Forty-eight healthy adolescent human males aged between @ to @ years were randomly recruited as volunteers and were randomly split into two groups : A ( n = @ ) and B ( n = @ ) .


The treatment procedure for group A and B were one capsule of @ mg placebo and @ mg NS respectively once daily for four weeks .


All the volunteers were assessed for cognition with modified California verbal learning test-II ( CVLT-II ) , mood with Bond-Lader scale and anxiety with State-Trait Anxiety Inventory ( STAI ) at the beginning and after four weeks of either NS or placebo ingestion .


No parameter showed statistically significant variation between A and B in measurements in the beginning , but after @ weeks of one capsule of NS @ mg intake , there was statistically significant variation of mood within group B but there was not statistically significant variation between group A and B. No significant variation was found in state anxiety within groups and between group A and B but in case of trait anxiety , significant variation was found within group B but not between group A and B.


In case of CVLT II , there was significant variation within B in immediate short-term recall at trial @ and @ whereas this difference was found only in case of trial @ between group A and B. Within group B , short term-free recall , long-term free recall and long-term cued recall had statistical difference whereas between group A and B long-term free recall and long-term cued recall had statistical difference .


No parameters had significant variation within group A after placebo intake for @ weeks .


Over the @ weeks study period , the use of NS as a nutritional supplement been observed to - stabilize mood , decrease anxiety and modulate cognition positively .


However , long term study is suggested before using NS extensively .


Although noninvasive positive pressure ventilation ( NPPV ) has been successfully used for various kinds of acute respiratory failure , the data are limited regarding its application in postoperative respiratory failure after cardiac surgery .


Therefore , we conducted a prospective randomized control study in a university surgical intensive care unit to evaluate the efficacy and safety of NPPV in the treatment of acute respiratory failure after cardiac surgery , and explore the predicting factors of NPPV failure .


From September @ to November @ patients with acute respiratory failure after cardiac surgery who had indication for the use of NPPV were randomly divided into a NPPV treatment group ( NPPV group ) and the conventional treatment group ( control group ) .


The between-group differences in the patients ' baseline characteristics , re-intubation rate , tracheotomy rate , ventilator associated pneumonia ( VAP ) incidence , in-hospital mortality , mechanical ventilation time after enrollment ( MV time ) , intensive care unit ( ICU ) and postoperative hospital stays were compared .


The factors that predict NPPV failure were analyzed .


During the study period , a total of @ patients who had acute respiratory failure after cardiac surgery were recorded , and @ of them met the inclusion criteria , which included @ males and @ females with a mean age of ( @ @ ) years .


Forty-three patients underwent coronary artery bypass grafting ( CABG ) , @ underwent valve surgery , @ underwent CABG + valve surgery , @ underwent major vascular surgery , and three underwent other surgeries .


The NPPV group had @ patients and the control group had @ patients .


In the NPPV group , the re-intubation rate was @ % , tracheotomy rate was @ % , VAP incidence was @ , and the in-hospital mortality was @ % , significantly lower than in the control group @ % , @ % , @ % and @ % respectively , P < @ or P < @ .


The MV time and ICU stay ( expressed as the median ( P@ , P@ ) ) were @ ( @ , @ ) hours and @ ( @ , @ ) days , which were significantly shorter than in the control group , @ ( @ , @ ) hours and @ ( @ , @ ) days respectively , P < @ or P < @ .


The postoperative hospital stays of the two groups were similar .


The univariate analysis showed that the NPPV success subgroup had more patients with acute lung injury ( ALI ) ( @ vs. @ , P = @ ) , fewer patients with pneumonia ( @ vs. @ , P < @ ) and lower acute physiology and chronic health evaluation II ( APACHE II ) scores ( @ @ vs. @ @ , P < @ ) .


Multivariate analysis showed that pneumonia ( P = @ ) and a high APACHE II score > @ ( P = @ ) were the independent risk factors of NPPV failure .


We conclude that NPPV can be applied in selected patients with acute respiratory failure after cardiac surgery to reduce the need of re-intubation and improve clinical outcome as compared with conventional treatment .


Pneumonia and a high APACHE II score > @ might be the independent risk factors of NPPV failure in this group of patients .


Rifaximin is a gut-selective , oral antimicrobial agent shown to reduce the recurrence of overt hepatic encephalopathy ( HE ) and HE-related hospitalizations in a @-month , randomized , controlled trial ( RCT ) .


We performed a phase @ , open-label maintenance study to assess the safety and rate of hospitalization with long-term rifaximin use .


We conducted a @-month , open-label maintenance study of rifaximin ( @ mg , twice daily ) in patients with HE who participated in the previous RCT of rifaximin or new patients enrolled from March @ to December @ .


Safety was assessed ( adverse events , clinical laboratory parameters ) for the integrated population of all patients , who were given rifaximin @ mg twice daily ( all-rifaximin population , N = @ ) .


Safety and hospitalization data were compared between the group given placebo in the original RCT ( n = @ ) and those given rifaximin ( n = @ ) .


In the all-rifaximin population , the median exposure to rifaximin was @ days ( range , @-@ d ) , with @ person-years of exposure .


The profile and rate of adverse events with long-term rifaximin treatment were similar to those of the original RCT .


There was no increase in the rate of infections , including with Clostridium difficile , or development of bacterial antibiotic resistance .


Rates of hospitalizations with long-term rifaximin administration remained low : the HE-related hospitalization rate , normalized for exposure ( @ ; all-rifaximin population ) , was similar to that of the rifaximin group in the original RCT ( @ ) , and lower than that for the placebo group ( @ ) .


Long-term treatment ( @ mo ) with rifaximin ( @ mg , twice daily ) appears to provide a continued reduction in the rate of HE-related and all-cause hospitalization , without an increased rate of adverse events .


ClinicalTrials.gov number : NCT@ .


Physical activity levels of Australia 's ageing population are declining and coincidentally rates of overweight and obesity are increasing .


Adequate levels of physical activity and a healthy diet are recognised as important lifestyle factors for the maintenance of a healthy weight and prevention of chronic diseases .


Retirement village ( RV ) residents rarely engage in physical activity and nutrition programmes offered , with poor attendance and low use of existing facilities such as on-site fitness centres and classes and nutrition seminars .


The RV provides a unique setting to access and engage with this older target group , to test the effectiveness of strategies to increase levels of physical activity , improve nutrition and maintain a healthy weight .


This cluster-randomised controlled trial will evaluate a physical activity , nutrition and healthy weight management intervention for insufficiently active ( ` not achieving @ min of moderate-intensity physical activity per week ' ) adults aged @-@ residing in RV 's .


A total of @ participants will be recruited from @ randomly selected RV 's in Perth , Western Australia .


Villages will be assigned to either the intervention group ( n = @ ) or the control group ( n = @ ) each containing @ participants .


The Retirement Village Physical Activity and Nutrition for Seniors ( RVPANS ) programme is a home-based physical activity and nutrition programme that includes educational resources , along with facilitators who will motivate and guide the participants during the @-month intervention .


Descriptive statistics and mixed regression models will be performed to assess the intervention effects .


This trial will evaluate an intervention for the modification of health risk factors in the RV setting .


Such research conducted in RV 's has been limited .


The supplementation of fat to lactating dairy cows has long been used as a management tool to increase dietary energy density for improving cow production , reproduction and to alleviate negative energy balance .


Attempts have been made to investigate the effect of canola meal on plasma metabolites in lactating cows , but the results have been diverse and inconsistent .


To our current knowledge , there is a dearth of published information on the utilization of Crude Degummed Canola Oil ( CDCO ) in pasture-based dairy systems .


Therefore , the objective of this study was to investigate the changes in plasma metabolite profiles of pasture-based , primiparous , Holstein-Friesian cows supplemented with varying dietary levels of CDCO for eight weeks .


The study tested the hypothesis that feeding grazing primiparous Holstein-Friesian cows for eight weeks with incremental levels of CDCO supplement will decrease plasma non-esterified fatty acids ( NEFA ) and - hydroxybutyrate ( BHBA ) , but increase plasma cholesterol and glucose metabolites .


Twenty lactating primiparous Holstein-Friesian cows @ days in milk were randomly allotted into four treatment groups that consisted of a wheat-based , pelleted basal diet with no supplemental CDCO ( control ) , basal diet with CDCO added at @ ml/kgDM ( DM ; dry matter ) ( low ) , @ ml/kgDM ( medium ) and @ ml/kgDM ( high ) in an eight-week feeding trial , after two weeks of adjustment .


Treatment influenced BHBA but had no effect on plasma NEFA , cholesterol and glucose metabolite profiles ( P > @ ) .


However , week of supplementation had a significant effect ( P < @ ) on BHBA , NEFA and glucose concentrations .


We concluded that with the exception of BHBA , CDCO at current levels of supplementation does not alter the plasma metabolite profiles of grazing primiparous cows .


The lack of significant differences across treatments seems to indicate that higher levels of CDCO than the current levels used in this study , are probably needed .


