Cardiorespiratory data ( SpO ( @ ) ; hr ; rr ) were monitored and the following scales were used : Neonatal Infant Pain Scale ( NIPS ) , for pain evaluation , and Bulletin of Silverman-Andersen ( BSA ) , for respiratory distress assessment .


The data were verified by analysis of variance ( ANOVA ) for repeated measures , being significant p < @ .


@ infants with heart disease , ten in each group ( seven acyanotic and three cyanotic ) were enrolled , with ages ranging from zero to @ months .


In the analysis of the interaction between group and time , there was a significant difference in the variation of SpO ( @ ) ( p = @ ) , without changes in the other variables .


Considering the main effect on time , only rr showed a significant difference ( p = @ ) .


As for the group main effect , there were no statistical differences ( SpO ( @ ) - p = @ , hr - p = @ , rr - p = @ , NIPS - p = @ and BSA - p = @ ) .


The manual vibrocompression and the nasotracheal suctioning applied to infants in postoperative of cardiac surgery did not altered SpO ( @ ) and rr , and did not trigger pain and respiratory distress .


In a subset of patients with asthma , standard-of-care treatment does not achieve disease control , highlighting the need for novel therapeutic approaches .


Lebrikizumab is a humanised , monoclonal antibody that binds to and blocks interleukin-@ activity .


LUTE and VERSE were replicate , randomised , double-blind , placebo-controlled studies , evaluating multiple doses of lebrikizumab in patients with uncontrolled asthma despite the use of medium-to-high-dose inhaled corticosteroid and a second controller .


Patients received lebrikizumab @ , @ , @mg or placebo subcutaneously every fourweeks .


The primary endpoint was the rate of asthma exacerbations during the placebo-controlled period .


Analyses were performed on prespecified subgroups based on baseline serum periostin levels .


Following the discovery of a host-cell impurity in the study drug material , protocols were amended to convert from phase III to phase IIb .


Subsequently , dosing of study medication was discontinued early as a precautionary measure .


The data collected for analysis were from a placebo-controlled period of variable duration and pooled across both studies .


The median duration of treatment was approximately @weeks .


Treatment with lebrikizumab reduced the rate of asthma exacerbations , which was more pronounced in the periostin-high patients ( all doses : @ % reduction ) than in the periostin-low patients ( all doses : @ % reduction ) ; no dose-response was evident .


Lung function also improved following lebrikizumab treatment , with greatest increase in FEV@ in periostin-high patients ( all doses : @ % placebo-adjusted improvement ) compared with periostin-low patients ( all doses : @ % placebo-adjusted improvement ) .


Lebrikizumab was well tolerated and no clinically important safety signals were observed .


These data are consistent with , and extend , previously published results demonstrating the efficacy of lebrikizumab in improving rate of asthma exacerbations and lung function in patients with moderate-to-severe asthma who remain uncontrolled despite current standard-of-care treatment .


This study aimed to test whether a very early nutrition intervention delivered over the telephone was feasible and could improve outcomes amongst patients with upper gastrointestinal cancer .


Participants with a histologically proven new diagnosis of primary oesophageal or stomach cancer and who were to undergo surgery and/or chemotherapy were randomised to receive either standard nutrition care ( SC ) or early and intensive nutrition intervention ( NI ) over the telephone/face-to-face .


Participants were followed for @ months .


The primary outcome was quality of life ( QoL ) , assessed using the European Organization for Research and Treatment of Cancer Global Quality of Life questionnaire C@ ( EORTC QLQ-C@ ) and the European Quality of Life Instrument ( EQ-@D ) tool ; secondary outcomes were nutritional status and survival .


Twenty-one participants were recruited ( @ SC and @ NI ) .


At baseline , the prevalence of malnutrition was @ % .


Compared with SC , the NI group had a significantly higher EORTC global QoL score at the first mid-study follow-up ( coefficient ( @ % CI ) @ ( @ , @ ) adjusted for baseline , p < @ ) and at @ weeks ( @ ( @ , @ ) adjusted for baseline , p < @ ) .


Nutritional risk score was lower ( p < @ ) , and loss of body weight attenuated ( p < @ ) in the NI group compared with SC .


Six deaths occurred during the study , five in the SC group and one in the NI group ( p = @ ) .


The mean time spent with a dietitian per contact was significantly less for the NI group compared with SC ( @ ( @ ) vs @ ( @ ) min per dietetic contact , p < @ ) .


This pilot study has shown the potential of a novel telephone-based early and intensive dietetic model of care for newly diagnosed upper gastrointestinal cancer patients .


We investigated the potential benefits of early tracheotomy performed before day eight of mechanical ventilation ( MV ) compared with late tracheotomy ( from day @ if it still indicated ) in reducing mortality , days of MV , days of sedation and ICU length of stay ( LOS ) .


Randomized controlled trial ( RCT ) including all-consecutive ICU admitted patients requiring seven or more days of MV .


Between days five to seven of MV , before randomization , the attending physician ( AP ) was consulted about the expected duration of MV and acceptance of tracheotomy according to randomization .


Only accepted patients received tracheotomy as result of randomization .


An intention to treat analysis was performed including patients accepted for the AP and those rejected without exclusion criteria .


A total of @ patients were included in the RCT .


Of @ patients randomized to the early group , the procedure was performed for @ patients ( @ % ) whereas in the @ patients randomized to the late group was performed for @ patients ( @ % ) ( P < @ ) .


Mortality at day @ was similar in both groups ( @ % versus @ % ) , but duration of sedation was shorter in the early tracheotomy group median @ days ( range @ to @ ) days compared to @ days ( range @ to @ ) in the late group ( P < @ ) .


The AP accepted the protocol of randomization in @ cases ( @ % ) , @ were included in early group and @ in the late group .


In these subgroup of patients ( per-protocol analysis ) no differences existed in mortality at day @ between the two groups , but the early group had more ventilator-free days , less duration of sedation and less LOS , than the late group .


This study shows that early tracheotomy reduces the days of sedation in patients undergoing MV , but was underpowered to prove any other benefit .


In those patients selected by their attending physicians as potential candidates for a tracheotomy , an early procedure can lessen the days of MV , the days of sedation and LOS .


However , the imprecision of physicians to select patients who will require prolonged MV challenges the potential benefits of early tracheotomy .


Fear of Falling ( FoF ) is commonly reported among older adults ( up to @ % ) and can impact negatively on physical and social activities , mood and quality of life .


This paper explores the development , acceptability and feasibility of a cognitive behavioural therapy intervention ( CBTi ) for FoF .


The process evaluation of the CBTi development phase of an RCT ( conducted in the UK ) reported here , used ethnographic methods .


Data included : interviews with patients and carers ( n = @ ) , clinic staff ( n = @ ) and the psychologists developing the CBTi ( n = @ ) ; observational field notes and transcripts of intervention development meetings ( n = @ ) and stakeholder engagement meetings ( n = @ ) ; and informal discussions with staff developing the CBTi ( n = @ ) .


Data collection and thematic analysis were guided by Normalisation Process Theory ( NPT ) .


The process evaluation showed two domains of work necessary to develop a CBTi that made sense to stakeholders , and that could be delivered as part of an RCT .


For the psychologists developing the content of the CBTi , a growing understanding of the complexity of FoF highlighted the need for an individualised rather than a manualised intervention .


For the research team , the work involved adapting the structures and processes of the RCT to address preliminary concerns over the acceptability and feasibility of the proposed CBTi .


Theory-based approaches to process evaluation can sensitise researchers to contested understandings about proposed interventions that could undermine implementation .


Drawing on the coherence construct of NPT , this study emphasises the nature and extent of work required to ensure an intervention makes sufficient sense to key stakeholders in order to maximise chances of successful implementation .


To determine whether a novel guarded @-gauge injection device can make the intravitreal injection procedure faster and more comfortable for patients .


Single-center , prospective , randomized interventional study .


Seventy participants receiving bilateral injections on the same day had one eye injected with the @-gauge injection device without a speculum and the other eye injected with a standard @-gauge needle using a speculum .


Length of time needed for the injection procedure was assessed , and subjects were asked to complete a questionnaire regarding their comfort level with each device during the injection procedure as well as immediately after , later that evening , and the next day .


Intravitreal injections using the @-gauge injection device were significantly faster , but there was no significant difference in the incidence or levels of pain between the two needle types .


The @-gauge injection device may offer advantages over a standard @-gauge needle when performing an intravitreal injection .


Human motivation and decision-making is influenced by the interaction of Pavlovian and instrumental systems .


The neurotransmitters dopamine and serotonin have been suggested to play a major role in motivation and decision-making , but how they affect this interaction in humans is largely unknown .


We investigated the effect of these neurotransmitters in a general Pavlovian-to-instrumental transfer ( PIT ) task which measured the nonspecific effect of appetitive and aversive Pavlovian cues on instrumental responses .


For that purpose , we used selective dietary depletion of the amino acid precursors of serotonin and dopamine : tryptophan ( n = @ ) and tyrosine/phenylalanine ( n = @ ) , respectively , and compared the performance of these groups to a control group ( n = @ ) receiving a nondepleted ( balanced ) amino acid drink .


We found that PIT differed between groups : Relative to the control group that exhibited only appetitive PIT , we found reduced appetitive PIT in the tyrosine/phenylalanine-depleted group and enhanced aversive PIT in the tryptophan-depleted group .


These results demonstrate a differential involvement of serotonin and dopamine in motivated behavior .


They suggest that reductions in serotonin enhance the motivational influence of aversive stimuli on instrumental behavior and do not affect the influence of appetitive stimuli , while reductions in dopamine diminish the influence of appetitive stimuli .


No conclusions could be drawn about how dopamine affects the influence of aversive stimuli .


The interplay of both neurotransmitter systems allows for flexible and adaptive responses depending on the behavioral context .


Some patients with refractory asthma have evidence of uncontrolled eosinophilic inflammation in the distal airways .


While traditional formulations of inhaled steroids settle predominantly in the large airways , newer formulations with an extra-fine particle size have a more peripheral pattern of deposition .


Specifically treating distal airway inflammation may improve asthma control .


@ patients with refractory asthma despite high dose inhaled corticosteroids were identified as having persistent airway eosinophilia .


Following @weeks of prednisolone @mg , patients demonstrating an improvement in asthma control were randomised to receive either ciclesonide @g twice daily or placebo in addition to usual maintenance therapy for @weeks .


The primary outcome measure was sputum eosinophil count at week @ .


Alveolar nitric oxide was measured as a marker of distal airway inflammation .


There was continued suppression of differential sputum eosinophil counts with ciclesonide ( median @ % ) but not placebo ( median @ % ) though the between-group difference was not significant .


When patients who had changed their maintenance prednisolone dose during the trial were excluded the difference between groups was significant ( @ % vs @ % , p = @ ) .


Though alveolar nitric oxide decreased with ciclesonide the value did not reach statistical significance .


These data demonstrate that patients with ongoing eosinophilic inflammation are not truly refractory , and that suppression of airway eosinophilia may be maintained with additional inhaled corticosteroid .


