Change in best-corrected visual acuity ( BCVA ) after cataract surgery compared with preoperative BCVA .


Adjusting for age at time of surgery , gender , interval between preoperative and postoperative visits , and type and severity of cataract , the mean changes in visual acuity were as follows : eyes with mild AMD ( n = @ ) gained @ letters ( @ % confidence interval -LSB- CI -RSB- , @-@ @ ) , eyes with moderate AMD ( n = @ ) gained @ letters ( @ % CI , @-@ @ ) , eyes with severe AMD ( n = @ ) gained @ letters ( @ % CI , @-@ @ ) , eyes with noncentral geographic atrophy ( n = @ ) gained @ letters ( @ % CI , @-@ @ ) , and eyes with advanced AMD ( central geographic atrophy , neovascular disease , or both ; n = @ ) gained @ letters ( @ % CI , @-@ @ ) .


The visual acuity gain across all AMD severity groups was statistically significant from preoperative values ( P < @ ) .


Mean visual acuities improved significantly after cataract surgery across varying degrees of AMD severity .


The objective of this study is to compare the effects of @ types of diuretics , indapamide and hydrochlorothiazide , added to an angiotensin-converting enzyme inhibitor , on ventricular and arterial functions in patients with hypertension and diabetes .


This is a prospective , randomized , active-controlled , PROBE design study in @ patients ( @ @ years , @ % men ) with mild-to-moderate hypertension and type @ diabetes , with normal ejection fraction , randomized to either indapamide ( @ mg Slow Release ( SR ) / day ) or hydrochlorothiazide ( @ mg/d ) , added to quinapril ( @-@ mg/d ) .


All patients had conventional , tissue Doppler and speckle tracking echocardiography and assessment of endothelial and arterial functions and biomarkers , at baseline and after @ months .


Baseline characteristics were similar between groups ; systolic and diastolic blood pressures decreased similarly , by @ % and @ % on indapamide and by @ % and @ % on hydrochlorothiazide ( P < @ ) .


Mean longitudinal systolic velocity and longitudinal strain increased by @ % and @ % on indapamide ( from @ @ to @ @ cm/s and from @ % @ % to @ % @ % , both P < @ ) , but did not change on hydrochlorothiazide ( P < @ for intergroup differences ) , whereas ejection fraction and radial systolic function did not change .


Similarly , mean longitudinal early diastolic velocity increased by @ % on indapamide ( P < @ ) , but did not change on hydrochlorothiazide ( P < @ for intergroup differences ) .


These changes were associated with improved endothelial and arterial functions on indapamide , but not on hydrochlorothiazide .


Indapamide was found to improve measures of endothelial and arterial functions and to increase longitudinal left ventricular function compared with hydrochlorothiazide in patients with hypertension and diabetes , after @ months of treatment .


This study suggests that indapamide , a thiazide-like diuretic , has important vascular effects that can improve ventriculoarterial coupling .


There is a strong correlation between adverse clinical events and peak values of myocardial necrosis markers in non-ST-elevation acute coronary syndrome patients .


In this clinical setting , high-dose statin treatment exerts acute beneficial effects against renal and myocardial damage .


The aim of this report was to evaluate if , on admission , high-dose rosuvastatin can exert cardioprotective effects when administered in addition to high-dose clopidogrel .


In the PRATO-ACS trial , @ consecutive statin-nave non-ST-elevation acute coronary syndrome patients scheduled for early invasive strategy and pretreated with high-dose clopidogrel were randomly assigned to rosuvastatin ( @ mg on admission followed by @ mg/d ; statin group , n = @ ) or no statin treatment ( control group , n = @ ) .


Serial myocardial biomarker samples were collected before and after angiography and/or percutaneous coronary intervention .


The primary end point was the peak level of cardiac troponin I ( cTnI ) during the index event .


Statin-treated patients presented median cTnI peak values similar to controls ( @ -LSB- @-@ @ -RSB- vs @ -LSB- @-@ @ -RSB- ng/mL , respectively ; P = @ -RSB- ; no differences were found between the @ groups in cTnI and creatine kinase-MB values at any time point , in either preangiography and postangiography peak values or their cumulative release .


In patients submitted to percutaneous coronary intervention , periprocedural myocardial infarction occurred in @ ( @ % ) of @ statin-treated and @ ( @ % ) of @ control patients ( P = @ ) .


In the PRATO-ACS trial , early high-dose rosuvastatin did not show cardioprotective effects when administered in addition to high-dose clopidogrel .


The goal of this study was to evaluate the pharmacodynamic effects of switching patients from ticagrelor to prasugrel .


Clinicians may need to switch between more potent P@Y@ inhibitors because of adverse effects or switch to the use of a once-daily dosing regimen due to compliance issues .


After a @ - to @-day run-in phase with a ticagrelor @-mg loading dose ( LD ) followed by a ticagrelor @-mg twice-daily maintenance dose ( MD ) , aspirin-treated patients ( N = @ ) with stable coronary artery disease were randomized to continue ticagrelor or switch to prasugrel @-mg once-daily MD , with or without a @-mg LD .


Pharmacodynamic assessments were defined according to P@Y@ reaction unit ( PRU ) ( P@Y@ assay ) and platelet reactivity index ( vasodilator-stimulated phosphoprotein phosphorylation assay ) at baseline ( before and after the run-in phase ) and @ , @ , @ , and @ h and @ days after randomization .


Platelet reactivity was significantly greater at @ and @ h after switching to prasugrel versus continued therapy with ticagrelor , although to a lesser extent in those receiving an LD .


Mean PRU remained significantly higher in the combined prasugrel groups versus the ticagrelor group ( least-squares mean difference : @ -LSB- @ % confidence interval @ to @ -RSB- ) and did not meet the primary noninferiority endpoint ( upper limit of the confidence interval @ ) , although PRU in the prasugrel cohort was lower at @ days than at @ or @ h. Accordingly , rates of high on-treatment platelet reactivity were higher at @ and @ h in both prasugrel groups .


At @ days , there was no difference in high on-treatment platelet reactivity rate between the combined prasugrel and ticagrelor groups .


Compared with continued ticagrelor therapy , switching from ticagrelor to prasugrel therapy was associated with an increase in platelet reactivity that was partially mitigated by the administration of an LD .


Low-density lipoprotein ( LDL ) cholesterol is a strong risk factor for atherosclerosis but has an inverse association with atrial fibrillation ( AF ) .


We aimed to provide insight into the paradoxical association of LDL cholesterol with AF by evaluating the relationship of various lipoprotein measures and incident AF .


We prospectively evaluated lipoprotein measures among @ @ healthy middle-aged and older women ( median follow-up @ years ; N = @ incident AF events ) .


Baseline LDL cholesterol was directly measured , lipoprotein particle concentrations and size were measured by nuclear magnetic resonance spectroscopy , and apolipoproteins were measured by immunoassay .


Cox regression models were adjusted for age , AF risk factors , inflammatory , and dysglycemic biomarkers .


After multivariable adjustment , inverse associations with AF were observed ( hazard ratio , @ % confidence interval for top versus bottom quintile , P value ) for LDL cholesterol ( @ , @-@ @ , P = @ ) , the total number of LDL particles ( @ , @-@ @ , P = @ ) , and very-low-density lipoprotein particles ( @ , @-@ @ , P = @ ) , which was driven by the number of cholesterol-poor small LDL ( @ , @-@ @ , P = @ ) and small very-low-density lipoprotein particles ( @ , @-@ @ , P = @ ) .


By contrast , the larger cholesterol-rich LDL particles and all high-density lipoprotein measures were not associated with AF in multivariable models .


Adjustment for inflammatory and dysglycemic biomarkers had minimal impact on these associations .


In this prospective study , the inverse association between LDL cholesterol and AF extended to several other atherogenic lipoproteins , and these associations are unlikely to be mediated by direct cholesterol effects .


To observe the clinical effects of acupoint injection of metoclopramide for postsurgical gastroparesis syndrome ( PGS ) .


A total of @ patients with PGS ( from abdominal surgery ) were randomly divided into control and acupoint injection groups ( n = @ in each group ) .


Patients of the acupoint injection group were treated by injection of Metoclopramide ( @ mg + normal saline ) into bilateral Zusanli ( ST @ ) and Weishu ( BL @ ) alternatively , while patients of the control group treated by injection of @ mg of Metoclopramide into the deltoid muscle and gluteus maximus muscle alternatively .


The treatment of both groups was conducted once daily for @ days .


A @-point scale of clinical symptoms ( abdominal distension , belching , nausea-vomiting , upper-abdominal distending pain , sour regurgitation and gastric burning sensation ) was used to evaluate the therapeutic effect .


There were no statistical differences between two groups in clinical symptom scores before the treatment ( P > @ ) .


Following treatment , the clinical symptom scores of both groups were significantly decreased in comparison with pre-treatment ( P < @ ) and the scores of the acupoint injection group were significantly lower than those of the control group ( P < @ ) .


Of the @ PGS patients in the control group and acupoint injection group , @ and @ were cured , @ and @ were significantly improved , @ and @ were improved , @ and @ failed , with the effective rates being @ % and @ % , respectively .


Acupoint injection of Metoclopramide is effective for improving clinical symptoms of PGS patients .


To examine the association between brain structural changes and - amyloid deposition , and incident dementia in @ elderly subjects without dementia ( mean age @ years ) @ years later .


Subjects had a brain structural MRI scan and a PET scan with ( @ ) C-labeled Pittsburgh compound B ( PiB ) in @ , and were evaluated clinically in @ .


At baseline evaluation , of the @ participants ( @ cognitively normal -LSB- CN -RSB- ) ; @ mild cognitive impairment -LSB- MCI -RSB- ) , @ ( @ % ) were PiB + , had small hippocampal volume ( < @th percentile ) , or had high white matter lesion ( WML ) volume ( > @th percentile ) .


Two years later , @ ( @ % ) were classified as CN , @ ( @ % ) as MCI , and @ ( @ % ) as dementia .


At baseline , @ % of the CN participants and @ % of the MCI cases were PiB + .


Thirty percent of the CN and @ % of the MCI cases had small hippocampi , and @ % of the CN and @ % of the MCI cases had abnormal WMLs .


Of the @ participants who progressed to dementia , @ ( @ % ) had at least one imaging abnormality .


Only @ ( @ % ) were only PiB + , @ ( @ % ) had only small hippocampi , @ ( @ % ) had only WMLs , @ ( @ % ) was biomarker negative , and the other @ had various pairs of imaging abnormalities .


Continuous variables of PiB retention , left and right hippocampal volume , and WML volume were independent predictors of dementia in a logistic regression analysis controlling for age , sex , education level , and Mini-Mental State Examination scores .


The prevalence of - amyloid deposition , neurodegeneration ( i.e. , hippocampal atrophy ) , and small vessel disease ( WMLs ) is high in CN older individuals and in MCI .


A combination of @ or @ of these factors is a powerful predictor of short-term incidence of dementia .


Molecular characteristics of cancer vary between individuals .


