The incidence of postoperative ileus ( @ % vs @ % ; p = @ ) and hospital stay ( @ vs @ days ; p = @ ) was also lower in the stimulated patients .


Small numbers of patients means that no definitive statements can be made regarding the effectiveness of this technique .


Stimulation of the efferent limb of the ileostomy before closure is a safe technique that reduces postoperative ileus and fosters early intestinal transit and oral tolerance with a shorter postoperative hospital stay .


To study the relationship between the severity of carpal tunnel syndrome ( CTS ) symptoms and surgery for CTS and the relationship between conservative treatments and surgery for CTS .


A secondary analysis of baseline to @-month data from a randomized controlled trial , which examined the effectiveness of orthosis/stretch combinations on the symptoms of CTS , was conducted for a total of @ participants with CTS .


Participants completed the Carpal Tunnel Questionnaire and posttreatment surveys .


Statistical analyses included exploration of correlates of progression to surgery for CTS and logistical regression to examine the association between conservative treatments and CTS symptoms and progression to surgery for CTS .


Twenty-one participants received surgery for their CTS , and @ participants received @ or more conservative treatments .


Severity of baseline CTS symptoms and additional treatments were indicators of progression to surgery .


The randomized controlled trial intervention was inversely associated with progression to surgery .


CTS that does not respond to an initial course of conservative treatment may not improve with additional treatments .


More than half of the participants who received additional conservative treatment still progressed to surgery .


Current intervention guidelines for CTS provide limited guidance as to the best methods to efficiently treat CTS .


CTS is a costly and high-burden disorder , resulting in reduced quality of life .


Research should examine when and for whom conservative care is an effective choice and the association between conservative care and the eventual need for CTS surgery .


Evaluate potential gender effects on efficacy and safety of a buffered zolpidem sublingual tablet ( ZST ) formulation .


Post hoc analysis of the pivotal sleep laboratory and outpatient studies , per gender .


In the sleep laboratory study , polysomnography-derived latency to persistent sleep after middle-of-the-night was significantly improved for both genders at both @ mg and @ mg ZST ( females : @ and @ min , respectively , vs. @ min -LSB- placebo -RSB- ; males : @ and @ min vs. @ min -LSB- placebo -RSB- ) with no significant gender differences .


In the outpatient study , subjective sleep onset latency after middle-of-the-night was significantly shorter for both genders treated with ZST @ mg versus placebo over the @-week average ( females : @ vs. @ min , p < @ ; males : @ vs. @ min , p@ @ ) .


There were no gender differences in subjective sleep onset latency after middle-of-the-night awakening .


In the outpatient study , weekly usage of ZST and placebo by both genders declined throughout the study .


Morning alertness following dosing nights improved in both genders , although significant only in females .


In both studies , there were no gender differences in adverse events .


Time to return to sleep after middle-of-the-night dosing with ZST improved in both genders , with no gender differences in efficacy and safety .


This randomized , double-blind , placebo-controlled , single and multiple ascending-dose study evaluated the pharmacodynamic effects and safety/tolerability of canagliflozin , a sodium glucose co-transporter @ inhibitor , in patients with type @ diabetes .


Patients ( N = @ ) discontinued their antihyperglycemic medications @ weeks before randomization .


Patients received canagliflozin @ , @ , @ , or @ mg once daily or @ mg twice daily , or placebo at @ study centers in the United States and Germany , or canagliflozin @ mg once daily or placebo at @ study center in Korea , while maintaining an isocaloric diet for @ weeks .


On Days -@ , @ , and @ , urinary glucose excretion ( UGE ) , plasma glucose ( PG ) , fasting PG ( FPG ) , and insulin were measured .


The renal threshold for glucose ( RTG ) was calculated from UGE , PG , and estimated glomerular filtration rate .


Safety was evaluated based on adverse event ( AE ) reports , vital signs , electrocardiograms , clinical laboratory tests , and physical examinations .


Canagliflozin increased UGE dose-dependently ( @-@ g/day with canagliflozin @ mg ) , with increases maintained over the @-day dosing period with each dose .


Canagliflozin dose-dependently decreased RTG , with maximal reductions to @-@ mM ( @-@ mg/dL ) .


Canagliflozin also reduced FPG and @-hour mean PG ; glucose reductions were seen on Day @ and maintained over @ weeks .


Plasma insulin reductions with canagliflozin were consistent with observed PG reductions .


Canagliflozin also reduced body weight .


AEs were transient , mild to moderate in intensity , and balanced across groups ; @ canagliflozin-treated female reported an episode of vaginal candidiasis .


Canagliflozin did not cause hypoglycemia , consistent with the RTG values remaining above the hypoglycemia threshold .


At Day @ , there were no clinically meaningful changes in urine volume , urine electrolyte excretion , renal function , or routine laboratory test values .


Canagliflozin increased UGE and decreased RTG , leading to reductions in PG , insulin , and body weight , and was generally well tolerated in patients with type @ diabetes .


Patient perceptions of financial burden and rates of cost-related nonadherence are high among individuals with asthma across the socioeconomic spectrum .


Little is known about preferences and frequency of physician-patient discussions about cost/affordability among individuals managing respiratory conditions .


To examine who has a preference to discuss the cost of their asthma care with their physician , how often physician-patient communication about cost/affordability actually is occurring , and what clinical and demographic characteristics of patients are predictive of communication .


Data came from @ African American adult women with asthma who were asked about communication preferences and practices around cost and affordability with their physician .


Data were analyzed using descriptive statistics and multiple variable logistic regression models .


Fifty-two percent ( n = @ ) of this sample perceived financial burden .


Seventy-two percent ( n = @ ) reported a preference to discuss cost with their health-care provider .


Thirty-nine percent ( n = @ ) reported actually having a conversation with their physician about cost .


Among the @ % who reported no discussion , @ % ( n = @ ) reported financial burden , and @ % ( n = @ ) reported a preference for discussion .


Lower household income ( P < @ ) , perception of financial burden ( P < @ ) , and higher out-of-pocket expenses for medicines ( P < @ ) were significantly predictive of greater preference to communicate about cost/affordability with the doctor when adjusted for clinical and demographic characteristics .


Perception of financial burden ( P < @ ) , preference to discuss affordability ( P < @ ) , and greater number of chronic conditions ( P < @ ) were significantly predictive of greater likelihood of communication about cost/affordability with the doctor when adjusted for clinical and demographic characteristics .


Bivariate analyses revealed that patients who reported a discussion of cost were more likely to report worse asthma control and lower asthma-related quality of life .


An imbalance is evident between patients who would like to discuss cost with their doctor and those who actually do .


Patients are interested in low-cost options and a venue for addressing their concerns with a care provider ; therefore , a greater understanding is needed in how to effectively and efficiently integrate these conversations and viable solutions into the delivery of health care .


Additional research is necessary to determine whether communication about the cost of therapy is associated with health outcomes .


In colorectal cancer ( CRC ) , unresectable liver metastases are linked to poor prognosis .


Systemic chemotherapy with regimens such as FOLFOX ( combination of infusional @-fluorouracil , leucovorin and oxaliplatin ) is the standard first-line treatment .


The SIRFLOX trial was designed to assess the efficacy and safety of combining FOLFOX-based chemotherapy with Selective Internal Radiation Therapy ( SIRT or radioembolisation ) using yttrium-@ resin microspheres ( SIR-SpheresR ; Sirtex Medical Limited , North Sydney , Australia ) .


SIRFLOX is a randomised , multicentre trial of mFOLFOX@ chemotherapy + / - SIRT as first-line treatment of patients with liver-only or liver-predominant metastatic CRC ( mCRC ) .


The trial aims to recruit adult chemotherapy-naive patients with proven liver metastases with or without limited extra-hepatic disease , a life expectancy of > = @ months and a WHO performance status of @-@ .


Patients will be randomised to receive either mFOLFOX@ or SIRT + mFOLFOX@ ( with a reduced dose of oxaliplatin in cycles @-@ following SIRT ) .


Patients in both arms can receive bevacizumab at investigator discretion .


Protocol chemotherapy will continue until there is unacceptable toxicity , evidence of tumour progression , complete surgical resection or ablation of cancerous lesions , or the patient requests an end to treatment .


The primary endpoint of the SIRFLOX trial is progression-free survival ( PFS ) .


Secondary endpoints include : PFS in the liver ; tumour response rate ( liver and any site ) ; site of tumour progression ; health-related quality of life ; toxicity and safety ; liver resection rate ; and overall survival .


Assuming an increase in the median PFS from @ months to @ months with the addition of SIRT to mFOLFOX@ , recruiting > = @ patients will be sufficient for @ % power and @ % confidence .


The SIRFLOX trial will establish the potential role of SIRT + standard systemic chemotherapy in the first-line management of mCRC with non-resectable liver metastases .


The authors compared the effectiveness of fluoxetine and desipramine treatment in a prospective double-blind pharmacogenetics study in first-generation Mexican Americans and examined the role of whole-exome functional gene variations in the patients ' antidepressant response .


A total of @ Mexican Americans who met DSM-IV criteria for major depressive disorder were randomly assigned to receive @ weeks of double-blind treatment with desipramine ( @-@ mg/day ) or fluoxetine ( @-@ mg/day ) after a @-week placebo lead-in period .


Outcome measures included the Hamilton Depression Rating Scale ( HAM-D ) , the Hamilton Anxiety Rating Scale , and the Beck Depression Inventory .


At week @ , whole-exome genotyping data were obtained for @ participants who remitted and @ who did not respond to treatment .


Compared with desipramine treatment , fluoxetine treatment was associated with a greater reduction in HAM-D score , higher response and remission rates , shorter time to response and remission , and lower incidences of anticholinergic and cardiovascular side effects .


Pharmacogenetics analysis showed that exm-rs@ achieved exome-wide significance for treatment remission .


This variant is located in a brain methylated DNA immunoprecipitation sequencing site , which suggests that it may be involved in epigenetic regulation of neuronal gene expression .


This and two other common gene variants provided a highly accurate cross-validated predictive model for treatment remission of major depression ( receiver operating characteristic integral = @ ) .


Compared with desipramine , fluoxetine treatment showed a more rapid reduction of HAM-D score and a lower incidence of side effects in a population comprising primarily first-generation Mexican Americans with major depression .


This study 's pharmacogenetics approach strongly implicates the role of functional variants in antidepressant treatment response .


The txt@stop trial demonstrated that smoking-cessation support delivered by text message doubles biochemically verified abstinence at @ months .


There was no significant heterogeneity in any of the pre-specified subgroups .


To explore participants ' experiences of the txt@stop intervention via a qualitative study using telephone interviews .


Qualitative telephone interviews in the community .


