ mg CP/day .


Consenting participants were randomized into control and dose reduction groups .


In the control group , patients continued with their normal regimen for @ months without a dose change before undergoing the SCAP protocol .


The dose reduction group followed the SCAP strategy over @-@ months with a subsequent @-month follow-up period .


Outcome measures were measured at baseline and then at @-month intervals , and included clinical symptoms measured on the Manchester scale , the extent of extrapyramidal and autonomic side effects , and quality of life using the Euro QOL scale .


We also measured blood drug concentrations and drug efficacy-associated biochemical parameters .


The Brief Assessment of Cognition in Schizophrenia , Japanese version , was also undertaken in centers where it was available .


The safety and efficacy of the SCAP method required further validation in a large randomized trial .


The design of this study aimed to address some of the limitations of the previous case-controlled study , to build a more robust evidence base to assist clinicians in their efforts to reduce potentially harmful polypharmacy in this vulnerable group of patients .


To investigate the short-term cost-effectiveness of cognitive-behavioral therapy ( CBT ) and psychodynamic therapy ( PDT ) compared to waiting list ( WL ) .


The analysis was conducted alongside the SOPHO-NET multi-center efficacy trial .


Patients were randomly assigned to CBT ( n = @ ) , PDT ( n = @ ) , or WL ( n = @ ) .


Resource use was assessed prior and during treatment to determine direct and absenteeism costs .


Unadjusted incremental cost-effectiveness ratios ( ICERs ) were calculated based on remission and response rates .


To visualize statistical uncertainty , cost-effectiveness acceptability curves ( CEACs ) were constructed based on adjusted net-benefit regression .


Different values for the societys willingness to pay ( WTP ) were assumed .


Both interventions were more efficacious than WL but were associated with increased direct costs besides intervention costs .


Unadjusted ICERs per responder were @ for CBT and @ for PDT .


Unadjusted ICERs per remitted patient were @ and @,@ .


CEACs revealed a high degree of uncertainty : applying the @ % probability threshold , CBT proved cost-effective at a WTP @,@ per responder and @,@ per remitted patient .


Regarding PDT cost-effectiveness only was certain for response at a WTP @,@ .


The WL condition is assumed to represent untreated patients , although the expectation to start treatment in the near future probably affects symptom severity and health care utilization .


At the end of treatment cost-effectiveness of CBT and PDT compared to WL is uncertain and depends on the societal WTP .


The interventions may induce a more adequate utilization of other health care services - involving increased costs .


Development of costs and effects in the long-run should be considered .


Diarrhea 's impact on childhood morbidity can be reduced by administering oral rehydration solution ( ORS ) with zinc ; challenges to wider use are changing health-seeking behavior and ensuring access .


We conducted a randomized controlled trial to increase ORS plus zinc uptake in rural Myanmar .


Village tracts , matched in @ pairs , were randomized to standard ORS access vs. a social franchising program training community educators and supplying ORS plus zinc .


Intervention and control communities were comparable on demographics , prevalence of diarrhea and previous use of ORS .


One year after randomization , ORS plus zinc use was @ % in the most recent case of diarrhea in intervention households compared with @ % in control households ( p < @ ) ( N = @ ) .


A significant increase in ORS plus zinc use was noted in the intervention ( p = @ ) but not in the control ( p = @ ) group .


Social franchising increased optimal treatment of childhood diarrhea in rural Myanmar .


Scale-up stands to reduce morbidity among children in similar settings .


Salsalate treatment has well-known effects on improving glycemia , and the objective of this study was to examine whether the mechanism of this effect was related to changes in adipose tissue .


A randomized double-blind and placebo-controlled trial in obese Hispanics ( @-@ years ) was conducted .


The intervention consisted of @ g day ( -@ ) of salsalate ( n = @ ) versus placebo ( n = @ ) for @ weeks .


Outcome measures included glycemia , adiposity , ectopic fat , and adipose tissue gene expression and inflammation .


In those receiving salsalate , plasma fasting glucose decreased by @ % ( P < @ ) , free fatty acids decreased by @ % ( P = @ ) , and adiponectin increased by @ % ( P < @ ) .


Salsalate increased insulin AUC by @ % ( P = @ ) and HOMA-B by @ % ( P < @ ) while estimates of insulin sensitivity/resistance were unaffected .


These metabolic improvements occurred without changes in total , abdominal , visceral , or liver fat .


Plasma markers of inflammation/immune activation were unchanged following salsalate .


Salsalate had no effects on adipose tissue including adipocyte size , presence of crown-like structures , or gene expression of adipokines , immune cell markers , or cytokines downstream of NF-B with the exception of downregulation of IL-@ ( P < @ ) .


Findings suggest that metabolic improvements in response to salsalate occurred without alterations in adiposity , ectopic fat , or adipose tissue gene expression and inflammation .


Providing e-learning modules can be an effective strategy for enhancing gatekeepers ' knowledge , self-confidence and skills in adolescent suicide prevention .


The aim of this study was to test the effectiveness of an online training program called Mental Health Online which consists of eight short e-learning modules , each capturing an important aspect of the process of recognition , guidance and referral of suicidal adolescents ( @-@years ) .


The primary outcomes of this study are participant 's ratings on perceived knowledge , perceived self-confidence , and actual knowledge regarding adolescent suicidality .


A randomized controlled trial will be carried out among @ gatekeepers .


After completing the first assessment ( pre-test ) , participants will be randomly assigned to either the experimental group or the waitlist control group .


One week after completing the first assessment the experimental group will have access to the website Mental Health Online containing the eight e-learning modules and additional information on adolescent suicide prevention .


Participants in both conditions will be assessed @weeks after completing the first assessment ( post-test ) , and @weeks after completing the post-test ( follow-up ) .


At post-test , participants from the experimental group are asked to complete an evaluation questionnaire on the modules .


The waitlist control group will have access to the modules and additional information on the website after completing the follow-up assessment .


Gatekeepers can benefit from e-learning modules on adolescent suicide prevention .


This approach allows them to learn about this sensitive subject at their own pace and from any given location , as long as they have access to the Internet .


Given the flexible nature of the program , each participant can compose his/her own training creating an instant customized course with the required steps in adolescent suicide prevention .


Researchers and participants ' expectations can influence treatment response .


Less is known about the effects of researchers ' expectations on the accuracy of data collection in the context of a weight loss trial .


Student raters ( N = @ ; age = @ years ) were recruited to weigh individuals who they thought were completing a @-month weight loss trial , although these ` participants ' were actually standardized patients ( SPs ) playing these roles .


Prior to data collection , student raters were provided information suggesting that the tested treatment had been effective .


Each student rater received a list of @-@ ` participants ' to weigh .


While the list identified each person as ` treatment ' or ` control ' , this assignment was at random , which allowed us to examine the effects of non-blinding and expectancy manipulation on weight measurement accuracy .


We hypothesized that raters would record the weights of ` treatment participants ' as lower than those of ` control participants ' .


Contrary to our hypothesis , raters recorded weights that were @ kg heavier when weighing ` treatment ' vs. ` control ' SPs , although this difference was not significant ( P = @ ) .


This pilot study found no evidence that manipulating expectancies about treatment efficacy or not blinding raters biased measurements .


Future work should examine other biases which may be created by not blinding research staff who implement weight loss trials as well as the participants in those trials .


To evaluate the efficacy and long-term safety of linagliptin added to basal insulin in Asian patients with type @ diabetes mellitus ( T@DM ) inadequately controlled by basal insulin with/without oral agents .


This was a post hoc analysis of Asian patients from a global @ week study in which patients on basal insulin were randomized ( @:@ ) to double-blind treatment with linagliptin @mg once daily or placebo ( NCT@ ) .


Basal insulin dose remained stable for @ weeks , after which adjustments could be made according to the investigator 's discretion to improve glycemic control .


The primary endpoint was the mean change in glycated hemoglobin ( HbA@c ) from baseline to @ weeks .


Data were available for @ Asian patients ( @ linagliptin , @ placebo ) .


Baseline HbA@c ( standard deviation -LSB- SD -RSB- ) was @ ( @ ) % ( @ -LSB- @ -RSB- mmol/mol ) .


The placebo-corrected mean change ( standard error -LSB- SE -RSB- ) in HbA@c from baseline was -@ ( @ ) % ( -@ -LSB- @ -RSB- mmol/mol ) ( @ % confidence interval -LSB- CI -RSB- : -@ , -@ ; p < @ ) at Week @ and -@ ( @ ) % ( -@ -LSB- @ -RSB- mmol/mol ) ( @ % CI : -@ , -@ ; p < @ ) at Week @ .


The frequency of adverse events ( linagliptin @ % , placebo @ % ) and hypoglycemia ( Week @ : linagliptin @ % , placebo @ % ; treatment end : linagliptin @ % , placebo @ % ) was similar between groups .


By Week @ , changes ( SE ) in mean body weight were similar in both groups ( linagliptin -@ -LSB- @ -RSB- kg , placebo -@ -LSB- @ -RSB- kg ) .


This study was limited by the post hoc nature of the analysis and the small number of patients in the subgroup .


However , the results suggest that linagliptin significantly improves glycemic control in Asian patients with T@DM inadequately controlled by basal insulin , without increasing the risk for hypoglycemia or weight gain .


ClinicalTrials identifier : NCT@ .


Dual dependence on opiate and cocaine occurs in about @ % of patients admitted to methadone maintenance and negatively impacts prognosis ( Kosten et al. @ .


Drug Alcohol Depend .


Topiramate ( TOP ) is an antiepileptic drug that may have utility in the treatment of cocaine dependence because it enhances the GABAergic system , antagonizes the glutamatergic system , and has been identified by NIDA as one of only a few medications providing a `` positive signal '' warranting further clinical investigation .