Furthermore , the duration of supplementation with CDCO had a greater impact on plasma metabolites than the levels of supplementation .


Our findings also suggest that primiparous cows grazing high quality pastures during spring have sufficient energy intakes to prevent negative energy balance at @ days in milk without the need for added fat supplements .


To investigate the variations in blood glucose levels , hemodynamic effects and patient anxiety scores during tooth extraction in patients with type @ diabetes mellitus T@DM and coronary disease under local anesthesia with @ % lidocaine with or without epinephrine .


This is a prospective randomized study of @ patients with T@DM with coronary disease who underwent oral surgery .


The study was double blind with respect to the glycemia measurements .


Blood glucose levels were continuously monitored for @ hours using the MiniMed Continuous Glucose Monitoring System .


Patients were randomized into two groups : @ patients received @ mL of @ % lidocaine , and @ patients received @ mL of @ % lidocaine with @:@,@ epinephrine .


Hemodynamic parameters ( blood pressure and heart rate ) and anxiety levels were also evaluated .


There was no difference in blood glucose levels between the groups at each time point evaluated .


Surprisingly , both groups demonstrated a significant decrease in blood glucose levels over time .


The groups showed no significant differences in hemodynamic and anxiety status parameters .


The administration of @ mL of @ % lidocaine with epinephrine neither caused hyperglycemia nor had any significant impact on hemodynamic or anxiety parameters .


However , lower blood glucose levels were observed .


This is the first report using continuous blood glucose monitoring to show the benefits and lack of side effects of local anesthesia with epinephrine in patients with type @ diabetes mellitus and coronary disease .


An acid-base imbalance precedes renal disease progression in patients with chronic kidney disease ( CKD ) .


Little is known about the effects of a low-salt diet ( LSD ) on net endogenous acid production ( NEAP ) levels in CKD patients using angiotensin receptor blockade .


We enrolled a total of @ nondiabetic CKD patients who underwent an @-week treatment with olmesartan from the original trial -LSB- Effects of Low Sodium Intake on the Antiproteinuric Efficacy of Olmesartan in Hypertensive Patients with Albuminuria ( ESPECIAL ) trial : NCT@ -RSB- .


The patients were divided into good - and poor-LSD-compliance groups .


During the interventional @ weeks , the NEAP in the good-compliance group increased compared to the control group ( @ @ vs. -@ @ mmol/day , p = @ ) .


NEAP was positively associated with the good-LSD-compliance group in the fully adjusted analyses ( r = @ , p = @ ) .


The additional reduction of @ g/day of protein intake with a reduction of @ g/day of salt intake did not increase the NEAP under angiotensin II receptor blockade ( ARB ) treatment with an LSD ( r = @ , p < @ ) .


We found that an LSD may increase the NEAP in nondiabetic CKD patients using ARB , which suggests that additional acid producing-protein restriction should be required to prevent the NEAP from rising .


Coenzyme Q@ ( CoQ@ ) supplementation is the most popular therapy for statin myalgia among both physicians and patients despite limited and conflicting evidence of its efficacy .


This study examined the effect of coenzyme Q@ ( CoQ@ ) supplementation on simvastatin-associated muscle pain , muscle strength and aerobic performance in patients with confirmed statin myalgia .


Statin myalgia was confirmed in @ patients with prior symptoms of statin myalgia using an @-week randomized , double-blind crossover trial of simvastatin @mg/d and placebo .


Forty-one subjects developed muscle pain with simvastatin but not with placebo and were randomized to simvastatin @mg/d combined with CoQ@ ( @mg/d ubiquinol ) or placebo for @ weeks .


Muscle pain ( Brief Pain Inventory -LSB- BPI -RSB- ) , time to pain onset , arm and leg muscle strength , and maximal oxygen uptake ( VO@max ) were measured before and after each treatment .


Serum CoQ@ increased from @ to @ mcg/mL with simvastatin and CoQ@ , but did not increase with simvastatin and placebo ( @ to @ ) ( p < @ ) .


BPI pain severity and interference scores increased with simvastatin therapy ( both p < @ ) , irrespective of CoQ@ assignment ( p = @ and @ ) .


There were no changes in muscle strength or VO@max with simvastatin with or without CoQ@ ( all p > @ ) .


Marginally more subjects reported pain with CoQ@ ( @ of @ vs @ of @ ; p = @ ) .


There was no difference in time to pain onset in the CoQ@ ( @ weeks ) vs. placebo ( @ wks ) groups ( p = @ ) .


A similar lack of CoQ@ effect was observed in @ subjects who were then crossed over to the alternative treatment .


Only @ % of patients complaining of statin myalgia develop symptoms during a randomized , double-blind crossover of statin vs placebo .


CoQ@ supplementation does not reduce muscle pain in patients with statin myalgia .


Trial RegistrationNCT@ ; www.clinicaltrials.gov .


The purpose of this study was to investigate the effects of whole-body vibration training on muscle strength and balance in children with diplegic cerebral palsy .


Fifteen children were assigned to the experimental group , which received whole-body vibration training ( @ mins per day , @ days per week ) .


Another @ were assigned to the control group , which participated in a traditional physical therapy exercise program for @ successive months .


Baseline and posttreatment assessments were performed using the Biodex isokinetic dynamometer to evaluate the knee extensors peak torque at @ degrees per second and @ degrees per second and using the Biodex balance system to evaluate stability index .


The children in the experimental group showed a significant improvement when compared with those in the control group ( P < @ ) .


The peak torque at @ degrees per second and @ degrees per second after treatment was @ @ and @ @ N m and @ @ and @ @ N m for the control and the experimental group , respectively .


The overall stability index after treatment was @ and @ for the control group and the experimental group , respectively .


Whole-body vibration training may be a useful tool for improving muscle strength and balance in children with diplegic cerebral palsy .


To evaluate the short-term and long-term effects on treatment of neck pain caused by cervical spondylosis with the combination of acupuncture and moxibustion with seed-size moxa cone .


One hundred and forty-five patients of neck pain were randomly divided into an acupuncture-moxibustion group ( @ cases ) , an acupuncture group ( @ cases ) and a moxibustion group ( @ cases ) .


Acupoints of Bailao ( Extra ) , Dazhui ( GV @ ) , Jianzhongshu ( SI@ ) and Zhongzhu ( TE @ ) were adopted for all the @ groups .


Acupuncture was applied at all the acupoints with @ min needling retention for the acupuncture group .


Moxibustion with seed-size moxa cone was used with @ cones on each point for the moxibustion group .


And both acupuncture and moxibustion with seed-size moxa cone were adopted for the acupuncture-moxibustion group .


The treatment was applied once every @ days , and @ treatments should be finished within @ weeks .


Follow-up should be carried out for @ months .


The short-term and long-term effects were evaluated with the scores of Northwick Park Pain Questionnaire ( NPQ ) and McGill Pain Questionnaire ( MPQ ) as the indices of therapeutic effect .


The NPQ score and MPQ score of all the @ groups after the treating course and the @-month follow-up were both decreased when compared with those before the treatment ( all P < @ ) .


The scores of NPQ and MPQ the acupuncture-moxibustion group were lower than that of the other two groups .


And the difference had obvious significance ( P < @ ) .


High efficiency of pain relieving for cervical spondylosis could be found in all the @ groups , which showed that short-term and long-term effects were good for all the @ groups .


And the highest curative effect could be found in acupuncture-moxibustion group .


Combination of acupuncture and moxibustion with seed-size moxa cone has reached a superior effect in short-term and long-term for neck pain caused by cervical spondylosis .


Polycystic ovary syndrome ( PCOS ) patients are at increased risk of pregnancy complications , which may impair pregnancy outcome .


Transfer of fresh embryos after superovulation may lead to abnormal implantation and placentation and further increase risk for pregnancy loss and complications .


Some preliminary data suggest that elective embryo cryopreservation followed by frozen-thawed embryo transfer into a hormonally primed endometrium could result in a higher clinical pregnancy rate than that achieved by fresh embryo transfer .


This study is a multicenter , prospective , randomized controlled clinical trial ( @:@ treatment ratio of fresh vs. elective frozen embryo transfers ) .


A total of @,@ infertile PCOS patients undergoing the first cycle of in vitro fertilization ( IVF ) or intracytoplasmic sperm injection will be enrolled and randomized into two parallel groups .


Participants in group A will undergo fresh embryo transfer on day @ after oocyte retrieval , and participants in group B will undergo elective embryo cryopreservation after oocyte retrieval and frozen-thawed embryo transfer in programmed cycles .


The primary outcome is the live birth rate .


Our study is powered at @ to detect an absolute difference of @ at the significance level of @ based on a two-sided test .


We hypothesize that elective embryo cryopreservation and frozen-thawed embryo transfer will reduce the incidence of pregnancy complications and increase the live birth rate in PCOS patients who need IVF to achieve pregnancy .


To compare the safety and efficiency of plasmakinetic enucleation of the prostate ( PKEP ) with that of plasmakinetic resection of the prostate ( PKRP ) in the treatment of benign prostatic hyperplasia ( BPH ) .