Thematic content analysis of @ feedback forms was conducted to develop a topic guide for @ telephone interviews .


Key themes were identified and described .


Any differences in the experiences of those who did , and did not , successfully quit were specifically explored .


Participants liked the fact that smoking-cessation support delivered by text message was convenient , easy to access , and chemical free .


They reported that the intervention was a reminder that they were quitting and why , provided emotional support , was a reminder of the physical benefits of stopping smoking , and they saved messages so they could refer back to them .


However , the intervention was not helpful for all .


Receiving texts about smoking could also stimulate craving , and the timing , frequency , and duration of messages were not optimal for some participants .


Those who did not quit reported that additional factors influenced them , such as periods of stress or social events , or reported that they had been unable to cope with the physical effects of withdrawal , and combining text-message support with medication could help with this .


Although the intervention did stimulate craving in some participants at some times , recipients reported that it also provided emotional support and reinforcement at temporally appropriate moments .


It was successful at helping people to quit smoking but could be used together with other forms of smoking-cessation support .


The administration of @-agonists to patients with airways obstruction often results in transient decrease in PaO@ despite concomitant bronchodilation .


This effect is potentially dangerous for patients suffering from acute exacerbation of COPD ( AECOPD ) .


In this study , we investigated the effect of indacaterol @g and @g on the arterial blood gas tensions of hospitalised patients with AECOPD .


We explored the acute effects on arterial blood gases and spirometry of two doses of indacaterol Breezhaler ( @ and @g ) in @ patients hospitalised because of an AECOPD in @ non-consecutive days under open-label , randomized , crossover conditions , with blind evaluation .


Blood specimens were taken just before the inhalation and at @ , @ , @ , @ , @ and @min after inhalation of each treatment , and spirometry was performed at the same time points .


Both doses of indacaterol did not cause significant changes in blood gases , although some patients with relatively well-preserved PaO@ presented transient episodes of oxygen desaturation that normalize spontaneously in a very short time .


Moreover , they induced a significant mean increase in FEV@ and FVC , although the improvement caused by indacaterol @g was larger .


Indacaterol up to @g is a potent bronchodilator that may induce small , transient decrease in PaO@ mainly in patients with relatively well-preserved PaO@ .


There appeared to be no clinical consequences of these PaO@ abnormalities in patients suffering from AECOPD .


To investigate the efficacy profile of entecavir capsule ( ETV ) as a chronic hepatitis B therapy , as compared to lamivudine ( LAM ) .


In this multicenter , randomized , double-blind , parallel group evaluation of ETV , @ subjects were administered a @-week course of @ mg/day ETV or @ mg/day LAM .


PCR measurement of hepatitis B virus ( HBV ) was conducted throughout the treatment course to determine achievement of complete virologic response ( CVR ; defined as less than @ copies/ml of HBV DNA ) or experience of virology rebound ( more than @ copies/ml of HBV DNA after achievement of CVR ) .


After week-@ of treatment , the ETV group showed a higher CVR rate ( @ % vs. LAM : @ % ) and lower virology rebound rate ( @ % vs. LAM : @ % ) .


After week-@ of treatment , the ETV group continued to have a higher CVR rate ( @ % vs. LAM : @ % ) , and virology rebound was experienced by significantly less subjects in the ETV group ( @ % vs. LAM : @ % , P = @ ) .


ETV therapy can quickly and continuously suppress HBV replication in chronic hepatitis B patients , and has a lower resistance rate than LAM .


Compared to LAM , ETV may be a superior long-term treatment choice for chronic hepatitis B.


This study was designed to assess the feasibility of dual closed-loop titration of propofol and remifentanil guided solely by the Bispectral Index ( BIS ) monitor in pediatric and adolescent patients during anesthesia .


Children undergoing elective surgery in this single-blind randomized study were allocated into the closed-loop ( auto ) or manual ( manual ) group .


Primary outcome was the percentage of time with the BIS in the range @ to @ ( BIS@-@ ) .


Secondary outcomes were the percentage of deep ( BIS < @ ) anesthesia and drug consumption .


Data are presented as median ( interquartile range ) or number ( % ) .


Twenty-three patients ( @ -LSB- @ to @ -RSB- yr ) were assigned to the auto group and @ ( @ -LSB- @ to @ -RSB- yr ) to the manual group .


The closed-loop controller was able to provide induction and maintenance for all patients .


The percentage of time with BIS@-@ was greater in the auto group ( @ % -LSB- @ to @ -RSB- vs. @ % -LSB- @ to @ -RSB- ; P = @ ) , with a decrease in the percentage of BIS < @ ( @ % -LSB- @ to @ -RSB- vs. @ % -LSB- @ to @ -RSB- ; P = @ ) .


Propofol ( @ -LSB- @ to @ -RSB- vs. @ -LSB- @ to @ -RSB- mg/kg ) and remifentanil ( @ -LSB- @ to @ -RSB- vs. @ -LSB- @ to @ -RSB- g/kg ) consumptions were similar in auto versus manual groups during induction , respectively .


During maintenance , propofol consumption ( @ -LSB- @ to @ -RSB- vs. @ -LSB- @ to @ -RSB- mg kg h ; P = @ ) was similar between the two groups , but remifentanil consumption was greater in the auto group ( @ -LSB- @ to @ -RSB- vs. @ -LSB- @ to @ -RSB- g kg min ; P = @ ) .


Perioperative adverse events and length of stay in the postanesthesia care unit were similar .


Intraoperative automated control of hypnosis and analgesia guided by the BIS is clinically feasible in pediatric and adolescent patients and outperformed skilled manual control .


To evaluate the efficacy of two surgical treatments for conjunctivochalasis .


Prospective randomized control study .


Thirty-three conjunctivochalasis patients ( @ eyes ) were randomly divided into two groups : simple resection group , and resection and fixation group .


The former received simple conjunctival resection , and the latter received conjunctival resection and scleral fixation .


Postoperative conjunctiva relaxation , BUT and ocular surface disease index ( OSDI ) points were compared to evaluate the efficacy of the two kinds of surgical methods .


The recurrence rate of conjunctivochalasis was @/@ in the simple resection group and @/@ in the resection and fixation group on month @ after operation , and there was significant difference ( P = @ ) .


In @ month , @ months and @ months postoperatively , the proportion of normal BUT increased respectively in both groups ( simple resection group :@ / @ , @/@ , @/@ ; resection and fixation group :@ / @ , @/@ , @/@ ) compared with that before operation ( simple resection group :@ / @ ; resection and fixation group :@ / @ ) .


The difference was statistically significant @ months after operation compared with that before operation ( simple resection group :P = @ ; resection and fixation group :P = @ ) , but there was no statistical significance between the two groups at each time point postoperatively ( P = @ ) .


OSDI scores were significantly decreased in @ months after operation in both groups ( simple resection group :@ @ ; resection and fixation group :@ @ ) compared with those before operation ( simple resection group :@ @ ; resection and fixation group :@ @ ) .


Both of the differences were statistically significant ( simple resection group : t = @ , P < @ ; resection and fixation group : t = @ , P < @ ) , but there was no statistically significant difference between the two groups on month @ postoperatively ( t = @ , P = @ ) .


Both conjunctival resection and conjunctival resection with sclera fixation can effectively improve symptoms , but the latter has a lower recurrence rate .


This paper presents the prevalence of health promotion in workplaces in Poland .


It characterises the undertaken ac tions , their rationale and perceived obstacles .


It analyses the diversity of these phenomena in the companies of different financial soundness and level of employment .


The study was conducted with the use of Computer Assisted Telephone Interview in @ on the representative national sample of @ workplaces hiring more than @ employees .


The data was compared with the results of the survey conducted in @ , with the use of a Paper and Pencil interview on @ similar companies .


Both studies have shown that @ % of the companies are concerned about their employees ' health to a greater extent than they are obliged to by the law .


At the same time , more than @ % of the companies have been introducing various modifications and health-oriented actions without definite health intentions .


Most companies improve their physical working environment , organise/sponsor medical services , sports activities and try to reduce stress and smoking .


Managers have increased their awareness of business benefits re ceived from health promotion .


They have displayed more personal involvement in health promotion implementation .


The most often mentioned obstacles have included limited financial resources and little interest of employees regarding health issues .


The larger and wealthier the company is , the more often health promotion in the company is performed .


Such a company is more convinced about an increase in its activities and has more reasons to care about health .


Unequal access to health promotion of wor kers in different companies may contribute to an increase in health inequalities in the working population .


The objective was to test the hypothesis that hydrocodone/acetaminophen ( Vicodin -LSB- @/@ -RSB- ) provides more efficacious analgesia than codeine/acetaminophen ( Tylenol # @ -LSB- @/@ -RSB- ) in patients discharged from the emergency department ( ED ) .


Both are currently Drug Enforcement Administration ( DEA ) Schedule III narcotics .


This was a prospective , randomized , double-blind , clinical trial of patients with acute extremity pain who were discharged home from the ED , comparing a @-day supply of oral hydrocodone/acetaminophen ( @ mg/@ mg ) to oral codeine/acetaminophen ( @ mg/@ mg ) .


Pain was measured on a valid and reproducible verbal numeric rating scale ( NRS ) ranging from @ to @ , and patients were contacted by telephone approximately @ hours after being discharged .


The primary outcome was the between-group difference in improvement in pain at @ hours following the most recent ingestion of the study drug , relative to the time of phone contact after ED discharge .


Secondary outcomes compared side-effect profiles and patient satisfaction .


The median time from ED discharge to follow-up was @ hours ( interquartile range -LSB- IQR -RSB- = @ to @ hours ) .


The mean NRS pain score before the most recent dose of pain medication after ED discharge was @ NRS units for both groups .


The mean decrease in pain scores @ hours after pain medications were taken were @ NRS units in the hydrocodone/acetaminophen group versus @ NRS units in the codeine/acetaminophen group , for a difference of @ NRS units ( @ % confidence interval -LSB- CI -RSB- = -@ to @ NRS units ) .


No differences were found in side effects or patient satisfaction .


Both medications decreased NRS pain scores by approximately @ % .


However , the oral hydrocodone/acetaminophen failed to provide clinically or statistically superior pain relief compared to oral codeine/acetaminophen when prescribed to patients discharged from the ED with acute extremity pain .


Similarly , there were no clinically or statistically important differences in side-effect profiles or patient satisfaction .


If the DEA reclassifies hydrocodone as a Schedule II narcotic , as recently recommended by its advisory board , our data suggest that the codeine/acetaminophen may be a clinically reasonable Schedule III substitute for hydrocodone/acetaminophen at ED discharge .


These findings should be regarded as tentative and require independent validation in similar and other acute pain models .