( Vocci and Ling , @ .


Pharmacol .


Ther .


In this double-blind controlled clinical trial , cocaine dependent methadone maintenance patients ( N = @ ) were randomly assigned to one of four groups .


Under a factorial design , participants received either TOP or placebo , and monetary voucher incentives that were either contingent ( CM ) or non-contingent ( Non-CM ) on drug abstinence .


TOP participants were inducted onto TOP over @ weeks , stabilized for @ weeks at @ mg daily then tapered over @ weeks .


Voucher incentives were supplied for @ weeks , starting during the fourth week of TOP induction .


Primary outcome measures were cocaine abstinence ( Y/N ) as measured by thrice weekly urinalysis and analyzed using Generalized Estimating Equations ( GEE ) and treatment retention .


All analyses were intent to treat and included the @-week evaluation phase of combined TOP/P treatment and voucher intervention period .


There was no significant difference in cocaine abstinence between the TOP vs. P conditions nor between the CM vs. Non-CM conditions .


There was no significant TOP/CM interaction .


Retention was not significantly different between the groups .


Topiramate is not efficacious for increasing cocaine abstinence in methadone patients .


The question-behaviour effect ( QBE ) refers to the finding that measuring behavioural intentions increases performance of the relevant behaviour .


This effect has been used to change health behaviours .


The present research asks why the QBE occurs and evaluates one possible mediator-attitude accessibility .


University staff and students ( N = @ ) were randomly assigned to an intention measurement condition where they reported their intentions to eat healthy foods , or to one of two control conditions .


Participants completed a response latency measure of attitude accessibility , before healthy eating behaviour was assessed unobtrusively using an objective measure of snacking .


Intention measurement participants exhibited more accessible attitudes towards healthy foods , and were more likely to choose a healthy snack , relative to control participants .


Furthermore , attitude accessibility mediated the relationship between intention measurement and behaviour .


This research demonstrates that increased attitude accessibility may explain the QBE , extending the findings of previous research to the domain of health behaviour .


Laparoscopy-assisted distal gastrectomy ( LADG ) for gastric cancer may prevent the development of an impaired nutritional status due to reduced surgical stress compared with open distal gastrectomy ( ODG ) .


This study was performed as an exploratory analysis of a phase III trial comparing LADG and ODG for stage I gastric cancer during the period between May and December of @ .


All patients received the same perioperative care via fast-track surgery .


The level of surgical stress was evaluated based on the white blood cell count and the interleukin-@ ( IL-@ ) level .


The nutritional status was measured according to the total body weight , amount of lean body mass , lymphocyte count , and prealbumin level .


Twenty-six patients were randomized to receive ODG ( @ patients ) or LADG ( @ patients ) .


The baseline characteristics and surgical outcomes were similar between the two groups .


The median IL-@ level increased from @ to @ pg/dl in the ODG group and from @ to @ pg/dl in the LADG group .


The median amount of lean body mass decreased from @ to @ kg in the ODG group and from @ to @ kg in the LADG group .


There are no significant differences between two groups .


The level of surgical stress and the nutritional status were found to be similar between the ODG and LADG groups in a randomized comparison using the same perioperative care of fast-track surgery .


From a previously validated paediatric population pharmacokinetic model , it was derived that non-linear morphine maintenance doses of @ g/kg ( @ ) / h , with a @ % dose reduction in neonates with a postnatal age ( PNA ) < @ days , yield similar morphine and metabolite concentrations across patients younger than @ years .


Compared with traditional dosing , this model-derived dosing regimen yields significantly reduced doses in neonates aged < @ days .


Concentration predictions of the population model were prospectively evaluated in postoperative term neonates and infants up to the age of @ year who received morphine doses according to the model-derived algorithm .


The efficacy of this dosing algorithm was evaluated using morphine rescue medication and actual average infusion rates .


Morphine and metabolite concentrations were accurately predicted by the paediatric pharmacokinetic morphine model .


With regard to efficacy , @ out of @ neonates ( @ % ) with a PNA of < @ days needed rescue medication versus @ of the @ older patients ( @ % ) ( p = @ ) .


The median ( interquartile range -LSB- IQR -RSB- ) total morphine rescue dose was @ ( @-@ ) g/kg in younger patients versus @ ( @-@ ) g/kg in older patients ( p = @ ) .


The median ( IQR ) actual average morphine infusion rate was @ ( @-@ @ ) g/kg/h in younger patients versus @ ( @-@ @ ) g/kg/h in older patients ( p < @ ) .


Morphine paediatric dosing algorithms corrected for pharmacokinetic differences alone yield effective doses that prevent over-dosing for neonates with a PNA < @ days .


The fact that many neonates and infants with a PNA @ days still required rescue medication warrants pharmacodynamic studies to further optimize the dosing algorithm for these patients .


Palonosetron is a potent second generation @ - hydroxytryptamine-@ selective antagonist which can be administered by either intravenous ( IV ) or oral routes , but subcutaneous ( SC ) administration of palonosetron has never been studied , even though it could have useful clinical applications .


In this study , we evaluate the bioavailability of SC palonosetron .


Patients treated with platinum-based chemotherapy were randomized to receive SC or IV palonosetron , followed by the alternative route in a crossover manner , during the first two cycles of chemotherapy .


Blood samples were collected at baseline and @ , @ , @ , @ , @ , @ minutes and @ , @ , @ , @ , @ , @ and @ h after palonosetron administration .


Urine was collected during @ hours following palonosetron .


We compared pharmacokinetic parameters including AUC@-@h , t@/@ , and Cmax observed with each route of administration by analysis of variance ( ANOVA ) .


From October @ to July @ , @ evaluable patients were included .


AUC@-@h for IV and SC palonosetron were respectively @ and @ ng h/ml ( p = @ ) .


Bioavalability of SC palonosetron was @ % ( @ % IC : @-@ ) .


Cmax was lower with SC than with IV route and was reached @ minutes following SC administration .


Palonosetron bioavailability was similar when administered by either SC or IV route .


This new route of administration might be specially useful for outpatient management of emesis and for administration of oral chemotherapy .


Inorganic nitrate ( NO@ ( - ) ) , abundant in certain vegetables , is converted to nitrite by bacteria in the oral cavity .


Nitrite can be converted to nitric oxide in the setting of hypoxia .


We tested the hypothesis that NO@ ( - ) supplementation improves exercise capacity in heart failure with preserved ejection fraction via specific adaptations to exercise .


Seventeen subjects participated in this randomized , double-blind , crossover study comparing a single dose of NO@-rich beetroot juice ( NO@ ( - ) , @ mmol ) with an identical nitrate-depleted placebo .


Subjects performed supine-cycle maximal-effort cardiopulmonary exercise tests , with measurements of cardiac output and skeletal muscle oxygenation .


We also assessed skeletal muscle oxidative function .


Study end points included exercise efficiency ( total work/total oxygen consumed ) , peak VO@ , total work performed , vasodilatory reserve , forearm mitochondrial oxidative function , and augmentation index ( a marker of arterial wave reflections , measured via radial arterial tonometry ) .


Supplementation increased plasma nitric oxide metabolites ( median , @ versus @ mol/L ; P = @ ) , peak VO@ ( @ versus @ mL O@min ( -@ ) kg ( -@ ) ; P = @ ) , and total work performed ( @ versus @ kJ ; P = @ ) .


However , efficiency was unchanged .


NO@ ( - ) led to greater reductions in systemic vascular resistance ( -@ % versus -@ % ; P = @ ) and increases in cardiac output ( @ % versus @ % ; P = @ ) with exercise .


NO@ ( - ) reduced aortic augmentation index ( @ % versus @ % ; P = @ ) and tended to improve mitochondrial oxidative function .


NO@ ( - ) increased exercise capacity in heart failure with preserved ejection fraction by targeting peripheral abnormalities .


Efficiency did not change as a result of parallel increases in total work and VO@ .


NO@ ( - ) increased exercise vasodilatory and cardiac output reserves .


NO@ ( - ) also reduced arterial wave reflections , which are linked to left ventricular diastolic dysfunction and remodeling .


The combination of pulsed dye laser ( PDL ) and topical propranolol are used with variable effectiveness for the treatment of infantile hemangiomas ( IH ) , particularly for superficial lesions .


The aim of this study was to investigate whether the therapeutic efficacy of prescribing topical propranolol along with PDL was superior to PDL therapy alone in the treatment of IH .


A total of @ patients with IH were recruited to the study .


Among them , nine patients were treated with PDL , @ sessions @ weeks apart , and @ patients underwent PDL treatment alongside with topical propranolol for @ weeks .


The therapeutic efficacies of each regimen were assessed by comparing photographs of skin lesions before and after the treatment based on the cessation of the lesion growth , reduction in the lesion size , and lightening of the lesion color .


No side-effect was reported by the parents .


Among nine patients in PDL group , only two ( @ % ) had excellent clearance , one ( @ % ) had good , three ( @ % ) had weak , and three ( @ % ) had no responses .


On the other hand , among @ patients who were treated with both the PDL and topical propranolol , five ( @ % ) showed excellent responses and five ( @ % ) displayed good responses .


Statistical data analysis with Mann-Whitney test revealed a significant difference in the clinical response between two treatment groups .


The combination of PDL and topical propranolol seem to be a safe and effective therapy , and results in better clinical responses in the treatment of IH than PDL therapy alone .


Surfactant has been shown to be dysfunctional in ARDS , and exogenous surfactant has proven effective in many forms of neonatal and pediatric acute lung injury ( ALI ) .


In view of the positive results of our studies in children along with evidence that surfactant-associated protein B containing pharmaceutical surfactants might be more effective , we designed a multiinstitutional , randomized , controlled , and masked trial of calfactant , a calf lung surfactant , in adults and children with ALI/ARDS due to direct lung injury .