In future , most trials will require assessment of biomarkers to allocate patients into enriched populations in which targeted therapies are more likely to be effective .


The MRC FOCUS@ trial is a feasibility study to assess key elements in the planning of such studies .


Patients with advanced colorectal cancer were registered from @ centres between February @ and April @ .


With their consent , patients ' tumour samples were analysed for KRAS/BRAF oncogene mutation status and topoisomerase @ ( topo-@ ) immunohistochemistry .


Patients were then classified into one of four molecular strata ; within each strata patients were randomised to one of two hypothesis-driven experimental therapies or a common control arm ( FOLFIRI chemotherapy ) .


A @-stage suite of patient information sheets ( PISs ) was developed to avoid patient overload .


A total of @ patients were registered , @ randomised .


Among randomised patients , biomarker results were provided within @ working days ( w.d. ) in @ % , @w .


d. in @ % and @w .


d. in @ % .


DNA mutation analysis was @ % concordant between two laboratories .


Over @ % of participants reported excellent understanding of all aspects of the trial .


In this randomised phase II setting , omission of irinotecan in the low topo-@ group was associated with increased response rate and addition of cetuximab in the KRAS , BRAF wild-type cohort was associated with longer progression-free survival .


Patient samples can be collected and analysed within workable time frames and with reproducible mutation results .


Complex multi-arm designs are acceptable to patients with good PIS .


Randomisation within each cohort provides outcome data that can inform clinical practice .


To compare the efficacies of internal fixation by elastic intramedullary nail versus conventional plate osteosynthesis in the treatment of both radius and ulna fractures in children .


A total of @ cases were randomly divided into control and experimental groups at our department from July @ to @ .


The control group underwent conventional plating while the experimental group received elastic intramedullary nail .


Preoperative preparations and postoperative rehabilitation protocols were similar .


The operative outcomes were evaluated from pain score at Day @ post-operation , radiology and forearm curative function , local wound healing after @ , @ , @ weeks , @ , @ months and @ year .


Local wound healing time , radiology and forearm curative function had statistical significance between two groups ( P < @ ) .


And the pain score had significant difference ( P < @ ) .


Elastic intramedullary nail has multiple advantages of mini-invasiveness , quicker healing and excellent function recovery in the treatment of both ulna and radius fractures in children .


As the second commonest cause of death and a major cause of disability worldwide , stroke has greatly influenced patients ' quality of life and created a huge public health burden .


As a special form of physical activity that has been widely practiced in China , and even throughout the world , Tai Chi may be favorable for the rehabilitation of stroke patients .


Several studies have been conducted to investigate the rehabilitative effects of Tai Chi for stroke patients , but none of them have been focused on the recovery phase ( @ to @ weeks ) of stroke .


This study is an assessor-blinded randomized controlled trial .


A total of @ eligible participants will be randomly assigned to either a control group or a Tai Chi group .


Patients in the control group will receive standard , conventional rehabilitation therapies , and a combination of Tai Chi and conventional rehabilitation programs will be applied in the Tai Chi group .


The recovery of motor impairment , functional activity and balance abilities as measured with the Fugl-Meyer Assessment , Barthel Index and Berg Balance Scale will be assessed as primary outcome measures .


The secondary outcome measures to be used are the scores on the Stroke-Specific Quality of Life Scale , the National Institutes of Health Stroke Scale and the objective parameters of the RSscan footscan gait system .


All assessments will be conducted at baseline , @ weeks after the rehabilitation course and at the end of @-month follow-up .


The results of this study will provide preliminary evidence regarding the efficacy and feasibility of Tai Chi as an additional rehabilitative program for stroke patients in the recovery phase .


Omega-@ polyunsaturated fatty acid ( PUFA ) may benefit humans and animals with chronic inflammatory diseases .


Omega-@ PUFA supplementation improves clinical signs , lung function , and airway inflammation in horses with recurrent airway obstruction ( RAO ) and inflammatory airway disease ( IAD ) .


Eight research horses and @ client-owned horses .


A pilot study examined the dose of PUFA that can alter plasma PUFA composition .


Then , a randomized , controlled clinical trial was performed in horses with RAO and IAD .


Horses were fed a complete pelleted diet with no hay and randomly assigned to @ of @ daily treatments for @ months : @ or @ g of the supplement or @ g of placebo .


Clinical signs , lung function , plasma PUFA composition , and bronchoalveolar lavage fluid ( BALF ) cytology were evaluated .


Data were expressed as median ( @-@th percentiles ) .


P < @ was considered significant .


Polyunsaturated fatty acid supplementation resulted in increased plasma docosahexaenoic acid ( DHA ) that peaked at @ weeks .


Clinical improvement was noted in all horses involved in the clinical trial , but the group that received PUFA had greater improvement in clinical signs ( cough score improved @ % ) , lung function ( respiratory effort decreased @ % ) , and BALF ( neutrophils decreased from @ to @ % ) when compared to placebo ( cough score improved @ % , respiratory effort decreased @ % , BALF neutrophils increased from @ to @ % ; P < @ ) .


Feeding horses with RAO and IAD a PUFA supplement containing @-@ g DHA for @ months provides an additional benefit to low-dust diet .


Patients with severe left ventricular dysfunction , ischemic heart failure , and coronary artery disease suitable for coronary artery bypass grafting ( CABG ) are at higher risk for surgical morbidity and mortality .


Paradoxically , those patients with the most severe coronary artery disease and ventricular dysfunction who derive the greatest clinical benefit from CABG are also at the greatest operative risk , which makes decision making regarding whether to proceed to surgery difficult in such patients .


To better inform such decision making , we analyzed the Surgical Treatment for Ischemic Heart Failure ( STICH ) CABG population for detailed information on perioperative risk and outcomes .


In both STICH trials ( hypotheses ) , @ patients with a left ventricular ejection fraction of @ % and coronary artery disease were allocated to medical therapy , CABG plus medical therapy , or CABG with surgical ventricular reconstruction .


Relationships of baseline characteristics and operative conduct with morbidity and mortality at @ days were evaluated .


There were a total of @ patients randomized to and receiving surgery , and @ ( @ % ) of these high-risk patients developed a severe complication within @ days .


Worsening renal insufficiency , cardiac arrest with cardiopulmonary resuscitation , and ventricular arrhythmias were the most frequent complications and those most commonly associated with death .


Mortality at @ days was @ % and was generally preceded by a serious complication ( @ of @ deaths ) .


Left ventricular size , renal dysfunction , advanced age , and atrial fibrillation/flutter were significant preoperative predictors of mortality within @ days .


Cardiopulmonary bypass time was the only independent surgical variable predictive of @-day mortality .


CABG can be performed with relatively low @-day mortality in patients with left ventricular dysfunction .


Serious postoperative complications occurred in nearly @ in @ patients and were associated with mortality .


We explored sex differences in the neural mechanisms mediating placebo analgesia in an established visceral pain model involving painful rectal distensions in healthy volunteers .


N = @ men and N = @ women underwent three consecutive functional magnetic resonance imaging sessions during which cued painful rectal distensions were delivered .


After an adaptation session , positive expectations were induced with deceptive instructions regarding administration of an analgesic drug ( placebo session ) .


In the other session ( control ) , truthful information about an inert substance was given .


Sex differences in placebo-induced modulation of neural activation during anticipation and pain were analyzed along with ratings of expected and perceived pain intensity .


Placebo-induced reductions in pain ratings were comparable between men and women .


At the level of the brain , group comparisons with respect to differences between the placebo and control conditions revealed greater modulation of the posterior insula ( regions-of-interest analysis : pFWE < @ ) and dorsolateral prefrontal cortex ( whole-brain analysis : p < @ , uncorrected ) during pain anticipation in women .


During pain , placebo-induced down-regulation of the insula was altered in women compared to men ( ROI analysis : pFWE < @ ) .


Our data provide first evidence supporting sex differences in pain-induced neural modulation during visceral placebo analgesia despite similar placebo-induced reductions in perceived pain intensity .


These preliminary findings might contribute to elucidating mechanisms mediating placebo effects in clinical conditions associated with chronic abdominal pain such as in irritable bowel syndrome .


Task-specific locomotor training has been promoted to improve walking-related outcome after incomplete spinal cord injury ( iSCI ) .


However , there is also evidence that lower extremity strength training might lead to such improvements .


The aim of this randomized cross-over pilot study was to compare changes in a broad spectrum of walking-related outcome measures and pain between robot-assisted gait training ( RAGT ) and strength training in patients with chronic iSCI , who depended on walking assistance .


We hypothesized that task-specific locomotor training would result in better improvements compared to strength training .


Nine participants with a chronic iSCI were randomized to group @ or @ .


Group @ received @ sessions of RAGT ( @min each ) within @ weeks followed by @ sessions of strength training ( @min each ) within @ weeks .


Group @ received the same interventions in reversed order .


Main outcome measures were the @m Walk Test ( @MWT ) at preferred and maximal speed .


Furthermore , we assessed several measures such as walking speed under different conditions , balance , strength , and @ questionnaires that evaluate risk of falling and pain .


Data were collected at baseline , between interventions after @ weeks , directly after the interventions and at follow-up @ months after the interventions .


Pain was assessed repeatedly throughout the study .


There were no significant differences in changes in scores between the @ interventions , except for maximal walking speed ( @MWT ) , which improved significantly more after strength training than after RAGT .


Pain reduced after both interventions .


In patients with chronic iSCI dependent on walking assistance , RAGT was not more effective in improving walking-related outcome compared to lower extremity strength training .


However , the low sample size limits generalizability and precision of data interpretation .


Dental caries is the most prevalent communicable disease in the world amongst the population of the children .


To compare the outcome of restorations in primary molars using two Glass ionomer cements Ketac-Molar , a Glass ionomer cement ( GIC ) and Vitremer , a Resin modified glass ionomer cement ( RMGIC ) in small and medium sized cavities .


A randomized controlled trial was conducted on @ children between ages @-@ years who had bilateral matched pair of carious lesions in primary posterior teeth .


A split mouth design was used in which two materials , Ketac Molar and Vitremer , were placed on contralateral sides of the oral cavity in the same patient .


The aim was to compare clinical performance of these restorations after @ months using United States Public Health Service ( USPHS ) criteria .


Data were collected six months after restoration using USPHS criteria .


Statistical analysis was conducted using SPSS-@ .


Categorical variables were described as frequencies , and percentages .


Chi-square test was used to compare the frequencies between groups keeping statistical significance at p < @ .


Based on the USPHS criteria , after six months the results of Ketac Molar and Vitemer were comparable , except for sensitivity where RMGIC performed significantly better ( p = @ ) .


Though not significantly different , GIC performed better in @/@ variables namely marginal discoloration and surface staining .


RMGIC did better in @/@ variables namely marginal integrity , retention , secondary caries and sensitivity .


Both cements performed almost equally well in @/@ variables , i.e. , colour match , anatomic form , surface texture and proximal contact .


Overall the clinical performance of Vitremer was better than Ketac molar and is to be considered as a preferable material for restoration of primary molars .