To demonstrate equivalence of polyquaternium-@-preserved travoprost @ % with benzalkonium chloride-preserved travoprost @ % in patients with open-angle glaucoma or ocular hypertension .


Double-masked , randomized , @-treatment , equivalence clinical trial .


setting : Multicenter clinical trial conducted in @ centers in the United States and Europe .


Adult patients with open-angle glaucoma or ocular hypertension .


One eye per patient was analyzed .


Patients were randomized @:@ to receive polyquaternium-@-preserved travoprost @ % ( n = @ ) or benzalkonium chloride-preserved travoprost @ % ( n = @ ) once daily for @ months .


Mean intraocular pressure ( IOP ) was assessed at @ AM , @ AM , and @ PM at week @ , week @ , and month @ .


Supportive outcomes were mean and percent IOP change , percentage of patients achieving IOP < @ mm Hg or @ % IOP reduction , and adverse events .


Mean IOP was similar between groups at all study visits ( travoprost @ % range , @-@ @ mm Hg ; travoprost @ % range , @-@ @ mm Hg ) .


Mean change ( least squares mean differences , -@ to @ mm Hg ; @ % confidence interval , -@ to @ mm Hg ) and percentage change ( travoprost @ % , @ % -@ % ; travoprost @ % , @ % -@ % ) from baseline were comparable .


The percentages of patients with IOP < @ mm Hg and @ % reduction of IOP were also similar .


Hyperemia was the most frequent treatment-related adverse event with both formulations ( travoprost @ % , @ % ; travoprost @ % , @ % ) .


In patients with open-angle glaucoma or ocular hypertension , polyquaternium-@-preserved travoprost @ % solution provided equivalent IOP-lowering efficacy to that of benzalkonium chloride-preserved travoprost @ % .


Physical fitness is a fundamental prerequisite for soccer players .


Kaempferia parviflora is an herbal plant that has been used in some Asian athletes with the belief that it might prevent fatigue and improve physical fitness .


This study aimed to determine the effects of Kaempferia parviflora on the physical fitness of soccer players .


Sixty soccer players who routinely trained at a sports school participated in a double-blind placebo-controlled trial and were randomly allocated to the treatment group or the placebo group .


The participants in both groups were given either @ mg of Kaempferia parviflora extract in capsules or a placebo once daily for @ weeks .


Baseline data were collected using the following @ tests of physical performance : a sit-and-reach test , a hand grip strength test , a back-and-leg strength test , a @-yard technical test , a @-metre sprint test , and a cardiorespiratory fitness test .


All of the tests were performed every @ weeks throughout the @-week study period .


The study showed that after treatment with Kaempferia parviflora , the right-hand grip strength was significantly increased at weeks @ , @ , and @ .


The left-hand grip strength was significantly increased at week @ .


However , the back-and-leg strength , the @-yard technical test , the sit-and-reach test , the @-metre sprint test , and the cardiorespiratory fitness test results of the treatment group were not significantly different from those of the placebo group .


Taking Kaempferia parviflora supplements for @ weeks may significantly enhance some physical fitness components in soccer players .


To further explore the impact of smoking on antiplatelet activity and treatment response , we evaluated time-dependent relationships between smoking status with on-treatment platelet reactivity and clinical outcomes for prasugrel vs. clopidogrel in patients with acute coronary syndromes managed medically without revascularization .


A total of @ patients aged < @ years from the primary TRILOGY ACS cohort randomized to prasugrel vs. clopidogrel were evaluated through @ months by baseline and time-dependent smoking status with adjusted proportional-hazards models .


A total of @ participants ( @ % ) -LSB- corrected -RSB- were included in a platelet function sub-study evaluating serial P@Y@ reaction unit ( PRU ) measurements .


Current smokers ( n = @ -LSB- @ % -RSB- ) at baseline had fewer comorbidities compared with non-smokers ; nearly half quit smoking during follow-up .


Although median on-treatment PRU values were lower with prasugrel vs. clopidogrel , persistent smokers had lower serial PRU values in both treatment groups compared with non-smokers , with no differential interaction of treatment response by smoking status .


The frequency of cardiovascular death , myocardial infarction , or stroke in current smokers was significantly lower with prasugrel ( @ % ) vs. clopidogrel ( @ % ) , but there was no difference in non-smokers ( @ % vs. @ % ) , with significant interaction between treatment and baseline smoking status ( P = @ ) .


Bleeding events occurred more frequently in prasugrel-treated patients with no significant interaction between treatment and baseline smoking status .


Among medically managed ACS patients < @ years of age , the risk of ischemic outcomes was significantly reduced with prasugrel vs. clopidogrel among smokers vs. non-smokers .


No interaction between on-treatment platelet reactivity and smoking status was found .


Hyperglycaemia could substantially increase the risk of ischaemic heart disease in patients with type @ diabetes .


We investigated whether intensive lowering of glucose concentrations affects risk .


We assessed @,@ adults aged @-@ years with established type @ diabetes , mean glycated haemoglobin A@c ( HbA@c ) concentration of @ mmol/mol ( @ % ) , and risk factors for ischaemic heart disease enrolled in the ACCORD trial .


Participants were assigned to intensive or standard therapy ( target HbA@c less than @ or @-@ mmol/mol -LSB- less than @ % or @-@ % -RSB- , respectively ) .


We assessed fatal or non-fatal myocardial infarction , coronary revascularisation , unstable angina , and new angina during active treatment ( mean @ years ) plus a further mean @ years .


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


Myocardial infarction was less frequent in the intensive than in the standard therapy group during active treatment ( hazard ratio -LSB- HR -RSB- @ , @ % CI @-@ ; p = @ ) and overall ( @ , @-@ ; p = @ ) .


Findings were similar for combined myocardial infarction , coronary revascularisation , and unstable angina ( active treatment HR @ , @ % CI @-@ , overall @@-@ ) and for coronary revascularisation alone ( @ , @-@ ) and unstable angina alone ( @ , @-@ ) during full follow-up .


With lowest achieved HbA@C concentrations included as a time-dependent covariate , all hazards became non-significant .


Raised glucose concentration is a modifiable risk factor for ischaemic heart disease in middle-aged people with type @ diabetes and other cardiovascular risk factors .


Different studies have reported the effectiveness of Web-based computer-tailored lifestyle interventions , but economic evaluations of these interventions are scarce .


The objective was to assess the cost-effectiveness and cost-utility of a sequential and a simultaneous Web-based computer-tailored lifestyle intervention for adults compared to a control group .


The economic evaluation , conducted from a societal perspective , was part of a @-year randomized controlled trial including @ study groups .


All groups received personalized health risk appraisals based on the guidelines for physical activity , fruit intake , vegetable intake , alcohol consumption , and smoking .


Additionally , respondents in the sequential condition received personal advice about one lifestyle behavior in the first year and a second behavior in the second year ; respondents in the simultaneous condition received personal advice about all unhealthy behaviors in both years .


During a period of @ months , health care use , medication use , absenteeism from work , and quality of life ( EQ-@D-@L ) were assessed every @ months using Web-based questionnaires .


Demographics were assessed at baseline , and lifestyle behaviors were assessed at both baseline and after @ months .


Cost-effectiveness and cost-utility analyses were performed based on the outcome measures lifestyle factor ( the number of guidelines respondents adhered to ) and quality of life , respectively .


We accounted for uncertainty by using bootstrapping techniques and sensitivity analyses .


A total of @ respondents were included in the analyses .


From a willingness to pay of @ per additional guideline met , the sequential intervention ( n = @ ) was likely to be the most cost-effective , whereas from a willingness to pay of @,@ , the simultaneous intervention ( n = @ ) was likely to be most cost-effective .


The control condition ( n = @ ) appeared to be preferred with regard to quality of life .


Both the sequential and the simultaneous lifestyle interventions were likely to be cost-effective when it concerned the lifestyle factor , whereas the control condition was when it concerned quality of life .


However , there is no accepted cutoff point for the willingness to pay per gain in lifestyle behaviors , making it impossible to draw firm conclusions .


Further economic evaluations of lifestyle interventions are needed .


The primary objective of this trial was to demonstrate , based on the estimated glomerular filtration rate ( eGFR ) , superior renal function at month @ after conversion of maintenance kidney transplant patients from calcineurin inhibitor ( CNI ) therapy to everolimus , compared to continuing a standard CNI regimen .


APOLLO was an open-label , @-month , prospective , multicenter study in which @ maintenance kidney transplant patients were randomized to convert from CNI to everolimus ( n = @ ) or remain on standard CNI-based immunosuppression ( n = @ ) .


The primary efficacy variable was eGFR ( Nankivell formula ) @ months after randomization .


The study was terminated prematurely due to slow recruitment and was thus underpowered .


Mean time post-transplant was @ months with everolimus and @ months with CNI .


Adjusted values for eGFR ( Nankivell ) at month @ were @ ( @ % CI @ , @ ) mL / min/@ @ m with everolimus and @ ( @ % CI @ , @ ) mL/min/@ @ m with CNI , a difference of @ ( @ % CI -@ , @ ) mL / min/@ @ m ( p = @ ) i.e. , the primary objective was not met .


Using the modification of diet in renal disease ( MDRD ) formula , adjusted eGFR at month @ was significantly higher with everolimus ( p = @ ) .


In the subpopulation who remained on the study drug ( n = @ ) , the difference in the adjusted change from randomization was @ ( @ % CI @ , @ ) mL/min/@ @ m ( p = @ ) in favor of everolimus .


There was no biopsyproven acute rejection and no graft losses .


Adverse events led to discontinuation of everolimus and CNI in @ % and @ % of patients , respectively .


Conversion from CNI to everolimus to preserve renal function can be considered several years after kidney transplantation and does not compromise immunosuppressive efficacy .


We evaluated whether remote ischemic postconditioning ( RiPoC ) could improve initial graft function in living donor kidney transplantation ( KT ) .


Patients undergoing living donor KT were randomly assigned to either RiPoC ( n = @ ) or control group ( n = @ ) .


Immediately after reperfusion in the RiPoC group , three cycles of ischemia and reperfusion , lasting @ min each , were performed on one upper limb .


Renal function was assessed before surgery , @ hr after surgery , and at @-hr intervals for @ hr postsurgery by measuring serum creatinine ( sCr ) and the estimated glomerular filtration rate ( eGFR ) .


Urine output and urine creatinine were assessed until postoperative day @ , and hospital stay and complication rates were compared .


The time for sCr to reach @ % of its preoperative level was significantly shorter in the RiPoC group than in the control group -LSB- @ ( @-@ ) hr for RiPoC vs. @ ( @-@ ) hr for the control , P = @ -RSB- .