Adult subjects within @ h of initiation of mechanical ventilation for direct ARDS were randomized to receive up to three interventions with instilled calfactant vs air placebo .


The primary outcome was @-day all-cause mortality .


Three hundred seventeen subjects were enrolled , @ of whom could be evaluated .


There were no significant baseline differences between groups .


Calfactant administration was not associated with improved survival , lengths of stay , or oxygenation .


Calfactant instillation was frequently associated with transient hypoxia and hypotension .


The study was stopped at the first interim analysis at the sponsor 's request .


Administration of calfactant was not associated with improved oxygenation or longer-term benefits relative to placebo in this randomized , controlled , and masked trial .


At present , exogenous surfactant can not be recommended for routine clinical use in ARDS .


Herpes simplex keratitis ( HSK ) caused by herpes simplex virus @ ( HSV-@ ) , which has high recurrent rate and incidence of severe vision loss , is the leading cause of infectious blindness in the world .


The aim was to explore the clinical efficacy of oral ganciclovir ( GCV ) in the prevention of recurrent HSK .


A multicenter , prospective , randomized , single-blind , and controlled clinical trial was conducted from April @ to June @ .


One hundred seventy-three patients ( @ eyes involved ) who were diagnosed as recurrent HSK definitely , including stromal keratitis and corneal endotheliitis , were divided into three groups randomly : negative control ( placebo ) group was topically administered with @ % GCV ophthalmic gel , @ times per day and @ % fluorometholone eye drops , @ times per day until resolution of HSK ; positive control acyclovir ( ACV ) group was topically adopted the same ophthalmic gel and eye drops and additionally received oral ACV @ mg @ times a day for @ weeks and followed by @ mg @ times per day for @ months ; test GCV group was topically adopted the same treatment as negative control group and additionally received oral GCV @ mg @ times per day for @ weeks .


The symptoms and signs were evaluated before and after the therapy @ st week , @ nd week and then followed up every @ weeks until recovery .


Furthermore , we followed up recurrence of HSK for every @ months after recovery and then assessed the cure time , recurrent rate and adverse reactions .


One hundred and seventy-three patients were followed up @-@ months ( mean @ @ months ) , but @ patients were failed to follow-up .


The cure time was @ @ , @ @ weeks in negative control ( placebo ) group and positive control ACV group respectively ( P = @ ) , which was longer than that in test GCV group ( @ @ weeks ) and there was a significant difference between test GCV group and negative control ( placebo ) group or positive control ACV group ( P = @ ) .


Furthermore , the recurrent rate was higher in negative control ( placebo ) group ( @ % ) than that in positive control group ACV ( @ % ) and test GCV group ( @ % ) , and there was a great significant difference among the three groups ( P = @ ) , but there was no significant difference between positive control ACV group and test GCV group ( P = @ ) .


In addition , there was no obvious adverse reaction expect neutropenia ( only one patient in test GCV group ) .


Short-term oral GCV could cure recurrent HSK and endotheliitis , shorten the course , reduce recurrent rate of HSK and have confirmed safety .


We planned a randomized , open-label trial to evaluate differences between pre-emptive and reactive skin treatment for panitumumab ( Pmab ) - associated skin toxicities in Japanese patients with metastatic colorectal cancer .


Patients receiving third-line Pmab-containing regimens were randomized to pre-emptive or reactive treatment .


The primary end point was the cumulative incidence of grade @ skin toxicities during @ weeks .


Retrospectively , a dermatologist reviewed skin toxicities , in a blinded manner .


A total of @ patients were enrolled ( pre-emptive : @ , reactive : @ ) .


The primary end point was achieved ( @ and @ % -LSB- risk ratio : @ ; p < @ -RSB- , for pre-emptive and reactive treatment , respectively ) .


A similar trend was observed in central review .


Pre-emptive skin treatment could reduce the severity of Pmab-associated skin toxicities in Japanese metastatic colorectal cancer patients .


VEGF and VEGF receptor-@-mediated angiogenesis contribute to hepatocellular carcinoma pathogenesis .


Ramucirumab is a recombinant IgG@ monoclonal antibody and VEGF receptor-@ antagonist .


We aimed to assess the safety and efficacy of ramucirumab in advanced hepatocellular carcinoma following first-line therapy with sorafenib .


In this randomised , placebo-controlled , double-blind , multicentre , phase @ trial ( REACH ) , patients were enrolled from @ centres in @ countries .


Eligible patients were aged @ years or older , had hepatocellular carcinoma with Barcelona Clinic Liver Cancer stage C disease or stage B disease that was refractory or not amenable to locoregional therapy , had Child-Pugh A liver disease , an Eastern Cooperative Oncology Group performance status of @ or @ , had previously received sorafenib ( stopped because of progression or intolerance ) , and had adequate haematological and biochemical parameters .


Patients were randomly assigned ( @:@ ) to receive intravenous ramucirumab ( @ mg/kg ) or placebo every @ weeks , plus best supportive care , until disease progression , unacceptable toxicity , or death .


Randomisation was stratified by geographic region and cause of liver disease with a stratified permuted block method .


Patients , medical staff , investigators , and the funder were masked to treatment assignment .


The primary endpoint was overall survival in the intention-to-treat population .


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


Between Nov @ , @ , and April @ , @ , @ patients were enrolled , of whom @ were assigned to ramucirumab and @ were assigned to placebo .


Median overall survival for the ramucirumab group was @ months ( @ % CI @-@ ) versus @ months ( @-@ ) for the placebo group ( HR @ -LSB- @ % CI @-@ -RSB- ; p = @ ) .


Grade @ or greater adverse events occurring in @ % or more of patients in either treatment group were ascites ( @ -LSB- @ % -RSB- of @ patients treated with ramucirumab vs @ -LSB- @ % -RSB- of @ patients treated with placebo ) , hypertension ( @ -LSB- @ % -RSB- vs ten -LSB- @ % -RSB- ) , asthenia ( @ -LSB- @ % -RSB- vs five -LSB- @ % -RSB- ) , malignant neoplasm progression ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , increased aspartate aminotransferase concentration ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , thrombocytopenia ( @ -LSB- @ % -RSB- vs one -LSB- < @ % -RSB- ) , hyperbilirubinaemia ( three -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , and increased blood bilirubin ( five -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) .


The most frequently reported ( @ % ) treatment-emergent serious adverse event of any grade or grade @ or more was malignant neoplasm progression .


Second-line treatment with ramucirumab did not significantly improve survival over placebo in patients with advanced hepatocellular carcinoma .


No new safety signals were noted in eligible patients and the safety profile is manageable .


Early ceramic bearing systems in total hip arthoplasty ( THA ) sought to provide long term wear improvement over traditional metal on polyethylene systems .


However , previous designs exhibited fractures of the ceramic acetabular liner , leading to the development of the Implex Hedrocel ceramic bearing THA system where the ceramic liner was supported on a layer of polyethylene intended to transition liner loads to the metal shell , a so-called `` sandwich '' design .


Unfortunately , the device trial was stopped to further enrollment when liner fractures were reported .


The current study examines nearly @-year follow-up on @ devices implanted by two surgeons at one institution in order to document ceramic bearing system performance over a longer time period .


Radiographic and patient reported outcomes , in the form of Harris Hip Scores ( HHS ) and @-Item Short Form Health Survey ( sF-@ ) , were collected .


During the study period two cups were replaced , one at three years and a second at seven years .


At the five year follow-up HHS were similar to those reported in the literature for devices with traditional metal-on-polyethylene bearing surfaces and for other sandwich ceramic bearing designs .


At the nine year follow-up , the HHS had not changed significantly and SF-@ scores measuring overall physical and mental health were higher than age matched national norms ( p < @ ) .


There were no signs of cup migration , stem subsidence , osteolysis or cup loosening at any time up to the last follow-up in this patient cohort .


The @ % survivorship rate and device revisions due to delamination of the liner observed in this group were similar to those reported earlier for this device and for other `` sandwich design '' ceramic bearing systems .


This cohort did not exhibit new failure modes and HHS and SF-@ scores indicated high functionality for the majority of patients .


These data suggest that a focus on preventing ceramic liner fracture through design and/or materials improvements may result in a device with long-term functionality .


In this study , our aim was to evaluate the effects of intravenous dexketoprofen trometamol with ilioinguinal and iliohypogastric nerve block on analgesic quality and morphine consumption after total abdominal hysterectomy operations .


We conducted this randomized controlled clinical study on @ patients .


The study was conducted in the operation room , post-anesthesia care unit , and inpatient clinic .


We randomly grouped the @ patients into control group ( group C ) , block group ( group B ) and dexketoprofen-block group ( group DB ) .


Before the skin incision performed after anesthesia induction , we performed ilioinguinal iliohypogastric block ( group C given saline and group P and DB given levobupivacaine ) .


In contrast to group C and B , group DB was given dexketoprofen .


We administered morphine analgesia to all patients by patient-controlled analgesia ( PCA ) during the postoperative @ hours .


We recorded Visual Analogue Scale ( VAS ) , satisfaction scores , morphine consumption and side effects during postoperative @ hours .


We found the DB group 's VAS scores to be lower than the control group and block group 's ( p < @ ) values at postoperative @ ( st ) , @ ( nd ) , @ ( th ) and @ ( th ) hours .


VAS scores of group C were higher than of group B at postoperative first @ hours .


Time to first PCA demand was longer , morphine consumption values were lower and satisfaction scores were higher in group DB than in the other two groups ( p < @ ) .