More studies are recommended to confirm the results of the present study .


To compare the incidence rates of postoperative urinary incontinence between transurethral bipolar plasmakinetic enucleation and resection of the prostate ( PKERP ) and transurethral bipolar plasmakinetic resection of the prostate ( PKRP ) , and provide evidence for the clinical application of PKERP .


Totally , @ BPH patients were equally and randomly assigned to undergo PKERP and PKRP , respectively .


We measured the urinary incontinence of the patients by pad test at @ hours after extubation and every week after surgery for @ weeks .


Meanwhile , we recorded and compared the PSA level , prostate volume , Qmax , residual urine , IPSS , QOL , and the results of pad test between the two groups before and after surgery .


The incidence rates of urinary incontinence in the PKERP and PKRP groups were @ % and @ % ( P < @ ) at @ hours after extubation , @ % and @ % at @ week after surgery ( P < @ ) , and @ % and @ % at @ weeks .


There was no significant difference in the severity of urinary incontinence between the two groups at any time point ( P > @ ) .


No permanent urinary incontinence was observed in either group .


Compared with PKRP , PKERP has a higher incidence rate of short-term urinary incontinence in the treatment of BPH , but not that of genuine incontinence , with similar severity and recovery time .


To investigate the relationship between Vitamin D deficiency and acute otitis media infection .


The randomised , single-blind , case-control study was conducted at the Paediatric Department of Ataturk University , Erzurum , Turkey , from January to April @ .


It comprised ambulatory children diagnosed with acute otitis media and healthy controls .


The subjects were divided into groups according to their serum @-hydroxy vitamin D levels .


SPSS @ was used for statistical analysis .


Of the @ subjects in the study , @ ( @ % ) were the cases and @ ( @ % ) were controls .


The mean age of the cases was @ years , and @ years for the controls ( p < @ ) .


Serum @-hydroxy vitamin D levels in the cases and controls were @ ng/mL and @ ng/mL ( p < @ ) .


There was no statistically significant difference between the groups in terms of parathormone and calcium levels ( p > @ ) .


Serum @-hydroxy vitamin D levels being significantly lower in children diagnosed with acute otitis media compared to the controls in two otherwise similar groups suggests that Vitamin D deficiency plays a role in otitis media infection .


Chronic kidney disease ( CKD ) is strongly related to outcome in cardiovascular diseases .


The relationship between treatment of mitral regurgitation ( MR ) and renal function is not well described .


We sought to evaluate renal function before and after mitral valve repair by the MitraClip device .


Patients with moderate-to-severe or severe ( @ + or @ + , respectively ) MR by core laboratory determination who underwent transcatheter mitral valve repair with the MitraClip device in multicenter , investigational trials were included in this study .


Estimated glomerular filtration rate ( eGFR ) was evaluated before and at hospital discharge , @ days , @ months , and @ year after mitral valve repair .


Eight hundred fifty-four patients with baseline mean eGFR @ @ mL/min/@ @ m ( @ ) were studied , including @ ( @ % ) with eGFR @ mL/min/@ @ m ( @ ) ( CKD stage @ or @ ) , @ ( @ % ) with eGFR @ to @ mL/min/@ @ m ( @ ) ( CKD stage @ ) , and @ ( @ % ) with eGFR < @ mL/min/@ @ m ( @ ) ( CKD stage @ or @ ) .


Baseline renal dysfunction was more prevalent in older patients with a history of heart failure , coronary artery disease , cerebrovascular disease , diabetes mellitus , hypertension , and atrial fibrillation .


Baseline eGFR was associated with @-year survival ( P < @ ) after MitraClip repair .


At @-year follow-up , the mean change in eGFR for the overall cohort was -@ @ mL/min/@ @ m ( @ ) ; for patients with CKD stage @ or @ , stage @ , or stage @ or @ , mean change was -@ @ , +@ @ , and +@ @ mL/min/@ @ m ( @ ) , respectively .


Linear mixed effect modeling demonstrated a strong association between MR and eGFR , and a statistically significant improvement in eGFR in patients with CKD stage @ or @ associated with MR reduction to @ + ( P = @ ) .


Renal dysfunction is associated with lower survival in patients with severe MR even after percutaneous mitral valve repair .


Reduction in MR severity by the MitraClip device is associated with improvement in renal function at @ year in patients with baseline renal dysfunction .


Bipolar Disorder ( BD ) is a severe mental health problem .


Psychological interventions are recommended by the National Institute for Health and Care Excellence ( NICE ) but patients experience severe inequalities in access .


This study assessed the feasibility and potential effectiveness of a recovery informed web-based self-management intervention for people with BD .


An online randomised controlled trial ( n = @ ) compared treatment as usual ( TAU ) plus the ` Living with Bipolar ' ( LWB ) intervention with a waiting list control ( WLC ) group .


The study recruited to target and the retention rates were high .


Participants engaged with the approach .


Compared with the WLC , those receiving LWB showed the most robust improvement in psychological and physical domains of quality of life , wellbeing and recovery at the end of the intervention .


The trial was not definitive and requires further investigation .


There is preliminary evidence that a web-based treatment approach in BD is feasible and potentially effective .


Such interventions could form part of the Improving Access to Psychological Therapy ( IAPT ) initiative in severe mental health .


Trauma exposure predicts mental disorders , medical morbidity , and health care costs .


Yet trauma-related impacts have not received sufficient attention in primary care provider ( PCP ) training programs .


This study adapted a theory-based approach to working with trauma survivors , Risking Connection , into a @-hour CME course , Trauma-Informed Medical Care ( TI-Med ) , and evaluated its efficacy .


We randomized PCPs to training or wait-list ( delay ) conditions ; wait-list groups were trained after reassessment .


The primary outcome assessing newly acquired skills was a patient-centeredness score derived from Roter Interactional Analysis System ratings of @ taped visits between PCPs and standardized patients ( SPs ) .


PCPs were family medicine residents ( n = @ ) and community physicians ( n = @ , @ % family medicine specialty ) , from four sites in the Washington , DC metropolitan area .


Immediately trained PCPs trended toward a larger increase in patient centeredness than did the delayed PCPs , with a moderate effect size ( @ ) .


The combined trained PCP groups showed a significant increase in patient centeredness from before to after training .


This is a promising approach to supporting relationship-based trauma-informed care among PCPs to help promote better patient health and higher compliance with medical treatment plans .


In this study , we compared the effectiveness of laser-aided circumferential supracrestal fiberotomy ( CSF ) and low-level laser therapy ( LLLT ) with conventional CSF in reducing relapse of corrected rotations .


The study included @ patients who were at the finishing stage of orthodontic treatment and had at least @ maxillary incisor with @ to @ of rotation before starting therapy .


The subjects were divided into @ groups by treatment : conventional CSF , Er : YAG laser-aided CSF , LLLT , and control .


After alginate impressions were taken , the archwire was sectioned from the experimental incisors , and they were allowed to relapse .


The second impression was taken @month later , and the degree and percentage of relapse were calculated in photographs taken from the dental models .


Gingival recession , pocket depth , and pain were also measured in the CSF groups .


The mean percentages of relapse were @ % in the conventional CSF , @ % in the Er : YAG laser-aided CSF , @ % in the LLLT , and @ % in the control groups .


Relapse was significantly greater in the control than the experimental groups ( P < @ ) , which were not statistically different from each other .


The changes in sulcus depth and gingival recession were small and not significantly different among the CSF groups ( P > @ ) , but pain intensity was greater in subjects who underwent conventional CSF ( P = @ ) .


Er : YAG laser-aided CSF proved to be an effective alternative to conventional CSF in reducing rotational relapse .


LLLT with excessively high energy density was also as effective as the CSF procedures in alleviating relapse , at least in the short term .


The aim of this study was to investigate the difference in subjective cure rate and patient satisfaction between tension-free vaginal tape ( TVT ) and transobturator tape ( TOT ) surgical methods in the treatment of stress and mixed urinary incontinence .


From January @ to November @ , a total of @ patients suffering from stress or mixed urinary incontinence and evaluated to benefit from operative treatment were randomized to undergo either TVT or TOT surgery in Oulu University Hospital .


There were no significant differences between the study groups concerning the patient characteristics .


During the @ , @ and @ month follow-up steps , information on subjective cure and patient satisfaction was gathered with Urinary Incontinence Severity Score and Detrusor Instability Score questionnaires and a specific question about satisfaction .


The subjective cure rate was @ % in both study groups .


The satisfaction rate was @ % in the TVT group and @ % in the TOT group at the final follow-up .


Urge symptoms were relieved in @ % of patients in the mixed urinary incontinence subgroup .


De novo urgency occurred in @ % of the patients in the stress urinary incontinence subgroup , and @ % of these patients were unsatisfied after the follow-up .


TVT and TOT are equally effective methods in the treatment of urinary incontinence and patient satisfaction is similar in both methods .


A large proportion of patients with mixed urinary incontinence found the operation beneficial for urge symptoms .


A single nucleotide polymorphism ( SNP ) of the patatin-like phospholipase-@ ( PNPLA@ ) / adiponutrin gene ( rs@ C > G ) is strongly associated with nonalcoholic fatty liver disease ; to our knowledge , no data are available on the impact of this PNPLA@ SNP on liver and metabolic outcomes during pregnancy in patients with gestational diabetes ( GD ) .


We evaluated the impact of the PNPLA@ rs@ SNP on liver enzymes , metabolic indexes , and maternal and neonatal outcomes in @ GD patients enrolled in a lifestyle intervention .


In a randomized trial with a @ @ factorial design , exercise significantly improved maternal and neonatal outcomes in GD patients .


Effects of the G allele on metabolic and liver indexes and maternal and neonatal outcomes were evaluated in these patients .


At the end of the trial , fasting insulin and homeostasis model assessment of insulin resistance ( HOMA-IR ) values were significantly lower and liver enzymes significantly higher in PNPLA@ G-allele carriers .


In a multiple regression model , the G allele was associated directly with aspartate aminotransferase ( = @ ; @ % CI : @ , @ ) , alanine aminotransferase ( = @ ; @ % CI : @ , @ ) , and - glutamyl transferase ( = @ ; @ % CI : @ , @ ) and inversely with insulin ( = -@ ; @ % CI : -@ , -@ ) and HOMA-IR ( = -@ ; -@ , -@ ) values at the end of the trial .


In a multiple logistic regression model , the G allele was associated directly with risk of developing liver enzyme elevation during pregnancy ( OR : @ ; @ % CI : @ , @ ) and inversely with the birth of large-for-gestational-age newborns ( OR : @ ; @ % CI : @ , @ ) .


No diet genotype or exercise genotype interaction was shown .


The PNPLA@ SNP rs@ G allele was associated with risk of mildly elevated transaminases in GD independent of a lifestyle intervention and despite a significant reduction in insulin resistance and risk of macrosomic offspring .


This trial was registered at clinicaltrials.gov as NCT@ .