Three hundred ten patients diagnosed to have BPH were randomized to undergo either PKEP or PKRP .


The perioperative data and postoperative outcomes followed at @ , @ , @ , @ , @ , and @ months after surgery were recorded and compared in the groups classified according to the baseline prostate volume : @ mL and > @ mL .


There were no significant differences in the preoperative data .


Compared with PKRP , PKEP costs longer operative time ( @ @ vs @ @ min ; P < @ ) for prostate volume @ mL , but reduced operative time ( @ @ vs @ @ minutes ; P < @ ) and caused less blood loss ( @ @ vs @ @ mL ; P < @ ) for prostate volume > @ mL .


However , regardless of prostate size , the incidence of transient incontinence after PKEP was higher .


The postoperative improvement among these groups in International Prostate Symptom Score , quality of life , and maximal flow rate was similar at @-month follow-up .


PKEP and PKRP are both safe and effective treatments for BPH independent of prostate size .


Despite that the incidence of transient incontinence after PKEP was higher , PKEP was significantly superior to PKRP in operative time and blood loss for prostate volume > @ mL and may become the modern alternative to PKRP for large BPH .


Paravertebral block ( PVB ) has been shown to be an ideal aid for analgesia after thoracic or abdominal surgery .


The authors studied the safety and efficacy of the single-dose and bilateral ultrasound-guided ( USG ) - PVB before combined thoracoscopic-laparoscopic esophagectomy ( TLE ) along with intravenous sufentanil analgesia as a method of pain relief in comparison with intravenous sufentanil as a sole analgesic agent .


Prospective , randomized study .


Single university hospital .


Fifty-two patients undergoing TLE .


A USG-PVB was performed before surgery using a solution of @ mL of @ % ropivacaine by @ injections of @ mL each at the right T@ and bilateral T@ ( PVB group , n = @ ) or the saline injection of @ mL at every site ( control group , n = @ ) .


Successful PVBs were achieved in all patients of the PVB group .


Intraoperative mean remifentanil usage and end-tidal sevoflurane concentration were lower in the PVB group ( p < @ ) .


Hemodynamic parameters were stable in both groups .


Postoperative pain scores both at rest and on coughing were lower during the first @ hours in the PVB group than those in the control group ( p < @ ) .


Cumulative sufentanil consumption delivered by patient-controlled analgesia ( PCA ) was significantly lower in the PVB group at all time points ( p < @ ) .


Postoperative pulmonary function was better at the third postoperative day in the PVB group ( p < @ ) , with quicker hospital discharge and lower hospital costs ( p < @ ) .


The single-dose and bilateral PVB given before TLE combined with sufentanil may provide better postoperative analgesia and early discharge in patients undergoing TLE .


Dysregulation of lipid homeostasis is related to multiple major healthcare problems .


The aim of this study was to investigate the effects of n-@ fatty acid ( FA ) and polyphenol rich diets on plasma and HDL fraction lipidomic profiles in subjects at high cardiovascular risk .


Ultra performance LC coupled to quadrupole TOF/MS mass spectrometry global lipidomic profiling was applied to plasma and HDL fraction from an @ wk randomized intervention with four isoenergetic diets , differing in their natural n-@ FA and polyphenols content , in @ subjects with a high BMI , abdominal obesity , and at least one other feature of the metabolic syndrome .


Dependency network analysis showed a different pattern of associations between lipidomics , dietary , and clinical variables after the dietary interventions .


The most remarkable associations between variables were observed after the diet high in n-@ FA and polyphenols , as the inverse association between gallic acid intake and LDL cholesterol levels , which was indirectly associated with a HDL cluster exclusively comprised lysophospholipids .


This is the first human randomized controlled trial showing direct and indirect associations with lipid molecular species and clinical variables of interest in the evaluation of the metabolic syndrome after diets naturally rich in polyphenols .


Chemotherapy-induced peripheral neuropathy ( CIPN ) is a significant side effect of taxane and platinum-based chemotherapy .


Several studies have supported the potential benefit of glutathione for the prevention of platinum-induced CIPN .


The current trial was designed to determine whether glutathione would prevent CIPN as a result of carboplatin/paclitaxel therapy .


In total , @ patients who received treatment with paclitaxel and carboplatin were accrued between December @ , @ and December @ , @ .


Patients were randomized to receive either placebo ( n = @ ) or @ g/m ( @ ) glutathione ( n = @ ) over @ minutes immediately before chemotherapy .


CIPN was assessed using the European Organization for Research and Treatment of Cancer Quality-of-Life ( EORTC-QLQ ) @-item , CIPN-specific ( CIPN@ ) sensory subscale and the National Cancer Institute Common Terminology Criteria for Adverse Events ( CTCAE ) , version @ .


There were no statistically significant differences between the @ study arms with regard to : @ ) peripheral neurotoxicity , as assessed using both the EORTC-QLQ-CIPN@ ( P = @ ) and the CTCAE scales ( P = @ for grade @ neurotoxicity ; P = @ for time to development of grade @ neuropathy , in favor of the placebo ) ; @ ) the degree of paclitaxel acute pain syndrome ( P = @ for patients who received paclitaxel every @-@ weeks and P = @ , in favor of the placebo , for patients who received weekly paclitaxel ) ; @ ) the time to disease progression ( P = @ ) ; or @ ) apparent toxicities .


Subgroup analyses did not reveal any evidence of benefit in any particular subgroup .


The results from this study do not support the use of glutathione for the prevention of paclitaxel/carboplatin-induced CIPN .


The single most distressing symptom for patients with advanced esophageal cancer is dysphagia .


Amongst the more effective treatments for relief of dysphagia is insertion of a self-expanding metal stent ( SEMS ) .


It is possible that the addition of a palliative dose of external beam radiotherapy may prolong the relief of dysphagia and provide additional survival benefit .


The ROCS trial will assess the effect of adding palliative radiotherapy after esophageal stent insertion .


The study is a randomized multicenter phase III trial , with an internal pilot phase , comparing stent alone versus stent plus palliative radiotherapy in patients with incurable esophageal cancer .


Eligible participants are those with advanced esophageal cancer who are in need of stent insertion for primary management of dysphagia .


Radiotherapy will be administered as @ Gray ( Gy ) in five fractions over one week or @ Gy in @ fractions over two weeks , within four weeks of stent insertion .


The internal pilot will assess rates and methods of recruitment ; pre-agreed criteria will determine progression to the main trial .


In total , @ patients will be randomized in a @:@ ratio with follow up until death .


The primary outcome is time to progression of patient-reported dysphagia .


Secondary outcomes include survival , toxicity , health resource utilization , and quality of life .


An embedded qualitative study will explore the feasibility of patient recruitment by examining patients ' motivations for involvement and their experiences of consent and recruitment , including reasons for not consenting .


It will also explore patients ' experiences of each trial arm .


The ROCS study will be a challenging trial studying palliation in patients with a poor prognosis .


The internal pilot design will optimize methods for recruitment and data collection to ensure that the main trial is completed on time .


As a pragmatic trial , study strengths include collection of all follow-up data in the usual place of care , and a focus on patient-reported , rather than disease-orientated , outcomes .


Exploration of patient experience and health economic analyses will be integral to the assessment of benefit for patients and the NHS .


Pathophysiology of tinnitus known to accompany nearly all disorders in hearing system has not been fully understood , and therefore , there are some difficulties in evaluation and treatment thereof .


The objective of the current study is to research the effectiveness of transcranial magnetic stimulation ( TMS ) application in treatment of tinnitus .


Sixty patients aged between @ and @ years who applied to a polyclinic of Ear-Nose-Throat Department , Cerrahpasa Medical Faculty , Istanbul University , because of the complaint of tinnitus between January @ and July @ were selected using simple random sampling method .


The treatment group and the placebo group were separated randomly as to include @ patients .


The tinnitus loudness , tinnitus frequency , tinnitus subjective score , and tinnitus handicap inventory results were compared before application of TMS and after @ month .


It was found that the difference of tinnitus handicap inventory score within the TMS group ( before the treatment : mean , @ ; SD , @ ; after the treatment : mean , @ ; SD , @ ) was statistically significant ( P < @ ) and the difference of tinnitus handicap inventory score within the placebo group ( before the treatment : mean , @ ; SD , @ ; after the treatment : mean , @ ; SD , @ ) was significantly insignificant ( P = @ ) .


When tinnitus severities determined at the beginning and end of the treatment were evaluated within each group , it was found that the difference of loudness within the group subjected to TMS was statistically significant ( P < @ ) but the difference of loudness within the placebo group was statistically insignificant ( P = @ ) .


When tinnitus subjective scores were evaluated within each group before and after the treatment , the difference of subjective score within the group subjected to transcranial magnetic stimulation was statistically significant ( P < @ ) , and the difference of subjective score within the placebo group was statistically significant ( P = @ ) .


The studies showed that low-frequency repeating TMS is useful in the treatment of chronic tinnitus .