Ilioinguinal-iliohypogastric nerve block with IV dexketoprofen increases patient satisfaction by decreasing opioid consumption , increasing patient satisfaction , which suggests that dexketoprofen trometamol is an effective non-steroidal anti-inflammatory analgesic in postoperative analgesia .


To determine whether strict blood pressure ( BP ) control is the best medical management for patients with symptomatic carotid artery occlusion and hemodynamic cerebral ischemia .


In this prospective observational cohort study , we analyzed data from @ participants in the nonsurgical group of the Carotid Occlusion Surgery Study ( COSS ) who had recent symptomatic internal carotid artery occlusion and hemodynamic cerebral ischemia manifested by ipsilateral increased oxygen extraction fraction .


The target BP goal in COSS was @/@ mm Hg .


We compared the occurrence of ipsilateral ischemic stroke during follow-up in the @ participants with mean BP @/@ mm Hg to the remaining @ with higher BP .


Of @ total ipsilateral ischemic strokes that occurred during follow-up , @ occurred in the @ participants with mean follow-up BP of @/@ mm Hg , compared to @ in the remaining @ participants with mean follow-up BP > @/@ mm Hg ( hazard ratio @ , @ % confidence interval @-@ @ , log-rank p = @ ) .


BPs @/@ mm Hg were associated with lower subsequent stroke risk in these patients .


This study provides Class III evidence that control of hypertension @/@ mm Hg is associated with a reduced risk of subsequent ipsilateral ischemic stroke in patients with recently symptomatic carotid occlusion and hemodynamic cerebral ischemia ( increased oxygen extraction fraction ) .


Arthroscopic capsular release is an effective treatment for shoulder stiffness , yet its extent is controversial .


To compare the clinical outcomes of arthroscopic capsular release in patients with and without posterior extended capsular release for shoulder stiffness .


Randomized controlled trial ; Level of evidence , @ .


Between January @ and March @ , @ patients who underwent arthroscopic capsular release for shoulder stiffness were enrolled and randomized into @ groups .


In group I ( n = @ ) , capsular release was performed , including release of the rotator interval and anterior and inferior capsule .


In group II ( n = @ ) , capsular release was extended to the posterior capsule .


The American Shoulder and Elbow Surgeons score , Simple Shoulder Test , visual analog scale for pain , and range of motion ( ROM ) were used for the evaluation before surgery and at @ , @ , and @ months after surgery and at the last follow-up .


Preoperative demographic data of age , sex , symptom duration , and clinical outcomes showed no significant differences ( P > @ ) .


The average follow-up was @ months .


Both groups showed significantly increased ROM at the last follow-up compared with preoperative ROM ( P < @ ) .


At the last follow-up , no statistical differences were found ( P > @ ) between groups I and II in American Shoulder and Elbow Surgeons score ( @ vs. @ ) , Simple Shoulder Test ( @ vs. @ ) , and visual analog scale ( @ vs. @ ) .


There were also no statistical differences between the @ groups at the last follow-up ( P > @ ) in ROM : forward flexion , @ vs. @ ; external rotation with @ of abduction , @ vs. @ ; external rotation at side , @ vs. @ ; and internal rotation , @ vs. @ .


Posterior extended capsular release might not be necessary in arthroscopic surgery for shoulder stiffness .


The aim of this study is to compare quality of life in @-month follow-up after the use of transobturator tape TVT-O and single incision tape AJUST in the treatment of urodynamic stress urinary incontinence ( USI ) .


Randomized trial .


Gynekologicko-porodnick klinika LF UK a FN Plze , Gynekologicko-porodnick klinika @ .


LF UK a VFN Praha .


Between May @ and May @ @ women with proven urodynamic stress urinary incontinence were included in this randomized trial .


These patients were randomly chosen and devided into two group : @ patients for TVT-O procedure and @ patients for AJUST procedure .


All of the patients underwent a complete urogynecological examination prior to the actual procedure ( clinical examination , urodynamic examination , ultrasound examination ) and filled in ICIQ-SF and iQol questionnaires .


After the surgery , the patients satisfaction was evaluated by visual analoque scale ( VAS ) and Likert scale and by ICIQ-SF and iQol questionnaires .


The intensity and length of postoperative pain was monitored using the visual analogue scale .


The patients underwent an examination after @ months .


In both groups of participants no significant differences regarding age , BMI , parity , history of surgery for gynecological disorders , were found .


Preoperative urodynamic , ICIQ-SF and iQol parameters were also not significantly different .


In the @-month follow-up @ participants from TVT-O group and @ participants from the AJUST group were monitored .


No statistically significant differences in subjective and objective parameters were found .


Subjectively stress incontinence was not present in @ % in the TVT-O and @ % in the group AJUST .


Objectively stress test was negative in @ % in the TVT-O and @ % in group AJUST .


By evaluating the ICIQ and iQol were found no statistical differences in the quality of life in both operating groups .


At @-months follow up we did not find any statistical difference between subjective and objective outcome for single incision tape AJUST and TVT-O .


In the AJUST group lower intensity and shorter duration of postoperative pain were observed .


Patients who develop relapsing-remitting multiple sclerosis ( MS ) present with a first clinical demyelinating event .


In this double-blind , multicentre , randomised , phase @ study we investigated the effect of oral cladribine on conversion to clinically definite MS in patients with a first clinical demyelinating event , when given at the same doses shown to be effective in relapsing-remitting MS.


Between Oct @ , @ , and Oct @ , @ , we recruited patients aged @-@ years , inclusive , from @ hospitals , private clinics , or treatment centres in @ countries .


Eligible patients had a first clinical demyelinating event within @ days before screening , at least two clinically silent lesions of at least @ mm on a T@-weighted brain MRI scan , and an Expanded Disability Status Scale score of @ or lower .


Patients with a first clinical demyelinating event @ days before screening were randomly assigned ( @:@:@ ) to receive cladribine tablets at cumulative doses of @ mg/kg or @ mg/kg or placebo .


Randomisation was done with a central web-based randomisation system and was stratified by geographic region .


Masking was maintained using a two-physician model .


The primary endpoint of this @-week study was time to conversion to clinically definite MS according to the Poser criteria .


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


Of @ participants assessed for eligibility , @ patients received cladribine @ mg/kg ( n = @ ) , cladribine @ mg/kg ( n = @ ) , or placebo ( n = @ ) .


At trial termination on Oct @ , @ , cladribine was associated with a risk reduction versus placebo for time to conversion to clinically definite MS ( hazard ratio -LSB- HR -RSB- for @ mg/kg = @ , @ % CI @-@ @ , p < @ ; HR for @ mg/kg = @ , @-@ @ , p < @ ) .


Adverse events were reported in @ ( @ % ) patients in the cladribine @ mg/kg group , @ ( @ % ) patients in the cladribine @ mg/kg group , and @ ( @ % ) patients in the placebo group .


We noted no increase in risk of adverse events with active treatment versus placebo apart from lymphopenia , which was a severe event in @ ( @ % ) patients in the @ mg/kg group and four ( @ % ) patients in the @ mg/kg group .


Both doses of cladribine significantly delayed MS diagnosis compared with placebo .


The safety profile of cladribine was similar to that noted in a trial in patients with relapsing-remitting MS. Further research could clarify the potential effects of oral cladribine treatment in the early stages of MS.


The aim of this work was to study the reduction in intraocular pressure ( IOP ) after two selective laser trabeculoplasty ( SLT ) treatments in the same area of the trabecular meshwork ( TM ) compared to two SLT treatments in two different areas of the TM when the initial SLT treatment has failed .


This was a prospective randomized clinical trial for testing the effect of repeated SLT treatments in reducing IOP .


The patients in the study all suffered from primary open-angle or pseudoexfoliation glaucoma .


All patients were treated initially with SLT ( SLT @ ) over @ in the lower half of the TM .


Patients who were chosen for retreatment with SLT ( SLT @ ) were asked to participate in the study .


The patients in the study were randomized to either SLT @ in the same , already-treated TM area or to SLT @ in the upper untreated TM area .


The IOP was measured before and @h , @month , @months , and @months after the SLT @ treatment .


Patients who changed medical therapy regimens during this time were excluded .


A total of @ patients were included in both groups .


At baseline , there were no significant differences between the groups in regards to age ( t-test , p = @ ) , gender ( ( @ ) , p = @ ) , pseudoexfoliation glaucoma ( ( @ ) , p = @ ) , time between SLT @ and SLT @ ( t-test , p = @ ) , IOP before SLT @ ( t-test , p = @ ) , or IOP before SLT @ ( t-test , p = @ ) .


At the conclusion of the study , there were no significant differences in IOP between the groups @h ( t-test , p = @ ) , @month ( t-test , p = @ ) , @months ( t-test , p = @ ) , or @months ( t-test , p = @ ) after the SLT @ treatment .


Two SLT treatments of the same TM area do not have a significant effect on IOP compared to two SLT treatments in two different areas .


Using the database of the National Institute of Mental Health-sponsored acute treatment of late life mania study ( GERI-BD ) , we assessed the role of social support in the presentation of late life bipolar mania .


In the first @ subjects randomized in geriatric BD , we explored the demographic , clinical , and social support characteristics ( assessed using the Duke Social Support Index ) and aspects of manic presentation .


We selected two dependent variables : symptom severity , as determined by the Young Mania Rating Scale ( YMRS ) at baseline , and duration of episode .


We selected nine potential independent variables on the basis of Pearson correlation coefficients .


We derived two final models using multiple regression analysis employing an iterative process .


In our severity model , being married was associated with a higher YMRS score ( p = @ ) , whereas higher social interaction scores with non-family members were associated with a lower YMRS score ( p = @ ) .


In the episode duration model , longer duration was associated with a higher Hamilton Depression Rating Scale score ( p = @ ) and higher social interaction scores with non-family members ( p = @ ) , younger age ( p = @ ) , higher number of persons in one 's family social network ( p = @ ) , and higher instrumental support scores ( p = @ ) .