Day-hospital-based treatment programmes have been recommended for poorly functioning patients with personality disorders ( PD ) .


However , more research is needed to confirm the cost-effectiveness of such extensive programmes over other , presumably simpler , treatment formats .


This study compared health service costs and psychosocial functioning for PD patients randomly allocated to either a day-hospital-based treatment programme combining individual and group psychotherapy in a step-down format , or outpatient individual psychotherapy at a specialist practice .


It included @ PD patients , @ % of whom had borderline PD , and @ % of whom had avoidant PD .


Costs included the two treatment conditions and additional primary and secondary in - and outpatient services .


Psychosocial functioning was assessed using measures of global ( observer-rated GAF ) and occupational ( self-report ) functioning .


Repeated assessments over three years were analysed using mixed models .


The costs of step-down treatment were higher than those of outpatient treatment , but these high costs were compensated by considerably lower costs of other health services .


However , costs and clinical gains depended on the type of PD .


For borderline PD patients , cost-effectiveness did not differ by treatment condition .


Health service costs declined during the trial , and functioning improved to mild impairment levels ( GAF > @ ) .


For avoidant PD patients , considerable adjuvant health services expanded the outpatient format .


Clinical improvements were nevertheless superior to the step-down condition .


Our results indicate that decisions on treatment format should differentiate between PD types .


For borderline PD patients , the costs and gains of step-down and outpatient treatment conditions did not differ .


For avoidant PD patients , the outpatient format was a better alternative , leaning , however , on costly additional health services in the early phase of treatment .


Induction of therapeutic hypothermia is often complicated by shivering .


Nefopam , a nonsedative benzoxazocine analgesic , reduces the shivering threshold ( triggering core temperature ) with minimal side effects .


Consequently , nefopam is an attractive drug for inducing therapeutic hypothermia .


However , nefopam alone is insufficient and thus needs to be combined with another drug .


Meperidine also reduces the shivering threshold .


We therefore determined whether the combination of nefopam and meperidine is additive , infra-additive , or synergistic on the shivering threshold .


Ten volunteers were each studied on @ randomly assigned days .


In random order , they were given the following treatments : ( @ ) control , no drug ; ( @ ) nefopam to a target concentration of @ g/mL ; ( @ ) meperidine to a target concentration of @ g/mL ; and ( @ ) both nefopam and meperidine at target concentrations of @ g/mL each .


Lactated Ringer 's solution at @C was infused to decrease core temperature while mean skin temperature was kept near @ C.


The core temperature that increased oxygen consumption > @ % defined the shivering threshold .


Nefopam reduced the shivering thresholds by @ C @ C compared with no drug .


Meperidine reduced the shivering thresholds by @ C @ C compared with no drug .


When combined , the shivering threshold decreased by only @ C @ C , which was about half what would have been expected based on the individual effects of each drug ( P < @ ) .


The effect of combined nefopam and meperidine on the shivering threshold was thus infra-additive .


The combination of nefopam and meperidine should be avoided for induction of therapeutic hypothermia .


Better options would be combinations of drugs that are at least additive or even synergistic .


Research on face-to-face treatment for substance misuse suggests that patients ' social networks may impact treatment entry and participation , but there has been no similar research on entry and participation in telephone-based continuing care .


We examined whether alcohol-specific social support predicted engagement and participation in telephone continuing care for alcohol dependence , and whether treatment participation resulted in beneficial changes in participants ' social networks .


Participants were @ adults ( @ male ) enrolled in a randomized clinical trial testing the effectiveness of telephone continuing care for alcohol dependence .


Participants who completed @ weeks of intensive outpatient treatment were randomly assigned to treatment as usual , telephone monitoring ( TM ; N = @ ) , or telephone monitoring and brief counseling ( TMC ; N = @ ) .


TM and TMC included @ months of telephone treatment .


Alcohol-specific social support was measured with the Important People Inventory at baseline and @ , @ , @ , and @-month follow-up .


Alcohol-specific social support did not predict entry into TM or TMC .


Among those who entered telephone treatment ( N = @ ) , participants with higher network percentage of daily drinkers , higher percentage of network members who accept drinking , and lower percentage of network members who do not accept drinking completed more continuing care calls .


There was no effect of continuing care participation on alcohol-specific social support over @ months of follow-up .


Participants with more problematic social networks may self-select additional support in the form of telephone continuing care .


Telephone continuing care does not appear to result in social network change .


A serogroup B meningococcal vaccine ( @CMenB ) has been licensed by the European commission for use in various infant schedules .


However , data are limited on persistence of serum bactericidal antibodies ( SBA ) , which is necessary to inform cost-effectiveness analysis .


Sera were obtained from @ groups of @-year-old children previously immunized at @ , @ , @ and @ months with either @CMenB or rMenB ( which lacks the outer membrane vesicle of @CMenB ) or at @ and @ months with @CMenB only .


Forty-nine control children were also recruited and blood obtained before and after @ doses of @CMenB at @ and @ months of age .


Sera were tested for SBA to meningococcal B reference strains .


At @ years of age , @ % of those receiving @CMenB in infancy had SBA titers @:@ for strain @/@ , @ % for @/@ , @ % for NZ@/@ and @ % for M@ .


Results for rMenB recipients varied from @ ( NZ@/@ ) to @ % ( @/@ ) .


Of those immunized with @CMenB at @ and @ months , @ % had SBA titers @:@ at age @ for @/@ , @ % for @/@ , @ % ( NZ@/@ ) and @ % ( M@ ) .


Among controls , SBA titers were @:@ in @ % ( H@/@ , @/@ ) , @ % ( NZ@/@ ) and @ % ( M@ ) at baseline , increasing to @ % ( H@/@ and @/@ ) , @ % ( NZ@/@ ) and @ % ( M@ ) postimmunization .


The variable rates of waning of antibody to the @ components of @CMenB complicates estimates of duration of protection and should be taken into account in cost-effectiveness analyses .


A @-dose schedule of @CMenB in @-year-old children was immunogenic .


To compare the postoperative analgesic efficacy and side effects of paracetamol and tramadol in patients undergoing lumbar disc surgery .


Group P ( paracetamol group ) was given @ g of paracetamol intravenously @ min before the end of the operation and @ g each day at @-h intervals .


Group T ( tramadol group ) was given @ mg/kg of tramadol as a loading dose and patient-controlled analgesia for @ day .


Hemodynamic parameters , modified Aldrete score , Ramsay sedation scale score , patient satisfaction scale ( PSS ) score , visual analog scale ( VAS ) score , nausea/vomiting scale score , and additional analgesic needs/times were recorded .


PSS scores were significantly higher in Group T ( P < @ ) .


The total analgesic consumption was significantly higher in Group P.


There were no significant differences in the VAS scores at any time points .


Twenty-one patients in Group P and @ patients in Group T needed additional analgesia ( P < @ ) .


The first additional analgesic time was earlier in Group P , and pain was more evident at the @th minute and at hours @ and @ ( P < @ ) .


Paracetamol alone was not able to provide effective analgesia .


Tramadol was more effective in the treatment of postoperative pain after lumbar disc surgery .


Unintended pregnancy remains a serious public health challenge in the USA .


We assessed the effects of an intervention to increase patients ' access to long-acting reversible contraceptives ( LARCs ) on pregnancy rates .


We did a cluster randomised trial in @ reproductive health clinics across the USA in @-@ @ clinics were randomly assigned to receive evidence-based training on providing counselling and insertion of intrauterine devices ( IUDs ) or progestin implants and @ to provide standard care .


Usual costs for contraception were maintained at all sites .


We recruited women aged @-@ years attending family planning or abortion care visits and not desiring pregnancy in the next @ months .


The primary outcome was selection of an IUD or implant at the clinic visit and secondary outcome was pregnancy within @ months .


We used generalised estimating equations for clustered data to measure the intervention effect on contraceptive selection , and used survival analysis to assess pregnancy rates .


Of @ women enrolled , more at intervention than control sites reported receiving counselling on IUDs or implants ( @ -LSB- @ % -RSB- of @ vs @ -LSB- @ % -RSB- of @ , odds ratio @ , @ % CI @-@ ) and more selected LARCs during the clinic visit ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- , @ , @-@ ) .


The pregnancy rate was lower in intervention group than in the control group after family planning visits ( @ vs @ per @ person-years ) , but not after abortion visits ( @ vs @ per @ person-years ) .


We found a significant intervention effect on pregnancy rates in women attending family planning visits ( hazard ratio @ , @ % CI @-@ ) .


The pregnancy rate can be reduced by provision of counselling on long-term reversible contraception and access to devices during family planning counselling visits .


The anti-IgE monoclonal antibody , omalizumab , is approved in the US as add-on therapy for patients @ years of age with moderate-to-severe persistent allergic asthma .


Omalizumab is administered according to the US Food and Drug Administration approved dosing table included in the prescribing information .


The dosing table was developed using Genentech 's free IgE assay and is designed to achieve free serum IgE levels of < @ng/mL , known to be associated with clinical benefit .


Lack of clinical benefit in a subset of patients on omalizumab has prompted demand for commercial free IgE assays to guide omalizumab dosing .


To date , two commercial free IgE assays marketed by ViraCor-IBT ( no longer offered ) and BioTeZ have been available to physicians .


This study compares the results generated from the two commercial free IgE assays with the free IgE levels generated by the Genentech assay .


Two serum sample sets were prepared using @ samples from patients with a wide range of IgE and omalizumab from an omalizumab clinical trial and @ samples from omalizumab-nave patients .


Different amounts of omalizumab were added to the @ omalizumab nave samples based on measured total IgE levels to ensure that a good range of IgE and omalizumab was represented in the study samples .


Samples were randomized for blinded analysis of free IgE levels using the Genentech , ViraCor-IBT and BioTeZ free serum IgE assays .


Analysis of samples in the ViraCor-IBT assay were conducted by ViraCor-IBT and the analysis of samples using the Genentech and BioTeZ assay methods were conducted by a third party contract research organization .


The ViraCor-IBT and BioTeZ free IgE assays demonstrated significantly higher free IgE levels than the Genentech free IgE assay .


Twenty-nine of @ samples tested < @ng/mL in the Genentech assay ; of these , @/@ ( @ % ) and @/@ ( @ % ) tested > @ng/mL in the BioTeZ and ViraCor-IBT assays , respectively .


In the BioTeZ free IgE evaluations , @/@ samples that were re-tested had inter-assay differences ranging from @-@ % .


Free ligand ( such as IgE ) measurements are challenging and dependent on the method and reagents used .


The Viracor-IBT and BioTeZ methods tend to over-estimate free serum IgE levels compared with the Genentech free IgE assay .


Using these assays to monitor therapy and adjust omalizumab doses post treatment is considered off-label use and could lead to a potential risk for unnecessary treatment and/or risk to patient safety .


Acute liver failure ( ALF ) usually develops in multiple organ dysfunction syndrome ( MODS ) and carries a high mortality risk in patients after cardiac surgery .


Artificial liver support devices aim to remove albumin-bound and water-soluble toxins arising as a result of liver failure .