Further work is needed with a focus on patient-orientated outcome measures such as exacerbation rate , with additional tests of small airway function .


Plasma adiponectin levels are reduced in type @ diabetes mellitus ( T@DM ) and other insulin-resistant states .


We examined whether plasma adiponectin levels at baseline and after pioglitazone treatment in impaired glucose tolerance ( IGT ) subjects were associated with improved insulin sensitivity ( SI ) and glucose tolerance status .


A total of @ high-risk IGT subjects in ACT NOW were randomized to receive pioglitazone or placebo with a median follow-up of @ years .


Pioglitazone reduced IGT conversion to diabetes by @ % in association with improved - cell function by @ % ( insulin secretion/insulin resistance index ) and increased tissue sensitivity by @ % ( Matsuda index ) .


In pioglitazone-treated subjects , plasma adiponectin concentration increased threefold from @ @ to @ @ g/mL ( P < @ ) and was strongly correlated with the improvement in SI ( r = @ , P < @ ) and modestly correlated with glucose area under the curve during oral glucose tolerance test ( r = @ , P < @ ) and insulin secretion/insulin resistance index ( r = @ , P < @ ) .


The increase in adiponectin was a strong predictor of reversion to normal glucose tolerance and prevention of T@DM .


In the placebo group , plasma adiponectin did not change and was not correlated with changes in glucose levels .


There was an inverse association between baseline plasma adiponectin concentration and progression to diabetes in the placebo group but not in the pioglitazone group .


Baseline adiponectin does not predict the response to pioglitazone .


The increase in plasma adiponectin concentration after pioglitazone therapy in IGT subjects is strongly related to improved glucose tolerance status and enhanced tissue sensitivity to insulin .


Although CRC is the third most commonly diagnosed cancer in the United States , second-line CRC treatment is limited .


In this trial we examined the efficacy and safety of linifanib , an oral , potent , selective tyrosine kinase inhibitor of vascular endothelial growth factor and platelet-derived growth factor receptor families , with mFOLFOX@ , compared with bevacizumab and mFOLFOX@ , in previously treated metastatic CRC .


One hundred forty-eight patients with advanced CRC previously treated with fluoropyrimidine or irinotecan received bevacizumab ( @ mg/kg , intravenous ) , low-dose linifanib ( @ mg ) , or high-dose linifanib ( @ mg ) , with mFOLFOX@ .


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


Secondary objectives included overall survival ( OS ) , objective response rate ( ORR ) , and safety .


No statistically significant differences in PFS occurred between bevacizumab and linifanib doses ( low , hazard ratio -LSB- HR -RSB- , @ -LSB- @ % confidence interval -LSB- CI -RSB- , @-@ @ -RSB- ; high , HR , @ -LSB- @ % CI , @-@ @ -RSB- ) .


Median OS values were similar for bevacizumab and high-dose linifanib ( bevacizumab , @ months -LSB- @ % CI , @-not available -RSB- ; high-dose linifanib , @ months -LSB- @ % CI , @-@ @ -RSB- ; low-dose linifanib , @ months -LSB- @ % CI , @-@ @ -RSB- ) .


ORRs were similar ( bevacizumab , @ % -LSB- @ % CI , @-@ @ -RSB- ; low-dose linifanib , @ % -LSB- @ % CI , @-@ @ -RSB- ; high-dose linifanib , @ % -LSB- @ % CI , @-@ @ -RSB- ) .


Median cycles of @-fluorouracil were reduced in the linifanib arms , versus the bevacizumab arm .


Grade @/@ adverse event occurrences were more frequent with linifanib .


Palmar-plantar erythrodysesthesia , hypothyroidism , and thrombocytopenia were more common with high-dose linifanib than bevacizumab .


Combining linifanib with mFOLFOX@ as a second-line treatment for metastatic CRC did not improve PFS , radiographic findings , or duration of response versus bevacizumab and mFOLFOX@ .


Adolescent substance use and delinquency are major public health problems .


Although community-based prevention strategies have been recommended to produce population-level reductions in rates of substance use and delinquency , few models show evidence of effectiveness .


To test the efficacy of a community-based prevention system , Communities That Care ( CTC ) , in reducing community rates of problem behaviors , particularly effects on specific profiles of adolescent substance use and delinquency in eighth - and tenth-graders .


Twenty-four communities were randomized to CTC intervention or control groups .


Data were collected from @,@ @th - and @th-grade students in these communities using anonymous cross-sectional surveys in @ and @ and analyzed in @ .


Outcomes were four different profiles of self-reported substance use and delinquency in @th grade and five profiles in @th grade .


In the cross-sectional @ data , there was no intervention effect on the probability of experimenting with substances or of substance use coupled with delinquent activities for either grade .


However , tenth-graders in intervention communities were significantly less likely to be alcohol users than those in control communities ( OR = @ , CI = @ , @ ) .


Cross-sectional population surveys showed evidence of CTC effects in reducing tenth-grade alcohol users but not experimenters .


A community-wide reduction in adolescent alcohol use is important because alcohol is the most commonly used illicit substance during adolescence , and early initiation of alcohol use has been associated with alcohol-related disorders in adulthood .


Failure to find hypothesized effects on experimenters qualifies these results .


Perineural dexamethasone prolongs the duration of single-injection peripheral nerve block when added to the local anesthetic solution .


Postulated systemic mechanisms of action along with theoretical safety concerns have prompted the investigation of intravenous dexamethasone as an alternative , with decidedly mixed results .


We aimed to confirm that addition of intravenous dexamethasone will prolong the duration of analgesia after single-injection supraclavicular block compared with conventional long-acting local anesthetic alone or in combination with perineural dexamethasone for ambulatory upper extremity surgery .


Seventy-five patients were randomized to receive supraclavicular block using @-mL bupivacaine @ % alone ( Control ) , with concomitant intravenous dexamethasone @ mg ( DexIV ) , or with perineural dexamethasone @ mg ( DexP ) .


Duration of analgesia was designated as the primary outcome .


To test our hypothesis , the superiority of DexIV was first compared with Control and then with DexP .


Motor block duration , pain scores , opioid consumption , opioid-related side effects , patient satisfaction , and block-related complications were also analyzed .


Twenty-five patients per group were analyzed .


The duration of analgesia ( mean -LSB- @ % confidence interval -RSB- ) was prolonged in the DexIV group ( @ hours -LSB- @ -RSB- ) compared with Control ( @ hours -LSB- @ -RSB- ; P < @ ) but similar to the DexP group ( @ hours -LSB- @ -RSB- ; P = @ ) .


-LSB- corrected -RSB- Both DexIV and DexP had reduced pain scores , reduced postoperative opioid consumption , and improved satisfaction compared with Control .


In a single-injection supraclavicular block with long-acting local anesthetic , the effectiveness of intravenous dexamethasone in prolonging the duration of analgesia seems similar to perineural dexamethasone .


This prospective , multicenter , randomized clinical trial was performed to compare the effectiveness of the bioprosthesis Surgisis Gold ( Cook Biotech , Inc , West Lafayette , IN ) to suture closure alone in reinforcing the abdominal wall after open Roux-en-Y gastric bypass ( RYGB ) .


A total of @ adult patients ( body mass index @kg/m ( @ ) ) scheduled to undergo open RYGB procedures were randomized to receive either Surgisis Gold placed as a sublay directly under and opposed to the posterior rectus fascia without intervening preperitoneal fat or suture closure alone .


Peri - and postoperative complications were tracked .


Incisional hernia formation in each group was examined at @weeks , @ , @ , and @months , and @ and @years after RYGB .


A total of @ ( @ male ; @ female ) patients with a mean age of @years ( range @-@ ) and a mean BMI of @ ( range @-@ ) underwent RYGB .


There were no differences in patient demographics or comorbidities between groups .


Placement of the Surgisis Gold increased operating time by an average of @minutes .


Complications were more common in the Surgisis Gold group with significantly more wound events and seroma formation compared with the suture closure alone group .


At final follow-up , @ of @ ( @ % ) of patients in the reinforced arm and @ of @ ( @ % ) in the suture alone arm developed an incisional hernia ( P = @ ) .


In this challenging patient population , the use of Surgisis Gold for reinforcing the abdominal wall after open RYGB was not shown to be greatly different from a primary suture repair .


Weight loss induced only by exercise is frequently less than expected , possibly because of compensatory changes in energy intake and/or energy expenditure .


The purpose of the Examination of Mechanisms ( E-MECHANIC ) of Exercise-Induced Weight Compensation trial is to examine whether increased energy intake and/or reduced spontaneous activity or energy expenditure ( outside of structured exercise ) account for the less than expected , exercise-associated weight loss .


E-MECHANIC is a three-arm , @-month randomized ( @:@:@ ) controlled trial .


The two intervention arms are exercise doses that reflect current recommendations for ( @ ) general health ( @ kcal/kg body weight per week ( @ KKW ) , about @ kcal/wk ) and ( @ ) weight loss ( @ KKW , about @,@ kcal/wk ) .


The third arm , a nonexercise control group , will receive health information only .


The sample will include a combined total of @sedentary , overweight or obese ( body mass index : @ kg/m to @ kg/m ) men and women ages @ to @ years .


The exercise dose will be supervised and tightly controlled in an exercise training laboratory .


The primary outcome variables are energy intake , which will be measured using doubly labeled water ( adjusted for change in energy stores ) and laboratory-based food intake tests , and the discrepancy between expected weight loss and observed weight loss .


Secondary outcomes include changes in resting metabolic rate ( adjusted for change in body mass ) , activity levels ( excluding structured exercise ) and body composition .


In an effort to guide the development of future interventions , the participants will be behaviorally phenotyped and defined as those who do compensate ( that is , fail to lose the amount of weight expected ) or do not compensate ( that is , lose the amount of weight expected or more ) .


In this study , we will attempt to identify underlying mechanisms to explain why exercise elicits less weight loss than expected .


This information will guide the development of interventions to increase exercise-induced weight loss and maximize weight loss retention and related health benefits .


We aimed to evaluate whether atrial electromechanical delay ( AEMD ) measured by tissue Doppler imaging ( TDI ) , which is an indicator for structural and electrical remodelling of the atria , is prolonged in patients with active or inactive acromegaly , or both , compared with a control group .


A total of @ patients with acromegaly ( @ active/@ inactive ) and @ patients as a control group were enrolled .


Both intra - and inter-AEMD were calculated by TDI .


The correlation between clinical variables and AEMD were analyzed .


Both inter-AEMD and right and left intra-AEMD were prolonged in patients with acromegaly compared with the control group ( P < @ , P < @ , and P = @ , respectively ) .


Also , patients with active acromegaly showed higher inter-AEMD and right intra-AEMD compared with patients with inactive acromegaly ( P < @ ) .


There was no significant difference in left intra-AEMD between patients with active acromegaly and those with inactive acromegaly ( P = @ ) .


The growth hormone and insulin-like growth factor ( IGF-@ ) levels positively correlated with inter-AEMD ( r = @ ; P < @ ; r = @ ; P < @ , respectively ) .