In late life mania , more social interaction with one 's community appears to be associated with less severe symptoms at presentation for treatment , however , it can also be associated with slightly longer the duration of episode .


Two aspects of the Duke Social Support Index are associated with a shorter episode duration prior to seeking treatment : being part of a larger family network and a having a higher level of instrumental support prior to treatment .


The Instrumental Support Subscale measures the degree of assistance that is available for the respondent in performing daily tasks .


These findings suggest that in older adults with BD , close social interactions and support are important in limiting the length of the illness episode prior to treatment .


Social interactions involving non-family members may be less important in moderating the intensity of the symptoms at presentation .


To determine the efficacy of brief Culturally adapted CBT ( CaCBT ) for depression when added to Treatment As usual ( TAU ) - delivered by trained therapists using a manual compared with alone TAU .


This was an assessor-blinded , randomised controlled clinical trial .


Particpants with a diagnosis of depression , attending psychiatry departments of three teaching hospitals in Lahore , Pakistan , were included in the study .


We screened a total of @ patients and randomly allocated @ of them to CaCBT plus Treatment As Usual ( TAU ) -LSB- Treatment group -RSB- or to TAU alone -LSB- Control group -RSB- .


Assessments were completed at baseline , at @ months and at @ months after baseline .


Reduction in depression score ( Hospital Anxiety and Depression-Depression Subscale ) at @ months was primary outcome measure .


The secondary outcome measures included anxiety scores ( Hospital Anxiety and Depression-Anxiety Subscale ) , somatic symptoms ( Bradford Somatic Inventory ) , disability ( Brief Disability Questionnaire ) and satisfaction with the treatment .


A total of @ participants were randomised to Treatment group and @ to Control group .


Participants in Treatment group showed statistically significant improvement in depression ( p = @ ) , anxiety ( p = @ ) , somatic symptoms ( p = @ ) and disability ( p = @ ) .


This effect was sustained at @ months after baseline ( Except for disability ) .


Participants in Treatment group also reported higher satisfaction with treatment compared with those in Control group .


Brief CaCBT can be effective in improving depressive symptoms , when compared with treatment as usual .


This is the first report of a trial of Culturally adapted CBT from South Asia and further studies are needed to generalise these findings .


Interactive voice response systems integrated with electronic health records have the potential to improve primary care by engaging parents outside clinical settings via spoken language .


The objective of this study was to determine whether use of an interactive voice response system , the Personal Health Partner ( PHP ) , before routine health care maintenance visits could improve the quality of primary care visits and be well accepted by parents and clinicians .


English-speaking parents of children aged @ months to @ years called PHP before routine visits and were randomly assigned to groups by the system at the time of the call .


Parents ' spoken responses were used to provide tailored counseling and support goal setting for the upcoming visit .


Data were transferred to the electronic health records for review during visits .


The study occurred in an urban hospital-based pediatric primary care center .


Participants were called after the visit to assess ( @ ) comprehensiveness of screening and counseling , ( @ ) assessment of medications and their management , and ( @ ) parent and clinician satisfaction .


PHP was able to identify and counsel in multiple areas .


A total of @ % of parents responded to the mailed invitation .


Intervention parents were more likely to report discussing important issues such as depression ( @ % vs @ % ; P < @ ) and prescription medication use ( @ % vs @ % ; P = @ ) and to report being better prepared for visits .


One hundred percent of clinicians reported that PHP improved the quality of their care .


Systems like PHP have the potential to improve clinical screening , counseling , and medication management .


Secondary exploratory analysis of a randomized controlled trial comparing supervised exercise therapy to usual care in patients with patellofemoral pain ( PFP ) .


To explore which patients with PFP are more likely to benefit from exercise therapy .


Patellofemoral pain is a common condition for which exercise therapy is effective in reducing pain and improving function .


However , not all patients benefit from exercise therapy .


The present study explored patient characteristics that might interact with treatment effects of PFP in @ patients treated with usual care or exercise therapy .


These characteristics were tested for interaction with treatment in a regression analysis .


The primary outcomes were function and pain on activity at a @-month follow-up .


None of the tested variables had a significant interaction with treatment .


A positive trend was seen for females with PFP : they were more likely to report higher function scores with exercise therapy than with usual care compared to males with PFP ( = @ ; @ % confidence interval : @ , @ ; P = @ ) .


A positive trend was seen for patients with a longer duration of complaints ( greater than @ months ) ; they were more likely to report higher function scores and to have less pain on activity with exercise therapy than with usual care compared to those with a shorter duration of complaints ( = @ ; @ % confidence interval : -@ , @ ; P = @ and = -@ ; @ % confidence interval : -@ , @ ; P = @ , respectively ) .


Two factors , sex and duration of complaints , may have a predictive value for response to exercise therapy at @-month follow-up .


Due to the exploratory design of the study , future research should confirm this tendency .


Tobacco use is epidemic among persons living with HIV ( PLWH ) , and several studies have shown self-efficacy ( SE ) to be a predictor of successful cessation .


This study examined sociobehavioral correlates of SE and its predictive value for successful cessation in a group of PLWH smokers .


The study was conducted on combined patient data from @ separate randomized controlled trials of tobacco treatment for PLWH smokers .


Both trials utilized the same SE scale at the same timepoints , and both had the same smoking cessation endpoint ( biochemically confirmed , @-day , point prevalence abstinence at @ months ) .


Univariate and multivariate techniques were used to analyze the merged dataset .


Baseline SE data were available for @ subjects .


The Self-Efficacy/Temptations Scale-Long Form demonstrated good internal reliability with overall and subscale Cronbach 's alpha of @ -@ .


Younger age , HIV risk other than injection drug use , recent alcohol use , and higher scores for anxiety , depression , loneliness , and nicotine dependence were all significantly correlated with lower baseline SE .


Posttreatment SE was significantly predictive of successful cessation , whereas baseline SE was not .


Subjects randomized to the treatment interventions were significantly more likely to quit ( AOR = @ -LSB- @-@ @ -RSB- , p = @ ) , and logistic regression suggested a possible mediating effect of posttreatment SE .


SE is tightly correlated with a number of modifiable affective and behavioral factors in PLWH smokers , and measures aimed at increasing the SE to abstain in such individuals may enhance the effect of targeted tobacco treatment strategies .


In this study , we assessed the efficacy of @ pharmacodynamically different antidepressants , citalopram ( a selective serotonin reuptake inhibitor ) and reboxetine ( a norepinephrine reuptake inhibitor ) , as adjunctive therapy to risperidone and olanzapine for the treatment of negative symptoms in schizophrenia .


We performed a @-month , multicenter , double-blind , randomized , placebo-controlled clinical trial .


The recruitment period was from November @ to December @ .


The sample comprised @ patients with a diagnosis of schizophrenia ( DSM-IV criteria ) who exhibited negative symptoms .


The patients were recruited from @ centers in different cities of the Spanish State .


The primary efficacy measure was change in score on the negative subscale of the Positive and Negative Syndrome Scale ( PANSS ) between baseline and @-month assessment .


Other efficacy measures were changes in the PANSS subscales and total score , as well as the Scale for the Assessment of Negative Symptoms ( SANS ) subscales and total score .


For statistical analysis , we employed mixed-effects models .


We did not find statistically significant differences between the placebo group and the @ treatment groups at @-month assessments for the PANSS total ( P = @ ) , any PANSS subscale ( negative -LSB- P = @ -RSB- , positive -LSB- P = @ -RSB- , or general psychopathology -LSB- P = @ -RSB- ) , or the SANS ( P = @ ) .


Cohen d measure showed a small effect size below the @ threshold for all comparisons .


In conclusion , our results do not support adjunctive use of citalopram or reboxetine with risperidone or olanzapine for the treatment of negative symptoms in schizophrenia .


It has been found that mask style can affect the amount of continuous positive airway pressure ( CPAP ) required to reduce an apnoea/hyponoea index ( AHI ) to < @/h on a titration study .


However , it was not previously known whether switching from one CPAP mask style to another post titration could affect the residual AHI with CPAP .


The purpose of this study was to investigate the differences in residual AHI with CPAP treatment between oronasal and nasal masks .


Twenty-one subjects ( age mean ( M ) = @ , body mass index ( BMI ) M = @ kg/m@ ) were randomised ( @ subjects completed the protocol ) to undergo an in-laboratory CPAP titration with either a nasal mask or an oronasal mask .


Subjects were then assigned this mask for @weeks of at-home CPAP use with the optimal treatment pressure determined on the laboratory study ( CPAP M = @ cm of H@O ) .


At the end of this @-week period , data were collected from the CPAP machine and the subject was given the other mask to use with the same CPAP settings for the next @weeks at home ( if the nasal mask was given initially , the oronasal one was given later and vice versa ) .


On completion of the second @-week period , data on residual AHI were again collected and compared with the first @-week period on CPAP .


A Wilcoxon Signed-Rank Test ( two-tailed ) revealed that residual AHI with CPAP treatment was significantly higher with the oronasal compared with the nasal mask ( z = -@ , p < @ ) .


All @ subjects had a higher residual AHI with the oronasal versus nasal mask , and @ % of the subjects had a residual AHI > @/h in the oronasal mask condition , even though all of these subjects were titrated to an AHI of < @/h in the laboratory .


A higher residual AHI was seen in all patients with the use of an oronasal mask compared with a nasal mask .


Switching to an oronasal mask post titration results in an increase in residual AHI with CPAP treatment , and pressure adjustment may be warranted .


To report on risk factors for severe events ( hospitalisation or infant death ) within the first half of infancy amongst HIV-unexposed infants in South Africa .