The currently most used devices combine haemodialysis with albumin dialysis ( MARS ) or plasma separation and adsorption ( Prometheus ) .


The aim of this study was to assess safety and efficacy of use MARS or Prometheus in elderly patients with ALF have been operated for heart diseases .


We studied @ elder patients with ALF and MODS as postoperative complication after cardiac surgery .


Patients were assigned to groups , given a combination of MARS and standard medical therapy ( SMT ) ( MARS-group , n = @ ) or Prometheus and SMT ( Prometheus-group , n = @ ) .


Inclusion criteria were clinical and laboratory signs of ALF : serum total bilirubin level > @ mkmol/L , @-fold increasing serum aspartate aminotransferase ( AST ) and alanine aminotransferase ( ALT ) , low serum cholinesterase and high serum ammonia levels .


A variety of clinical and biochemical parameters were assessed .


Primary endpoint was survival probabilities at day @ .


MARS was used to provide @ to @ rounds ( minimum of @ hours each ) and Prometheus was used to provide @ to @ rounds ( minimum of @ hours each ) .


There were amelioration of haemodinamic instability , especially in MARS-group ( increase in ADmean was @ % in MARS ( p = @ ) and @ % in Prometheus-group ( p = @ ) ) , increase in P/F ratio ( @ % in Prometheus-group ( p = @ ) ) , decrease in serum total bilirubin ( @ % in MARS-group ( p = @ ) and @ % in Prometheus-group ( p < @ ) ) and unconjugated bilirubin levels ( @ % in Prometheus-group ( p = @ ) ) , also we had decreasing in serum aminotransferase levels and trend to increasing in serum cholinesterase level ( @ % in MARS-group ( p = @ ) and @ % in Prometheus-group ( p = @ ) ) .


There were no side effects of extracorporeal liver support in both patients groups .


Survival of patients with ALF , treated with MARS was @ % , in Prometheus group -- @ % .


MARS and Prometheus are found to be safe and effective in patients with ALF after cardiac surgery .


Further studies are needed to assess whether therapy might be beneficial in specific sublets of patients .


To compare the effects of different arm positions on dose exposure and image quality ( IQ ) in cervical spine CT after trauma in different patient groups .


Patients in standard ( STD = @ ) and in swimmer 's position ( SWIM = @ ) were included .


Body mass index ( BMI subgroup @ = underweight to subgroup @ = obese ) , anterior-posterior diameter ( AP ) , left-right diameter ( LR ) , area of an ellipse ( AoE ) and angle between the humeral heads ( optimal STD < @ , optimal SWIM > @ ) were used as grouping criteria .


Computed tomography dose index ( CTDI ) was documented .


Two radiologists rated the IQ at three levels ( CV@/@ , CV@/@ , CV@/T@ ) using a semi-quantitative scale ( @ = not diagnostic , @ = diagnostic with limitations , @ = diagnostic without limitations ) .


The Mann-Whitney U test correlations of grouping criteria with dose effects and intra-class correlation ( ICC ) were calculated .


ICC was @ .


BMI grouping showed the strongest correlation with dose effects : CTDI of optimal STD versus optimal SWIM positioning was @ mGy versus @ mGy ( subgroup @ ) , @ mGy versus @ mGy ( subgroup @ ) , @ mGy versus @ mGy ( subgroup @ ) and @ mGy versus @ mGy ( subgroup @ ) .


Mean IQ at CV@/T@ was @ versus @ ( subgroup @ ) , @ versus @ ( subgroup @ ) , @ versus @ ( subgroup @ ) , @ versus @ ( subgroup @ ) .


Patients with a BMI > @ kg/m ( @ ) benefited from both potential dose reduction and improved image quality at the critical cervicothoracic junction when swimmer 's position was used .


BMI is a useful metric for personalized optimization in CT for the c-spine .


Using swimmer 's position , patients can benefit from dose reduction .


In some patients a superior image quality can be achieved with swimmer 's position .


For swimmer 's positioning an angle of more than @ is optimal .


To study the mechanism of Dan ' e Fukang Soft Extract ( DFSE ) on improving oocyte and embryo qualities in endometriosis patients undergoing in vitro fertilization-embryo transfer ( IVF-ET ) .


Totally @ patients with endometriosis confirmed by laparoscope were randomly assigned to two groups , the treated group and the control group , @ cases in each group .


Patients in the treated group were treated with DFSE + controlled ovarian hyperstimulation ( COH ) , while those in the control group were treated with DFSE placebo + COH .


Besides , recruited were another @ subjects undergoing intracytoplasmic sperm injection-embryo transfer ( ICSI-ET ) as a normal control group .


The content of growth differentiation factor @ ( GDF-@ ) in the granulocytes of the mature follicular fluid on the oocyte retrieval day was determined by Western blot .


The mRNA expression of GDF-@ was detected by RT-PCR .


The oocyte retrieval number , the cleavage rate , the fertilization rate , the high-quality embryo rate , and the pregnancy rate were compared .


The mRNA expression of GDF-@ in the granulocytes was significantly higher in the treated group than in the control group , showing statistical difference ( P < @ ) , but with no statistical difference when compared with that of the normal control group .


There was no statistical difference in the cleavage rate between the two groups ( P > @ ) .


The fertilization rate and the high-quality embryo rate were higher in the treated group than in the control group , showing statistical difference ( P < @ ) , but with no statistical difference when compared with that of the normal control group .


DFSE could improve the oocyte and embryo qualities of endometriosis patients undergoing IVF-ET .


Its mechanism might be associated with regulating the GDF-@ mRNA level of granulocytes .


To study the efficacy/safety of apremilast , an oral phosphodiesterase @ inhibitor , compared with placebo in patients with active rheumatoid arthritis ( RA ) who had an inadequate response to methotrexate ( MTX ) .


Patients were randomized @:@:@ to receive placebo , apremilast @ mg twice a day , or apremilast @ mg twice a day .


Patients whose swollen and tender joint counts had not improved by @ % were considered nonresponders at week @ and were required to enter the protocol-defined early escape .


At week @ , patients were transitioned in a blinded manner to receive apremilast @ mg twice a day if they were initially randomized to receive placebo .


Patients who were not initially randomized to receive placebo continued to receive their target apremilast dose .


Patients were required to take a stable dose of MTX ( @-@ mg/week ) throughout the study .


Magnetic resonance imaging ( MRI ) was performed in a subset of patients .


A total of @ patients who were receiving MTX therapy were randomized and received @ dose of study medication .


At week @ , similar proportions of patients receiving placebo ( @ % ) , apremilast @ mg twice a day ( @ % ) , and apremilast @ mg twice a day ( @ % ) met the American College of Rheumatology criteria for @ % improvement in disease activity ( the primary efficacy end point ) .


In the MRI substudy , mean change from baseline in total joint damage scores according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system was generally similar with either apremilast dose at week @ .


At week @ , no trends were noted for clinical end points by treatment group .


Both apremilast doses were generally well tolerated .


Apremilast efficacy was not demonstrated in patients who had active RA despite stable MTX therapy .


Each year , approximately @ % of women diagnosed with breast cancer in the United States are @ years of age or younger .


These women have concerns specific to or accentuated by their age , including fertility-related concerns , and have higher rates of psychosocial distress than women diagnosed at older ages .


Current guidelines recommend that fertility risks be considered early in all treatment plans ; however , the extant research indicates that attention to fertility by the healthcare team is limited .


Importantly , attention to fertility may be a proxy for whether or not other important issues warranting attention in younger women with breast cancer are addressed , including genetic risks , psychosocial distress , sexual functioning , and body image concerns .


The Young & Strong study tests the efficacy of an intervention designed for young women recently diagnosed with breast cancer and their oncologists with the intention to : @ ) increase attention to fertility as an important surrogate for other issues facing young women , @ ) educate and support young women and their providers , and @ ) reduce psychosocial distress among young women with breast cancer .


The study employs a cluster randomized design including @ academic institutions and @ community sites across the U.S. assigned to either the study intervention arm or contact-time comparison intervention arm .


Academic institutions enroll up to @ patients per site while community sites enroll up to @ patients .


Patient eligibility requirements include : an initial diagnosis of stage I-III invasive breast cancer within three months prior , without a known recurrence or metastatic breast cancer ; @-@ years of age at diagnosis ; ability to read and write in English .


The primary outcome is oncologists ' attention to fertility concerns as determined by medical record review .


Secondary outcomes include differences in patient satisfaction with care and psychosocial distress between the two study arms .


Study findings will provide valuable insight into how to increase attention to fertility and other issues specific to young women with breast cancer and how to improve doctor-patient communication around these issues , which may promote better quality of care for this population .


To evaluate the clinical efficiency , tolerance , and pharmacoeconomic parameters of treatment for mild community-acquired pneumonia ( CAP ) in patients with risk factors for ineffective treatment with levofloxacin ( Glevo ) versus original levofloxacin and standard pharmacotherapy regimens for mild pneumonia ( real practice ) .


An open-label comparative randomized trial was conducted in parallel groups of @ patients aged > or = @ years with mild CAP and risk factors for ineffective treatment .


Group @ included @ patients ( @ men and @ women ; mean age @ + / - @ years ) receiving levofloxacin ( Glevo ) @ mg/day ; Group @ comprised @ patients ( @ men and @ woman ; mean age @ + / - @ years ) treated with original levofloxacin @ mg/day ; Group @ consisted of @ patients ( all men ; mean age @ + / - @ years ) on standard therapy .


The trial was performed in @ pulmonology centers .


The use of the respiratory fluoroquinolone levofloxacinto treat mild CAP in the patients with risk factors for failure for its therapy demonstrated a higher efficiency than the antibiotic regimens used in real clinical practice .


This suggests that physicians underestimate risk factors and do not always make a rational choice of an antimicrobial agent in the given clinical situation .


The generic form of levofloxacin ( Glevo ) is as clinically effective as its original drug in the treatment of CAP and characterized by its optimal pharmacoeconomic parameters .


Abaloparatide is a novel synthetic peptide analog of parathyroid hormone-related protein ( PTHrP ) that is currently being developed as a potential anabolic agent in the treatment of postmenopausal osteoporosis .


This study sought to assess the effects of abaloparatide on bone mineral density ( BMD ) at the lumbar spine , total hip , and femoral neck in postmenopausal women with osteoporosis .


Multi-center , multi-national , double-blind placebo controlled trial in which postmenopausal women were randomly assigned to receive @ weeks of treatment with daily sc injections of placebo , abaloparatide , @ , @ , or @ g , or teriparatide , @ g.


A @-week extension was also performed in a subset of subjects .


Postmenopausal women with osteoporosis ( n = @ ) .


BMD by dual-x-ray absorptiometry and biochemical markers of bone turnover .


At @ weeks , lumbar spine BMD increased by @ , @ , and @ % in the abaloparatide , @ - , @ - , and @-g groups , respectively , and @ % in the teriparatide group .


The increases in the @ - and @-g abaloparatide groups and the teriparatide group were significantly greater than placebo ( @ % ) .