The number of patients whose sCr was reduced by @ % within @ hr was significantly greater in the RiPoC group than in the control group -LSB- n = @ ( @ % ) in RiPoC vs. n = @ ( @ % ) in control , P = @ -RSB- .


However , there were no differences in sCr and eGFR thereafter , the incidence of graft dysfunction or complication rates between groups .


In this study , RiPoC appeared to hasten the recovery of graft function within @ hr but did not affect the graft function thereafter .


However , considering most recipients had immediate graft function , further studies with deceased donors or studies powered to detect a smaller difference are needed .


Conjugated linoleic acid ( CLA ) , a C@ fatty acid with conjugated double bonds , has been shown to serve as a powerful anti-obesity agent by several research groups , although the precise mechanism remains elusive .


Previous studies showed that CLA induced apoptosis in @T@-L@ cells and in mice .


The aim of this research was to clarify the role of CLA in adipocyte apoptosis in pigs , a relevant model for obesity research .


Our results clearly show that back fat deposition of CLA-fed pigs was significantly lower than that of pigs in the control group .


Moreover , some typical apoptotic cells were observed among the adipocytes of CLA-fed pigs .


Furthermore , the CLA-fed pigs had reduced expression of the anti-apoptosis factor Bcl-@ and increased expression of the pro-apoptosis factors Bax and P@ .


Subsequently , increased cytochrome C was released from the mitochondria to the endochylema , and the caspase cascade was activated , resulting in cellular apoptosis .


These results are consistent with the effects of Bcl-@ and Bax in regulating CLA-induced adipocyte apoptosis via the mitochondrial signaling pathway .


However , the increased expression of tumor necrosis factor ( TNF ) - and its receptor TNFR indicate that the effect of CLA might partly be through the death receptor signaling pathway in adipose cells .


Our study has demonstrated that CLA reduces pig body fat deposition , an outcome that is partly meditated by apoptosis of adipose cells , and that both the mitochondrial pathway and the death receptor pathway are involved in this effect .


Despite administration of annual influenza vaccination , influenza-associated complications in transplant recipients continue to be an important cause of hospitalization and death .


Although influenza vaccination has been proven to be the most effective measure to reduce influenza infection after transplantation , transplant recipients are still vulnerable to influenza infections , with lower serological responses to vaccination compared to the general population .


In order to assess the efficacy and safety of an alternative immunization scheme for solid organ transplant recipients , the TRANSGRIPE@-@ Study Group aimed to test a booster dose administration @ weeks after the standard vaccination .


The primary objective of this trial was to compare short-term and long-term neutralizing antibody immunogenicity of a booster dose of influenza vaccination to the standard single-dose immunization scheme .


Secondary objectives included the evaluation of the efficacy and/or safety , cellular immune response , incidence of influenza infection , graft rejection , retransplant and mortality rates .


This phase III , randomized , controlled , open-label clinical trial was conducted between October @ and December @ in @ Spanish public referral hospitals .


Solid organ transplant recipients ( liver , kidney , heart or lung ) , older than @ years of age more than @ days after transplantation were eligible to participate .


Patients ( N = @ ) were stratified @:@ by center , type of organ and time after transplantation and who either received the standard single dose ( n = @ ) or were treated according to a novel influenza vaccination schedule comprising the administration of a booster dose @ weeks after standard vaccination ( n = @ ) .


Seroconversion rates were measured as a determinant of protection against influenza ( main outcome ) .


Efficacy and safety outcomes were followed until @ year after influenza vaccination with assessment of short-term ( @ , @ , @ and @ weeks ) and long-term ( @ months ) results .


Intention-to-treat , per-protocol and safety analyses will be performed .


This trial will increase knowledge about the safety and efficacy of a booster dose of influenza vaccine in solid organ transplant recipients .


At the time the manuscript was submitted for publication , trial recruitment was closed with a total of @ participants included during a @-month period ( within the seasonal influenza vaccination campaign ) .


This study investigates the reliability of muscle performance tests using cost - and time-effective methods similar to those used in clinical practice .


When conducting reliability studies , great effort goes into standardising test procedures to facilitate a stable outcome .


Therefore , several test trials are often performed .


However , when muscle performance tests are applied in the clinical setting , clinicians often only conduct a muscle performance test once as repeated testing may produce fatigue and pain , thus variation in test results .


We aimed to investigate whether cervical muscle performance tests , which have shown promising psychometric properties , would remain reliable when examined under conditions similar to those of daily clinical practice .


The intra-rater ( between-day ) and inter-rater ( within-day ) reliability was assessed for five cervical muscle performance tests in patients with ( n = @ ) and without neck pain ( n = @ ) .


The five tests were joint position error , the cranio-cervical flexion test , the neck flexor muscle endurance test performed in supine and in a @-upright position and a new neck extensor test .


Intra-rater reliability ranged from moderate to almost perfect agreement for joint position error ( ICC@-@ @ ) , the cranio-cervical flexion test ( ICC@ @ ) , the neck flexor muscle endurance test performed in supine ( ICC@ @ ) and in a @-upright position ( ICC@ @ ) with the exception of a new test ( neck extensor test ) , which ranged from slight to moderate agreement ( ICC = @-@ @ ) .


Likewise , inter-rater reliability ranged from moderate to almost perfect agreement for joint position error ( ICC@-@ @ ) , the cranio-cervical flexion test ( ICC@ @ ) , the neck flexor muscle endurance test performed in supine ( ICC@ @ ) and in a @-upright position ( ICC@ @ ) .


However , only slight to fair agreement was found for the neck extensor test ( ICC = @-@ @ ) .


Intra - and inter-rater reliability ranged from moderate to almost perfect agreement with the exception of a new test ( neck extensor test ) , which ranged from slight to moderate agreement .


The significant variability observed suggests that tests like the neck extensor test and the neck flexor muscle endurance test performed in a @-upright position are too unstable to be used when evaluating neck muscle performance .


To explore the mechanisms involved in the ligustrazine alleviation of the pulmonary artery hypertension ( PAH ) in patients of chronic obstructive pulmonary disease ( COPD ) associated with chronic cor pulmonale ( CCP ) during exacerbation .


Seventy patients of COPD and CCP with acute exacerbation were randomly and equally divided into control group and treatment group .


The control group received standard treatment with antibiotics , antiasthmatic and expectorant medications , and oxygenation ; and the ligustrazine treatment group received ligustrazine treatment ( @ mg/d ; i.v. ; for @ weeks ) in addition to the standard treatment .


Before and at the end of @ week treatment , the clinic responses of the two regimens were evaluated , plasma levels of endothelin-@ ( ET-@ ) and nitric oxide ( NO ) were determined ; arterial oxygen partial pressure ( PaO@ , mean pulmonary arterial pressure ( mPAP ) , outflow tract of right ventricle ( RVOT ) , and internal diameter of right ventricle ( RV ) were measured .


Good clinic benefits were achieved in both the standard and ligustrazine regimens , plasma level of ET-@ , values of mPAP , RV and RVOT decreased significantly , plasma level of NO and PaO@ values decreased ( all P < @ vs pre-treatment to all parameters ) .


Compared with the control group , ligustrazine greatly enhanced the clinic efficacy from @ % to @ % ( P < @ ) , and also resulted in more significant changes of all these parameters ( P < @ vs control group for all parameters ) .


For both groups , the levels of plasma ET-@ were positively correlated with values of mPAP , RVOT , and RV ( r = @ , @ , and @ , respectively , all P = @ ) , and negatively correlated with plasma NO and PaO@ ( r = - @ , and - @ , respectively , all P = @ ) .


Ligustrazine is effective in treating pulmonary artery hypertension during acute exacerbation of COPD and CCP in patients from the plateau area .


The observed changes in the plasma levels of NO and ET-@ in response to ligustrazine treatment suggest that ligustrazine may act through the selective effect on pulmonary blood vessels to enhance the synthesis and release of NO and suppress those of ET-@ from lung vascular endothelial cells , thus reducing pulmonary artery pressure and decreasing pulmonary arterial hypertension .


In patients with mild gallstone pancreatitis , cholecystectomy during the same hospital admission might reduce the risk of recurrent gallstone-related complications , compared with the more commonly used strategy of interval cholecystectomy .


However , evidence to support same-admission cholecystectomy is poor , and concerns exist about an increased risk of cholecystectomy-related complications with this approach .


In this study , we aimed to compare same-admission and interval cholecystectomy , with the hypothesis that same-admission cholecystectomy would reduce the risk of recurrent gallstone-related complications without increasing the difficulty of surgery .


For this multicentre , parallel-group , assessor-masked , randomised controlled superiority trial , inpatients recovering from mild gallstone pancreatitis at @ hospitals in the Netherlands ( with hospital discharge foreseen within @ h ) were assessed for eligibility .


Adult patients ( aged @ years ) were eligible for randomisation if they had a serum C-reactive protein concentration less than @ mg/L , no need for opioid analgesics , and could tolerate a normal oral diet .


Patients with American Society of Anesthesiologists ( ASA ) class III physical status who were older than @ years of age , all ASA class IV patients , those with chronic pancreatitis , and those with ongoing alcohol misuse were excluded .


A central study coordinator randomly assigned eligible patients ( @:@ ) by computer-based randomisation , with varying block sizes of two and four patients , to cholecystectomy within @ days of randomisation ( same-admission cholecystectomy ) or to discharge and cholecystectomy @-@ days after randomisation ( interval cholecystectomy ) .


Randomisation was stratified by centre and by whether or not endoscopic sphincterotomy had been done .


Neither investigators nor participants were masked to group assignment .


The primary endpoint was a composite of readmission for recurrent gallstone-related complications ( pancreatitis , cholangitis , cholecystitis , choledocholithiasis needing endoscopic intervention , or gallstone colic ) or mortality within @ months after randomisation , analysed by intention to treat .


The trial was designed to reduce the incidence of the primary endpoint from @ % in the interval group to @ % in the same-admission group .


Safety endpoints included bile duct leakage and other complications necessitating re-intervention .


This trial is registered with Current Controlled Trials , number ISRCTN@ , and is complete .


Between Dec @ , @ , and Aug @ , @ , @ inpatients from @ hospitals in the Netherlands were randomly assigned to interval cholecystectomy ( n = @ ) or same-admission cholecystectomy ( n = @ ) .


One patient from each group was excluded from the final analyses , because of an incorrect diagnosis of pancreatitis in one patient ( in the interval group ) and discontinued follow-up in the other ( in the same-admission group ) .


The primary endpoint occurred in @ ( @ % ) of @ patients in the interval group and in six ( @ % ) of @ patients in the same-admission group ( risk ratio @ , @ % CI @-@ ; p = @ ) .


Safety endpoints occurred in four patients : one case of bile duct leakage and one case of postoperative bleeding in each group .