South African data from the multisite community-based cluster-randomised trial PROMISE EBF promoting exclusive breastfeeding in three sub-Saharan countries from @ to @ were used .


The South African sites were Paarl in the Western Cape Province , and Umlazi and Rietvlei in KwaZulu-Natal .


This analysis included @ HIV-negative mother-infant pairs .


Data on severe events and infant feeding practices were collected at @ , @ , @ and @ weeks post-partum .


We used a stratified extended Cox model to examine the association between the time to the severe event and covariates including birthweight , with breastfeeding status as a time-dependent covariate .


Seventy infants ( @ % ) experienced a severe event .


The median age at first hospitalisation was @ weeks , and the two main reasons for hospitalisation were cough and difficult breathing followed by diarrhoea .


Stopping breastfeeding before @ months ( HR @ ; @ % CI @-@ @ ) and low birthweight ( HR @ ; @ % CI @-@ @ ) were found to increase the risk of a severe event , whilst maternal completion of high school education was protective ( HR @ ; @ % CI @-@ @ ) .


A strengthened primary healthcare system incorporating promotion of breastfeeding and appropriate caring practices for low birthweight infants ( such as kangaroo mother care ) are critical .


Given the leading reasons for hospitalisation , early administration of oral rehydration therapy and treatment of suspected pneumonia are key interventions needed to prevent hospitalisation in young infants .


As histopathologic assessment is subject to sampling error , some institutions ` preorder ' deeper sections on some or all cases ( hereafter referred to as prospective deeper sections ) , while others order additional sections only when needed ( hereafter referred to as retrospective deeper sections ) .


We investigated how often additional sections changed a diagnosis and/or clinical management .


Given the recent decrease in reimbursement for CPT-code @ , we also considered the financial implications of ordering additional sections .


Cases ( n = @ ) were assigned a preliminary diagnosis , based on review of the initial slide , and a final diagnosis , after reviewing additional sections .


Cases with discordant diagnoses were assessed by two dermatologists , who indicated whether the change in diagnosis altered clinical management .


Expenses were estimated for three scenarios : ( a ) no additional sections , ( b ) prospective deeper sections and ( c ) retrospective deeper sections .


Diagnoses were modified in @ % of cases , which changed clinical management in @ % of these cases .


Lesions obtained by punch-biopsy and inflammatory lesions were disproportionately overrepresented amongst cases with changed diagnoses ( p < @ , p = @ , respectively ) .


The cost of prospective deeper sections and retrospective deeper sections represented a @ % and @ % increase over base costs , respectively .


Labor costs , particularly the cost of dermatopathologist evaluation , were the most significant cost-drivers .


While additional sections improve diagnostic accuracy , they delay turn-around-time and increase expenditures .


In our practice , prospective deeper sections are cost effective , however , this may vary by institution .


To evaluate the role of @ different -@ blockers and @ phosphodiesterase-@ inhibitor as medical expulsive therapy for distal ureteric calculi .


Between January @ and December @ , @ patients presenting with distal ureteric stones of size @-@ mm were on consent randomly assigned to @ of @ outpatient treatment arms : tamsulosin ( group A ) , silodosin ( group B ) , and tadalafil ( group C ) .


Therapy was given for a maximum of @ weeks .


Stone expulsion rate , time to stone expulsion , analgesic use , number of hospital visits for pain , follow-up , and endoscopic treatment and adverse effects of drugs were noted .


All @ groups were compared for normally distributed data by the analysis of variance , Bonferroni or Kruskal-Wallis test , and Mann-Whitney U test , as required .


All the classified and categorical data were analyzed for all @ groups by using the chi-square test .


There was a statistically significant expulsion rate of @ % in group B compared with @ % and @ % in groups A and C , respectively , with lower time of stone expulsion ( P value = @ and P value = @ , respectively ) .


Statistically significant differences were noted in colicky episodes and analgesic requirement in group B than groups A and C.


There was no serious adverse event .


Medical expulsive therapy for the distal ureteric stones using tamsulosin , silodosin , and tadalafil is safe , efficacious , and well tolerated .


The result of this pilot study showed that silodosin increases ureteric stone expulsion quite significantly along with better control of pain with significantly lesser analgesic requirement .


Some cigarette smokers may not be ready to quit immediately but may be willing to reduce cigarette consumption with the goal of quitting .


To determine the efficacy and safety of varenicline for increasing smoking abstinence rates through smoking reduction .


Randomized , double-blind , placebo-controlled , multinational clinical trial with a @-week treatment period and @-week follow-up conducted between July @ and July @ at @ centers in @ countries .


The @ participants were cigarette smokers who were not willing or able to quit smoking within the next month but willing to reduce smoking and make a quit attempt within the next @ months .


Participants were recruited through advertising .


Twenty-four weeks of varenicline titrated to @ mg twice daily or placebo with a reduction target of @ % or more in number of cigarettes smoked by @ weeks , @ % or more by @ weeks , and a quit attempt by @ weeks .


Primary efficacy end point was carbon monoxide-confirmed self-reported abstinence during weeks @ through @ .


Secondary outcomes were carbon monoxide-confirmed self-reported abstinence for weeks @ through @ and weeks @ through @ .


The varenicline group ( n = @ ) had significantly higher continuous abstinence rates during weeks @ through @ vs the placebo group ( n = @ ) ( @ % for the varenicline group vs @ % for the placebo group ; risk difference ( RD ) , @ % -LSB- @ % CI , @ % -@ % -RSB- ; relative risk ( RR ) , @ -LSB- @ % CI , @-@ @ -RSB- ) .


The varenicline group had significantly higher continuous abstinence rates vs the placebo group during weeks @ through @ ( @ % for the varenicline group vs @ % for the placebo group ; RD , @ % -LSB- @ % CI , @ % -@ % -RSB- ; RR , @ -LSB- @ % CI , @-@ @ -RSB- ) and weeks @ through @ ( @ % for the varenicline group vs @ % for the placebo group ; RD , @ % -LSB- @ % CI , @ % -@ % -RSB- ; RR , @ -LSB- @ % CI , @-@ @ -RSB- ) .


Serious adverse events occurred in @ % of the varenicline group and @ % of the placebo group ( P = @ ) .


Among cigarette smokers not willing or able to quit within the next month but willing to reduce cigarette consumption and make a quit attempt at @ months , use of varenicline for @ weeks compared with placebo significantly increased smoking cessation rates at the end of treatment , and also at @ year .


Varenicline offers a treatment option for smokers whose needs are not addressed by clinical guidelines recommending abrupt smoking cessation .


To investigate the application and the clinical effect of nasal endoscope in styloid process truncating operation .


Dividing @ patients into nasal endoscope group and control group randomly , and then observe them .


Nasal endoscope group were cured with nasal endoscope during the styloid process truncating operation and the control group were treated with the routine method of intraoral path .


All the operations were executed by the same person .


Observation index included the following aspects : the length of the truncated styloid process , the operation time , intraoperative bleeding , postoperative pain and pain degree , inflammatory reaction of raw surface and rehaemorrhagia .


Compared with the control group , the length of the truncated styloid process of nasal endoscope group were longer and the operation time had no significant differences .


The intraoperative bleeding of intraoperative bleeding group were ( @ + / - @ ) ml and in control group were ( @ + / - @ ) ml .


There are no significant differences between the result .


Nasal endoscope group also had the advantages of fewer aches and less inflammatory reaction of raw surface .


Both of the team had no rehaemorrhagia .


nasal endoscope can truncate a longer styloid process in styloid process truncating operation and is effective to relieve pain , and ease inflammatory reaction , it 's a safe mini-trauma operation .


I.v. @ % sodium chloride ( normal saline ) is frequently used to treat ED patients with acute alcohol intoxication despite the lack of evidence for its efficacy .


The study aims to compare treatment with i.v. normal saline and observation with observation alone in ED patients with acute alcohol intoxication .


A single-blind , randomised , controlled trial was conducted to compare a single bolus of @ mL/kg i.v. normal saline plus observation with observation alone .


One hundred and forty-four ED patients with uncomplicated acute alcohol intoxication were included .


The study was conducted in one tertiary and one urban ED in Queensland , Australia .


Primary outcome was ED length of stay ( EDLOS ) .


Secondary outcomes were treatment time , breath alcohol levels , intoxication symptom score , level of intoxication and associated healthcare costs .


Both groups were comparable at baseline : blood alcohol content ( BAC ) was similar between treatment and control groups ( @ % BAC vs @ % BAC , P = @ ) as were initial intoxication symptom scores ( @ vs @ , P = @ ) .


Both groups had a similar EDLOS ( @ min vs @ min , P = @ ; difference @ min -LSB- @ % CI -@ -@ -RSB- ) and treatment time ( @ min vs @ min , P = @ ; difference @ min -LSB- @ % CI -@ -@ -RSB- ) .


Change of breath alcohol levels , intoxication score and level of intoxication were not significantly different between the two groups .


Patients in the treatment group had an additional healthcare cost of A$ @ compared with control .


I.v. normal saline therapy added to observation alone does not decrease ED length of stay compared with observation alone .


Intoxication symptom scores and general state of intoxication were similar in both groups .


The present study suggests that either approach is reasonable , but observation alone might be preferred as it is less resource intensive .


Inhaled corticosteroids are a mainstay of therapy for persistent asthma , but suboptimal adherence with twice-daily use is widespread .


Fluticasone furoate ( FF ) is a new inhaled corticosteroid ( ICS ) suitable for once-daily dosing in asthma .


This study was performed to descriptively assess the efficacy and safety of two doses of FF , with no planned formal statistical hypothesis testing .


This was a @-week double-blind , multicentre , parallel-group study ( NCT@ ) .