Femoral neck BMD increased by @ , @ , and @ % in abaloparatide , @ - , @ - , and @-g groups , respectively , and @ % in the teriparatide group .


The increase in femoral neck BMD with abaloparatide , @ g was significantly greater than placebo ( @ % ) .


Total hip BMD increased by @ , @ , and @ % in the abaloparatide , @ - , @ - , and @-g groups , respectively .


The total hip increases in the @ - and @-g abaloparatide groups were greater than both placebo ( @ % ) and teriparatide ( @ % ) .


Compared with placebo , @ weeks of daily sc abaloparatide increases BMD of the lumbar spine , femoral neck , and total hip in a dose-dependent fashion .


Moreover , the abaloparatide-induced BMD increases at the total hip are greater than with the marketed dose of teriparatide .


These results support the further investigation of abaloparatide as an anabolic therapy in postmenopausal osteoporosis .


To observe the clinical effects of myopia in children treated with abdominal acupuncture .


Ninety children with myopia were randomly divided into an abdominal acupuncture group ( @ cases with @ ill eyes ) and an auricular point group ( @ cases with @ ill eyes ) .


In the abdominal acupuncture group , Zhongwan ( CV @ ) , Shangqu ( KI @ ) , Xiawan ( CV @ ) , Tianshu ( ST @ ) , Qihai ( CV @ ) , Guanyuan ( CV @ ) were treated with tapping method .


The needles were not retained and down to the lower in accordance with the order from Zhongwan ( CV @ ) to Guanyuan ( CV @ ) for @ min , and the erubescence skin without blood was proper .


In the auricular point group , vaccaria seeds were pasted at gan ( CO@ ) , shen ( CO@ ) , pi ( CO@ ) , wei ( CO@ ) , yan ( LO@ ) , pingjianqian ( TG@i ) , pingjianhou ( ATli ) and zhen ( AT@ ) ; one ear was chosen every time and the other ear the second time with pressing of patient 's own for @ min every day .


The treatment was given twice a week and @ treatments were considered as one course in the two groups .


The changes of the visual levels in visual chart before treatment , @ min after the first treatment , after @ weeks ' and @ months ' treatment were compared between the two groups , and the clinicall efficacy was compared between the two groups as well .


( @ ) The visual levels in visual chart were improved in the abdominal acupuncture group and auricular point group , and the effects @ min after the first treatment , after @ weeks ' and @ months ' treatment in the abdominal acupuncture group were superior to those in the auricular point group ( @ vs @ , P < @ ; @ vs @ , P < @ ; @ vs @ , P < @ ) .


( @ ) The effective rates @ min after the first treatment , after @ weeks ' and @ months ' treatment in the abdominal acupuncture group were better than those in the auricular point group -LSB- @ % ( @/@ ) vs @ % ( @/@ ) .


@ % ( @/@ ) vs @ % ( @/@ ) ; @ % ( @/@ ) vs @ % ( @/@ ) , all P < @ -RSB- .


Abdominal acupuncture for improving the visual levels of myopia in children is superior to auricular point sticking .


To assess the impact of low concentration contrast media on the degree of vascular enhancement , image quality and radiation dose in coronary CT angiography ( cCTA ) studies when using a combination of iterative reconstruction and low tube voltage .


@ patients who underwent cCTA were randomly divided into two groups .


The patients in group A received iopromide @ were scanned using the conventional tube output , and images were reconstructed using filtered back projection ( FBP ) .


The patients in group B received iodixanol @ were scanned using the low tube output , and images were reconstructed using iterative reconstruction technique ( SAFIRE , Siemens Healthcare ) .


CT attenuation was measured in the coronary arteries , great arteries , interventricular septum and left ventricular cavity .


Noise , subjective image quality scores and effective radiation dose were compared between the two groups .


There was no significant difference in the mean CT attenuation achieved , image noise and mean image quality score at each anatomic site between iomeprol @ group and iopromide @ group .


The effective radiation dose were @ @ mSv and @ @ mSv for iomeprol @ and iopromide @ in low weight subgroups , and @ @ mSv and @ @ mSv in high weight subgroups , respectively , reflecting dose savings of @ % ( P < @ ) and @ % ( P < @ ) , respectively .


The results demonstrate that with a combination of iterative reconstruction and a low tube voltage , a low iodine concentration of @ mgI/ml still improves the contrast enhancement without impairing image quality , as well as significantly lowers effective radiation dose .


A prospective , randomized , and controlled clinical trial .


To compare surgical zipper with subcuticular Monocryl sutures in terms of incision closure time , cosmetic results , and the complication rate in patients with adolescent idiopathic scoliosis ( AIS ) undergoing posterior spinal fusion ( PSF ) surgery .


In previous literatures , the application of surgical zipper to incision closure has been reported to be associated with a favorable outcome .


However , in the PSF surgery of patients with AIS , the use of surgical zipper has not been described .


Ninety female patients with AIS undergoing PSF were assigned randomly to @ incision closure groups either using surgical zipper or using the @-@ absorbable subcuticular suture .


The incision outcome was evaluated with the Hollander Incision Evaluation Score at @ days , @ weeks , @ months , and @ year after surgery , respectively .


Besides , a visual analogue scale was allocated to each patient to rate the cosmetic result of the incision .


The @ groups were compared to determine the differences in terms of incision closure time , the complication rate , and cosmetic results .


The incision closure using surgical zipper consumed significantly less time than that using subcuticular suture ( @ vs. @ s , P < @ ) .


As for the cosmetic results , no significant differences of Hollander Incision Evaluation Score scores between the @ suturing groups were found .


Besides , patients ' satisfaction with cosmetic outcome on a linear visual analogue scale also revealed similar results between the @ groups .


As for postoperative complications , we found @ case of mild blister due to allergy to the tape of the dressings and @ cases of incisional pain in the Monocryl suture group .


The application of surgical zipper in PSF surgery is a safe and effective method .


The ease and the speed of application make surgical zipper an attractive option for incision closure in patients with AIS undergoing PSF .


D-dimer is related to adverse outcomes in arterial and venous thromboembolic diseases .


To evaluate the predictive value of D-dimer level for stroke , other cardiovascular events , and bleeds , in patients with atrial fibrillation ( AF ) treated with oral anticoagulation with apixaban or warfarin ; and to evaluate the relationship between the D-dimer levels at baseline and the treatment effect of apixaban vs. warfarin .


In the ARISTOTLE trial , @ patients with AF were randomized to apixaban or warfarin .


D-dimer was analyzed in @ patients at randomization .


The cohort was separated into two groups ; not receiving vitaminK antagonist ( VKA ) treatment and receiving VKA treatment at randomization .


Higher D-dimer levels were associated with increased frequencies of stroke or systemic embolism ( hazard ratio -LSB- HR -RSB- -LSB- Q@ vs. Q@ -RSB- @ , @ % confidence interval -LSB- CI -RSB- @-@ @ , P = @ ) , death ( HR -LSB- Q@ vs. Q@ -RSB- @ , @ % CI@-@ @ ) and major bleeding ( HR -LSB- Q@ vs. Q@ -RSB- @ , @ % CI@-@ @ , P < @ ) in the no-VKA group .


Similar results were obtained in the on-VKA group .


Adding D-dimer level to the CHADS@ score improved the C-index from @ to @ for stroke or systemic embolism , and from @ to @ for death , in the no-VKA group .


D-dimer level improved the HAS-BLED score for prediction of major bleeds , with an increase in the C-index from @ to @ .


There were no significant interactions between efficacy and safety of study treatment and D-dimer level .


In anticoagulated patients with AF , the level of D-dimer is related to the risk of stroke , death , and bleeding , and adds to the predictive value of clinical risk scores .


The benefits of apixaban were consistent , regardless of the baseline D-dimer level .


Rebleeding after an initial oesophageal variceal haemorrhage remains a significant problem despite therapy with band ligation , non-selective - blockers or a combination of these .


Carvedilol is a vasodilating non-selective - blocker with alpha-@ receptor and calcium channel antagonism .


A recent study has suggested it is effective in the prevention of a first variceal bleed .


Our aim was to compare oral carvedilol with variceal band ligation ( VBL ) in the prevention of rebleeding following a first variceal bleed .


Patients who were stable @ days after presentation with a first oesophageal variceal haemorrhage and had not been taking - blockers were randomised to oral carvedilol or VBL .


Patients were followed-up after one week , monthly , then every @ months .


The primary end point was variceal rebleeding on intention-to-treat analysis .


@ patients were randomised , @ to carvedilol and @ to VBL .


@ ( @ % ) patients had alcohol related liver disease .


Age and Child-Pugh score were similar in both groups at baseline .


Median follow-up was @ ( interquartile range -LSB- IQR -RSB- @-@ @ ) months .


Compliance was @ % and @ % for carvedilol and VBL respectively ( p = @ ) and serious adverse events between the two groups were similar ( p = @ ) .


Variceal rebleeding occurred during follow-up in @ ( @ % ) and @ ( @ % ) patients in the carvedilol and VBL groups , respectively ( p = @ ) , with @ ( @ % ) and @ ( @ % ) deaths in each group , respectively ( p = @ ) .


Carvedilol is not superior to VBL in the prevention of variceal rebleeding .


The trend to a survival benefit for patients taking this drug compared with those undergoing banding requires further exploration .


Alcohol is responsible for a large and growing proportion of the global burden of disease , as well as being the cause of social problems .


Brief interventions are one component of comprehensive policy measures necessary to reduce these harms .


Brief interventions increasingly take advantage of the Internet to reach large numbers of high risk groups such as students .


The research literature on the efficacy and effectiveness of online interventions is developing rapidly .


Although many studies show benefits in the form of reduced consumption , other intervention studies show no effects , for reasons that are unclear .


Sweden became the first country in the world to implement a national system in which all university students are offered a brief online intervention via an e-mail .


This randomized controlled trial ( RCT ) aims to evaluate the effectiveness of this national system comprising a brief online intervention among university students who are hazardous and harmful drinkers .


This study employs a conventional RCT design in which screening to determine eligibility precedes random allocation to immediate or delayed access to online intervention .


The online intervention evaluated comprises three main components ; assessment , normative feedback and advice on reducing drinking .


Screening is confined to a single question in order to minimise assessment reactivity and to prevent contamination .


Outcomes will be evaluated after @ months , with total weekly alcohol consumption being the primary outcome measure .


Invitations to participate are provided by e-mail to approximately @,@ students in @ Swedish universities .


This RCT evaluates routine service provision in Swedish universities via a delay in offer of intervention to the control group .


It evaluates effects in the key population for whom this intervention has been designed .


Study findings will inform the further development of the national service provision .


To determine whether the new selective binding agent sugammadex causes less postoperative nausea and vomiting ( PONV ) than the cholinesterase inhibitor neostigmine .


Prospective , randomized , double-blinded study .


University-affiliated hospital .


One hundred American Society of Anesthesiologists physical status @ and @ patients scheduled for extremity surgery .