In the current study performed on the patients with chronic tinnitus , it was shown that low-frequency repeating TMS has a statistically significant success when compared with the placebo group .


Although prompt reperfusion treatment restores normal epicardial flow , microvascular dysfunction may persist in some patients with acute coronary syndrome ( ACS ) .


Impaired myocardial perfusion is caused by intraluminal platelets , fibrin thrombi and neutrophil plugging ; antiplatelet agents play a significant role in terms of protecting against thrombus microembolization .


A novel antiplatelet agent , ticagrelor , is a non-thienopyridine , direct P@Y@ blocker that has shown greater , more rapid and more consistent platelet inhibition than clopidogrel .


However , the effects of ticagrelor on the prevention of microvascular dysfunction are uncertain .


The present study is a comparison between clopidogrel and ticagrelor use for preventing microvascular dysfunction in patients with ST elevation or non-ST elevation myocardial infarction ( STEMI or NSTEMI , respectively ) .


The TIME trial is a single-center , randomized , open-label , parallel-arm study designed to demonstrate the superiority of ticagrelor over clopidogrel .


A total of @ patients with a spectrum of STEMI or NSTEMI will undergo prospective random assignment to clopidogrel or ticagrelor ( @:@ ratio ) .


The primary endpoint is an index of microcirculatory resistance ( IMR ) measured after percutaneous coronary intervention ( PCI ) ; the secondary endpoint is wall motion score index assessed at @ months by using echocardiography .


The TIME trial is the first study designed to compare the protective effect of clopidogrel and ticagrelor on coronary microvascular dysfunction in patients with STEMI and NSTEMI .


Opioid-dependent patients often use the emergency department ( ED ) for medical care .


To test the efficacy of @ interventions for opioid dependence : ( @ ) screening and referral to treatment ( referral ) ; ( @ ) screening , brief intervention , and facilitated referral to community-based treatment services ( brief intervention ) ; and ( @ ) screening , brief intervention , ED-initiated treatment with buprenorphine/naloxone , and referral to primary care for @-week follow-up ( buprenorphine ) .


A randomized clinical trial involving @ opioid-dependent patients who were treated at an urban teaching hospital ED from April @ , @ , through June @ , @ .


After screening , @ patients were randomized to the referral group , @ to the brief intervention group , and @ to the buprenorphine treatment group .


Enrollment in and receiving addiction treatment @ days after randomization was the primary outcome .


Self-reported days of illicit opioid use , urine testing for illicit opioids , human immunodeficiency virus ( HIV ) risk , and use of addiction treatment services were the secondary outcomes .


Seventy-eight percent of patients in the buprenorphine group ( @ of @ -LSB- @ % CI , @ % -@ % -RSB- ) vs @ % in the referral group ( @ of @ -LSB- @ % CI , @ % -@ % -RSB- ) and @ % in the brief intervention group ( @ of @ -LSB- @ % CI , @ % -@ % -RSB- ) were engaged in addiction treatment on the @th day after randomization ( P < @ ) .


The buprenorphine group reduced the number of days of illicit opioid use per week from @ days ( @ % CI , @-@ @ ) to @ days ( @ % CI , @-@ @ ) vs a reduction from @ days ( @ % CI , @-@ @ ) to @ days ( @ % CI , @-@ @ ) in the referral group and from @ days ( @ % CI , @-@ @ ) to @ days ( @ % CI , @-@ @ ) in the brief intervention group ( P < @ for both time and intervention effects ; P = @ for the interaction effect ) .


The rates of urine samples that tested negative for opioids did not differ statistically across groups , with @ % ( @ % CI , @ % -@ % ) in the referral group , @ % ( @ % CI , @ % -@ % ) in the brief intervention group , and @ % ( @ % CI , @ % -@ % ) in the buprenorphine group ( P = @ ) .


There were no statistically significant differences in HIV risk across groups ( P = @ ) .


Eleven percent of patients in the buprenorphine group ( @ % CI , @ % -@ % ) used inpatient addiction treatment services , whereas @ % in the referral group ( @ % CI , @ % -@ % ) and @ % in the brief intervention group ( @ % CI , @ % -@ % ) used inpatient addiction treatment services ( P < @ ) .


Among opioid-dependent patients , ED-initiated buprenorphine treatment vs brief intervention and referral significantly increased engagement in addiction treatment , reduced self-reported illicit opioid use , and decreased use of inpatient addiction treatment services but did not significantly decrease the rates of urine samples that tested positive for opioids or of HIV risk .


These findings require replication in other centers before widespread adoption .


In cerebrospinal fluid ( CSF ) leakage endoscopic repair , lumbar drains ( LDs ) were used in an attempt to increase success rates .


To critically assess the relationship between use of LDs and recurrent leaks , we embarked on this randomized prospective study .


Patients undergoing CSF leak repair between @ and @ were randomized into two groups : @ patients were managed without LDs and in the other group of @ patients an LD was always placed .


Different parameters were analyzed to identify their relationship with failures : occurrence of increased intracranial pressure ( ICP ) , body mass index , smoking habits , existence of diabetes , chronic corticosteroid use , previous sinus surgery , etiology ( traumatic , iatrogenic , or spontaneous leak ) , site , and size of the CSF leak .


Success rate was @ % for the whole group .


Patients managed with LDs attained @ % success rate and those without LD attained @ % ; the difference is not significant ( p = @ ) .


The only factor predictive of recurrence is increased ICP : @ % success rate versus @ % for traumatic leaks and @ % for iatrogenic leaks .


Recurrence rates were identical in the two groups with increased ICP , regardless of the use of a LD ( @ % ) .


In this study , success rates of CSF repair were not associated with the use of LDs .


However , the small number of cases with high success rates precludes appropriate statistical analysis .


Migraine is a common form of headache that is a major burden for patients who often seek emergency care .


The goal of this study was to compare the effectiveness of intravenous non-steroidal anti-inflammatory medication ( dexketoprofen ) with paracetamol ( acetaminophen ) in the treatment of an acute migraine attack .


This prospective , randomised , double blind , controlled study was conducted in a tertiary care emergency unit .


Study patients were randomised into two groups to receive either @ mg of dexketoprofen trometamol or @ mg of paracetamol intravenously by rapid infusion in @ mL of normal saline .


Pain reduction was measured at baseline , and after @ and @ min , using a Visual Analogue Scale ( VAS ) ) as the primary outcome .


VAS is a measurement tool ranging from @ ( no pain ) to @ mm ( worst pain ) .


@ patients were included in the final analysis .


Mean ( SD ) age of the study subjects was @ @ years and @ % ( n = @ ) were women .


Median reduction in VAS score at @ min was @ ( IQR @-@ @ ) for the paracetamol group and @ ( IQR @-@ ) for the dexketoprofen group , with a difference of @ mm ( @ % CI -@ to @ ) between the two groups .


Intravenous paracetamol and dexketoprofen appear to produce equivalent pain relief for migraine in the emergency department .


CLINICALTRIALS.GOV NO : NCT@ .


The prognosis for locally advanced gastric cancer is poor despite advances in adjuvant chemotherapy .


We did the Stomach cancer Adjuvant Multi-Institutional group Trial ( SAMIT ) to assess the superiority of sequential treatment ( paclitaxel then tegafur and uracil -LSB- UFT -RSB- or paclitaxel then S-@ ) compared with monotherapy ( UFT or S-@ ) and also the non-inferiority of UFT compared with S-@ .


We did this randomised phase @ trial with a two-by-two factorial design at @ hospitals in Japan .


We enrolled patients aged @-@ years with T@a or T@b gastric cancer , who had had D@ dissection and a ECOG performance score of @-@ .


Patients were randomly assigned to one of four treatment groups with minimisation for tumour size , lymph node metastasis , and study site .


Patients received UFT only ( @ mg/m ( @ ) per day ) , S-@ only ( @ mg/m ( @ ) per day ) for @ days , with a @-day rest period or three courses of intermittent weekly paclitaxel ( @ mg/m ( @ ) ) followed by either UFT , or S-@ .


Treatment lasted @ weeks in monotherapy groups and @ weeks in the sequential treatment groups .


The primary endpoint was disease-free survival assessed by intention to treat .


We assessed whether UFT was non-inferior to S-@ with a non-inferiority margin of @ .


This trial was registered at UMIN Clinical Trials Registry , number C@ .


We randomly assigned @ patients between Aug @ , @ , and Sept @ , @ patients were assigned to receive UFT alone , @ to receive S-@ alone , @ to received paclitaxel then UFT , and @ to receive paclitaxel then S-@ .


We included @ patients in the primary analysis after at least @ years of follow-up ( @ , @ , @ , and @ in each group respectively ) .


Protocol treatment was completed by @ ( @ % ) patients in the UFT group , @ ( @ % ) in the S-@ group , @ ( @ % ) in the paclitaxel then UFT group , and @ ( @ % ) in the paclitaxel then S-@ group .