Additionally , we found that inter-AEMD was significantly and positively correlated with relationship between maximal values of passive mitral inflow ( E , PW-Doppler ) and lateral early diastolic mitral annular velocities ( e ' , TDI ) ( r = @ ; P = @ ) .


Only the serum IGF-@ level was independently associated with inter-AEMD in multivariate linear regression analysis ( = @ ; P = @ ) .


Our study findings showed that both inter - and intra-AEMD are prolonged in patients with acromegaly .


Also , AEMD was observed to be more prolonged in patients with active acromegaly than in those with inactive acromegaly .


IGF-@ was an independent predictor of inter - AEMD in patients with acromegaly .


Being a noninvasive , inexpensive , and simple technique , AEMD may be used as an indicator for atrial electrical and structural remodelling in patients with acromegaly .


Determine effects of low-dose estradiol and low-dose venlafaxine on self-reported sleep measures in menopausal women with hot flashes .


@-arm double-blind randomized trial .


Participants assigned in a @:@:@ ratio to @ estradiol @ mg/day ( n = @ ) , venlafaxine XR @ mg/day ( n = @ ) , or placebo ( n = @ ) for @ weeks .


Academic research centers .


@ community-dwelling perimenopausal and postmenopausal women with @ bothersome hot flashes per day .


Insomnia symptoms ( Insomnia Severity Index -LSB- ISI -RSB- ) and sleep quality ( Pittsburgh Sleep Quality Index -LSB- PSQI -RSB- ) at baseline , week @ and @ ; @ women ( @ % ) provided ISI data and @ women ( @ % ) provided PSQI data at baseline and follow-up .


At baseline , mean ( SD ) hot flash frequency was @ / day ( @ ) , mean ISI was @ ( @ ) , and mean PSQI was @ ( @ ) .


Mean ( @ % CI ) change from baseline in ISI at week @ was -@ points ( -@ to -@ ) with estradiol , -@ points ( -@ to -@ ) with venlafaxine , and -@ points ( -@ to -@ ) with placebo ( P overall treatment effect vs. placebo @ for estradiol and @ for venlafaxine ) .


Mean ( @ % CI ) change from baseline in PSQI at week @ was -@ points ( -@ to -@ ) with estradiol , -@ points ( -@ to -@ ) with venlafaxine , and -@ points ( -@ to -@ ) with placebo ( P overall treatment effect vs. placebo @ for estradiol and @ for venlafaxine ) .


Among perimenopausal and postmenopausal women with hot flashes , both low dose oral estradiol and low-dose venlafaxine compared with placebo modestly reduced insomnia symptoms and improved subjective sleep quality .


To compare the vaginal cytology of ovulating and non-ovulating queens .


The study group comprised @ queens showing behavioural oestrus .


Ovulation was induced in @ ( dioestrus group ) and @ were left untreated ( postoestrus group ) .


Vaginal smears were collected from all animals prior to ovariohysterectomy on day @ .


Epithelial cells were classified as basal-parabasal , intermediate , superficial , or anucleated superficial cells and counted using computer-assisted image analysis .


From each smear , @ representative vaginal epithelial cells were chosen .


Digital images of cells were taken and cell area , cytoplasm area , nucleus area , cell diameter , cell perimeter , nucleus/cytoplasm ratio and red-green-blue ( RGB ) values were measured using image analysis software .


Measurement data were compared between groups .


Ovulation induction was successful in all animals .


The swabbing procedure in oestrus did not induce ovulation in any postoestrus queens .


Mean duration of oestrus was @ @ and @ @ days ( P > @ ) in the postoestrus and dioestrus queens , respectively .


Intermediate cell count averaged @ % in dioestrus cats and @ % in postoestrus cats ( P < @ ) .


Epithelial cells in the postoestrus group had higher cell area , cytoplasm area , cell diameter and cell perimeter measurements ( P < @ ) .


Red ( @ @ ) , green ( @ @ ) and blue ( @ @ ) channel values in postoestrus were higher than the values ( @ @ , @ @ and @ @ , respectively ) in dioestrus ( P < @ ) .


Induction of ovulation in oestrus queens results in a significant increase in the number of intermediate cells and a significant decrease in both the dimensions and RGB values of vaginal epithelial cells on day @ .


Varenicline carries a black box warning for neuropsychiatric adverse events .


We examined varenicline use and past history of major depressive disorder ( MDD ) on depressive symptoms during smoking cessation .


This is a secondary analysis of two smoking cessation studies in @ postmenopausal women who received placebo or nicotine patch , or @ women who received varenicline with relaxation .


Lifetime history of MDD ( LH-MDD ) was assessed at baseline and women with current MDD were excluded .


Center for Epidemiologic Study Depression scale ( CESD ) measured depressive symptoms at baseline , @ and @ weeks .


Baseline CESD scores were @ +@ .


Those with a LH-MDD reported higher CESD scores ( p > @ ) .


Those taking varenicline reported lower scores over all time periods compared to nicotine or placebo ( p < @ ) .


The differences between varenicline and the other treatments remained when controlling for LH-MDD , indicating an independent effect .


CESD scores were associated with concurrent smoking status ( p < @ ) , and with withdrawal symptoms ( p < @ ) .


CESD score were lower in those receiving varenicline , whether this is due to an anti-depressant effect , subject selection , use of relaxation or another cause is unknown .


Varenicline does not increase depressive symptoms during smoking cessation in postmenopausal women without current MDD .


Subjects with a LH-MDD are susceptible to developing depressive symptoms during smoking cessation , regardless of pharmacologic aid .


Pharmacologic aids did not increase depression symptoms in this select population of postmenopausal women without current depression .


Smoking cessation does increase depressive symptoms in those with LH-MDD , though the degree of increase was not clinically meaningful .


Previous research suggests that testosterone ( T ) plays a key role in shaping competitive and aggressive behavior in humans , possibly by modulating threat-related neural circuitry .


However , this research has been limited by the use of T augmentation that fails to account for baseline differences and has been conducted exclusively in women .


Thus , the extent to which normal physiologic concentrations of T affect threat-related brain function in men remains unknown .


In the current study , we use a novel two-step pharmacologic challenge protocol to overcome these limitations and to evaluate causal modulation of threat - and aggression-related neural circuits by T in healthy young men ( n = @ ) .


First , we controlled for baseline differences in T through administration of a gonadotropin releasing hormone antagonist .


Once a common baseline was established across participants , we then administered T to within the normal physiologic range .


During this second step of the protocol we acquired functional neuroimaging data to examine the impact of T augmentation on neural circuitry supporting threat and aggression .


Gonadotropin releasing hormone antagonism successfully reduced circulating concentrations of T and brought subjects to a common baseline .


Administration of T rapidly increased circulating T concentrations and was associated with heightened reactivity of the amygdala , hypothalamus , and periaqueductal grey to angry facial expressions .


These findings provide novel causal evidence that T rapidly potentiates the response of neural circuits mediating threat processing and aggressive behavior in men .


Survivors of ischemic stroke/transient ischemic attack ( TIA ) are at high risk for other vascular events .


We evaluated the impact of @ types of case management ( hard touch with pharmacist or soft touch with nurse ) added to usual care on global vascular risk .


This is a prespecified secondary analysis of a @-month trial conducted in outpatients with recent stroke/TIA who received usual care and were randomized to additional monthly visits with either nurse case managers ( who counseled patients , monitored risk factors , and communicated results to primary care physicians ) or pharmacist case managers ( who were also able to independently prescribe according to treatment algorithms ) .


The Framingham Risk Score -LSB- FRS -RSB- ) and the Cardiovascular Disease Life Expectancy Model ( CDLEM ) were used to estimate @-year risk of any vascular event at baseline , @ months ( trial conclusion ) , and @ months ( @ months after last trial visit ) .


Mean age of the @ evaluable patients was @ years .


Both study arms were well balanced at baseline and exhibited reductions in absolute global vascular risk estimates at @ months : median @ % ( Interquartile range ( IQR ) @ % -@ % ) for the pharmacist arm versus @ % ( IQR @ % -@ % ) for the nurse arm on the FRS ( P = @ between arms ) and median @ % ( @ % -@ % ) versus @ % ( @ % -@ % ) on the CDLEM ( P = @ ) .


These reductions persisted at @ months : median @ % ( @ % -@ % ) versus @ % ( @ % -@ % ) for the FRS ( P = @ ) and median @ % ( @ % -@ % ) versus @ % ( @ % -@ % ) on the CDLEM ( P = @ ) .


Case management by nonphysician providers is associated with improved global vascular risk in patients with recent stroke/TIA .


Reductions achieved during the active phase of the trial persisted after trial conclusion .


The aim of this study was to compare the effects of ethyl chloride and placebo sprays for reducing pain induced by needle electromyography and changes in parameters of the motor unit action potential during needle electromyography of the upper extremity .


Sixty patients were randomized into the ethyl chloride or placebo spray groups .


In both groups , spray was applied just before needle electromyography of the flexor carpi radialis , and a visual analog scale to evaluate the pain of needle electromyography and a five-point Likert scale for patient satisfaction and preference for reexamination were compared between the two groups .


Then , changes in the amplitude , phases , turns , and duration of the motor unit action potential during needle electromyography of the biceps brachii were compared before and after spraying in each group .


The visual analog scale was significantly lower , and patient satisfaction and preference for reexamination were significantly higher in the ethyl chloride spray group .


Among the parameters of the motor unit action potential , there were no significant changes except for an increased duration after spraying with ethyl chloride .


Ethyl chloride spray can effectively reduce pain , but it must be used with caution because it may affect parameters of the motor unit action potential during needle electromyography .


L-Menthol stimulates cutaneous thermoreceptors and induces cool sensations improving thermal comfort but has also been linked to heat storage responses .


Therefore , L-Menthol application could lead to a conflict in behavioural and thermoregulatory drivers improving comfort but leading to a higher rate of deep body temperature rise ; the present study examined this possibility .


Six untrained male participants ( age @ -LSB- @ -RSB- years ; height @ -LSB- @ -RSB- m ; mass @ -LSB- @ -RSB- kg ; surface area @ -LSB- @ -RSB- m@ ) took part .


They completed three trials in hot conditions ( @ C ) where their clothing was sprayed ( CONTROL-SPRAY or MENTHOL-SPRAY ) or not sprayed ( CONTROL ) after a fixed intensity exercise period ( @-minutes ) , which induced thermal discomfort , before completing a @ km treadmill time trial ( TT ) .


Thermal perception ( thermal sensation and comfort ; TS , TC ) , thermal responses ( aural temperature -LSB- Tau -RSB- , skin temperature -LSB- Tskin -RSB- ) , perceived exertion ( RPE ) , heart rate , pacing ( @ km split time ) and performance ( TT completion time ) were measured .


MENTHOL-SPRAY induced improvements in TS ( up to @ km of TT ) and TC ( up to @ km ) with Tau showing a tendency to be higher than CONTROL-SPRAY ( +@ -LSB- @ -RSB- C ) and CONTROL condition ( @ -LSB- @ -RSB- C ) ; this was not statistically significant and the rate of rise in Tau was linear .