All of these were serious adverse events and were judged to be treatment related , but none led to death .


Compared with interval cholecystectomy , same-admission cholecystectomy reduced the rate of recurrent gallstone-related complications in patients with mild gallstone pancreatitis , with a very low risk of cholecystectomy-related complications .


Umbilical Mesenchymal Stem Cells possess immunoregulatory capacities that have been permissive to allogenic transplantation .


Recent animal studies have demonstrated histologically that bone marrow - derived mesenchymal stem cells ( MSCs ) may enhance the regeneration of periodontal defects in dogs by differentiating MSCs into cementoblasts , osteoblasts and periodontal fibroblasts .


To compare the clinical efficacy between stem cells in combination with PLA/PGA membrane and subepithelial connective tissue graft ( SCTG ) in the treatment of multiple gingival recession defects .


Twenty four patients aged between @ to @ years ( mean age @ @ years ) with multiple gingival recession defects on labial or buccal surface of the teeth in the aesthetic zone either in maxilla or mandible were treated .


The test group was treated using stem cells cultured on bioresorbable PLA/PGA membrane , while control group was treated using SCTG .


Following parameters were assessed , Plaque Index ( PI ) , Gingival Bleeding Point Index ( GBI ) , Relative gingival margin level ( RGML ) , Relative attachment level ( RAL ) and Probing pocket depth ( PPD ) Results : In the test group , mean percent defect coverage was @ @ % and the predictability was @ % for root coverage i.e @ of @ defects , while in the control group , mean percent defect coverage was @ @ % and the predictability was @ % for root coverage i.e @ of @ defects .


Stem cells in combination with bioresorbable PLA/PGA membrane was effective for root coverage resulted in a significant reduction in gingival recession , greater gain in CAL and WKG .


Stem cells in combination with bioresorbable PLA/PGA membrane resulted in significantly higher CAL gain than SCTG .


Laparoscopic adhesiolysis is emerging as an alternative for open surgery in adhesive small bowel obstruction .


Retrospective studies suggest that laparoscopic approach shortens hospital stay and reduces complications in these patients .


However , no prospective , randomized , controlled trials comparing laparoscopy to open surgery have been published .


This is a multicenter , prospective , open label , randomized , controlled trial comparing laparoscopic adhesiolysis to open surgery in patients with computed-tomography diagnosed adhesive small bowel obstruction that is not resolving with conservative management .


The primary study endpoint is the length of postoperative hospital stay in days.Sample size was estimated based on preliminary retrospective cohort , which suggested that @ patients would provide @ % power to detect a difference of @ days in the length of postoperative hospital stay with significance level of @ .


Secondary endpoints include passage of stool , commencement of enteral nutrition , @-day mortality , complications , postoperative pain , and the length of sick leave .


Tertiary endpoints consist of the rate of ventral hernia and the recurrence of small bowel obstruction during long-term follow-up .


Long-term follow-up by letter or telephone interview will take place at @ , @ , and @ years .


To the best of our knowledge , this trial is the first one aiming to provide level Ib evidence to assess the use of laparoscopy in the treatment of adhesive small bowel obstruction .


The prevalence of childhood obesity and insulin resistance is rising , increasing the risk of diabetes mellitus type @ .


To prevent these complications , lifestyle intervention is the corner stone in treatment .


However , long-term efficacy of lifestyle intervention is questionable .


In addition to lifestyle intervention , pharmacological treatments have been explored .


Metformin has been shown to be moderately effective to reduce BMI in obese adolescents with hyperinsulinemia .


However , data on pharmacokinetics and long-term efficacy and safety are lacking as well as an evidence-based dosing regimen for this age group .


The primary objective of the METFORMIN study is to determine the effect of adding metformin treatment to lifestyle intervention in reducing BMI in obese adolescents with insulin resistance .


In addition , the pharmacokinetics of metformin in obese adolescents will be studied .


The METFORMIN study is a multi-centre prospective study that consists of two @-month phases : a double-blind randomized placebo-controlled trial ( part @ ) and an open-label follow-up study ( part @ ) .


During part @ , the participants will be given metformin @,@ mg or placebo twice daily and will be offered a lifestyle intervention programme ; @ participants will be included , @ in each arm .


Primary endpoints are reduction in body mass index , insulin resistance , and percentage body fat .


This study will provide data on short - and long-term efficacy and safety of metformin and on the pharmacokinetics of metformin in obese adolescents .


Practicing evidence-based medicine is an important aspect of providing good medical care .


Accessing external information through literature searches on computer-based systems can effectively achieve integration in clinical care .


We conducted a pilot study using smartphones , tablets , and stationary computers as search devices at the bedside .


The objective was to determine possible differences between the various devices and assess students ' internet use habits .


In a randomized controlled pilot study , @ students were divided in three groups .


One control group solved clinical problems on a computer and two intervention groups used mobile devices at the bedside .


In a questionnaire , students were asked to report their internet use habits as well as their satisfaction with their respective search tool using a @-point Likert scale .


Of @ surveys , @ ( @ % ) complete data sets were analyzed .


The mobility of the tablet ( @ ) and the smartphone ( @ ) was seen as a significant advantage over the computer ( @ , p < @ ) .


However , for performing an effective literature search at the bedside , the computer ( @ ) was rated superior to both tablet computers ( @ ) and smartphones ( @ ) .


No significant differences were detected between tablets and smartphones except satisfaction with screen size ( tablet @ , smartphone @ , p < @ ) .


Using a mobile device at the bedside to perform an extensive search is not suitable for students who prefer using computers .


However , mobility is regarded as a substantial advantage , and therefore future applications might facilitate quick and simple searches at the bedside .


Isoflavone supplements , consumed by women experiencing menopausal symptoms , are suggested to have positive effects on menopause-related adiposity and cardiovascular disease risk profile , but discussions about their safety are still ongoing .


The objective was to study the effects of an @-wk consumption of @ different isoflavone supplements compared with placebo on whole-genome gene expression in the adipose tissue of postmenopausal women .


This double-blind , randomized , placebo-controlled crossover intervention consisted of @ substudies , one with a low-genistein ( LG ) supplement ( @ % daidzein + daidzin , @ % genistein + genistin , and @ % glycitein + glycitin ) and the other with a high-genistein ( HG ) supplement ( @ % daidzein + daidzin , @ % genistein + genistin , and @ % glycitein + glycitin ) .


Both supplements provided @ mg isoflavones/d ( aglycone equivalents ) .


After the @-wk isoflavone and placebo period , whole-genome arrays were performed in subcutaneous adipose tissue of postmenopausal women ( n = @ after LG , n = @ after HG ) .


Participants were randomized by equol-producing phenotype , and data analysis was performed per substudy for equol producers and nonproducers separately .


Gene set enrichment analysis showed downregulation of expression of energy metabolism-related genes after LG supplementation ( n = @ ) in both equol-producing phenotypes and oppositely regulated expression for equol producers ( down ) and nonproducers ( up ) after HG supplementation ( n = @ ) .


Expression of inflammation-related genes was upregulated in equol producers but downregulated in nonproducers , independent of supplement type .


Only @-@ @ % of the genes with significantly changed expression were estrogen responsive .


Body weight , adipocyte size , and plasma lipid profile were not affected by isoflavone supplementation .


Effects of isoflavones on adipose tissue gene expression were influenced by supplement composition and equol-producing phenotype , whereas estrogen-responsive effects were lacking .


LG isoflavone supplementation resulted in a caloric restriction-like gene expression profile for both producer phenotypes and pointed toward a potential beneficial effect , whereas both supplements induced anti-inflammatory gene expression in equol producers .


The study was registered at clinicaltrials.gov as NCT@ .


To confirm the non-inferiority of the IOP-lowering effect of the @ % Tafluprost ophthalmic solution to the @ % Latanoprost ophthalmic solution in patients with primary open-angle glaucoma or ocular hypertension.Safety was also compared between two groups .


This study was conducted from August @ to December @ , at five clinical trial sites in China .


Patients of this study population was diagnosed with primary open-angle glaucoma or ocular hypertension in both eyes.Subjects were randomized into @ % Tafluprost group or @ % Latanoprost group.Intraocular pressure ( IOP ) measurement by Goldmann applanation tonometer , slit-lamp microscopy , Gonioscopy , Fundascopy , Visual acuity test , Perimetry , Blood pressure and pulse rate , Subjective symptoms were compered between two groups at Week @ , Week @ and Week @ .


For main effectiveness evaluation index adopt the bad effect evaluation , safety evaluation index by Fisher 's exact test probability method .


The @ subjects/@ eyes were randomized ( Tafluprost group :@ subjects/@ eyes , Latanoprost group :@ subjects / @ eyes ) .


Change in the IOP at @:@ of Week @ is ( @ @ ) mmHg and ( @ @ ) mmHg ( @ mmHg = @ kPa ) in Tafluprost group and Latanoprost group .


Percent change in the IOP at @:@ of Week @ is ( @ @ ) % and ( @ @ ) % in Tafluprost group and Latanoprost group .


Change in the IOP at @:@ at the end of treatment is ( @ @ ) mmHg and ( @ @ ) mmHg in Tafluprost group and Latanoprost group .


Percent change in the IOP at @:@ at the end of treatment is @ % @ % group and @ % @ % in Tafluprost and Latanoprost group.In addition , distribution of subjects with percentage decrease of IOP > @ % was @ % in Tafluprost group higher than @ % in Latanoprost group .


The major adverse reactions were conjunctival hyperemia , eye irritation , eye pain and foreign body sensation .


The incidence of adverse reactions is @ % in Tafluprost group and @ % in Latanoprost group .


The inter-group difference had no statistical significance .


Efficacy and safety of Tafluprost ophthalmic solution are no less than Latanoprost ophthalmic solution in patients with primary open-angle glaucoma or ocular hypertension .


Disease-modifying biological agents and other drug regimens have substantially improved control of disease activity and joint damage in people with rheumatoid arthritis of the hand .


However , commensurate changes in function and quality of life are not always noted .


Tailored hand exercises might provide additional improvements , but evidence is lacking .


We estimated the effectiveness and cost-effectiveness of tailored hand exercises in addition to usual care during @ months .


In this pragmatic , multicentre , parallel-group trial , at @ National Health Service sites across the UK we randomly assigned @ adults with rheumatoid arthritis who had pain and dysfunction of the hands and had been on a stable drug regimen for at least @ months , to either usual care or usual care plus a tailored strengthening and stretching hand exercise programme .


Participants were randomly assigned with stratification by centre .


Allocation was computer generated and unmasked to participants and therapists delivering treatment after randomisation .


Outcome assessors and all investigators were masked to allocation .


Physiotherapists or occupational therapists gave the treatments .