@-year disease-free survival for monotherapy was @ % ( @ % CI @-@ ) and that of sequential treatment was @ % ( @-@ ; hazard ratio -LSB- HR -RSB- @ , @ % CI @-@ , p = @ ) .


@-year disease-free survival for the UFT group was @ % ( @ % CI @-@ ) and that of the S-@ group was @ % ( @-@ ; HR @ , @ % CI @-@ , p = @ ; pnon-inferiority = @ ) .


The most common grade @-@ haematological adverse event was neutropenia ( @ -LSB- @ % -RSB- of @ patients in the UFT group , @ -LSB- @ % -RSB- of @ in the S-@ group , @ -LSB- @ % -RSB- of @ in the paclitaxel then UFT group , and @ -LSB- @ % -RSB- of @ in the paclitaxel then S-@ group ) .


The most common grade @-@ non-haematological adverse event was anorexia ( @ -LSB- @ % -RSB- , @ -LSB- @ % -RSB- , seven -LSB- @ % -RSB- , and @ -LSB- @ % -RSB- , respectively ) .


Sequential treatment did not improve disease-free survival , and UFT was not non-inferior to S-@ ( and S-@ was superior to UFT ) , therefore S-@ monotherapy should remain the standard treatment for locally advanced gastric cancer in Japan .


To explore the effect of high positive end-expiratory pressure ( PEEP ) for the treatment of neurological pulmonary edema ( NPE ) in patients undergoing mechanical ventilation , and to look for the best mechanical ventilation strategy to improve the prognosis .


A prospective study was conducted , and @ patients with NEP admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Guangxi Traditional Chinese Medical University from January @ to August @ were enrolled and divided into two groups according to random number table ( n = @ in each group ) .


The patients in two groups were given empiric treatment for the disease , and they underwent mechanical ventilation .


In the normal PEEP group PEEP was @-@ cmH@O ( @ cmH@O = @ kPa ) , and in the high PEEP group PEEP was @-@ cmH@O , and all the rest parameters were the same .


Clinical indices before and @ days after treatment , and @-day morality rate were compared between two groups .


The @-day morality rate in high PEEP group was obviously lower than that in the normal PEEP group -LSB- @ % ( @/@ ) vs. @ % ( @/@ ) , ( @ ) = @ , P = @ -RSB- .


The clinical signs in both groups were improved after treatment .


Compared with the normal PEEP group , the clinical indices in high PEEP group were more significantly improved .


There were significant differences in body temperature ( @ centigrade vs. @ centigrade ) , respiratory rate ( @ times/min vs. @ times/min ) , heart rate ( @ beats/min vs. @ beats/min ) , white blood cell count ( WBC : @ @ ( @ ) / L vs. @ @ ( @ ) / L ) , acute physiology and chronic health evaluation II ( APACHEII ) score ( @ vs. @ ) , Glasgow coma score ( GCS : @ vs. @ ) , gastrointestinal dysfunction score ( @ vs. @ ) , oxygenation index ( PaO@/FiO@ : @ mmHg vs. @ mmHg ) , serum creatinine ( SCr : @ mol/L vs. @ mol/L ) , total bilirubin ( TBil : @ mol/L vs. @ mol/L ) , C-reacting protein ( CRP : @ mmol/L vs. @ mmol/L ) , prothrombin time ( PT : @ s vs. @ s ) , activated partial thromboplastin time ( APTT : @ s vs. @ s ) , international normalized ratio ( INR : @ vs. @ ) , extra vascular lung water index ( EVLWI : @ mL/kg vs. @ mL/kg ) , pulmonary vascular permeability index ( PVPI : @ vs. @ ) , mean arterial pressure ( MAP : @ mmHg vs. @ mmHg ) , cardiac output ( CO : @ L/min vs. @ L/min ) , systemic vascular resistance index ( SVRI : @ KP vs. @ KP ) , and blood lactate ( @ mmol/L vs. @ mmol/L ) between high PEEP group and normal PEEP group ( P < @ or P < @ ) .


Prognosis can be improved in NPE patients with the use of high PEEP in mechanical ventilation .


To assess the contribution of contrast material in detecting and evaluating enthesitis of pelvic entheses by MRI .


Sixty-seven hip or pelvic @-T MRIs ( @:@ male : female , mean age : @ years ) were retrospectively evaluated for the presence of hamstring and gluteus medius ( GM ) enthesitis by two readers ( a resident and an experienced radiologist ) .


Short tau inversion recovery ( STIR ) and T@-weighted pre - and post-contrast ( T@ + Gd ) images were evaluated by each reader at two sessions .


A consensus reading of two senior radiologists was regarded as the gold standard .


Clinical data was retrieved from patients ' referral form and medical files .


Cohen 's kappa was used for intra - and inter-observer agreement calculation .


Diagnostic properties were calculated against the gold standard reading .


A total of @ entheses were evaluated .


Gold standard analysis diagnosed @ ( @ % ) enthesitis lesions .


Intra-reader reliability for the experienced reader was significantly ( p = @ ) higher in the T@ + Gd images compared to the STIR images ( hamstring : k = @ / @ , GM : k = @ / @ ) .


Sensitivity and specificity increased from @ / @ to @ / @ in the STIR images and T@ + Gd sequences .


Intra-reader reliability for the inexperienced reader was lower ( p > @ ) .


Evidence showing that contrast material improves the reliability , sensitivity , and specificity of detecting enthesitis supports its use in this setting .


Irritable bowel syndrome ( IBS ) is a chronic , disabling condition that greatly compromises patient functioning .


The aim of this study was to assess the impact of a @-week twice per week Iyengar yoga ( IY ) program on IBS symptoms in adolescents and young adults ( YA ) with IBS compared with a usual-care waitlist control group .


Assessments of symptoms , global improvement , pain , health-related quality of life , psychological distress , functional disability , fatigue , and sleep were collected pre - and posttreatment .


Weekly ratings of pain , IBS symptoms , and global improvement were also recorded until @-month follow-up .


A total of @ participants completed the intervention ( yoga = @ ; usual-care waitlist = @ ) .


Baseline attrition was @ % .


On average , the yoga group attended @ % of classes .


Analyses were divided by age group .


Relative to controls , adolescents ( @-@ years ) assigned to yoga reported significantly improved physical functioning , whereas YA ( @-@ years ) assigned to yoga reported significantly improved IBS symptoms , global improvement , disability , psychological distress , sleep quality , and fatigue .


Although abdominal pain intensity was statistically unchanged , @ % of adolescents and @ % of YA reported a minimally clinically significant reduction in pain following yoga , and one-third of YA reported clinically significant levels of global symptom improvement .


Analysis of the uncontrolled effects and maintenance of treatment effects for adolescents revealed global improvement immediately post-yoga that was not maintained at follow-up .


For YA , global improvement , worst pain , constipation , and nausea were significantly improved postyoga , but only global improvement , worst pain , and nausea maintained at the @-month follow-up .


The findings suggest that a brief IY intervention is a feasible and safe adjunctive treatment for young people with IBS , leading to benefits in a number of IBS-specific and general functioning domains for YA .


The age-specific results suggest that yoga interventions may be most fruitful when developmentally tailored .


The objective of this study was to characterize the pharmacokinetics of @ , @ , and @mg equivalents ( eq . )


of paliperidone long-acting injection in Chinese subjects with schizophrenia .


This was an open-label , randomized , parallel group , multicenter study .


A total of @ patients were randomized in a @:@:@ ratio to one of three groups .


Sequential blood samples were collected immediately before injection on day@ and up to @days after the first injection .


The plasma paliperidone concentrations were determined by a validated high-performance liquid chromatography/tandem mass spectrometry method .


A total of @ patients received at least one injection of the study medication , and @ completed the study .


The pharmacokinetic ( PK ) parameters , such as time to maximum concentration , t@/@ , and CL/F , were comparable across the three treatment groups ( p = @ , @ , and @ , respectively ) .


The differences in maximum plasma concentration , AUC ( @days ) , AUC ( @-@ days ) , and AUC ( @ - ) were significant ( p < @ ) and dose proportional .


The inter-individual variation of PK parameters was large .


The most frequent treatment-emergent adverse events were prolactin level increasing , injection site pain , tremor , dry mouth , and constipation .


The pharmacokinetics of paliperidone palmitate are linear with respect to time in Chinese subjects with schizophrenia at injections from @ to @mg eq .


Prasugrel is an antiplatelet agent that shows more prompt , potent , and consistent platelet inhibition than clopidogrel .


The objective of this study was to confirm the efficacy and safety of prasugrel at loading/maintenance doses of @/@ @ mg .


Japanese patients ( n = @,@ ) with acute coronary syndrome undergoing percutaneous coronary intervention were randomized to either prasugrel ( @/@ @ mg ) or clopidogrel ( @/@ mg ) , both in combination with aspirin ( @-@ mg for the first dose and @-@ mg/day thereafter ) , for @-@ weeks .


The primary efficacy endpoint was the incidence of major adverse cardiovascular events ( MACE ) at @ weeks , defined as a composite of cardiovascular death , nonfatal myocardial infarction , and nonfatal ischemic stroke .