Tau was continuing to rise between the @th and @th kilometre of the TT .


The other variables were unchanged .


TT completion time and pace were not different : CONTROL @ -LSB- @ -RSB- , CONTROL-SPRAY @ -LSB- @ -RSB- , MENTHOL-SPRAY @ -LSB- @ -RSB- minutes .


Spraying L-MENTHOL prior to exercise in the heat culminated in improved perception but not altered performance .


Emergence of artemisinin resistance has raised concerns that the most potent anti-malarial drug may be under threat .


Artesunate-amodiaquine ( AS-AQ ) and artemether-lumefantrine ( AL ) are , respectively , the first - and second-line treatments for uncomplicated falciparum malaria in Cte d'Ivoire .


Constant monitoring by National Malaria Control Programme ( NMCP ) of drug efficacy is an important tool in establishing rational anti-malarial drug policies in Cte d'Ivoire .


In an open label , randomized controlled clinical trial , children and adults were randomized to receive AS-AQ or AL. .


Both drug regimens were given for three days , and follow-up was for @ days .


The primary endpoint was the @-day cure rate and was defined as proportion of patients with PCR-corrected cure rate after @ days of follow-up .


A total of @ patients who were attending the Anonkoua-koute ( Abidjan ) , Petit Paris ( Korhogo ) and Libreville ( Man ) hospitals and presenting with symptomatic acute uncomplicated falciparum malaria were randomized to receive AS-AQ ( @ ) and AL ( @ ) .


The intention-to-treat analysis showed effectiveness rates of @ % and @ % for AS-AQ and AL , respectively on day @ .


After adjustment for PCR , these rates were @ % and @ % , respectively .


At day @ , in per-protocol analysis , Adequate clinical and parasitological response ( ACPR ) PCR uncorrected was @ % and @ % for AS-AQ and AL , respectively .


The PCR adjusted ACPR was @ % for each combination and both regimens were well tolerated .


This study has shown the high efficacy of AS-AQ in patients of all ages with acute uncomplicated falciparum malaria and AS-AQ was non-inferior to AL. .


Continuous efficacy monitoring is recommended .


Hypertension management strategies have traditionally focused on `` tailored therapy '' and `` stepped-care '' approaches .


These tend to be costly and time consuming and often fail to achieve adequate blood pressure ( BP ) control .


The TRIUMPH study aims to investigate the effectiveness , cost-effectiveness , and acceptability of early use of a @-in-@ BP-lowering pill ( `` Triple Pill '' ) compared with usual care for the management of hypertension .


The prospective , open , randomized controlled clinical trial ( n = @ ) will compare Triple Pill-based strategy to usual care among individuals with persistent mild-to-moderate hypertension ( systolic BP > @ mm Hg and/or diastolic BP > @ mm Hg , or systolic BP > @ mm Hg and/or diastolic BP > @ mm Hg in patients with diabetes or chronic kidney disease ) on no or minimal drug therapy .


The study will be conducted within approximately @ hospital-based clinics in India .


Participants will be randomized to the Triple Pill ( initially strength @-telmisartan @ mg , amlodipine @ mg , hydrochlorothiazide @ mg , with the option of subsequent titration to strength @-telmisartan @ mg , amlodipine @ mg , hydrochlorothiazide @ mg ) or continued usual care .


Participants will be followed up for @ months .


The primary outcome is the proportion of participants achieving target BP at the end follow-up .


This study will determine whether early use of a low-dose triple combination therapy has the potential to address some of the challenges in hypertension control through earlier achievement of BP control , better adherence , and fewer adverse effects , in the context of less intensive clinical follow-up .


The study aim was , for the first time , to conduct a multicenter randomized controlled trial to evaluate the effect of tonsillectomy in patients with IgA nephropathy ( IgAN ) .


Patients with biopsy-proven IgAN , proteinuria and low serum creatinine were randomly allocated to receive tonsillectomy combined with steroid pulses ( Group A ; n = @ ) or steroid pulses alone ( Group B ; n = @ ) .


The primary end points were urinary protein excretion and the disappearance of proteinuria and/or hematuria .


During @ months from baseline , the percentage decrease in urinary protein excretion was significantly larger in Group A than that in Group B ( P < @ ) .


However , the frequency of the disappearance of proteinuria , hematuria , or both ( clinical remission ) at @ months was not statistically different between the groups .


Logistic regression analyses revealed the assigned treatment was a significant , independent factor contributing to the disappearance of proteinuria ( odds ratio @ , @ % CI @-@ @ , P = @ ) , but did not identify an independent factor in achieving the disappearance of hematuria or clinical remission .


The results indicate tonsillectomy combined with steroid pulse therapy has no beneficial effect over steroid pulses alone to attenuate hematuria and to increase the incidence of clinical remission .


Although the antiproteinuric effect was significantly greater in combined therapy , the difference was marginal , and its impact on the renal functional outcome remains to be clarified .


@-@ % diabetes patients will develop diabetic foot ulceration at some time during the life .


The purpose of this study was to compare the effectiveness of Mepilex Lite dressings and vaseline gauze care in the healing of foot ulcers in diabetic patients .


This was a randomized controlled trial , and a sample of @ diabetic patients who had developed foot ulcers was assessed .


Comparisons were made regarding parameters related to wound healing , including healing time and wound pain , and also regarding the adverse events .


The results showed that foot ulcers in the study group ( Mepilex Lite , @ patients ) healed in a median of @ days , which was significantly different from the healing time in the control group ( median , @ days , @ patients ; P = @ ) .


No statistically significant differences were detected between the @ groups with pain .


However , Mepilex Lite dressings significantly reduced wound area ( P < @ ) .


The researchers conclude that Mepilex Lite dressing provides a promising alternative to diabetic foot ulcers and is worthy of further research .


To determine the effect of Chinese massage combined with core stability exercises on nonspecific low back pain .


In the prospective study , ninety-two participants with nonspecific low back pain were divided into experimental and control group at random , and @ in each .


The experimental group were treated using Chinese massage combined with core stability exercises , while the control group were treated using Chinese massage alone .


The two groups were evaluated using visual analog scale and Oswestry disability index at baseline , immediately after two and eight weeks .


In addition , the recurrence rate of nonspecific low back pain was evaluated one year after the last intervention .


Two weeks after treatment , both VAS and ODI scores decreased significantly in two groups ( p < @ ) , when compared with the values before treatment , but no difference between the two groups ( p > @ ) .


Eight weeks later , the VAS and ODI scores decreased significantly in both groups ( p < @ ) ; at the same time , both VAS and ODI scores were significantly lower ( p < @ ) in the experimental group than those in the control group .


At the final follow-up , five cases recurred in the experimental group and nineteen cases in the control group , the control group has a significantly higher recurrence rate ( p < @ ) .


Core stability exercises can improve the therapeutic effect of Chinese massage in treating nonspecific low back pain .


To evaluate the acceptability and efficacy of a psycho-educational intervention designed to improve effective coping and reduce symptom severity in children with cancer .


Cancer treatments increase survival rates and also cause physical and psychological effects on children with cancer .


A psycho-educational intervention is used to assist children and adolescents with these effects and its efficacy has been described in several studies .


A randomized controlled trial .


Participants being treated were recruited and randomly assigned to two groups from September @-February @ in Taiwan .


The intervention group received a psycho-educational intervention in addition to standard care , while the control group received only standard care .


Each participant was assessed using a paediatric cancer coping scale and perceived symptom severity was evaluated at three time points ( baseline , @ month and @ months ) .


A repeated-measures analysis of variance was used to estimate the effects of intervention .


Qualitative findings were analysed using content analysis .


No significant difference in coping scores was found between groups , but the experimental group reported significantly lower scores in gastrointestinal problems and pain .


Most symptoms decreased significantly over time in both groups , except for gastrointestinal problems .


The scores in pain , bone marrow suppression and body image showed significant interaction effects between groups on changes over time .


Qualitative results reported that participants evaluated the intervention positively , especially about receipt of psychological support and learnt coping skills .


The psycho-educational intervention administered was acceptable for children with cancer and was found to reduce gastrointestinal problems and pain .


Renin-angiotensin system inhibitors have renoprotective effects in patients with chronic kidney disease , but most patients treated with these drugs have residual urinary albumin excretion .


Some small clinical studies show that mineralocorticoid receptor blockade reduces albuminuria .


Our study aimed to examine the beneficial effects of addition of a selective aldosterone antagonist , eplerenone , to renin-angiotensin system inhibitors in hypertensive patients with non-diabetic chronic kidney disease .


In this double-blind , randomised , placebo-controlled trial , we enrolled hypertensive patients , aged @ years , with albuminuria ( urinary albumin-to-creatinine ratio -LSB- UACR -RSB- in the first morning void urine of @ mg/g ) , an estimated glomerular filtration rate of @ mL/min per @ m@ or more , and who had received an angiotensin-converting enzyme inhibitor , an angiotensin receptor blocker , or both , for at least @ weeks .


Participants were from @ clinics and hospitals in Japan .


Eligible patients were randomly assigned ( @:@ ) , stratified by baseline characteristics , to either low-dose eplerenone ( @ mg/day ) or placebo , with continuation of standard antihypertensive treatment to attain therapeutic goals ( < @/@ mm Hg ) for @ weeks .


We assessed efficacy in all patients who received allocated treatment , provided a baseline and post-treatment urine sample , and remained in follow-up .


We assessed safety in all patients who received allocated treatment .


The primary efficacy measure was percent change in UACR in the first morning void urine at week @ from baseline .


The trial is registered at the clinical trials registry of University Hospital Medical Information Network ( UMIN ) , trial identification number UMIN@ .


Between April @ , @ , and March @ , @ , we randomly allocated @ patients to the eplerenone group and @ patients to the placebo group .


In the primary efficacy analysis , mean percent change in UACR from baseline was @ % ( @ % CI @ to @ ) for @ patients in the eplerenone group compared with @ % ( @ to @ ) for @ patients in the placebo group ( absolute difference @ % -LSB- @ to @ -RSB- ; p = @ ) .


In the safety analyses , @ ( @ % ) of @ patients in the eplerenone group had adverse events ( five serious ) , as did @ ( @ % ) of @ in the placebo group ( seven serious ) .


Although mean serum potassium concentration was higher in the eplerenone group than the placebo group , severe hyperkalaemia ( > @ mmol/L ) was not recorded in either group .


Addition of low-dose eplerenone to renin-angiotensin system inhibitors might have renoprotective effects through reduction of albuminuria in hypertensive patients with non-diabetic chronic kidney disease , without serious safety concerns .


Patients with kidney failure treated with maintenance hemodialysis ( HD ) are poor responders to clopidogrel .


More beneficial platelet-inhibiting strategies in HD patients therefore are required .


Single-center , prospective , randomized , crossover study .


@ HD patients in Seoul , Korea .