Patients aged @ years with moderate-severe persistent asthma and uncontrolled on mid-high dose ICS were stratified by baseline FEV@ and randomised ( @:@ ) to treatment with FF @ g or @ g once daily in the evening .


The primary endpoint was change from baseline trough FEV@ after @ weeks ; secondary and other endpoints included peak expiratory flow ( PEF ) and rescue-free and symptom-free @-hour periods over Weeks @-@ , and Asthma Control Test ( ACT ) score at Week @ .


A pre-specified subgroup analysis of patients by randomisation strata was performed for the primary and selected secondary and other endpoints .


Safety assessments included adverse events , laboratory and vital sign measurements , and change from baseline in @-hour urinary cortisol at Week @ .


With FF @ g and @ g , least squares mean trough FEV@ improved from baseline by @ mL and @ mL , respectively , at Week @ ; treatment difference : @ mL ( @ % CI : -@ , @ ) .


Similar improvements from baseline in rescue - and symptom-free periods , and morning and evening PEF were observed in both groups .


Patients were @ % more likely to be well-controlled ( ACT score @ ) with FF @ g than with FF @ g. Slightly more patients receiving FF @ g vs. FF @ g reported adverse events ( @ % vs. @ % ) and events deemed treatment related ( @ % vs. < @ % ) .


Seven serious adverse events ( FF @ g @ ; FF @ g @ ) were reported , none of which were deemed treatment related .


No clinically relevant effects of either dose on @-hour urinary cortisol were observed .


Improvements from baseline in trough FEV@ were observed after @ weeks of treatment with both doses of FF , with a numerically greater improvement in FEV@ observed in patients receiving FF @ g. Secondary endpoint findings were similar between groups .


No safety concerns were identified during the study .


This study evaluated the effectiveness of a school-community program on Health-Related Quality of Life ( HRQoL ; the primary outcome ) , physical activity ( PA ) , and potential mediators of PA among adolescent girls living in low-socioeconomic rural/regional settings .


The study was a cluster-randomized controlled trial .


Twelve communities with the requisite sports clubs and facilities were paired according to relevant criteria ; one of each pair was randomly assigned to the intervention or control condition .


Eight schools per condition were randomly selected from these communities and the intervention was conducted over one school year ( @ ) .


Female students in grades @-@ in intervention schools participated in two @-session PA units - a sport unit ( football or tennis ) and a recreational unit ( leisure centre-based ) .


These were incorporated into physical education ( PE ) curriculum and linked to PA opportunities for participation outside school .


Students were surveyed at baseline and endpoint , self-reporting impact on primary and secondary outcome measures ( HRQoL , PA ) and PA mediators ( e.g. self-efficacy ) .


Linear mixed models for two-group ( intervention , control ) and three-group ( completers , non-completers , control ) analyses were conducted with baseline value , age and BMI as covariates , group as a fixed effect and school as random cluster effect .


Participants completing baseline and endpoint measures included : @ intervention ( baseline response rate @ % , retention rate @ % ) and @ control ( @ % and @ % ) .


Adjustment for age and BMI made no substantive difference to outcomes , and there were no cluster effects .


For HRQoL , after adjustment for baseline scores , the intervention group showed significantly higher scores on all three PedsQL scores ( physical functioning : MSE = @ , p = @ ; psychosocial : @ , p = @ ; total score : @ , p = @ ) than the control group ( @ ; @ and @ ) .


The three-group analysis found intervention non-completers had significantly higher PedsQL scores ( @ , p = @ ; @ , p = @ ; @ , p = @ ;) than controls ( @ , @ and @ ) .


There were no significant differences for any PA measure .


Intervention completers had significantly higher scores than non-completers and controls for some mediator variables ( e.g. self-efficacy , behavioural control ) .


Positive outcomes were achieved from a modest school-community linked intervention .


The school component contributed to maintaining HRQoL ; students who completed the community component derived a range of intra-personal and inter-personal benefits .


This study examined the effects of moderate renal impairment on the pharmacokinetics and pharmacodynamics of canagliflozin in Japanese patients with type @ diabetes mellitus .


Japanese patients with stable type @ diabetes ( @ with moderate renal impairment and @ with normal renal function or mild renal impairment ) were eligible .


This was an open-label , randomized , two-way crossover , two-sequence , single-dose study performed at a single center in Japan .


The subjects were hospitalized for the pharmacodynamic/pharmacokinetic evaluations .


Twenty-four patients received a single dose each of canagliflozin @ and @ mg before breakfast in a crossover manner with a @-day washout between doses .


The main outcome measures were pharmacokinetics of canagliflozin and its main metabolites ( M@ and M@ ) in plasma and urine , and change from baseline in @-h urinary glucose excretion ( UGE@ h ) .


There was no significant effect of moderate renal impairment on the maximum canagliflozin concentration .


The ratios of least square means ( @ % confidence intervals -LSB- CIs -RSB- ) of moderate renal impairment relative to normal renal function or mild renal impairment were @ ( @-@ @ ) and @ ( @-@ @ ) for the @ and @ mg doses , respectively .


The canagliflozin area under the plasma concentration-time curve was greater in those with moderate renal impairment than in those without , after both canagliflozin doses ( ratio of least square means -LSB- @ % CI -RSB- @ -LSB- @-@ @ -RSB- and @ -LSB- @-@ @ -RSB- ) .


UGE@ h increased after administration of both doses , but in patients with moderate renal impairment , the increase was approximately @ % of that in patients with normal renal function or mild renal impairment .


The incidence of adverse events was low and no patient developed hypoglycemia .


The pharmacokinetics of canagliflozin are affected by renal function , with slight decreases in renal clearance observed .


No effect of renal impairment on the maximum concentration was observed .


Renal impairment reduced the ability of canagliflozin to promote urinary glucose excretion .


This study evaluated the efficacy and safety of canagliflozin , a sodium glucose co-transporter @ inhibitor , in patients with type @ diabetes mellitus ( T@DM ) and within a subset of Stage @ chronic kidney disease ( CKD ; estimated glomerular filtration rate -LSB- eGFR -RSB- @ and < @ ml/min/@ @ m ( @ ) ) .


In this @-week , randomized , double-blind , placebo-controlled study , patients ( N = @ ; mean eGFR , @ ml/min/@ @ m ( @ ) ) received canagliflozin @ or @ mg and placebo once daily .


Efficacy endpoints included changes in glycated haemoglobin ( HbA@c ) , fasting plasma glucose ( FPG ) , body weight and systolic blood pressure ( BP ) ; adverse events ( AEs ) were also recorded .


At week @ , canagliflozin @ and @ mg reduced HbA@c compared with placebo ( -@ , -@ and @ % , respectively ) ; placebo-subtracted differences ( @ % confidence interval ) were -@ % ( -@ , @ ) and -@ % ( -@ , -@ ) .


Canagliflozin also lowered FPG , body weight and BP versus placebo .


Overall AE incidence was @ , @ , and @ % with canagliflozin @ and @ mg and placebo , respectively .


Osmotic diuresis-related AEs were more common with both canagliflozin doses , and incidences of urinary tract infections and volume depletion-related AEs were higher with canagliflozin @ mg versus placebo .


Decreases in eGFR ( -@ , -@ and -@ ml/min/@ @ m ( @ ) ) were seen with canagliflozin @ and @ mg compared with placebo .


Canagliflozin @ and @ mg provided median percent reductions in urine albumin to creatinine ratio versus placebo ( -@ , -@ and @ % ) .


Canagliflozin improved glycaemic control and was generally well tolerated in patients with T@DM and within a subset of Stage @ CKD over @ weeks .


To evaluate the use and effectiveness of two `` in-home '' strategies for delivering diabetes prevention programming using cable television .


An individually randomized , two-arm intervention trial including adults with diabetes risk factors living in two US cities .


Interventions involved a @-session lifestyle intervention delivered via `` video-on-demand '' cable television , offered alone versus in combination with web-based lifestyle support tools .


Repeated measures longitudinal linear regression with imputation of missing observations was used to compare changes in body weight .


A total of @ individuals were randomized and offered the interventions .


After @ months , @ ( @ % ) participants viewed at least @ , and @ ( @ % ) viewed @ of the video episodes .


A total of @ ( @ % ) participants completed a @-month weight measurement .


In intention-to-treat analysis with imputation of missing observations , mean weight loss at @ months for both treatment groups combined was @ % ( @ % CI @-@ @ % ) , regardless of intervention participation ( with no differences between randomized groups ( P = @ ) ) , and was @ % ( @ % CI @-@ @ % ) for participants who viewed @ episodes .


In-home delivery of evidence-based diabetes prevention programming in a reality television format , offered with or without online behavioral support tools , can achieve modest weight losses consistent with past implementation studies of face-to-face programs using similar content .


To study the effect of residual myrosinase ( MYR ) activity in differently processed broccoli on sulforaphane ( SR ) and iberin ( IB ) formation , bioavailability , and excretion in human volunteers .


Five different broccoli products were obtained with similar glucoraphanin ( GR ) and glucoiberin ( GI ) content , yet different MYR activity .


Excretion of SR and IB conjugates in urine were determined in @ participants after ingestion of the broccoli products .


A reduction of @ % of MYR in the product did not cause differences in the total amount of SR and IB found in urine compared to the product with @ % MYR .


Complete inactivation of MYR gave the lowest total amount of SR and IB in urine ( @ and @ % ) .


A residual MYR of only @ % in the product gave an intermediate amount ( @ and @ % ) .


The excretion half-lives of SR and IB conjugates were comparable for all the products ( @ h on average ) , although the maximum excretion peak times were clearly shorter when the residual MYR was higher ( @-@ @ h ) .


For the first time , the effect of residual MYR activity on isothiocyanate bioavailability was systematically and quantitatively studied .