Patients were randomly assigned to neostigmine ( @ g/kg ) and atropine ( @ mg per mg neostigmine ) or sugammadex @ mg/kg for neuromuscular antagonism at the end of anesthesia , when @ twitches in response to train-of-four stimulation were visible with fade .


We recorded PONV , recovery parameters , antiemetic consumption , and side effects .


Nausea and vomiting scores were lower in the sugammadex patients upon arrival in the postanesthesia care unit ( med : @ -LSB- min-max , @-@ -RSB- vs med : @ -LSB- min-max , @-@ -RSB- ; P < @ ) , but thereafter low and comparable .


Postoperative antiemetic and analgesic consumption were similar in each group .


Extubation ( median -LSB- interquartile range -RSB- , @ -LSB- @-@ @ -RSB- vs @ -LSB- @-@ @ -RSB- ; P < @ ) first eye opening ( @ -LSB- @-@ @ -RSB- vs @ -LSB- @-@ -RSB- ; P < @ ) , and head lift ( @ -LSB- @-@ @ -RSB- vs @ -LSB- @-@ -RSB- ; P < @ ) in minutes were shorter in patients given sugammadex .


Postoperative heart rates were significantly lower in all measured times patients given neostigmine .


Nondepolarizing neuromuscular blocking antagonism with sugammadex speeds recovery of neuromuscular strength but only slightly and transiently reduces PONV compared with neostigmine and atropine .


Intravitreal high dose ( @ mg ) ranibizumab may lead to quicker resolution of choroidal neovascularization ( CNV ) and associated retinal pigment epithelial detachment in eyes with exudative age-related macular degeneration , although it may possibly correlate with RPE tears in certain cases .


This prospective study compared the outcomes of @ vs @ mg intravitreal ranibizumab injections ( RI ) for treating vascularized pigment epithelial detachment ( vPED ) due to age-related macular degeneration .


Patients with vPED were randomized to receive @ vs @ mg RI monthly for @ months or for @ months and then repeated on a pro-re nata basis .


Optical coherence tomography , fundus photography , and fluorescein and indocyanine-green angiography were obtained at baseline and subsequent specific intervals .


Outcome measures were best-corrected standardized visual acuities , central @-mm thickness , surface area ( SA ) , greatest linear diameter ( GLD ) , heights ( PED and CNV ) , and amount of subretinal fluid ( SRF ) and cystoid macular edema ( CME ) .


Both groups yielded reductions of the central @-mm thickness , PED and CNV SA and PED height and GLD , SRF , and CME .


Vision improvement and reduction in SRF and PED height occurred earlier for eyes receiving the @ mg dose .


Cataract progression was similar but RPE tears developed more often with the @ mg dose .


There were similar visual and anatomical outcomes at the end of the study ; however , the higher dose yielded more rapid reductions and more complete resolution of the PED , although there was possible increased tendency for an RPE tear with the higher dose .


Acute kidney injury ( AKI ) is associated with increased mortality .


While angiotensin-converting enzyme inhibitors ( ACEI ) are known to slow progression of chronic kidney disease , their role in AKI remains unclear .


The Randomised Evaluation of Normal vs. Augmented Level Replacement Therapy ( RENAL ) study data were analysed according to ACEI use over time .


The primary outcome was all-cause mortality at @ days following randomisation .


Analyses used a multivariate Cox model adjusted for either baseline or for time-dependent covariates , and a sensitivity analysis of patients surviving to at least the median time to ACEI initiation .


Of the @ participants with available data on ACE inhibitors usage , @ ( @ % ) received ACEI at least once during study data collection .


Participants treated with ACEI were older ( P = @ ) and had less sepsis at baseline ( P < @ ) .


ACEI use was significantly associated with lower mortality at @ days ( HR @ , @ % CI @-@ @ , P < @ ) , and an increase in renal replacement therapy-free days ( P < @ ) , intensive care unit-free days ( P < @ ) and hospital free-days ( P < @ ) after adjusting for baseline covariates .


Using the time-dependent analysis , however , the effect of ACEI administration was not significant ( HR @ , @ % CI @-@ @ , P = @ ) .


The sensitivity analysis in day @ survivors produced similar results .


In the RENAL study cohort , the use of ACEI during the study was not common and , after adjustment for time-dependent covariates , was not significantly associated with reductions in mortality .


Further assessment of the effect of ACEI use in AKI patients is needed .


To observe effects of syndrome-differentiation acupuncture on life quality in patients with functional dyspepsia ( FD ) in order to evaluate its clinical efficacy .


One hundred and five cases of FD were randomly divided into a syndrome-differentiation acupuncture group , a regular acupuncture group and a non-acupoint group , @ cases in each one .


Zhongwan ( CV @ ) , Tianshu ( ST @ ) , Zusanli ( ST @ ) were selected as main acupoints in the syndrome-differentiation acupuncture group .


After syndrome differentiation , Danzhong ( CV @ ) and Zhangmen ( LR @ ) were added for those with stagnation of liver qi ; Pishu ( BL @ ) and Weishu ( BL @ ) were added for those with deficiency of spleen-stomach qi ; Qimen ( LR @ ) and Taichong ( LR @ ) were added for liver-qi invading stomach and Yinlingquan ( SP @ ) and Neiting ( ST @ ) were added for dampness-heat blocking stomach .


The selection of acupoints in the regular acupuncture group was the same as main acupoints in the syndrome-differentiation acupuncture group .


The points @ mm lateral to the main acupoints were selected in the non-acupoint group .


The treatment was given once a day , six days as a treatment course and totally two courses were required .


The symptom total score , health-related quality of life survey ( SF-@ ) and Nepean dyspepsia index ( NDI ) were evaluated before and after the treatment as well as one month after the treatment ( follow-up visit ) , respectively .


The efficacy was also assessed .


After the treatment , the total effective rate was @ % ( @/@ ) in the syndrome-differentiation acupuncture group , which was superior to @ % ( @/@ ) in the regular acupuncture group and @ % ( @/@ ) in the non-acupoint group ( P < @ , P < @ ) .


Compared before the treatment , the SF-@ , NDI and symptom total score after the treatment and in the follow-up visit were all obviously improved in the syndrome-differentiation acupuncture group and regular acupuncture group ( all P < @ ) , which was the most obvious in the syndrome-differentiation acupuncture group -LSB- after the treatment , SF-@ : @ + / - @ vs @ + / - @ , @ + / - @ ; NDSI : @ + / - @ vs @ + / - @ , @ + / - @ ; NDLQI : @ + / - @ vs @ + / - @ , @ + / - @ ; symptom total score : @ + / - @ vs @ + / - @ , @ + / - @ -RSB- ; the improvement in the regular acupuncture group was more obvious than that in the non-acupoint group ( P < @ , P < @ ) .


Compared before the treatment , only NDSI score was improved in the non-acupoint group after the treatment ( P < @ ) .


The syndrome-differentiation acupuncture could obviously improve patient 's life quality in the treatment of FD , which is an effective therapy for FD .


To assess the efficacy of a mouthwash containing @ % green tea as compared to a placebo mouthwash for the control of plaque and gingivitis .


A randomised controlled clinical trial was conducted on @ male subjects @-@ years of age .


The inclusion criteria were having a minimum of @ sound natural teeth , a plaque index ( PI ) of at least @ and a gingival index ( GI ) of at least @ .


The subjects were randomised into two parallel groups , test and control .


Subjects in the test group and control group were instructed to rinse twice daily for @ min with @ ml of test ( mouthwash containing @ % green tea ) and placebo mouthwash , respectively .


After @ days of using the mouthwash , inter - and intragroup differences for mean plaque index and gingival index scores were analysed .


There was a significant ( p < @ ) reduction in mean GI and PI scores among the test group from baseline to @ days , whereas it was not significant in the control group .


A statistically significant ( p < @ ) reduction was found in the mean difference in GI scores in the test group ( @ @ ) as compared to the control group ( @ @ ) and a statistically significant ( p < @ ) reduction was observed in the mean difference in PI scores in the test group ( @ @ ) compared to the control group ( @ @ ) .


The results showed that the green tea mouthwash was effective in the reduction of plaque and gingivitis scores .


Mixed ( subsyndromal hypomanic ) features are prevalent in patients with bipolar depression and are associated with more severe and complex illness , including increased risk for suicide attempts , higher switch to mania during antidepressant therapy , and a higher rate of recurrence .


The aim of this post hoc analysis was to evaluate the efficacy and safety of lurasidone in the treatment of patients with bipolar depression presenting with mixed features .


Patients with a DSM-IV-TR diagnosis of major depressive episode associated with bipolar I disorder , with or without rapid cycling , and with a Montgomery-Asberg Depression Rating Scale ( MADRS ) score @ and a Young Mania Rating Scale ( YMRS ) score @ were randomly assigned to @ weeks of double-blind , once-daily treatment with lurasidone @-@ mg , lurasidone @-@ mg , or placebo .


The presence of mixed features was defined as a YMRS score @ at study baseline .


Efficacy analyses included change in MADRS total score from baseline to week @ ( the primary outcome in the original study , conducted between April @ and February @ ) .


At baseline , mixed features were present in @ % of patients ( lurasidone , n = @/@ ; placebo , n = @/@ ) .


Treatment with lurasidone ( vs placebo ) was associated with significantly greater reductions in MADRS scores in the mixed features group ( -@ vs -@ ; P = @ ; week @ ; mixed model for repeated measures -LSB- MMRM -RSB- ; effect size , @ ) and in the group without mixed features ( -@ vs -@ ; P = @ ; week @ ; MMRM ; effect size , @ ) .


Rates of protocol-defined treatment-emergent hypomania or mania were similar for patients with mixed features ( lurasidone , @ % ; placebo , @ % ) and without mixed features ( lurasidone , @ % ; placebo , @ % ) .


Lurasidone was found in this post hoc analysis to be efficacious in the treatment of patients with bipolar depression who present with mixed features ( assessed cross-sectionally at study baseline ) .


No increased risk of treatment-emergent mania was observed in either group .


The present study observed the clinical outcomes of the sodium cantharidinate/vitamin B@/GP regimen in the treatment of middle-late stage Non-small-cell lung carcinoma ( NSCLC ) .


Eighty-six cases of NSCLC were selected and randomized into two groups .


Forty-five cases in the treatment group were subject to @ ml cantharidinate/vitamin B@ + GP regimen , for four @-day cycles .


Forty-one cases in the control group were subject to regular GP regimen , for four @-day cycles .


The effectiveness rate was @ % in the treatment group and @ % in the control group , suggesting statistical difference ( P < @ ) ; life quality in the treatment group was significantly better than that in the control group ( P < @ ) ; the occurrence rate of the toxic/adverse effects were significantly lower in the treatment group compared with that in the control group ( P < @ ) .


Sodium cantharidinate/vitamin B@/GP regimen had fair effectiveness and synergistically improved the clinical outcomes .


It lowered the toxic/adverse effects and its application is worth further investigation and promotion .