We compared the incidence of MACE between the @ groups using point estimates .


Safety outcomes included the incidence of bleeding events until @ weeks after the last dose .


The incidence of MACE at @ weeks was @ % in the prasugrel group and @ % in the clopidogrel group ( risk reduction @ % , hazard ratio @ , @ % confidence interval @-@ @ ) .


The incidence of non-coronary artery bypass graft-related major bleeding was similar in both groups ( @ % vs. @ % ) .


Prasugrel @/@ @ mg was associated with a low incidence of ischemic events , similar to the results of TRITON-TIMI @ , and with a low risk of clinically serious bleeding in Japanese ACS patients .


Bivalirudin , with selective use of glycoprotein ( GP ) IIb/IIIa inhibitor agents , is an accepted standard of care in primary percutaneous coronary intervention ( PPCI ) .


We aimed to compare antithrombotic therapy with bivalirudin or unfractionated heparin during this procedure .


In our open-label , randomised controlled trial , we enrolled consecutive adults scheduled for angiography in the context of a PPCI presentation at Liverpool Heart and Chest Hospital ( Liverpool , UK ) with a strategy of delayed consent .


Before angiography , we randomly allocated patients ( @:@ ; stratified by age -LSB- < @ years vs @ years -RSB- and presence of cardiogenic shock -LSB- yes vs no -RSB- ) to heparin ( @ U/kg ) or bivalirudin ( bolus @ mg/kg ; infusion @ mg/kg per h ) .


Patients were followed up for @ days .


The primary efficacy outcome was a composite of all-cause mortality , cerebrovascular accident , reinfarction , or unplanned target lesion revascularisation .


The primary safety outcome was incidence of major bleeding ( type @-@ as per Bleeding Academic Research Consortium definitions ) .


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


Between Feb @ , @ , and Nov @ , @ , @ of @ patients undergoing emergency angiography at our centre ( representing @ % of trial-naive presentations ) were randomly allocated treatment , with @ included in the final analyses .


@ ( @ % ) of @ patients in the bivalirudin group and @ ( @ % ) of @ patients in the heparin group had a percutaneous coronary intervention .


The rate of GP IIb/IIIa inhibitor use was much the same between groups ( @ patients -LSB- @ % -RSB- in the bivalirudin group and @ patients -LSB- @ % -RSB- in the heparin group ) .


The primary efficacy outcome occurred in @ ( @ % ) of @ patients in the bivalirudin group and @ ( @ % ) of @ patients in the heparin group ( absolute risk difference @ % ; relative risk -LSB- RR -RSB- @ , @ % CI @-@ , p = @ ) .


The primary safety outcome occurred in @ ( @ % ) of @ patients in the bivalirudin group and @ ( @ % ) of @ patients in the heparin group ( @ % ; @ , @-@ , p = @ ) .


Compared with bivalirudin , heparin reduces the incidence of major adverse ischaemic events in the setting of PPCI , with no increase in bleeding complications .


Systematic use of heparin rather than bivalirudin would reduce drug costs substantially .


Partial weight supported treadmill gait training ( PWSTT ) is widely used in rehabilitation of gait in patient with Parkinsons Diseases ( PD ) .


However , its effect on blood pressure variability ( BPV ) and baroreflex sensitivity ( BRS ) in PD has not been studied .


To evaluate the effect of conventional and treadmill gait training on BPV components and BRS .


Sixty patients with idiopathic PD were randomized into three groups .


Twenty patients in control group were on only stable medication , @ patients in conventional gait training ( CGT ) group ( Stable medication with CGT ) and @ patients in PWSTT group ( Stable medication with @ % PWSTT ) .


The CGT and PWSTT sessions were given for @ min per day , @ days per week , for @ weeks ( @ sessions ) .


Groups were evaluated in their best ON states .


The beat-to-beat finger blood pressure ( BP ) was recorded for @ min using a Finometer instrument ( Finapres Medical Systems , The Netherlands ) .


BPV and BRS results were derived from artifact-free @-min segments using Nevrocard software .


BRS showed a significant group with time interaction ( F = @ ; p = @ ) .


Post-hoc analysis revealed that PWSTT group showed significant improvement in BRS ( p < @ ) after @ weeks of training .


No significant differences found in BPV parameters ; systolic BP , diastolic BP , co-variance of systolic BP and low frequency component of systolic BP .


Four weeks of PWSTT significantly improves BRS in patients with PD .


It can be considered as a non-invasive method of influencing BRS for prevention of orthostatic BP fall in patients with PD .


To determine the impact of late radiation-induced toxicity on health-related quality of life ( HRQoL ) among patients with prostate cancer .


The study sample was composed of @ patients , treated with external beam radiotherapy .


Common Terminology Criteria for Adverse Events version @ were used to grade late genitourinary and gastrointestinal toxicity .


The European Organization for Research and Treatment of Cancer Quality of life Questionnaire C@ ( EORTC QLQ-C@ ) was used to assess HRQoL at baseline , and @ , @ and @ months after completion of radiotherapy .


Statistical analysis was performed using a multivariate analysis of variance ( MANOVA ) .


Urinary incontinence and rectal discomfort significantly affected HRQoL .


The impact of urinary incontinence on HRQoL was most pronounced @ months after radiotherapy and gradually decreased over time .


The impact of rectal discomfort on HRQoL was predominant at @ months after radiotherapy , decreased at @ months and increased again @ years after radiotherapy .


No significant impact on HRQoL was observed for any of the other toxicity endpoints , or non-toxicity related factors such as hormonal therapy , radiotherapy technique or age .


Urinary incontinence and rectal discomfort have a significant impact on HRQoL .


Prevention of these side effects may likely improve quality of life of prostate cancer patients after completion of treatment .


The purpose of this single-institution pilot study was to evaluate the feasibility and safety of an oil-based skin agent , Ultra Emu Oil , on skin-related toxicity in patients undergoing radiation therapy to the breast or chest wall .


Patients were randomized @:@ in a double-blind fashion and were instructed to apply processed Ultra Emu Oil or placebo ( cottonseed oil ) twice daily during the course of radiation therapy .


The oils were applied before the third fraction and continued for @ weeks after completion of treatment .


The primary endpoint was the area under the curve ( AUC ) of Skindex-@ scale scores over time .


Secondary outcomes included maximum grade of radiation dermatitis using the Common Terminology Criteria ( CTC ) for Adverse Events ( CTCAE @ ) , the Skin Toxicity Assessment Tool , quality of life ( QOL ) measured by Linear Analogue Self-Assessment , and a symptom experience diary ( SED ) .


In all , @ of @ patients completed the study and were evaluable .


The median times to peak rash , skin redness , peeling , and skin swelling were weeks @ , @ , @ , and @ , respectively as measured by the SED .


The Skindex AUC scores tended to be lower in emu oil patients than in placebo patients ( mean total AUC @ vs @ , respectively ) .


This trend was also seen in all the Skindex subdomains .


The overall QOL was slightly better in the emu oil group but remained stable throughout the study for both arms .


Peak CTC toxicity occurred at week @ .


Patients using emu oil appeared slightly worse on maximum CTC grade , but the difference was not significant .


This pilot study confirmed the safety of oil-based skin treatments during radiation therapy and suggests a trend for reduced skin toxicity for patients receiving emu oil .


A larger study is needed to evaluate the efficacy of emu oil in reducing radiation dermatitis in patients receiving breast radiation .


Behavioural lifestyle interventions can be effective at promoting initial weight loss and supporting physical activity and dietary behaviour change , however maintaining improvements in these outcomes is often more difficult to achieve .


Extending intervention contact to reinforce learnt behavioural skills has been shown to improve maintenance of behaviour change and weight loss .


This trial aims to evaluate the feasibility , acceptability and efficacy of a text message-delivered extended contact intervention to enhance or maintain change in physical activity , dietary behaviour and weight loss among participants who have completed a six month Government-funded , population-based telephone coaching lifestyle program : the Get Healthy Information and Coaching Service ( GHS ) .


GHS completers will be randomised to the @-month extended contact intervention ( Get Healthy , Stay Healthy , GHSH ) or a no contact control group ( standard practice following GHS completion ) .


GHSH participants determine the timing and frequency of the text messages ( @-@ per fortnight ) and content is tailored to their behavioural and weight goals and support preferences .


Two telephone tailoring calls are made ( baseline , @-weeks ) to facilitate message tailoring .


Primary outcomes , anthropometric ( body weight and waist circumference via self-report ) and behavioural ( moderate-vigorous physical activity via self-report and accelerometer , fruit and vegetable intake via self-report ) , will be assessed at baseline ( at GHS completion ) , @-months ( end of extended contact intervention ) and @-months ( @-months post intervention contact ) .


Secondary aims include evaluation of : the feasibility of program delivery ; the acceptability for participants ; theoretically-guided , potential mediators and moderators of behaviour change ; dose-responsiveness ; and , costs of program delivery .