Patients were randomly assigned to receive clopidogrel ( @mg loading , @mg once daily for maintenance dose ) or ticagrelor ( @mg loading , @mg twice daily for maintenance dose ) for @ days , and after a @-day washout period , crossover treatment for another @ days .


All patients received aspirin ( @mg/d ) .


Platelet function was evaluated predosing and at @ , @ , and @ hours and @ days after the first loading dose .


During the offset phase , platelet function was assessed at @ hour and @ , @ , and @ days after the last dose by light transmittance aggregometry and the VerifyNow P@Y@ assay , and patients were genotyped for the CYP@C@ * @ allele .


Maximal extent of aggregation , inhibition of platelet aggregation ( IPA ) , P@Y@ reaction units ( PRUs ) , and percentage of inhibition were evaluated .


We performed per-protocol analysis , excluding patients who did not complete the protocol .


@ patients did not complete the protocol ( @ patients due to adverse events ; @ , nonadherence ) .


Higher IPA occurred with ticagrelor than with clopidogrel at @ , @ , and @ hours and @ days after loading .


By @ hours after loading , a greater proportion of patients in the ticagrelor group than in the clopidogrel group achieved IPA > @ % ( @ % vs @ % , respectively ; P < @ ) and IPA > @ % ( @ % vs @ % , respectively ; P < @ ) .


Rates ( slope ) of onset and offset of the antiplatelet effect were faster in patients receiving ticagrelor than for those receiving clopidogrel ( P < @ ) .


Regardless of CYP@C@ * @ allele , the ticagrelor group had significantly lower PRUs at all times than the clopidogrel group .


Single-center study with a small number of patients , not a double-blind study , and not intention-to-treat analysis .


Ticagrelor may result in more rapid and greater platelet inhibition than clopidogrel in patients with kidney failure receiving HD .


Nowadays , laparoscopic cholecystectomy ( LC ) is undoubtedly considered the `` gold standard '' in the surgical treatment of symptomatic gallstones , gallbladder adenomas and acute cholecystitis .


Among the alternative energy sources proposed ( monopolar , bipolar electric scalpel , radiofrequency sealers ) with the aim to dissect and/or seal , the ultrasonic energy has been frequently adopted , however without a widespread acceptance among surgeons for routine or emergency laparoscopic cholecystectomy .


This study investigates the possible beneficial aspects of ultrasonic dissection and its efficacy in the closure of the cystic artery and duct .


Patients were retrospectively divided into @ groups according to the instruments used for division of the cystic artery and duct as well as for dissection of the liver bed : @ patients in whom dissection and coagulation were performed using monopolar coagulation and @ patients who were all treated with the ultrasonically activated scalpel harmonic ACE ( Ethicon Endo-Surgery ) as the sole instrument used in the whole procedure .


The mean operative time , was significantly shorter in the harmonic group than in the traditional group ( @ + @ min vs. @ +@ vs. respectively ; p < @ ) .


The rate of gallbladder perforation was significantly higher in the traditional group than in the harmonic group @ % ( @ patients ) vs. @ % ( @ patients ) , respectively ; p < @ ) .


Intraoperative volume blood loss was significantly more in the traditional group than in the HS group ( @ +@ vs. @ +@ ; p < @ ) .


The mean amount of postoperative drainage was not significantly different among the two group ( @ +@ vs. @ +@ ml , p > @ ) .


No considerable visceral injury has been recorded in either group .


The postoperative parameters observed included postoperative hospital stay and morbidity for each group .


The hospital stay was not significantly shorter in harmonic group ( @ +@ vs. @ +@ h , p > @ ) .


The overall morbidity rate was @ % ( not significant ) .


The use of the harmonic scalpel shows some statistically significant advantages limited to a few intraoperative parameters .


We conclude that a wider use of harmonic scalpel not offers such advantages to make it the reference technique .


Pulse pressure ( PP ) , might be a stronger determinants of cardiovascular risk .


To investigate the effect of interval training program on PP in subjects with hypertension .


Two hundred and forty five male patients with mild to moderate ( Systolic Blood Pressure -LSB- SBP -RSB- between @-@ & Diastolic Blood Pressure -LSB- DBP -RSB- between @-@ mmHg ) essential hypertension were age-matched and grouped into exercise and control groups .


The exercise ( work : rest ratio of @:@ ) groups involved in an @-weeks interval training programs of between @-@ minutes , at intensities of @-@ % of HR max ( maximum heart rate ) , while the control group remained sedentary during this period .


SBP , DBP , VO@max and PP were assessed .


Findings of the study revealed significant correlation between PP and blood pressure ; correlation of PP with SBP was much stronger ( @ % variance ) .


Also , there was significant effect of the exercise training program on SBP , DBP and PP .


Changes in VO@max also negatively correlated with changes in PP ( r = -@ ) at p < @ .


Moderate intensity interval training programs is effective in the non-pharmacological management of hypertension and may prevent cardiovascular event through the down regulation of PP in hypertension .


To evaluate the microleakage of Class II cavities restored with experimental low-shrinking resin composites proposed for bulk filling and to measure their microtensile bond strength ( microTBS ) to dentin and compare to those of previously marketed low-shrinkage composites .


Class II cavities ( @ mm occluso-gingival height , @ mm mesio-distal depth of the box , @ mm occlusal depth , @ mm bucco-lingual width ) were prepared in @ molars and randomly divided into five groups ( n = @ ) , according to the material : SureFil SDR flow ( SDR ) , Filtek Silorane ( FS ) and experimental materials ( G-aenial Flo bulk fill , GF ; G-aenial Universal Flo bulk fill , GUF ; GC Kalore bulk fill , GK ) .


Microleakage was separately assessed at enamel and dentin margins by scoring the depth of silver-nitrate penetration .


Twenty teeth divided into five groups ( n = @ ) were selected for microTBS testing .


The same materials as for microleakage assessment were placed in bulk to mid-coronal dentin .


Microtensile beams were loaded in tension , and microTBS at failure was calculated in MPa .


Microleakage and microTBS data were analyzed by ANOVA on ranks , followed Dunn 's post hoc test ( P < @ ) .


Microleakage was not observed at the enamel interface in any of the groups .


At the dentin interface , SDR recorded significantly higher microleakage than the other materials .


microTBS of GF , GUF and GK did not differ among each other ( @ + / - @ MPa , @ + / - @ MPa , @ + / - @ MPa , respectively ) , while SDR ( @ + / - @ MPa ) and FS ( @ + / - @MPa ) achieved significantly higher microTBS values .


No direct association between the sealing properties and the bond strength values was observed .


Failure of fusion after a transforaminal lumbar interbody fusion ( TLIF ) procedure is a challenging problem that can lead to ongoing low-back pain , dependence on pain medication , and inability to return to work .


B@A is a synthetic peptide that has proven efficacy in achieving fusion in animal models and may have a better safety profile than bone morphogenetic protein .


The authors undertook this study to evaluate the safety and efficacy of B@A peptide-enhanced ceramic granules ( Prefix ) in comparison with autogenous iliac crest bone graft ( ICBG , control ) in patients undergoing single-level TLIF .


Twenty-four patients with single-level degenerative disorders of the lumbar spine at L@-S@ requiring TLIF were enrolled between @ and @ .


They were randomly assigned to @ groups : a control group ( treated with ICBG , n = @ ) , a Prefix @ group ( treated with Prefix @ g/cm ( @ ) granules , n = @ ) , and a Prefix @ group ( treated with Prefix @ g/cm ( @ ) granules , n = @ ) .


Outcome measures included the Oswestry Disability Index ( ODI ) , visual analog pain scale , and radiographic fusion as assessed by CT and dynamic flexion/extension lumbar plain radiographs .


At @ months after surgery , the radiographic fusion rate was @ % in the Prefix @ group , @ % in the control group , and @ % in the Prefix @ group , although the difference was not statistically significant ( p = @ ) .


At @ weeks the mean ODI score was @ for the control group , @ for the Prefix @ group , and @ for the Prefix @ group , whereas at @ months the mean ODI was @ for control , @ for Prefix @ , and @ for Prefix @ groups .


Complications were evenly distributed among the groups .


Prefix appears to provide a safe alternative to autogenous ICBG .


Prefix @ appears to show superior radiographic fusion when compared with autograft at @ months after TLIF , although no statistically significant difference was demonstrated in this small study .


Prefix and control groups both appeared to demonstrate comparable improvements to ODI at @ months .


Interventional Management of Stroke ( IMS ) III is a randomized , parallel arm trial comparing the approach of intravenous tissue-type plasminogen activator followed by endovascular treatment with intravenous tissue-type plasminogen activator alone in patients with acute ischemic stroke presenting < @ hours of symptom onset .


The trial intended to enroll @ subjects to ensure adequate statistical power to detect an absolute @ % difference in the percentage of subjects with good outcome , defined as modified Rankin Scale score of @ to @ at @ months .


In April @ , after @ subjects were randomized , further enrollment was terminated by the National Institute of Neurological Disorders and Stroke based on the prespecified criterion for futility using conditional power < @ % .


Conditional power was defined as the likelihood of finding statistical significance at the end of the study , given the accumulated data to date and with the assumption that a minimum hypothesized difference of @ % truly exists between the @ groups .


The evolution of study data leading to futility determination is described , including the interaction between the unblinded study statisticians and the Data and Safety Monitoring Board in the complex deliberation of analysis results .


The futility boundary was crossed at the trial 's fourth interim analysis .


At this point , based on the conditional power criteria , the Data and Safety Monitoring Board recommended termination of the trial .


Even in spite of prespecified interim analysis boundaries , interim looks at data pose challenges in interpretation and decision making , underscoring the importance of objective stopping criteria .


To develop and validate a scoring system for evaluation of long term anorectal dysfunction following radiotherapy for prostate cancer .


Patients treated for prostate cancer with radiotherapy filled in questionnaires on anorectal function and quality of life .


Items for the condensed anorectal dysfunction score ( RT-ARD ) were identified and weighted by binomial regression analysis .


The score was tested in a separate patient material by receiver operating characteristic ( ROC ) analysis and correlations to quality of life domains .


A total of @ patients participated in the study .


The items selected were `` incontinence for solid stool '' , `` ability to defer defecation '' , `` unproductive call to stool '' , `` clustering of stool '' , and `` mucus in stool . ''


Patients were grouped into three categories according to the RT-ARD score ; @-@ ( no RT-ARD ) , @-@ ( minor RT-ARD ) , @-@ ( major RT-ARD ) .


ROC analyses revealed high sensitivity ( @ % ) and specificity ( @ % ) for major RT-ARD .


The prediction model demonstrated a perfect fit in @ % , moderate fit in @ % and no fit in @ % .


There was good correlation between the RT-ARD score and quality of life .


The RT-ARD score is a validated and simple instrument for evaluation of anorectal dysfunction following radiotherapy for prostate cancer , and the RT-ARD score correlates to the patient 's quality of life .


The evaluation of cardiac contraction could benefit from a connection with the underlying helical structure of cardiac fibers in athletes either completely healthy or with minor common cardiopathies like Bicuspid Aortic Valve ( BAV ) .