Approximately @ % of homeless youth smoke cigarettes , but their use of alternative tobacco products ( ATPs ) is unknown .


This paper reports on ATP use among past-month smokers in Los Angeles County , including whether it differs by demographic characteristics , homelessness severity , past-year quit attempts , and readiness to quit smoking .


Given the growing popularity of e-cigarettes , we also report on perceptions of harm and reasons for using this product .


We surveyed @ unaccompanied homeless youth who were randomly sampled from street sites .


Participants had smoked at least @ cigarettes during their lifetime and @ cigarette during the past month .


Seventy-two percent of youth reported past-month ATP use ( e-cigarettes = @ % ; little cigars/cigarillos = @ % ; hookah = @ % ; other smokeless tobacco product = @ % ; chewing tobacco/moist snuff = @ % ) .


Current ATP use was unrelated to most demographic characteristics or having a past-year quit attempt .


However , youth who planned to quit smoking in the next @ days were significantly less likely to report current use of hookahs , other smokeless tobacco products , or e-cigarettes .


Among lifetime e-cigarette users , the most common reasons for use included not having to go outside to smoke ( @ % ) and being able to deal with situations or places where they can not smoke ( @ % ) ; it was less common to report using e-cigarettes to quit smoking ( @ % -@ % ) .


Dual use of ATPs among homeless youth smokers is common and is more likely among those who have no immediate plans to quit smoking .


Effective and easily disseminable strategies for reducing all forms of tobacco use among homeless youth are urgently needed .


Rifabutin has been known to be effective in multidrug-resistant Helicobacter pylori-harboring patients undergoing treatment failure for H. pylori infection .


To evaluate the efficacy of @-day treatment regimen consisting rifabutin daily but increasing the dose of amoxicillin and lansoprazole in patients who have failed first and second eradication and to assess the side effect profiles in South Korea .


From December @ to May @ , @ H. pylori-infected patients with two previous eradication failures were enrolled for this study prospectively .


The eligible patients were randomly assigned to either group A or B. Group A received lansoprazole @ mg bid , amoxicillin @ g tid and rifabutin @ mg bid during @ days , whereas group B received lansoprazole @ mg bid , amoxicillin @ g tid and rifabutin @ mg bid during @ days .


In group A , H. pylori eradication was achieved in @ ( @ % ) of the @ patients in the ITT analysis and in @ ( @ % ) of the @ patients in the PP analysis .


In group B , H. pylori eradication was achieved in @ ( @ % ) of the @ patients in the ITT analysis and in @ ( @ % ) of the @ patients in the PP analysis .


There was statistically significant difference between the two groups in terms of the eradication rates in PP analysis ( p = @ ) , whereas a marginally statistical significance was found in terms of the eradication rates in ITT analysis ( p = @ ) .


Reported side effects were mild , and treatment was well tolerated .


No major changes in physical examination or in standard laboratory parameters were observed after treatment .


Rifabutin-based high-dose proton-pump inhibitor ( PPI ) - combined therapy as empirical rescue treatment is more effective than standard dose PPI-combined rifabutin-based therapy , safe and best tolerable in third-line therapy in the Korean population .


The key to successful rescue therapy with rifabutin-amoxicillin-PPI regimen may be to increase doses of PPI .


This open-label , randomized , phase @ study compared melphalan at a dose of @ mg per square meter of body-surface area plus autologous stem-cell transplantation with melphalan-prednisone-lenalidomide ( MPR ) and compared lenalidomide maintenance therapy with no maintenance therapy in patients with newly diagnosed multiple myeloma .


We randomly assigned @ patients @ years of age or younger to high-dose melphalan plus stem-cell transplantation or MPR consolidation therapy after induction , and @ patients to lenalidomide maintenance therapy or no maintenance therapy .


The primary end point was progression-free survival .


The median follow-up period was @ months .


Both progression-free and overall survival were significantly longer with high-dose melphalan plus stem-cell transplantation than with MPR ( median progression-free survival , @ months vs. @ months ; hazard ratio for progression or death , @ ; @ % confidence interval -LSB- CI -RSB- , @ to @ ; P < @ ; and @-year overall survival , @ % vs. @ % ; hazard ratio for death , @ ; @ % CI , @ to @ ; P = @ ) .


Median progression-free survival was significantly longer with lenalidomide maintenance than with no maintenance ( @ months vs. @ months ; hazard ratio for progression or death , @ ; @ % CI , @ to @ ; P < @ ) , but @-year overall survival was not significantly prolonged ( @ % vs. @ % ; hazard ratio for death , @ ; @ % CI , @ to @ ; P = @ ) .


Grade @ or @ neutropenia was significantly more frequent with high-dose melphalan than with MPR ( @ % vs. @ % ) , as were gastrointestinal adverse events ( @ % vs. @ % ) and infections ( @ % vs. @ % ) ; neutropenia and dermatologic toxic effects were more frequent with lenalidomide maintenance than with no maintenance ( @ % vs. @ % and @ % vs. @ % , respectively ) .


Consolidation therapy with high-dose melphalan plus stem-cell transplantation , as compared with MPR , significantly prolonged progression-free and overall survival among patients with multiple myeloma who were @ years of age or younger .


Lenalidomide maintenance , as compared with no maintenance , significantly prolonged progression-free survival .


( Funded by Celgene ; ClinicalTrials.gov number , NCT@ . )


The Stockholm III Trial randomized patients with primary operable rectal cancers to either short-course radiotherapy ( RT ) with immediate surgery ( SRT ) , short-course RT with surgery delayed @-@ weeks ( SRT-delay ) or long-course RT with surgery delayed @-@ weeks .


This preplanned interim analysis examined the pathological outcome of delaying surgery .


Patients randomized to the SRT and SRT-delay arms in the Stockholm III Trial between October @ and November @ were included , and data were collected in a prospective register .


Additional data regarding tumour regression grade , according to Dworak , and circumferential margin were obtained by reassessment of histopathological slides .


A total of @ of @ randomized patients had specimens available for reassessment .


Patients randomized to SRT-delay had earlier ypT categories , and a higher rate of pathological complete responses ( @ versus @ per cent ; P = @ ) and Dworak grade @ tumour regression ( @ versus @ per cent ; P < @ ) than patients randomized to SRT without delay .


Positive circumferential resection margins were uncommon ( @ per cent ) and rates did not differ between the two treatment arms .


Short-course RT induces tumour downstaging if surgery is performed after an interval of @-@ weeks .


Colonoscopy requires effective bowel preparation for adequate mucosal visualization .


Safety and acceptability of bowel preparation are key components in colorectal cancer screening ( CRC ) populations .


To compare the efficacy , safety and acceptability of bowel preparation with polyethylene glycol ( PEG ) , ascorbic acid , sodium ascorbate ( ascorbate components ) , sodium sulfate and electrolytes ( PEG+A sc ) or sodium phosphate ( NaP ) .


Consenting adults undergoing elective out-patient colonoscopy for CRC were randomized to take @ L PEG+A sc or @ mL NaP ( control ) following manufacturer 's instructions .


PEG+A sc was taken the evening before and morning of the colonoscopy ; NaP was taken the morning and evening before colonoscopy .


Participants followed a restricted diet specific to each preparation .


Primary endpoint was bowel cleansing success ( @ % colon mucosa visible ) rated by an independent expert panel ( all experienced endoscopists ) unaware of treatment allocations .


Subject reported outcomes about the preparations were elicited .


Adverse events were recorded .


Clinicaltrials.gov : NCT@ .


Successful bowel cleansing rate was significantly higher in the PEG+A sc ( N = @ ) than the NaP ( N = @ ) group ( PEG+A sc @ % -LSB- @ % CI @-@ @ -RSB- versus NaP @ % -LSB- @-@ @ % -RSB- , p < @ ) .


Subject reported outcomes on acceptability of the two different preparations were not significantly different ( p = @ ) .


However , taste ratings for PEG+A sc were significantly better versus NaP ( mean VAS : @ and @ respectively , p = @ ) .


The proportion of patients prepared to receive the same preparation again was significantly higher in the PEG+A sc group ( @ % vs. @ % , p < @ ) .


PEG+A sc provided superior bowel cleansing to NaP and was well tolerated .


Findings for PEG+A sc are aligned with previous similar studies ; however , differences observed in NaP cleansing results , especially for the proximal colon segments , may be due to factors including : differences in demographics and population types and the use of the validated Harefield Cleansing Scale as an assessment tool combined with expert reviews , which may have resulted in conservative cleansing assessments .


Recent studies show that enzymatically hydrolysed collagen , the collagen peptide , is absorbed and distributed to joint tissues and has analgesic and anti-inflammatory properties .


A double-blind , placebo-controlled , randomised trial with collagen peptides isolated from pork skin ( PCP ) and bovine bone ( BCP ) sources was carried out to study the effectiveness of orally supplemented collagen peptide to control the progression of osteoarthritis in patients diagnosed with knee osteoarthritis .


Improvement in treatment was assessed with reduction in Western Ontario McMaster Universities ( WOMAC ) , visual analogue scale ( VAS ) and quality of life ( QOL ) scores from baseline to @ weeks ( Visit @ ) .


Safety and tolerability were also evaluated .


There was significant reduction from baseline to Visit @ in the primary end points of WOMAC and VAS scores and in the secondary end point of QOL score in subjects with PCP and BCP groups , while in subjects with placebo group the end point indices remained unaltered .


Furthermore , all the score levels of WOMAC , VAS and QOL decreased significantly ( P < @ ) in the study group compared to placebo group in Visit @ .


The study demonstrated that collagen peptides are potential therapeutic agents as nutritional supplements for the management of osteoarthritis and maintenance of joint health .


To explore the feasibility , advantages and clinical value of gasless abdominal-wall lifting laparoscopic myomectomy with @ mm laparoscope and @ abdominal holes ( @-hole-gasless-laparoscopic myomectomy ) .


A total of @ cases of uterine fibroids were randomly divided into @ groups .


Lifting gasless group ( n = @ ) underwent gasless abdominal-wall lifting laparoscopic myomectomy with @ mm laparoscope and @ abdominal holes , and pneumoperitoneum group ( n = @ ) pneumoperitoneum laparoscopic myomectomy .


The operative duration , blood loss volume , average time of single-myoma-removal , intestinal function recovery and hospital stay of both groups were compared .


The operative duration , blood loss volume and average time of single-myoma-removal of lifting gasless group were respectively significantly less than those of pneumoperitoneum group ( P < @ ) .


The postoperative intestinal function recovery and postoperative hospital stay had no significant difference between two groups ( P > @ ) .


Three cases of pneumoperitoneum group were converted successfully into myomectomy with traditional @-hole gasless abdominal wall lifting laparoscopy because of large fibroids in uterine isthmus .


A total of @ newly discovered myomas , not pre-detected ultrasonically , were removed in @ cases of lifting gasless group .


@-hole-gasless-laparoscopic myomectomy , like traditional gasless laparoscopy , may avoid the complications of laparoscopic CO@ pneumoperitoneum .