The primary outcome was the Michigan Hand Outcomes Questionnaire overall hand function score at @ months .


The analysis was by intention to treat .


We calculated cost per quality-adjusted life-year .


This trial is registered as ISRCTN @ .


Between Oct @ , @ , and May @ , @ , we screened @ people , of whom @ were randomly assigned to usual care ( n = @ ) or tailored exercises ( n = @ ) .


@ of @ participants ( @ % ) provided @ month follow-up data .


Improvements in overall hand function were @ points ( @ % CI @-@ ) in the usual care group and @ points ( @-@ ) in the exercise group ( mean difference between groups @ , @ % CI @-@ ; p = @ ) .


Pain , drug regimens , and health-care resource use were stable for @ months , with no difference between the groups .


No serious adverse events associated with the treatment were recorded .


The cost of tailored hand exercise was @ per person ; cost per quality-adjusted life-year was @ with the EQ-@D ( @,@ with imputation for missing data ) .


We have shown that a tailored hand exercise programme is a worthwhile , low-cost intervention to provide as an adjunct to various drug regimens .


Maximisation of the benefits of biological and DMARD regimens in terms of function , disability , and health-related quality of life should be an important treatment aim .


A pegylated recombinant human granulocyte colony-stimulating factor ( G-CSF ) is effective in reducing the severity and duration of neutropenia .


This study was performed to investigate the pharmacokinetics ( PK ) , pharmacodynamics ( PD ) , and tolerability of GCPGC , a new formulation of pegylated G-CSF , in healthy volunteers and to compare them with those of pegfilgrastim ( Neulasta ) .


Twenty-five healthy Korean male volunteers randomly received a single subcutaneous ( SC ) GCPGC injection at a dose of @ ( n = @ ) , @ ( n = @ ) , or @ ( n = @ ) g/kg or placebo in a @:@ ratio in a double-blind manner .


Additionally , @ subjects received a SC dose of pegfilgrastim at @ g/kg .


Blood samples were collected up to @ days after both therapies .


The absolute neutrophil count ( ANC ) and CD@ ( + ) cell counts were the PD markers .


After GCPGC administration , @ different pharmacokinetic phases were identified , indicating target-mediated drug disposition ( TMDD ) for the elimination of GCPGC , which was slowed down as the dose was increased , resulting in a higher than proportional dose-normalized exposure to GCPGC .


Although GCPGC was cleared faster than pegfilgrastim , leading to a @ % lower systemic exposure to pegylated G-CSF , the increase in ANC and CD@ ( + ) were ~ @ % greater by GCPGC at @ g/kg than pegfilgrastim .


Thrombocytopenia , splenomegaly , and hemoperitoneum occurred in one subject in the @ g/kg GCPGC group , which resolved completely with appropriate care .


GCPGC showed a non-linear TMDD .


The PK-PD characteristics of GCPGC at @-@ g/kg were comparable to those of pegfilgrastim at @ g/kg .


GCPGC at @-@ g/kg was well tolerated in healthy Korean males .


Additional treatment with clarithromycin ( CAM ) reduced persistent middle ear inflammation after acute otitis media ( AOM ) caused by Haemophilus influenzae in children .


CAM is a treatment option for persistent inflammation following AOM and to prevent continuing otitis media with effusion .


We conducted a clinical study to evaluate a new method of treatment for persistent inflammation after AOM in children .


H. influenzae-infected children with AOM were treated acutely with antimicrobial agents , after which those still demonstrating effusion of the middle ear cavity received additional treatment with carbocysteine ( S-CMC ) alone or S-CMC combined with clarithromycin ( CAM ) for @ week .


The two regimens were compared in terms of clinical effects .


After the initial acute treatment , many patients still showed abnormal otoscopic findings .


At the completion of additional treatment , there were no significant differences between the two treatment groups .


However , @ week after completion of additional treatment , the prevalence of a diminished light reflex was significantly lower in the CAM + S-CMC group than in the S-CMC group ( p = @ ) .


The prevalence of redness of the tympanic membrane also tended to be lower in the combined treatment group than in those receiving a single drug ( p = @ ) .


A number of people are reporting an environmental sensitivity to sub-audible windfarm sound ( infrasound ) , characterised by the experience of recurrent non-specific symptoms .


A causal link between exposure and symptoms is not indicated by empirical evidence .


Research indicates symptoms may be explained by the nocebo response , whereby health concerns and negative expectations , created from social discourse and media reports , trigger symptom reporting .


The experimental aim was to test whether providing a nocebo explanation for symptoms , to individuals reporting symptomatic experiences during infrasound exposure , would ameliorate symptoms during further exposure .


Sixty-six volunteers were randomly assigned to nocebo explanation or biological explanation groups .


Participants were concurrently exposed to infrasound and audible windfarm sound , while reporting on current symptoms and mood , during two exposure sessions .


Preceding session one , participants watched a presentation integrating media warnings about purported health risks posed by windfarm infrasound .


Before session two , nocebo explanation participants viewed material outlining how nocebo responding could explain symptom reporting .


Instead biological explanation participants watched material presenting pathophysiological theories for symptoms .


During session one , participants reported increased symptoms and mood deterioration from baseline assessment .


During session two symptom reporting and mood deterioration was maintained by biological explanation participants , while mood and symptoms reported by nocebo explanation participants returned to baseline levels .


Results indicate that providing an explanation of the nocebo response , followed by exposure to infrasound , has the potential to operate as an intervention to reduce symptomatic experiences in people reporting symptoms attributed to windfarm generated infrasound .


The aim of the study was to examine the effect of a very short-term training program on the immediate and late changes in the fitness level of young soccer players during the pre-season period .


Twenty-four young ( @-@ years ) soccer players were randomly assigned to either an interval ( @ to @ X @ m ) or continuous ( @ to @ m ) training group , matched for total running distance .


While the number of intervals or total distance was reduced every day , speed was increased in each session throughout the five days of both training programs .


Each group performed @ m shuttle run , @ m sprint , @ X @ m run , @ m run and vertical jump test , before ( pre ) , immediately after ( post ) and @ days after ( late ) completion of five successive training days during the preseason period for the upcoming soccer season .


There was a significant increase in aerobic capacity both immediately post-training and in the late test , in both training groups .


We found a significantly greater reduced performance in the @ m run immediately following training in the interval compared to the continuous training group .


In addition , there was a decrease in vertical jump that was significantly greater in the interval compared to the continuous training group , both immediately post-training and in the late test .


Very short interval or continuous preseason training programs induce significant improvement in aerobic fitness but lead to stagnation or deterioration in anaerobic performance .


Considering the opposing effects of both training modes ( positive on the aerobic power but negative on the anaerobic performance ) , coaches should make their choices based on the relevant conditions at hand .


Accelerated partial breast irradiation ( APBI ) has been introduced as an alternative treatment method for selected patients with early stage breast cancer ( BC ) .


Intensity-modulated radiotherapy ( IMRT ) has the theoretical advantage of a further increase in dose conformity compared with three-dimensional techniques , with more normal tissue sparing .


The aim of this randomised trial is to compare the local recurrence and survival of APBI using the IMRT technique after breast-conserving surgery to conventional whole-breast irradiation ( WBI ) in early stage BC .


This study was performed at the University of Florence ( Florence , Italy ) .


Women aged more than @years affected by early BC , with a maximum pathological tumour size of @mm , were randomly assigned in a @:@ ratio to receive either WBI or APBI using IMRT .


Patients in the APBI arm received a total dose of @ Gy to the tumour bed in five daily fractions .


The WBI arm received @Gy in @ fractions , followed by a boost on the tumour bed of @Gy in five fractions .


The primary end-point was occurrence of ipsilateral breast tumour recurrences ( IBTRs ) ; the main analysis was by intention-to-treat .


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


A total of @ patients were randomised ( @ to external WBI and @ to APBI with IMRT ) between March @ and June @ .


At a median follow-up of @ years ( Interquartile Range ( IQR ) @-@ @ ) , the IBTR rate was @ % ( three cases ) in the APBI group ( @ % confidence interval ( CI ) @-@ @ ) and in the WBI group ( three cases ; @ % CI @-@ @ ) .


No significant difference emerged between the two groups ( log rank test p = @ ) .


We identified seven deaths in the WBI group and only one in the APBI group ( p = @ ) .


The @-year overall survival was @ % for the WBI group and @ % for the APBI group .


The APBI group presented significantly better results considering acute ( p = @ ) , late ( p = @ ) , and cosmetic outcome ( p = @ ) .


To our knowledge , this is the first randomised study using the IMRT technique for APBI delivery .


No significant difference in terms of IBTR and overall survival was observed between the two arms .


APBI displayed a significantly better toxicity profile .


Photodynamic therapy ( PDT ) is an effective and established treatment for actinic keratoses ( AK ) and nonmelanoma skin cancer .


The main side-effects of PDT are post-treatment erythema and oedema , and pain during illumination .


Severe erythema after PDT enhances the down time associated with the treatment .


To evaluate in a randomized intraindividual study whether use of a topical corticosteroid just before and just after PDT would reduce treatment-induced erythema compared with conventional PDT .


Twenty-two patients with multiple AKs in the face and scalp were treated with methyl aminolaevulinate PDT in two symmetrical areas .


One area was randomized to superpotent corticosteroid ( clobetasol propionate ) before and just after PDT .


Objective and visual erythema , protoporphyrin IX ( PpIX ) fluorescence and pain were evaluated .


Topical corticosteroid significantly reduced PDT-induced erythema ( P = @ ) .


The complete lesion response rate @ months after PDT , and PpIX fluorescence prior to illumination did not differ significantly between the two treated areas .


Superpotent corticosteroid before and just after PDT reduced the erythema @ h after treatment of multiple AKs on the face and scalp .


The use of topical corticosteroid did not affect the efficacy of PDT and may be an easy way to make PDT treatment of large visible areas more acceptable .


Determine the effects of high versus moderate workload on sleep physiology and neurobehavioral measures , during sleep restriction ( SR ) and no sleep restriction ( NSR ) conditions .


Ten-night experiment involving cognitive workload and SR manipulations .


Controlled laboratory environment .


Sixty-three healthy adults ( mean standard deviation : @ @ y ; @ females ) , age @-@ y.


Following three baseline @ h time in bed ( TIB ) nights , subjects were randomized to one of four conditions : high cognitive workload ( HW ) + SR ; moderate cognitive workload ( MW ) + SR ; HW + NSR ; or MW + NSR .


SR entailed @ consecutive nights at @ h TIB ; NSR entailed @ consecutive nights at @ h TIB .


Subjects received three workload test sessions/day consisting of @-min preworkload assessments , followed by a @-min ( MW ) or @-min ( HW ) workload manipulation comprised of visually based cognitive tasks , and concluding with @-min of postworkload assessments .