This study aims to exploit the potential role of @D strain to improve the physiological understanding of LV function and modification due to physical activity as a comparative model .


Three age-matched groups of young ( age @ ) individuals are prospectively enrolled : @ normal healthy subjects , @ healthy athletes , and @ athletes with bicuspid aortic valve ( BAV ) .


All subjects underwent echocardiographic examination and both @D and @D strain analysis .


All echo parameters were within the normal range in the three groups .


Global values of end-systolic longitudinal and circumferential strain , assesses by either @D or @D analysis , were not significantly different .


The @D strain analysis was extended in terms of principal and secondary strain ( PS , SS ) .


Global PS was very similar , global SS was significantly higher in athletes and displays a modified time course .


The comparative analysis of strain-lines pattern suggests that the enhancement of LV function is achieved by a more synchronous recruitment of both left - and right-handed helical fibers .


@D strain analysis allows a deeper physiological understanding of LV contraction in different types of athletes .


Secondary strain , only available in @D , identifies increase of performances due to physical activity ; this appears to follow from the synergic activation of endocardial and epicardial fibers .


To evaluate the effect on acne vulgaris of pricking-bloodletting cupping at Dazhui ( GV @ ) under acupuncture anesthesia , and establish whether providing anesthesia to the treatment area by manipulating Hegu ( LI @ ) and Quchi ( LI @ ) might have an additional therapeutic benefit .


Thirty-eight patients were recruited and randomized into a control group and an intervention group with a single-blind ( observer-blind ) method .


The control group was treated by pricking-bloodletting cupping at Dazhui ( GV @ ) - and the studied group by pricking-bloodletting cupping at Dazhui ( GV @ ) under acupuncture anesthesia at Hegu ( LI @ ) and Quchi ( LI @ ) .


Both groups were treated twice weekly for @ weeks .


The analgesic and therapeutic effects of acupuncture were evaluated on a visual analog scale ( VAS ) and global acne grading system ( GAGS ) , respectively .


There were differences in the VAS scores of pain on pricking and in the pricked area , and the duration of pain between the groups .


After @ treatments , there was a significant reduction in GAGS scores from baseline in both groups , but there was no significant difference between the groups .


Acupuncture anesthesia at Hegu ( LI @ ) and Quchi ( LI @ ) is an effective means of alleviating the pain of pricking-bloodletting cupping and reducing the duration of pain in the treatment area .


Pricking-bloodletting cupping at Dazhui ( GV @ ) improves the skin lesions of patients with moderate acne vulgaris , but acupuncture anesthesia does not appear to have an additional therapeutic effect .


Screening of immunization status at each health care encounter is recommended to improve immunization coverage rates but is often limited to primary care practices .


A pilot intervention study was performed to ascertain the immunization status of hospitalized children and determine if development of an immunization plan before discharge would improve the vaccination status for such children .


On the basis of power calculations estimated to detect an increase in immunization status from @ % to @ % with @ % power , @ randomly selected children were enrolled between March @ , @ and June @ , @ .


Immunization records were obtained , immunization status determined , and parent/guardian informed if catch-up dose ( s ) were needed .


If parent requested vaccine dose ( s ) , they were administered before discharge .


Vaccination status was current per Advisory Committee on Immunization Practices guidelines in @ % of hospitalized children , and @ % children required catch-up dose ( s ) ( @ doses for @ children ) .


Human papilloma virus vaccine ( dose @ ) , varicella zoster vaccine ( dose @ ) , and meningococcal conjugate vaccine were the most commonly identified dose ( s ) needed .


Of those requiring catch-up dose ( s ) , @ % were caught up , increasing vaccination status to @ % at @-month post hospital discharge .


This is the first study to determine the immunization status of hospitalized pediatric patients of all ages , including adolescents , providing new data on the immunization status of the inpatient pediatric population .


A pilot intervention consisting of obtaining immunization records , determining immunization status , and discussing catch-up dose ( s ) before discharge resulted in improvement of immunization status , suggesting that the inpatient setting may be used along with many other national strategies to help address missed vaccination opportunities .


The objective of our study was to conduct a randomized controlled trial of educational interventions that were created to improve performance of screening mammography interpretation .


We randomly assigned physicians who interpret mammography to one of three groups : self-paced DVD , live expert-led educational seminar , or control .


The DVD and seminar interventions used mammography cases of varying difficulty and provided associated teaching points .


Interpretive performance was compared using a pretest-posttest design .


Sensitivity , specificity , and positive predictive value ( PPV ) were calculated relative to two outcomes : cancer status and consensus of three experts about recall .


The performance measures for each group were compared using logistic regression adjusting for pretest performance .


One hundred two radiologists completed all aspects of the trial .


After adjustment for preintervention performance , the odds of improved sensitivity for correctly identifying a lesion relative to expert recall were @ times higher for DVD participants than for control subjects ( @ % CI , @-@ @ ; p = @ ) .


The odds of an improved PPV for correctly identifying a lesion relative to both expert recall ( odds ratio -LSB- OR -RSB- = @ ; @ % CI , @-@ @ ; p = @ ) and cancer status ( OR = @ ; @ % CI , @-@ @ ; p = @ ) were significantly improved for DVD participants compared with control subjects , with no significant change in specificity .


For the seminar group , specificity was significantly lower than the control group ( OR relative to expert recall = @ ; @ % CI , @-@ @ ; p = @ ; OR relative to cancer status = @ ; @ % CI , @-@ @ ; p = @ ) .


In this randomized controlled trial , the DVD educational intervention resulted in a significant improvement in screening mammography interpretive performance on a test set , which could translate into improved interpretative performance in clinical practice .


Pelubiprofen is a prodrug of @-arylpropionic acid with relatively selective effects on cyclooxygenase-@ activity .


The aim of this study was to compare the efficacy and safety profiles of pelubiprofen with those of celecoxib in patients with rheumatoid arthritis .


This was a @-week , multicenter , randomized , double-blind , double-dummy , parallel-group , phase III , non-inferiority clinical trial .


The primary end point was non-inferiority of pain decrease from baseline to week-@ as determined using a @ mm pain visual analog scale ( VAS ) .


Pelubiprofen was considered non-inferior to celecoxib if the lower limit of the @ % confidence interval for treatment difference -LSB- ( pain reduction in pelubiprofen group ) - ( pain reduction in celecoxib group ) -RSB- was more than -@ mm .


The secondary end points were as follows : non-inferiority of ( @ ) reduction of Korean health assessment questionnaire ( KHAQ ) score ; ( @ ) decreased duration of morning stiffness ; and ( @ ) decrease in the frequency and total dose of rescue drugs after @ weeks of treatment .


Seventy-seven patients in the pelubiprofen group and @ patients in the celecoxib group started the study medication .


Pelubiprofen was non-inferior to celecoxib with regard to reduction in VAS pain severity ( difference , mean SD @ @ ; @ % CI , -@ to ) .


Pelubiprofen was also non-inferior to celecoxib in terms of the secondary end points , such as , decrease in KHAQ score ( @ @ , @ % CI -@ to ) , decrease in duration of morning stiffness ( median @ minute in both groups ) , and decrease in the frequency ( @ @ , @ % CI -@ to ) and total amount ( @ @ , @ % CI -@ to ) of rescue medication uses during the @ week study period .


Safety analysis revealed @ % patients in the pelubiprofen group and @ % patients in the celecoxib group experienced an adverse drug reaction ( ADR ) .


The frequency of gastrointestinal ADRs was @ % and @ % , respectively .


Pelubiprofen was found to be as effective as celecoxib at pain reduction and for relieving stiffness in RA patients .


However , more patients in the pelubiprofen group experienced ADR and the frequency of gastrointestinal ADRs was higher in the pelubiprofen group .


ClinialTrials.gov identifier : NCT@ .


Topical corticosteroids ( TC ) consistently show effectiveness against itch , a paradigmatic symptom , in various eczemas .


Rapid itch relief is a therapeutic goal .


The early response of itch to TC has not been adequately studied .


To assess the effect on itch of a TC , methylprednisolone aceponate @ % ointment ( MPA ) , in induced eczema in volunteers sensitized to nickel sulphate .


Sixteen volunteers with a late positive patch-test reaction to nickel sulphate entered the study .


Eczema was treated once daily with fingertip unit of MPA for @days .


Pruritus intensity was assessed with a @cm visual analogue scale ( VAS ) .


Mean time to itch relief ( TR ) defined as the time to reach a @ % decrease in the highest VAS value recorded was assessed , as well as TR-baseline , colorimetry and planimetric morphometry of the reaction .


Mean TR was @ days -LSB- standard deviation ( SD ) = @ -RSB- and mean TR - baseline was @ days ( SD = @ ) .


Five volunteers reached @ % decrease from itch baseline-VAS in @ days , whereas a @ % decrease was obtained in @ days by @ volunteers .


A clinical improvement of patch-test reaction was apparent at day @ , although erythema was still present .


We present a valid model to assess the efficacy and speed of action of TC treatment to alleviate pruritus and the signs of eczema .


The fast effect of MPA against pruritus supports the appropriateness of treating allergic contact eczema with TC .


To assess whether urea-based cream ( UBC ) has prophylactic benefits on sorafenib-induced hand-foot skin reaction ( HFSR ) in patients with advanced hepatocellular carcinoma ( HCC ) .


In this randomized , open-label trial , @ patients with advanced HCC throughout China were treated with @ % UBC three times per day plus best supportive care ( BSC ; n = @ ) or BSC alone excluding all creams ( n = @ ) , starting on day @ of sorafenib treatment , for up to @ weeks .


HFSR was assessed every @ weeks and at @ weeks for patients completing the study .


Once HFSR occurred , patients were allowed any cream , including a UBC .


The @-week incidence of any grade HFSR was significantly lower in the UBC group versus the BSC-alone group ( @ % v @ % , respectively ; odds ratio -LSB- OR -RSB- , @ ; @ % CI , @ to @ ; P < @ ) , as was the incidence of grade @ HFSR ( @ % v @ % , respectively ; OR , @ ; @ % CI , @ to @ ; P = @ ) .


Median time to first occurrence of HFSR was significantly longer in the UBC group than the BSC-alone group ( @ v @ days , respectively ; hazard ratio , @ ; @ % CI , @ to @ ; P < @ ) .


Elevated AST was associated with increased risk of HFSR but did not alter the treatment effect of UBC .


UBC plus BSC , compared with BSC alone , did not affect the sorafenib dose reduction or interruption rate ( @ % v @ % , respectively ; P = @ ) , response rate ( @ % v @ % , respectively ; P = @ ) , or disease control rate ( @ % v @ % , respectively ; P = @ ) at week @ .


UBC prophylaxis in patients with advanced HCC starting sorafenib reduced HFSR rates , extended the time to first occurrence of HFSR , and improved patient quality of life compared with BSC .


Blinded , randomized , placebo-controlled trials to determine the role of UBC on the incidence and severity of HFSR are warranted .