Findings from this trial will inform the delivery of the GHS in relation to the maintenance of behaviour change and weight loss , and will contribute to the broader science of text message lifestyle interventions delivered in population health settings .


Mineralocorticoid receptor antagonists improve outcomes in patients with systolic heart failure but may induce worsening of renal function ( WRF ) and hyperkalemia ( HK ) .


We assessed the risk factors for mineralocorticoid receptor antagonist-related WRF and for HK , as well as the association between HK and WRF with clinical outcomes in the Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure ( EMPHASIS-HF ) .


Serial changes in estimated glomerular filtration rate and in serum potassium were available in @ patients during a median @-month follow-up .


HK variably defined as serum K > @ , @ , or @ mmol/L occurred in @ % , @ % , and @ % patients enrolled in EMPHASIS-HF , respectively .


WRF defined as a decrease in estimated glomerular filtration rate > @ % or > @ % from baseline occurred in @ % and @ % of patients , respectively .


Patients assigned eplerenone displayed modest and early but significant and persistent ( @ ) rise in serum potassium and ( @ ) reduction in estimated glomerular filtration rate when compared with those assigned placebo .


In multivariate analyses , eplerenone was associated with a higher incidence of WRF and HK , which were interrelated and also associated with baseline patient characteristics ( eg , age@ years , hypertension , diabetes mellitus , nonwhite race , ejection fraction < @ % , and treatment with an antiarrythmics drug or loop diuretic ) .


Eplerenone retained its survival benefits without any significant interaction with the association between HK > @ mmol/L only and WRF and worse outcomes .


In patients with heart failure receiving optimal therapy , WRF and HK were more frequent when eplerenone was added , but their occurrence did not eliminate the survival benefit of eplerenone .


Many primary care patients with raised blood pressure or depression drink potentially hazardous levels of alcohol .


Brief interventions ( BI ) to reduce alcohol consumption may improve comorbid conditions and reduce the risk of future alcohol problems .


However , research has not established their effectiveness in this patient population .


This study aimed to establish the feasibility of definitive trials of BI to reduce excessive drinking in primary care patients with hypertension or mild to moderate depression .


Thirteen general practices in North East England were randomized to the intervention or control arm of one of two parallel pilot trials .


Adult patients drinking excessively and diagnosed with hypertension or mild-to-moderate depression received the Alcohol Use Disorders Identification Test ( AUDIT ) by postal survey .


Consenting respondents scoring more than @ on AUDIT ( score range @ to @ ) received brief alcohol consumption advice plus an information leaflet ( intervention ) or an information leaflet alone ( control ) with follow-up at six months .


Measurements included the numbers of patients eligible , recruited , and retained , and the AUDIT score and systolic/diastolic blood pressure of each patient or the nine-item Patient Health Questionnaire ( PHQ-@ ) score .


Acceptability was assessed via practitioner feedback and patient willingness to be screened , recruited , and retained at follow-up .


In the hypertension trial , @ of @,@ adult patients ( @ % ) were eligible and were surveyed .


Among the eligible patients , @ ( @ % ) returned questionnaires ; @ ( @ % of those surveyed ) screened positively on AUDIT and @ ( @ % of those surveyed ) were recruited ( @ % of positive screens ) .


Sixty-seven cases ( @ % of recruited patients ) completed follow-up at six months .


In the depression trial , @,@ of @,@ adult patients ( @ % ) were eligible and surveyed .


Among these eligible patients , @ ( @ % ) responded ; @ ( @ % of those surveyed ) screened positively on AUDIT and @ ( @ % of those surveyed ) were recruited ( @ % of positive screens ) .


Nineteen cases ( @ % of recruited patients ) completed follow-up at six months .


Recruitment and retention rates were higher in the hypertension trial than in the depression trial .


A full brief intervention trial appears feasible for primary care patients with hypertension who drink excessively .


High AUDIT scores in the depression trial suggest the importance of alcohol intervention in this group .


However , future work may require alternative screening and measurement procedures .


Physicians are expected to serve as role models for healthy lifestyles , but long work hours reduce time for healthy behaviors .


A hospital-based physical activity intervention could improve physician health and increase counseling about exercise .


We conducted a two-phase intervention among @ medical residents at a large hospital in Boston , Massachusetts .


Phase @ was a @-week randomized controlled trial comparing daily steps of residents assigned to an activity monitor displaying feedback about steps and energy consumed ( intervention ) or to a blinded monitor ( control ) .


Phase @ immediately followed and was a @-week non-randomized team steps competition in which all participants wore monitors with feedback .


Phase @ outcomes were : @ ) median steps/day and @ ) proportion of days activity monitor worn .


The Phase @ outcome was mean steps/day on days monitor worn ( @ steps/day ) .


Physiologic measurements were collected at baseline and study end .


Median steps/day were compared using Wilcoxon rank-sum tests .


Mean steps were compared using repeated measures regression analyses .


In Phase @ , intervention and control groups had similar activity ( @ vs. @ steps/day , p = @ ) and compliance with wearing the monitor ( @ % vs. @ % of days , p = @ ) .


In Phase @ ( team competition ) , residents recorded more steps/day than during Phase @ ( CONTROL : @,@ vs. @,@ , p = @ ;


@,@ vs. @,@ , p = @ ) .


Mean compliance with wearing the activity monitor decreased for both groups during Phase @ compared to Phase @ ( @ % vs. @ % , p < @ ) .


Mean systolic blood pressure decreased ( p = @ ) and HDL cholesterol increased ( p < @ ) among all participants at end of study compared to baseline .


Although the activity monitor intervention did not have a major impact on activity or health , the high participation rates of busy residents and modest changes in steps , blood pressure , and HDL suggest that more intensive hospital-based wellness programs have potential for promoting healthier lifestyles among physicians .


Postoperative delirium is common in patients recovering from cardiac surgery .


Tight glucose control has been shown to reduce mortality and morbidity .


Therefore , the authors sought to determine the effect of tight intraoperative glucose control using a hyperinsulinemic-normoglycemic clamp approach on postoperative delirium in patients undergoing cardiac surgery .


The authors enrolled @ adult patients having cardiac surgery in this randomized , double-blind , single-center trial .


Patients were randomly assigned to either tight intraoperative glucose control with a hyperinsulinemic-normoglycemic clamp ( target blood glucose , @ to @ mg/dl ) or standard therapy ( conventional insulin administration with blood glucose target , < @ mg/dl ) .


Delirium was assessed using a comprehensive delirium battery .


The authors considered patients to have experienced postoperative delirium when Confusion Assessment Method testing was positive at any assessment .


A positive Confusion Assessment Method was defined by the presence of features @ ( acute onset and fluctuating course ) and @ ( inattention ) and either @ ( disorganized thinking ) or @ ( altered consciousness ) .


Patients randomized to tight glucose control were more likely to be diagnosed as being delirious than those assigned to routine glucose control ( @ of @ vs. @ of @ ; relative risk , @ ; @ % CI , @ to @ ; P = @ ) , after adjusting for preoperative usage of calcium channel blocker and American Society of Anesthesiologist physical status .


Delirium severity , among patients with delirium , was comparable with each glucose management strategy .


Intraoperative hyperinsulinemic-normoglycemia augments the risk of delirium after cardiac surgery , but not its severity .


School-aged children suffer high rates of influenza virus infections and associated illnesses each year , and are a major source of transmission in the community .


However , information on the cumulative incidence of infection in specific epidemics is scarce , and there are limited studies with sufficient follow-up to identify the strength and duration of protection against reinfection .


We randomly allocated children @-@ years of age to receive trivalent inactivated influenza vaccine ( TIV ) or placebo from September @ through January @ , and then conducted follow-up for @ years including regular collection of sera , symptom diaries , and collection of nose and throat swabs during illness episodes in participants or their household members .


Of @ children initially randomized , @ continued to participate for all @ years .


In unvaccinated children , cumulative incidence of infection was estimated to be @ % in the first wave of H@N@pdm@ in @-@ , and @ % , @ % , @ % , and @ % in subsequent epidemics of H@N@ ( @ ) , H@N@pdm@ ( @ ) , B ( @ ) , and H@N@ ( @ ) , respectively .


Infection with H@N@pdm@ in @-@ and H@N@ in @ was associated with protection against infection with subsequent epidemics of the same subtype in @ and @ , respectively , but we found no evidence of heterotypic or heterosubtypic protection against infection .


We identified substantial incidence of influenza virus infections in children in Hong Kong in @ major epidemics over a @-year period , and evidence of homosubtypic but not heterosubtypic protection following infection .


To construct and internally validate a risk score , the ' @ + score ' , for revisits to hospital and mortality for older patients , incorporating aspects of pharmacotherapy .


Our secondary aim was to compare the discriminatory ability of the score with that of three validated tools for measuring inappropriate prescribing : Screening Tool of Older Person 's Prescriptions ( STOPP ) , Screening Tool to Alert doctors to Right Treatment ( START ) and Medication Appropriateness Index ( MAI ) .