Experimental nights were followed by two @-h TIB recovery sleep nights .


Polysomnography was collected on baseline night @ , experimental nights @ , @ , and @ , and recovery night @ using three channels ( central , frontal , occipital -LSB- C@ , Fz , O@ -RSB- ) .


High workload , regardless of sleep duration , increased subjective fatigue and sleepiness ( all P < @ ) .


In contrast , sleep restriction produced cumulative increases in Psychomotor Vigilance Test ( PVT ) lapses , fatigue , and sleepiness and decreases in PVT response speed and Maintenance of Wakefulness Test ( MWT ) sleep onset latencies ( all P < @ ) .


High workload produced longer sleep onset latencies ( P < @ , d = @ ) and less wake after sleep onset ( P < @ , d = @ ) than moderate workload .


Slow-wave energy-the putative marker of sleep homeostasis-was higher at O@ than C@ only in the HW + SR condition ( P < @ ) .


High cognitive workload delayed sleep onset , but it also promoted sleep homeostatic responses by increasing subjective fatigue and sleepiness , and producing a global sleep homeostatic response by reducing wake after sleep onset .


When combined with sleep restriction , high workload increased local ( occipital ) sleep homeostasis , suggesting a use-dependent sleep response to visual work .


We conclude that sleep restriction and cognitive workload interact to influence sleep homeostasis .


In patients with cirrhosis and small hepatocellular carcinoma ( HCC ) , thermal ablation is currently recognized as an effective local treatment .


Among thermal procedures , radiofrequency ablation ( RFA ) is the most diffusely used and is the standard against which any new treatment should be compared .


In retrospective studies , laser ablation ( LA ) resulted as safe and effective as RFA .


Therefore , we performed a non-inferiority randomized trial comparing RFA with LA in patients with cirrhosis and HCC within Milan criteria .


Overall , @ patients with @ HCC nodules were randomly assigned to receive RFA or LA. .


The primary end-point was the proportion of complete tumor ablation ( CTA ) .


Secondary end-points were time to local progression ( TTLP ) and overall survival ( OS ) .


Per patient CTA rates after RFA and LA were @ % ( @ % CI , @-@ @ ) and @ % ( @-@ @ ) , respectively ( difference = @ % , @ % CI from -@ % to +@ % ) .


Per nodule CTA rates for RFA and LA were @ % ( @-@ @ ) and @ % ( @-@ @ ) , respectively ( difference = @ % , from -@ % to +@ % ) .


The mean TTLP was comparable between RFA group ( @ months ; @ % CI , @-@ @ ) and LA group ( @ months ; @ % CI , @-@ @ ) ( P = @ ) .


The mean OS was @ months in both groups and survival probability at @ and @ years was @ % and @ % in RFA group , and @ % and @ % in LA group .


LA resulted not inferior to RFA in inducing the CTA of HCC nodules and therefore it should be considered as an evaluable alternative for thermal ablation of small HCC in cirrhotic patients .


Refractory angina constitutes a clinical problem .


The aim of this study was to assess the safety and the feasibility of transendocardial injection of CD@ ( + ) cells to foster angiogenesis in patients with refractory angina .


In this randomized , double-blinded , multicenter controlled trial , eligible patients were treated with granulocyte colony-stimulating factor , underwent an apheresis and electromechanical mapping , and were randomized to receive treatment with CD@ ( + ) cells or no treatment .


The primary end point was the safety of transendocardial injection of CD@ ( + ) cells , as measured by the occurrence of major adverse cardiac and cerebrovascular event at @ months .


Secondary end points analyzed the efficacy .


Twenty-eight patients were included ( n = @ treatment ; n = @ control ) .


At @ months , @ patient in each group had ventricular fibrillation and @ patient in each group died .


One patient ( treatment group ) had a cardiac tamponade during mapping .


There were no significant differences between groups with respect to efficacy parameters ; however , the comparison within groups showed a significant improvement in the number of angina episodes per month ( median absolute difference , -@ -LSB- @ % confidence interval , -@ to -@ -RSB- ) and in angina functional class in the treatment arm but not in the control group .


At @ months , only @ simple-photon emission computed tomography ( SPECT ) parameter : summed score improved significantly in the treatment group at rest and at stress ( median absolute difference , -@ -LSB- @ % confidence interval , -@ to -@ -RSB- ) but not in the control arm .


Our findings support feasibility and safety of transendocardial injection of CD@ ( + ) cells in patients with refractory angina .


The promising clinical results and favorable data observed in SPECT summed score may set up the basis to test the efficacy of cell therapy in a larger randomized trial .


The goal of our study was to determine if lymph node activity could be visualized using a hybrid single-photon emission computed tomography/computed tomography ( SPECT/CT ) scanner with two commonly used colloidal lymphatic radiotracers -- @mTc-antimony sulfide colloid ( ASC ) and @mTc-filtered sulfur colloid ( FSC ) in the setting of low-stage non-small cell lung cancer ( NSCLC ) .


Patients undergoing CT-guided percutaneous lung biopsies for clinically suspected early-stage lung cancer were randomized to peri-lesional injection of @ MBq ( @ mL ) of either ASC or FSC .


SPECT/CT of the thorax was performed at either @ , @ , or @ h post-injection .


The images were reviewed to determine if lymph node activity separate from the injection site could be identified .


@ patients were included .


Lymph node activity was identified in @ % of patients .


A total of @ lymph nodes with activity were visualized including @ ipsilateral hilar , @ ipsilateral mediastinal , and @ distant locations .


No contralateral mediastinal or hilar activity was visualized .


There was a tendency to improved visualization with ASC and the longer @ h wait time .


Most patients also demonstrated significant pleural , tracheobronchial , and/or systemic activity .


SPECT/CT imaging can demonstrate lymph node activity separate from the injection site in at least some low-stage NSCLC patients with a perilesional injection of @mTc nanocolloid tracers .


Further investigation into the role of pre-operative lymphoscintigraphy with SPECT/CT in patients with lung cancer is warranted .


To explore the comprehensive program of integrated Chinese and western medicine in the treatment of cognitive impairment in earthquake brain injury .


The multi-central randomized controlled trial was adopted .


The qualified subjects were randomized into an acupuncture + rehabilitation group ( @ cases ) and a rehabilitation group ( @ cases ) .


In the acupuncture + rehabilitation group , acupuncture , hyperbaric oxygen ( HBO ) and cognitive rehabilitation training were combined as the comprehensive program of integrated Chinese and western medicine in the treatment .


In the rehabilitation group , HBO and cognitive rehabilitation training were adopted .


The efficacy and safety were assessed .


( @ ) After treatment of @ months , the intelligent state , cognitive function and activity of daily life of patients were improved in the both groups ( all P < @ ) .


( @ ) After treatment of @ months , the score of MMSE and the score of activity of daily life were ( @ + / - @ ) and ( @ + / - @ ) in the acupuncture + rehabilitation group , which were more significant as compared with ( @ + / - @ ) , ( @ + / - @ ) in the rehabilitation group , respectively ( both P < @ ) .


In @-month follow-up visit after treatment , the cognitive function and activity of daily life were improved continuously in the acupuncture + rehabilitation group , which was more significant as compared with the rehabilitation group ( P < @ , P < @ ) .


The integrated Chinese and western medicine of acupuncture , HBO and cognitive rehabilitation training is safe and effective in the treatment of cognitive impairment in earthquake brain injury .


The therapeutic effect is more advantageous as compared with the simple rehabilitation program of western medicine .


Urology clinical trials assessing bladder function have relied on the self-reported duration of the first uninterrupted sleep period ( FUSP ) as a proxy outcome for sleep , but the relationship between this measure and more conventional self-reported measures of sleep is unknown .


In this study , we examined the association between changes in FUSP and a widely used self-reported measure of sleep , the Pittsburgh Sleep Quality Index ( PSQI ) .


We conducted post hoc ( secondary ) analyses of unpublished data from a previously published randomized clinical trial ( NCT@ ) of desmopressin ( a medication used to treat nocturia ) and examined relationships between baseline and @-week change in FUSP and PSQI global and subscale scores for participants ( N = @ to N = @ ) having complete data .


Data indicated strong associations between change in PSQI global score and FUSP change in six of seven subscale scores .


A reduction of @ points in the PSQI global score was associated with a @-min lengthening of FUSP .


Results suggest that FUSP is a potentially valuable metric that correlates with changes in perceived sleep duration , depth , quality for the entire night , efficiency , latency , and daytime function .


An increase in FUSP was related to improvement in nearly all PSQI subscales .


The validity of this measure in the general population remains to be determined .


To evaluate the impact of a diet and physical activity intervention ( BeWEL ) on weight change in people with a body mass index > @ weight ( kg ) / height ( m ) ( @ ) at increased risk of colorectal cancer and other obesity related comorbidities .


Multicentre , parallel group , randomised controlled trial .


Four Scottish National Health Service health boards .


@ overweight or obese adults ( aged @ to @ years ) who had undergone colonoscopy after a positive faecal occult blood test result , as part of the national bowel screening programme , and had a diagnosis of adenoma confirmed by histopathology .


@ were randomised to intervention and @ to control .


Participants were randomised to a control group ( weight loss booklet only ) or @ month intervention group ( three face to face visits with a lifestyle counsellor plus monthly @ minute telephone calls ) .


A goal of @ % reduction in body weight was set and participants received a personalised energy prescription ( @ kJ ( @ kcal ) below that required for weight maintenance ) and bodyweight scales .


Motivational interviewing techniques explored self assessed confidence , ambivalence , and personal values concerning weight .


Behavioural strategies included goal setting , identifying intentions of implementation , self monitoring of body weight , and counsellor feedback about reported diet , physical activity , and weight change .


The primary outcome was weight change over @ months .


Secondary outcomes included changes in waist circumference , blood pressure , fasting cardiovascular biomarkers , and glucose metabolism variables , physical activity , diet , and alcohol consumption .


At @ months , data on the primary outcome were available for @ ( @ % ) participants in the intervention group and @ ( @ % ) in the control group .


Mean weight loss was @ kg ( SD @ ) ( @ % confidence interval @ to @ ) in the intervention group compared with @ kg ( SD @ ) ( @ to @ ) in the control group .


The group difference was @ kg ( @ % confidence interval @ to @ ) .


Differences between groups were significant for waist circumference , body mass index , blood pressure , blood glucose level , diet , and physical activity .


No reported adverse events were considered to be related to trial participation .


Significant weight loss can be achieved by a diet and physical activity intervention initiated within a national colorectal cancer screening programme , offering considerable potential for risk reduction of disease in older adults .