Epidemiological studies have found that a diet high in fibre and coffee , but low in red meat , reduces the risk for type @ diabetes .


We tested the hypothesis that these nutritional modifications differentially improve whole-body insulin sensitivity ( primary outcome ) and secretion .


Inclusion criteria were : age @-@ years , BMI @ kg/m ( @ ) , type @ diabetes treated with diet , metformin or acarbose and known disease duration of @ years .


Exclusion criteria were : HbA@c > @ mmol/mol ( @ % ) , type @ or secondary diabetes types and acute or chronic diseases including cancer .


Patients taking any medication affecting the immune system or insulin sensitivity , other than metformin , were also excluded .


Of @ patients ( randomised using randomisation blocks -LSB- four or six patients -RSB- with consecutive numbers ) , @ ( @ % female ) obese type @ diabetic patients completed this controlled parallel-group @-week low-energy dietary intervention .


The participants consumed either a diet high in cereal fibre ( whole grain wheat/rye : @-@ g/day ) and coffee ( @ cups/day ) , and free of red meat ( L-RISK , n = @ ) or a diet low in fibre ( @ g/day ) , coffee-free and high in red meat ( @ g/day ) diet ( H-RISK , n = @ ) .


Insulin sensitivity and secretion were assessed by hyperinsulinaemic-euglycaemic clamp and intravenous glucose tolerance tests with isotope dilution .


Whole-body and organ fat contents were measured by magnetic resonance imaging and spectroscopy .


Whole-body insulin sensitivity increased in both groups ( mean -LSB- @ % CI -RSB- ) ( H-RISK vs L-RISK : @ -LSB- @ , @ -RSB- vs @ -LSB- @ , @ -RSB- mg kg ( -@ ) min ( -@ ) , p = @ ) , while body weight decreased ( -@ % -LSB- -@ % , -@ % -RSB- vs -@ % -LSB- -@ % , -@ % -RSB- , respectively ) .


Hepatic insulin sensitivity remained unchanged , whereas hepatocellular lipid content fell in both groups ( -@ % -LSB- -@ % , -@ % -RSB- vs -@ % -LSB- -@ % , -@ % -RSB- ) .


Subcutaneous fat mass ( -@,@ -LSB- -@,@ , -@ -RSB- cm ( @ ) vs -@ -LSB- -@,@ ; @ -RSB- cm ( @ ) , respectively ) visceral fat mass ( -@ -LSB- -@ , @ -RSB- cm ( @ ) vs -@ -LSB- -@ , @ -RSB- cm ( @ ) , respectively ) and muscle fat content ( -@ % -LSB- -@ % , -@ % -RSB- vs -@ % -LSB- -@ % , @ % -RSB- , respectively ) decreased similarly .


Insulin secretion remained unchanged , while the proinflammatory marker IL-@ decreased only after the L-RISK diet .


No evidence of a difference between both low-energy diets was identified .


Thus , energy restriction per se seems to be key for improving insulin action in phases of active weight loss in obese type @ diabetic patients , with a potential improvement of subclinical inflammation with the L-RISK diet .


Safety of tenofovir disoproxil fumarate/emtricitabine ( TDF-FTC ) has been studied more extensively among HIV-infected patients than among HIV-uninfected people .


Using data from a pre-exposure trial - FEM-PrEP - , we determined the cumulative probabilities of grade @ + ALT , AST and creatinine and grade @ + phosphorus toxicities ; ALT/AST toxicities by baseline hepatitis B status ; and change in mean creatinine , phosphorus , ALT and AST levels controlling for TDF-FTC adherence .


FEM-PrEP was a randomized , blinded , placebo-controlled trial of daily TDF-FTC among women in Africa .


Enrolled women were in general good health , HIV antibody negative , @ to @ years old , hepatitis B surface antigen negative , and had normal hepatic and renal function at baseline .


AST , ALT , phosphorus and serum creatinine were measured regularly throughout the trial .


TDF-FTC concentrations were measured to assess adherence to TDF-FTC .


The cumulative probabilities of grade @ + creatininemia and grade @ + phosphatemia toxicities were not statistically different between TDF-FTC and placebo arms .


The cumulative probabilities of grade @ + ALT and AST toxicities were higher among participants in the TDF-FTC arm than in the placebo arm ( p = @ for both ) .


The proportions of grade @ + and grade @ + ALT or AST toxicities were significantly higher in participants who were hepatitis B virus surface antibody ( HBsAb ) positive than in those who were HBsAb-negative .


Women with good adherence had higher mean change from baseline to week @ in their AST levels ( @ ( @ , @ ) ; p = @ ) than women with less than good adherence .


We did not observe a significant relationship between randomization to TDF-FTC and creatinine or phosphorus toxicities .


Women randomized to TDF-FTC had higher rates of mild to moderate ALT/AST toxicities , especially women with prior hepatitis B virus exposure .


We also observed a significant increase in AST from baseline to week @ among women who had higher adherence to TDF-FTC during that interval .


This study implemented pharmacokinetic/pharmacodynamic modelling to support the clinical development of RBP-@ , a new , long-acting , sustained-release formulation of buprenorphine for the treatment of opioid dependence .


Such a formulation could offer advantages over existing buprenorphine pharmacotherapy by improving patient compliance and reducing the diversion of the product .


A population pharmacokinetic model was developed using @ opioid-dependent subjects who received single subcutaneous doses of RBP-@ .


Another pharmacokinetic/pharmacodynamic model was developed using - opioid receptor occupancy ( ORO ) data to predict efficacy of RBP-@ after repeated doses .


It was also assessed how buprenorphine plasma concentrations were correlated with opioid withdrawal symptoms and hydromorphone agonist blockade data from @ heroin-dependent subjects .


The resulting pharmacokinetic model accurately described buprenorphine and norbuprenorphine plasma concentrations .


A saturable maximum effect ( E max ) model with @ ng/mL effective concentration at @ % of maximum ( EC@ ) and @ % E max best described ORO versus buprenorphine plasma concentrations .


Linear relationships were found among ORO , withdrawal symptoms and blockade of agonist effects .


Previously published findings have demonstrated ORO @ % is needed to achieve withdrawal suppression and blockade of opioid agonist subjective effects .


Model simulations indicated that a @ mg RBP-@ dose should achieve @ ng/mL buprenorphine average concentrations and desired efficacy .


The aim of this study was to investigate the effects of the vasodilating - blocker nebivolol and the cardioselective - blocker metoprolol on nitric oxide ( NO ) levels at vascular graft endothelium and vasa vasorum compared to controls in patients undergoing coronary artery bypass graft surgery .


This was a prospective study .


Fifty-five patients were divided into three groups : nebivolol group ( group N , n = @ ) , metoprolol group ( group M , n = @ ) , and control group ( group A , n = @ ) .


Group N received nebivolol @ mg once daily , and group M received metoprolol @ mg once daily for @ days in the preoperative period .


Control patients did not use - blocker therapy .


Tissue samples of both left internal mammary artery ( LIMA ) and saphenous vein grafts were investigated for NO activity using immunohistochemical methods .


Demographic characteristics and risk factors were similar between groups .


We observed the highest NO activity in group N in both endothelial and vasa vasorum samples of LIMA and saphenous veins .


NO activity of metoprolol group was similar to controls .


According to our results , we think that nebivolol may be safer and preferable in order to diminish graft spasm in patients undergoing coronary artery bypass graft surgery due to the NO-mediated vasodilating effect .


To evaluate the effectiveness of subcostal TAP block and to compare its efficacy with that of posterior TAP block in decreasing postoperative pain in patients undergoing laparoscopic cholecystectomy during general anesthesia .


Prospective , randomized , double-blind study .


Academic medical center .


@ adult , ASA physical status @ and @ patients of both genders , aged @-@ years , scheduled for elective laparoscopic cholecystectomy .


Patients were randomized to three groups of @ patients each .


Group @ patients received standard general anesthesia ( control group ) ; Group @ patients received an ultrasound-guided posterior TAP block using @ mL of @ % ropivacaine on each side ; and Group @ patients underwent a subcostal TAP block with @ mL of @ % ropivacaine on each side .


The presence and severity of pain during rest and movement , as well as nausea or vomiting and sedation , were assessed in all patients postoperatively on PACU admission , then at @ , @ , @ , @ , @ , and @-hour intervals .


Patients with a visual analog score ( VAS ) greater than @ , or those requesting analgesic were given intravenous tramadol @ mg/kg as an initial dose ; subsequent @ mg/kg doses of tramadol , if needed , were given .


Patients who received a subcostal TAP block had significantly lower pain scores at rest and on movement than the control group at all times postoperatively .


Although , in the initial postoperative measurement times , the subcostal and posterior TAP groups had comparable pain scores , after @ hours these scores were significantly lower in patients who had received the subcostal TAP block .


For incisions mainly involving the supra-umbilical region , subcostal TAP block may be a better alternative than the posterior approach for providing postoperative analgesia .


To evaluate pharmacokinetics , recovery times , and recovery quality in horses anesthetized with @ times the minimum alveolar concentration of sevoflurane or desflurane .


@ healthy adult horses .


Anesthesia was maintained with sevoflurane or desflurane for @ hours at @ times the minimum alveolar concentration .


Horses recovered without assistance .


During recovery , end-tidal gas samples were collected until horses spontaneously moved .


Anesthetic concentrations were measured by use of gas chromatography .


After a @-week washout period , horses were anesthetized with the other inhalation agent .


Video recordings of anesthetic recovery were evaluated for recovery quality on the basis of a visual analogue scale by investigators who were unaware of the anesthetic administered .


Anesthetic washout curves were fit to a @-compartment kinetic model with multivariate nonlinear regression .


Normally distributed interval data were analyzed by means of paired Student t tests ; ordinal or nonnormally distributed data were analyzed by means of Wilcoxon signed rank tests .


Horses recovered from both anesthetics without major injuries .


Results for subjective recovery evaluations did not differ between anesthetics .


Area under the elimination curve was significantly smaller and time to standing recovery was significantly less for desflurane than for sevoflurane , although distribution and elimination constants did not differ significantly between anesthetics .


Differences in area under elimination the curve between anesthetics indicated more rapid clearance for desflurane than for sevoflurane in horses , as predicted by anesthetic blood solubility differences in this species .


More rapid elimination kinetics was associated with faster recovery times , but no association with improved subjective recovery quality was detected .


CLP is an orally administered , non-absorbed , superabsorbent polymer being developed to increase fecal excretion of sodium , potassium and water in patients with heart failure and end-stage renal disease .


This study was conducted to evaluate the safety of CLP , and to explore dose-related effects on fecal weight , fecal and urine sodium and potassium excretion , and serum electrolyte concentrations .


This Phase @ , open-label , dose-escalation study included @ healthy volunteers , who were administered CLP orally immediately prior to four daily meals for @ days at doses of @ , @ , and @ g/day ( n = @/group ) .


An additional dose group received @ g/day CLP under fasting conditions , and an untreated cohort ( n = @ ) served as control .


Twenty-four-hour fecal and urinary output was collected daily .