Processing conditions have a large effect on the kinetics and bioavailability of isothiocyanates from broccoli .


Depression is the leading cause of early death , affecting @ % of Americans older than @ y and costing $ @ billion each year .


The current mental health service system for seniors , particularly for the population hospitalized in acute inpatient psychiatric units , is fragmented because of poor funding and a shift to a transitory health care paradigm , leading to inadequate treatment modalities , questionable quality of care , and lack of research demonstrating the superiority of a particular treatment .


These issues are likely to lead to a public health crisis in the coming years .


To investigate the effectiveness of combining exercise and psychotherapy in improving acute depressive symptoms among older adults who were receiving treatment in an inpatient psychiatric unit .


Based on rolling admissions , inpatients were randomly assigned to @ of @ treatment groups .


The study was blinded and controlled .


This study took place in inpatient psychiatric units at the Loma Linda University 's Behavioral Medicine Center ( LLUBMC ) in Redlands , California .


Participants were @ inpatients , aged @-@ y.


Participants in the simultaneous exercise and psychotherapy ( STEP ) group ( n = @ ) took part in exercise and received psychotherapy for @ min per session , whereas those in the TALK group ( n = @ ) received individual psychotherapy for @ min per session .


Participants in the control group ( n = @ ) served as a comparison group , receiving standard therapy .


The effects of the interventions were determined by assessing differences from baseline to postintervention in the symptomatology of all @ groups .


The research team also administered the Behavioral and Symptom Identification Scale ( BASIS-@ ) and the Geriatric Depression Scale ( GDS ) pre - and postintervention .


At posttest , the STEP group ( M = @ , SE = @ ) had a better response than the TALK group ( M = @ , SE = @ , P < @ ) , which in turn showed greater improvement than the control group ( M = @ , SE = @ , P < @ ) .


Overall , these results indicate that patients ' posttreatment depression scores were significantly lower in those receiving the STEP treatment compared with those receiving individual psychotherapy only or standard care .


A short-term exercise program consisting of @ min of walking in conjunction with individual psychotherapy was an effective intervention for depression among older adults in inpatient psychiatric units .


High levels of physical inactivity are linked to several chronic diseases including coronary heart disease , type-@ diabetes , obesity , some cancers and poor mental health .


Encouraging people to be more active has proven difficult .


One way to incorporate physical activity into the daily routine is through the journey to and from work .


Although behaviour change techniques ( BCTs ) are considered valuable in promoting behaviour change , there is very little in the published literature about the views and experiences of those encouraged to use them .


The Walk to Work study was a feasibility study incorporating an exploratory cluster randomised controlled trial .


The @-week intervention involved training workplace-based Walk to Work promoters ( volunteers or nominated by participating employers ) to encourage colleagues to increase walking during their daily commute .


The intervention used nine specific BCTs : Intention formation , barrier identification , specific goal setting , instruction , general encouragement , self-monitoring of behaviour social support , review of behavioural goals and relapse prevention .


Digitally recorded interviews were undertaken with @ employees , eight of whom were Walk to Work promoters to understand their views and experiences of using these techniques .


The Framework method of data management and constant comparison were used to analyse the data and identify key themes .


For each individual BCT , there appeared to be people who found it useful in helping them to increase walking to work and others who did not .


Following training , the Walk to Work promoters varied in the extent to which they were able to fulfil their role : additional support and encouragement during the @-week intervention may be required for the promoters to maintain motivation .


Wider contextual ( economic climate , unprecedented wet weather ) and organisational ( workload , car parking facilities ) issues were identified that influenced the delivery of , and response to , the intervention .


Walk to work interventions employing BCTs should include sufficient techniques to enable participants to choose a ` package ' to suit their needs .


Additional support at organisational level should also be encouraged , and consideration given to wider contextual factors that impinge on the delivery of , and response to , the intervention .


Given the diversity of visual acuity tests being employed across the world , we compared two frequently applied tests : ETDRS charts and an eight-orientation projected Landolt C test in accordance with ISO @ and DIN @ part @ .


The goals of the investigation were to determine ( i ) test agreement and ( ii ) test-retest reliability , to assess ( iii ) test durations , and ( iv ) the acceptance of the tests by the examinees as well as the subjects ' coping with the tests as rated by the examiner .


Seventy-five adult subjects with a visual acuity of @ ( @/@ ) were included in one of the following groups : normal , media opacity , maculopathy , optic neuropathy , ( post ) chiasmal lesion , or amblyopia .


Visual acuity testing was carried out monocularly , in balanced randomized order and in two runs for each test on the same eye , applying forced choice .


Agreement : Within each group , all tests were performed similarly , within @ logMAR .


Reliability : Across all subject groups , with a probability of @ % , test-retest differences were < @ logMAR for both ETDRS and Landolt tests .


The Landolt test lasted , on average , @ times longer than ETDRS charts ( p < @ ) .


Acceptance : Examinees preferred the ETDRS test ( p < @ ) , the examiner on average had no preference .


The Landolt C test and the ETDRS test yielded comparable results in visual acuity and test-retest reliability in all disease groups .


The ETDRS test was usually faster and more accepted by both examiners and examinees than the Landolt test .


Depression is common after a cardiac event , yet there remain few approaches to management that are both effective and scalable .


We aimed to evaluate the @-month efficacy and feasibility of a tele-health program ( MoodCare ) that integrates depression management into a cardiovascular disease risk reduction program for acute coronary syndrome patients with low mood .


A two-arm , parallel , randomized design was used comprising @ patients admitted to one of six hospitals for acute coronary syndrome .


Significant treatment effects were observed for Patient Health Questionnaire @ ( PHQ@ ) depression ( mean difference -LSB- change -RSB- = -@ ; p = @ ; effect size : d = @ ) for the overall sample , when compared with usual medical care .


Results were more pronounced effects for those with a history of depression ( mean difference -LSB- change -RSB- = -@ ; p = @ ; effect size : d = @ ) .


MoodCare was effective for improving depression in acute coronary syndrome patients , producing effect sizes exceeding those of some face-to-face psychotherapeutic interventions and pharmacotherapy .


Heart failure is one of the most common und costly chronic diseases .


Patient education is an important part of heart failure therapy .


Rehabilitation aims to improve self-management abilities and the course of the disease .


A structured heart failure education program was established to create knowledge about the disease and to implement a disease friendly behavior .


The effectiveness was tested in a randomized controlled design .


Patients were cluster randomized - assigned to an intervention group or a control group at the beginning of a rehabilitation .


Both received a rehabilitation specifically geared to heart-failure-patients .


The intervention group received additionally the education program , the control group a single lecture on the disease .


At the end of rehabilitation and @ months later the knowledge and integrity of the recommended self-tests have been checked .


In addition the disease severity and pharmacotherapy were determined .


Both groups showed improvements in disease status .


Participants of the education program had a sustained higher knowledge , were better adjusted to medication after @ months and documented their self-tests more frequently .


Regardless to the education intervention an improvement of the disease status occurs during cardiac rehabilitation .


The effective single components are still unclear .


The evaluated education program leads specifically to an improved disease-related knowledge and improved self-management skills .


Due to these results it seems useful to include cardiac rehabilitation in heart failure disease-management programs - a specific heart failure education program should be integrated .


To propose and evaluate an automatic method of extracting parenchyma from a manually delineated whole liver for the R@ * measurement of iron load .


In all , @ transfusion-dependent patients with a wide range of hepatic iron content were scanned with a multiecho gradient-echo sequence .


The R@ * was measured by fitting the average signal of liver parenchyma , extracted by the proposed semiautomatic parenchyma extraction ( SAPE ) , traditional manually delineated multiple regions-of-interest ( mROIs ) , and T@ * thresholding methods to the noise-corrected monoexponential model .


The R@ * measurement accuracy of the SAPE method was evaluated through simulation ; the intra - and interobserver reproducibility of SAPE , mROI , and T@ * thresholding were assessed from the in vivo data using coefficient of variation ( CoV ) .


In the simulation , the mean absolute percentage error of R@ * measurement using SAPE was @ % ( range @ % -@ % ) .


In vivo study , the CoVs of intra - and interobserver reproducibility were @ % , @ % for SAPE , @ % , @ % for mROI , and @ % , @ % for T@ * thresholding , respectively .


The SAPE method provides an accurate and reliable approach to assessing the overall hepatic iron content .


The improved magnetic resonance imaging ( MRI ) R@ * reproducibility using the SAPE method may lead to more accurate tissue characterization and increased diagnostic confidence .


The objective of this study was to assess the ability of a dentifrice containing @ % arginine and calcium carbonate ( Pro-Argin ' Technology ) , and @ ppm fluoride as sodium monofluorophosphate ( MFP ) to prevent enamel loss from an erosive acid challenge in comparison to a silica-based dentifrice with @ ppm fluoride as MFP using an intra-oral erosion model .


The intra-oral clinical study used a double blind , two-treatment , crossover design .


A palatal retainer was used to expose the enamel specimens to the oral environment during the five-day treatment period .


The retainer was designed to house three partially demineralized bovine enamel samples .


The study population was composed of @ adults , ages @ to @ years .


The study consisted of two treatment periods , with a washout period lasting seven ( + / - three ) days preceding each treatment phase .


A silica-based dentifrice without fluoride was used during the washout period .


The Test Dentifrice used in this study contained @ % arginine and calcium carbonate ( Pro-Argin Technology ) , and @ ppm fluoride as sodium monofluorophosphate ( MFP ) .


The Control Dentifrice was silica-based and contained @ ppm fluoride as MFP .


The treatment period lasted five days , during which the panelists wore the retainer @ hours a day ( except during meals and the ex vivo acid challenges ) and brushed with their assigned product while wearing the retainer .