We tested the hypothesis that warm-humidified carbon dioxide ( CO@ ) insufflation would reduce postoperative pain and morphine requirement compared to cold-dry CO@ insufflation .


A double-blinded , randomized , controlled trial was conducted to compare warm , humidified CO@ and cold-dry CO@ .


Patients with benign uterine diseases were randomized to either treatment ( n = @ ) or control ( n = @ ) group during laparoscopically assisted vaginal hysterectomy .


Primary endpoints of the study were rest pain , movement pain , shoulder-tip pain , and cough pain at @ , @ , @ , @ , and @ hours postoperatively , measured by visual analogue scale .


Secondary outcomes were morphine consumption , rejected boli , temperature change , recovery room stay , and length of hospital stay .


There were no significant differences in all baseline characteristics .


Shoulder-tip pain at @ h postoperatively was significantly reduced in the intervention group .


Pain at rest , movement pain , and cough pain did not differ .


Total morphine consumption and rejected boli at @ h postoperatively were significantly higher in the control group .


Temperature change , recovery room stay , and length of hospital were similar .


Warm , humidified insufflation gas significantly reduces postoperative shoulder-tip pain as well as morphine demand .


This trial is registered with Clinical Trial Registration Number DRKS@ ( German Clinical Trials Register ( DRKS ) ) .


Research indicates that the chronic consumption of flavonoids is associated with cognitive benefits in adults with mild cognitive impairment and neurodegenerative disease , although to our knowledge , there have been no such studies in healthy older adults .


Furthermore , the effects of commonly consumed orange juice flavanones on cognitive function remain unexplored .


We investigated whether @ wk of daily flavanone-rich orange juice consumption was beneficial for cognitive function in healthy older adults .


High-flavanone ( @ mg ) @ % orange juice and an equicaloric low-flavanone ( @ mg ) orange-flavored cordial ( @ mL ) were consumed daily for @ wk by @ healthy older adults ( mean age : @ y ) according to a crossover , double-blind , randomized design separated by a @-wk washout .


Cognitive function , mood , and blood pressure were assessed at baseline and follow-up by using standardized validated tests .


Global cognitive function was significantly better after @-wk consumption of flavanone-rich juice than after @-wk consumption of the low-flavanone control .


No significant effects on mood or blood pressure were observed .


Chronic daily consumption of flavanone-rich @ % orange juice over @ wk is beneficial for cognitive function in healthy older adults .


The potential for flavanone-rich foods and drinks to attenuate cognitive decline in aging and the mechanisms that underlie these effects should be investigated .


Computer-delivered interventions have the potential to improve access to quality addiction treatment care .


The objective of this study was to evaluate the effectiveness of the Therapeutic Education System ( TES ) , an Internet-delivered behavioral intervention that includes motivational incentives , as a clinician-extender in the treatment of substance use disorders .


Adult men and women ( N = @ ) entering @ outpatient addiction treatment programs were randomly assigned to receive @ weeks of either treatment as usual ( N = @ ) or treatment as usual plus TES , with the intervention substituting for about @ hours of standard care per week ( N = @ ) .


TES consists of @ computerized interactive modules covering skills for achieving and maintaining abstinence , plus prize-based motivational incentives contingent on abstinence and treatment adherence .


Treatment as usual consisted of individual and group counseling at the participating programs .


The primary outcome measures were abstinence from drugs and heavy drinking ( measured by twice-weekly urine drug screens and self-report ) and time to dropout from treatment .


Compared with patients in the treatment-as-usual group , those in the TES group had a lower dropout rate ( hazard ratio = @ , @ % CI = @ , @ ) and a greater abstinence rate ( odds ratio = @ , @ % CI = @ , @ ) .


This effect was more pronounced among patients who had a positive urine drug or breath alcohol screen at study entry ( N = @ ) ( odds ratio = @ , @ % CI = @ , @ ) .


Internet-delivered interventions such as TES have the potential to expand access and improve addiction treatment outcomes .


Additional research is needed to assess effectiveness in non-specialty clinical settings and to differentiate the effects of the community reinforcement approach and contingency management components of TES .


Statins improve overall outcomes after noncardiac surgery .


The primary aim of the study was to determine whether use of perioperative atorvastatin reduced the rate of postoperative complications in patients undergoing pulmonary resection .


This was a prospective , randomized , placebo-controlled , double-blind trial of patients undergoing elective pulmonary resection who received atorvastatin ( @ mg daily ) or placebo beginning @ week before surgery and continued for @ week postoperatively .


Patient characteristics and postoperative complications were recorded .


Plasma inflammatory markers were sampled at baseline , in the post-anesthesia care unit , and on postoperative day @ .


Because of difficulty enrolling statin-naive patients , the study was stopped at the interim analysis .


Postoperative complications occurred in @ of @ patients ( @ % ) receiving placebo and in @ of @ patients ( @ % ) receiving atorvastatin ( P = @ ) .


For patients undergoing major anatomic resection , there were @ complications in @ of @ placebo-treated patients and @ complications in @ of @ atorvastatin-treated patients ( P = @ ) .


Plasma levels of C-reactive protein , tumor necrosis factor - , and myeloperoxidase did not differ between the @ treatment arms during the study .


After a @-week perioperative course of atorvastatin ( @ mg ) in statin-nave patients undergoing major pulmonary resection , we found evidence of a reduction in the number of clinically important cardiovascular and pulmonary complications compared with placebo .


These promising results merit evaluation in a larger , perhaps multicenter study .


Skin graft donor sites are notoriously painful , with potential complications of fluid loss , delayed healing , infection , and hypertrophic scarring , particularly in patients with burns or traumatic injury .


In this population , rapid epithelialization is critical to reducing morbidity and cost .


This prospective , randomized controlled trial compared the effects of @-kHz noncontact low-frequency ultrasound ( NLFU ) in addition to standard care ( SC ) with SC alone in subjects with split-thickness donor sites of @ to @ cm ( @ ) .


Standard care consisted of cleansing and moist wound dressings .


Outcomes measured were time to healing , defined as absence of drainage and full epithelialization ; pain and itching scores ; and recidivism rates .


Of @ patients enrolled ; @ were randomized and received a minimum of @ study treatments .


Median age was @ years , @ % were male , and @ % were burn patients .


Comorbidities included hypertension ( @ % ) , coronary artery disease ( @ % ) , pulmonary disease ( @ % ) , anemia ( @ % ) , and diabetes ( @ % ) .


Median donor site area was @ cm ( @ ) .


Noncontact low-frequency ultrasound and SC compared with SC demonstrated a mean time to heal of @ days vs @ days ( p = @ ) .


All NLFU+SC subjects had epithelialized by @ weeks compared with only @ % in SC .


Recidivism rates were @ % for NLFU+SC compared with @ % for SC .


Pain scores were reduced and significant differences in itching were observed .


Noncontact low-frequency ultrasound and SC compared with SC alone in the treatment of split-thickness donor sites demonstrated significant accelerated healing and reduced pain and itching .


Noncontact low-frequency ultrasound subjects experienced a better quality of healing with less incidence of infection and recidivism .


The aim of this analysis was to compare the effects of @ atypical antipsychotic agents , lurasidone ( @ mg/d or @ mg/d ) and quetiapine XR ( @ mg/d ) , on daytime alertness , and to evaluate the effects of daytime sleepiness on treatment outcomes in patients with an acute exacerbation of schizophrenia .


Patients who met Diagnostic and Statistical Manual of Mental Disorders , @th edition , text revision ( DSM-IV-TR ) criteria for schizophrenia were randomized to @ weeks of double-blind treatment with fixed doses of lurasidone @ mg/d ( n = @ ) , lurasidone @ mg/d ( n = @ ) , quetiapine XR @ mg/d ( n = @ ) , or placebo ( n = @ ) , all dosed once daily in the evening , with food .


Daytime sleepiness was assessed using the Epworth Sleepiness Scale ( ESS ) .


Daytime sleepiness improved in the lurasidone and placebo-treated groups but worsened in the quetiapine XR treatment group when compared to placebo ( p = @ ) and to either dose of lurasidone ( both p < @ ) .


Sedation associated with quetiapine XR treatment mediated an improvement in agitation -LSB- assessed by the Positive and Negative Syndrome Scale-Excitement ( PANSS-EC ) subscale -RSB- and a worsening in functional capacity -LSB- assessed by the University of California-San Diego ( UCSD ) Performance-Based Skills Assessment-Brief Version ( UPSA-B ) total score -RSB- ; these mediating relationships were not observed for the lurasidone or placebo treatment groups .


In this @-week double-blind study , treatment with lurasidone @ mg or @ mg , administered once daily in the evening , was associated with a reduction in daytime sleepiness similar in magnitude to placebo , while quetiapine XR @ mg/d was associated with a significant increase in daytime sleepiness , compared to both lurasidone dose groups and placebo .


Daytime sleepiness was associated with improvement in agitation and worsening in functional capacity for quetiapine XR , but not lurasidone or placebo-treated patients .


Distal upper limb pain ( pain affecting the elbow , forearm , wrist , or hand ) can be non-specific , or can arise from specific musculoskeletal disorders .


It is clinically important and costly , the best approach to clinical management is unclear .


Physiotherapy is the standard treatment and , while awaiting treatment , advice is often given to rest and avoid strenuous activities , but there is no evidence base to support these strategies .


This paper describes the protocol of a randomised controlled trial to determine , among patients awaiting physiotherapy for distal arm pain , ( a ) whether advice to remain active and maintain usual activities results in a long-term reduction in arm pain and disability , compared with advice to rest ; and ( b ) whether immediate physiotherapy results in a long-term reduction in arm pain and disability , compared with physiotherapy delivered after a seven week waiting list period .


Between January @ and January @ , new referrals to @ out-patient physiotherapy departments were screened for potential eligibility .


Eligible and consenting patients were randomly allocated to one of the following three groups in equal numbers : @ ) advice to remain active , @ ) advice to rest , @ ) immediate physiotherapy .


Patients were and followed up at @ , @ , and @ weeks post-randomisation by self-complete postal questionnaire and , at six weeks , patients who had not received physiotherapy were offered it at this time .


The primary outcome is the proportion of patients free of disability at @ weeks , as determined by the modified DASH ( Disabilities of the Arm , Shoulder and Hand ) questionnaire.We hypothesise ( a ) that advice to maintain usual activities while awaiting physiotherapy will be superior than advice to rest the arm ; and ( b ) that fast-track physiotherapy will be superior to normal ( waiting list ) physiotherapy .


These hypotheses will be examined using an intention-to-treat analysis .


Results from this trial will contribute to the evidence base underpinning the clinical management of patients with distal upper limb pain , and in particular , will provide guidance on whether they should be advised to rest the arm or remain active within the limits imposed by their symptoms .