Samples were weighed , and sodium , potassium , and other ion content in stool and urine were measured for each treatment group .


Effects on serum cation concentrations , other standard laboratory values , and adverse events were also determined .


At doses below @ g/day , CLP was well tolerated , with a low frequency of self-limiting gastrointestinal adverse events .


CLP increased fecal weight and fecal sodium and potassium content in a dose-related manner .


Concomitant dose-related decreases in urinary sodium and potassium were observed .


All serum ion concentrations remained within normal limits .


In this study , oral CLP removed water , sodium and potassium from the body via the gastrointestinal tract in a dose related fashion .


CLP could become useful for patients with fluid overload and compromised kidney function in conditions such as congestive heart failure , salt sensitive hypertension , chronic kidney disease and end stage renal disease .


Metacognitive training ( MCT ) for patients with psychosis is a psychological group intervention that aims to educate patients about common cognitive biases underlying delusion formation and maintenance , and to highlight their negative consequences in daily functioning .


In this randomized controlled trial , @ schizophrenia spectrum patients with delusions were randomly assigned to either MCT + treatment as usual ( TAU ) or TAU alone .


Both groups were assessed at baseline , and again after @ and @ weeks .


The trial was completed fully by @ patients .


Efficacy was measured with the Psychotic Symptom Rating Scales ( PSYRATS ) Delusions Rating Scale ( DRS ) , and with specific secondary measures referring to persecutory ideas and ideas of social reference ( the Green Paranoid Thoughts Scale , GPTS ) , cognitive insight ( the Beck Cognitive Insight Scale , BCIS ) , subjective experiences of cognitive biases ( the Davos Assessment of Cognitive Biases Scale , DACOBS ) and metacognitive beliefs ( the @-item Metacognitions Questionnaire , MCQ-@ ) .


Economic analysis focused on the balance between societal costs and health outcomes ( quality-adjusted life years , QALYs ) .


Both conditions showed a decrease of delusions .


MCT was not more efficacious in terms of reducing delusions , nor did it change subjective paranoid thinking and ideas of social reference , cognitive insight or subjective experience of cognitive biases and metacognitive beliefs .


The results of the economic analysis were not in favour of MCT+TAU .


In the present study , MCT did not affect delusion scores and self-reported cognitive insight , or subjective experience of cognitive biases and metacognitive beliefs .


MCT was not cost-effective .


To investigate the applicability of flowable composites as post luting agents by assessing the push-out strength of posts .


@ intact single rooted human premolars were selected .


The endodontic treatment was performed and half of the specimens were restored with light transmitting posts ( DT Light Post Illusion ) and the other half with opaque posts ( Tech @ X-OP ) .


In both groups the following combinations of adhesive/cement were tested : OptiBond Solo Plus/Nexus Third Generation ( NX@ ) , XP Bond/SureFil SDR Flow ( SDR ) , and Vertise Flow ( VF ) .


Push-out test was used to assess the retentive strength of fiber posts , which was expressed in megapascals ( MPa ) .


Specimens were analyzed under a stereomicroscope to determine failure mode ( adhesive between luting agent and post , adhesive between luting agent and dentin or mixed failure ) .


Push-out data and failure mode distribution were analyzed by two-way ANOVA and Chi-square test , respectively ( P < @ ) .


The statistical analysis revealed that only the type of luting material significantly influenced push-out bond strength of the post ( P < @ ) .


SDR ( @ + / - @ MPa ) performed similarly to the control group NX@ ( @ + / - @ MPa ) , while VF ( @ + / - @ MPa ) should significantly lower bond strength .


Failure modes differed significantly among groups .


Estrogen therapy is the gold standard treatment for hot flashes and night sweats , but some women are unable or unwilling to use it because of associated risks .


The serotonin-norepinephrine reuptake inhibitor venlafaxine hydrochloride is used widely as a nonhormonal treatment .


While the clinical impression is that serotonin-norepinephrine reuptake inhibitors are less effective than estrogen , these medications have not been simultaneously evaluated in one clinical trial to date .


To determine the efficacy and tolerability of low-dose oral @-estradiol and low-dose venlafaxine extended release in alleviating vasomotor symptoms ( VMS ) .


In total , @ perimenopausal and postmenopausal women with at least @ bothersome VMS per day ( mean , @ per day ) were recruited from the community to MsFLASH ( Menopause Strategies : Finding Lasting Answers for Symptoms and Health ) clinical network sites between December @ , @ , and October @ , @ .


Participants were randomized to double-blind treatment with low-dose oral @-estradiol ( @ mg/d ) ( n = @ ) , low-dose venlafaxine hydrochloride extended release ( @ mg/d ) ( n = @ ) , or placebo ( n = @ ) for @ weeks .


The primary outcome was the mean daily frequency of VMS after @ weeks of treatment .


Secondary outcomes were VMS severity , bother , and interference with daily life .


Intent-to-treat analyses compared the change in VMS frequency between each active intervention and placebo and between the @ active treatments .


Compared with baseline , the mean VMS frequency at week @ decreased to @ ( @ % CI , @-@ @ ) VMS per day ( @ % reduction ) in the estradiol group , to @ ( @ % CI , @-@ @ ) VMS per day ( @ % reduction ) in the venlafaxine group , and to @ ( @ % CI , @-@ @ ) VMS per day ( @ % reduction ) in the placebo group .


Estradiol reduced the frequency of symptoms by @ more per day than placebo ( P < @ ) , and venlafaxine reduced the frequency of symptoms by @ more per day than placebo ( P = @ ) .


The results were consistent for VMS severity , bother , and interference .


Low-dose estradiol reduced the frequency of symptoms by @ more per day than venlafaxine ( P = @ ) .


Treatment satisfaction was highest ( @ % ) for estradiol ( P < @ vs placebo ) , lowest ( @ % ) for placebo , and intermediate ( @ % ) for venlafaxine ( P = @ vs placebo ) .


Both interventions were well tolerated .


Low-dose oral estradiol and venlafaxine are effective treatments for VMS in women during midlife .


While the efficacy of low-dose estradiol may be slightly superior to that of venlafaxine , the difference is small and of uncertain clinical relevance .


Alternative forms of cardiac resynchronization therapy ( CRT ) , including biventricular endocardial ( BV-Endo ) and multisite epicardial pacing ( MSP ) , have been developed to improve response .


It is unclear which form of stimulation is optimal .


We aimed to compare the acute haemodynamic response ( AHR ) and electrophysiological effects of BV-Endo with MSP via two separate coronary sinus ( CS ) leads or a single-quadripolar CS lead .


Fifteen patients with a previously implanted CRT system received a second temporary CS lead and left ventricular ( LV ) endocardial catheter .


A pressure wire and non-contact mapping array were placed into the LV cavity to measure LVdP/dtmax and perform electroanatomical mapping .


Conventional CRT , BV-Endo , and MSP were then performed ( MSP-@ via two epicardial leads and MSP-@ via a single-quadripolar lead ) .


The best overall AHR was found using BV-Endo pacing with a @ @ % increase in AHR at the optimal endocardial site over baseline ( P < @ ) .


There was an increase in LVdP/dtmax with MSP-@ and MSP-@ compared with conventional CRT , but this was not statistically significant .


Biventricular endocardial pacing from the optimal site was significantly superior to conventional CRT ( P = @ ) .


The AHR achieved when BV-Endo pacing was highly site specific .


Within individuals , the best pacing modality varied and was affected by the underlying substrate .


Left ventricular activation times did not predict the optimal haemodynamic configuration .


Biventricular endocardial pacing and not MSP was superior to conventional CRT , but was highly site specific .


Within individuals , however , different methods of stimulation are optimal and may need to be tailored to the underlying substrate .


To compare the efficacy difference among acupuncture smoothing-liver and regulating-spleen method , regulating Governor Vessel method and oral administration of western medicine for menopausal insomnia .


One hundred and fifty-six cases of menopausal insomnia were randomized into a smoothing-liver and regulating-spleen group ( group A ) , a regulating Governor Vessel group ( group B ) and a medication group ( group C ) , @ cases in each one .


Acupuncture at Zhongwan ( CV @ ) , Daheng ( SP @ ) , Sanyinjiao ( SP @ ) and Taichong ( LR @ ) , etc. was applied in the group A ; acupuncture at Baihui ( GV @ ) , Fengfu ( GV @ ) , Shenting ( GV @ ) and Yintang ( GV @ ) , etc. was used in the group B ; oral administration of estazolam tablets ( @ mg each-day ) was adapted in the group C , all once a day for totally @ days .


The each item score and total score in Pittsburgh sleep quality index ( PSQI ) were evaluated before and after treatment in each group , also the efficacy in each group was assessed .


After the treatment , the sleeping rate in the group A and B was significantly higher than that in the group C ( both P < @ ) ; the total effective rate in the Group A and B was also significantly higher than that in the group C -LSB- @ % ( @/@ ) and @ % ( @/@ ) vs @ % ( @/@ ) , both P < @ ; the total cured rate in the group A was significantly higher than those in the group B and C -LSB- @ % ( @/@ ) vs @ % ( @/@ ) and @ % ( @/@ ) , both P < @ -RSB- .


Each item score and total score of PSQI were all improved after treatment in the group A and B ( P < @ , P < @ ) , while only sleeping time , sleeping efficiency and total score were improved in the group C ( all P < @ ) .


The sleeping quality , sleeping time , sleeping difficulty and daytime dysfunction in the group A were all lower than those in the group C ( all P < @ ) .


The sleeping quality , sleeping time and daytime dysfunction in the goup B were all lower than those in the group C ( all P < @ ) .


The total score in the group A was significantly lower than that in the group B and C ( both P < @ ) .


Acupuncture has better effect for menopausal insomnia than estazolam .


Between the two acupuncture methods , the acupuncture method of smoothing-liver and regulating-spleen has a better effect .


The aim of the present study was to evaluate the acute effects of resistance exercise ( RE ) leading to failure and RE that was not to failure on @ h blood pressure ( BP ) and heart rate variability ( HRV ) in sedentary normotensive adult women .


Ten women ( @ @ years ; @ @ cm ; @ @ kg ; body fat @ @ % ) randomly underwent three experimental sessions : control ( @ minutes of seated rest ) , RE leading to failure with @ sets of @ repetitions maximum ( @-RM ) , and RE not to failure at @ % of @-RM with @ sets of @ repetitions .


Immediately post session BP and HRV were measured for @ h.


Ratings of perceived exertion and heart rate were higher during the @-RM session when compared with @ % of @-RM ( @ @ vs @ @ and @ @ vs @ @ bpm , respectively ) .


The systolic , diastolic and mean BP decreased at @:@ a.m. after the @-RM session when compared with the control session ( -@ @ mmHg , -@ @ mmHg and -@ @ mmHg , respectively ) .


The root mean square of the squared differences between R-R intervals decreased after both the @ % of @-RM and @-RM sessions compared with the control session .


An acute RE session leading to failure induced a higher drop of BP upon awakening , while both RE sessions reduced cardiac parasympathetic modulation .