Two acute internal medicine wards at Uppsala University hospital .


Patient data were used from a randomised controlled trial investigating the effects of a comprehensive clinical pharmacist intervention .


Data from @ patients , aged @years and older , admitted to one of the study wards .


Time to rehospitalisation or death during the year after discharge from hospital .


Candidate variables were selected among a large number of clinical and drug-specific variables .


After a selection process , a score for risk estimation was constructed .


The @ + score was internally validated , and the discriminatory ability of the score and of STOPP , START and MAI was assessed using C-statistics .


Seven variables were selected .


Impaired renal function , pulmonary disease , malignant disease , living in a nursing home , being prescribed an opioid or being prescribed a drug for peptic ulcer or gastroesophageal reflux disease were associated with an increased risk , while being prescribed an antidepressant drug ( tricyclic antidepressants not included ) was linked to a lower risk of the outcome .


These variables made up the components of the @ + score .


The C-statistics were @ ( @ + ) , @ ( STOPP ) , @ ( START ) and @ ( MAI ) .


We developed and internally validated a score for prediction of risk of rehospitalisation and mortality in hospitalised older people .


The score discriminated risk better than available tools for inappropriate prescribing .


Pending external validation , this score can aid in clinical identification of high-risk patients and targeting of interventions .


An antagonist ( MK-@ ) of the cytokine receptor CXCR@ reduces neutrophil chemotaxis and thus may alleviate airway inflammation in chronic obstructive pulmonary disease ( COPD ) .


To assess the efficacy , safety , and tolerability of three dose levels of MK-@ , compared with placebo , in patients with moderate to severe COPD .


This @-month , double-blind study randomized patients with moderate to severe COPD ( already on standard therapy ) to daily MK-@ at @ , @ , or @ mg or placebo .


The primary endpoint was change from baseline in post-bronchodilator FEV@ .


A total of @ patients ( @ % male ; mean age , @ yr ; @ % current smokers ; baseline FEV@ -LSB- SD -RSB- , @ L -LSB- @ -RSB- ; mean FEV@ percent predicted , @ % ) were randomized .


Only MK-@ @ mg led to significant improvement in FEV@ over placebo ( mean difference -LSB- SE -RSB- , @ ml -LSB- @ -RSB- ) .


Reduced sputum neutrophil count was observed among the @ patients examined ; P = @ ( @ mo ) and P = @ ( @ mo ) ( MK-@ @ mg vs. placebo ) .


The stratum of current smokers , but not that of nonsmokers , showed significant improvement versus placebo in FEV@ ( @ ml ) and time-to-first exacerbation , and showed numerical improvement in St. George 's Respiratory Questionnaire for COPD score .


MK-@ caused a dose-dependent decrease in absolute neutrophil count ( ANC ) and reduced inflammatory biomarkers matrix metallopeptidase-@ and myeloperoxidase in plasma and sputum ; ANC lower than @ ( @ ) / L led to discontinuations with higher doses of MK-@ ( @ % in the MK-@ @-mg group vs. @ % in placebo ) .


Plasma C-reactive protein and fibrinogen increased with MK-@ treatment .


Rates of infections at @ months were similar in all groups .


Treatment with MK-@ @ mg versus placebo led to significant improvement in FEV@ in patients with COPD , suggesting clinically important antiinflammatory effects with CXCR@ antagonism , although dose-related discontinuations were observed because of ANC decreases with MK-@ .


Greater response was observed in smokers versus ex-smokers .


Clinical trial registered with www.clinicaltrials.gov ( NCT @ ) .


Single-blinded randomized controlled pilot study .


To examine the changes in pectoralis minor length ( PML ) , the supine measurement of rounded shoulder posture ( RSP ) , and the total scapular distance ( TSD ) in seated male workers with RSP , after rounded-shoulder-taping ( RST ) using kinesiology tape with ( experimental taping ) and without stretch ( placebo taping ) .


RSP , a postural impairment , is a known cause of upper quarter pain .


Fourteen men with RSP , who worked for at least @h/d in a seated position , were selected for RST , with the shoulders randomly assigned to two kinesiology taping methods : ( @ ) with @-@ % stretch of its original length ; and ( @ ) without stretch .


The PML , supine measurements of RSP , and TSD , before and after kinesiology taping , with and without stretch , were assessed .


Kinesiology taping with stretch significantly increased the PML and significantly decreased the supine measurement of RSP and TSD ; kinesiology taping without stretch did not increase the PML significantly and did not decrease the supine measurement of RSP and TSD .


RST using kinesiology tape with stretch produces immediate mechanical correction of RSP in seated male workers .


Transradial intervention ( TRI ) and bivalirudin infusion compared with transfemoral coronary intervention or unfractionated heparin plus glycoprotein IIb/IIIa inhibitors decrease bleeding complications in patients with acute coronary syndromes ( ACS ) .


Although bleeding is thought to be associated with worse outcomes , it remains unclear whether TRI and bivalirudin both independently lower ischemic or combined ischemic and bleeding complications in ACS patients undergoing contemporary invasive management .


The primary objectives of the MATRIX program are to assess whether TRI or bivalirudin as compared , respectively , with transfemoral coronary intervention ( MATRIX access site ) or unfractionated heparin plus provisional glycoprotein IIb/IIIa inhibitors , ( MATRIX antithrombin ) decrease the @-day incidence of an ischemic ( ie , death , myocardial infarction or stroke ) or an ischemic and bleeding composite end point across the whole spectrum of ACS patients , including clarifying the optimal duration of bivalirudin infusion after percutaneous coronary intervention ( MATRIX treatment duration ) .


The MATRIX ( NCT@ ) study , which incorporates @ randomized comparisons in a nonfactorial manner and primary end points at @ days and clinical follow-up @ year , is a large-scale , multicenter study with blind event adjudication conducted at approximately @ European sites .


With @,@ patients in the randomized comparison of access sites and @,@ individuals participating in the randomized comparison of antithrombin regimens , this study will have @ % power for the primary end points .


The MATRIX program aims at conclusively ascertaining the role of TRI and bivalirudin infusion in the whole spectrum of ACS patients undergoing contemporary invasive management .


A @-month topical application of clobetasol propionate ( CP ) represents the recommended and accepted first-line treatment for vulvar lichen sclerosus ( VLS ) ; however , to date , no randomized controlled trials have compared the efficacy and safety of CP with other topical corticosteroids .


To compare the effectiveness and tolerability of two different topical corticosteroids , CP @ % ointment and mometasone furoate ( MMF ) @ % ointment , in the treatment of VLS .


Fifty-four patients with VLS were enrolled in a @-week active treatment phase ( ATP ) and randomized to apply either CP or MMF in a tapering regimen .


The main efficacy parameters were the response rate , the rate of patients achieving an improvement from baseline of @ % in the subjective and objective scores , and the mean reduction in subjective and objective scores throughout the treatment .


By the end of the @-week ATP , @ ( @ % ) patients were considered to be responders among the CP patients and @ ( @ % ) among the MMF patients ; @ % and @ % of patients in the CP group and @ % and @ % in the MMF group achieved an improvement of at least @ % in subjective and objective scores , respectively .


The decrease in mean symptom and sign scores was significant compared with baseline with both treatments .


No significant differences were found in any of the assessed efficacy endpoints between CP and MMF .


Both treatments were well tolerated .


Clobetasol propionate and MMF appeared similarly efficacious and well tolerated for the treatment of VLS and both may represent the first-line treatment for the disease .


The aim of this study was to analyze the long-term survival of AML patients with CEBPA mutations .


We investigated @ AML patients with a median age of @years and ( @ ) cytogenetically normal AML ( CN-AML ) , ( @ ) monoallelic ( moCEBPA ) or biallelic ( biCEBPA ) CEBPA mutation , and ( @ ) intensive induction treatment .


@/@ patients have been described previously with a shorter follow-up .


Median follow-up time was @ years ( @ % CI : @-@ @ years ) compared to @ and @ years in our former analyses .


Patients with biCEBPA mutations survived significantly longer compared to those with moCEBPA ( median overall survival ( OS ) @ years vs. @ years , p = @ ) .


Patients@years and biCEBPA mutations showed a favorable prognosis with a @-year OS rate of @ % .


In this long-term observation we confirmed the favorable prognostic outcome of patients with biCEBPA mutations compared to moCEBPA-mutated CN-AML .


The high probability of OS ( @ % ) in younger patients is helpful to guide intensity of postremission therapy .


A simple approach is the predominant strategy for the percutaneous coronary intervention of bifurcation lesions .


Performing side branch ( SB ) predilation in this context is currently a matter of controversy .


In this study , we assess the efficacy of SB predilatation before a provisional T-stent strategy for bifurcation lesions .


Between February @ and November @ , @ patients with true bifurcation lesions were randomized to either predilation of the SB ( n = @ ) or no predilatation ( n = @ ) before main branch ( MB ) stent implantation and a subsequent SB provisional stent strategy .


There were no significant differences between the patient groups regarding the baseline characteristics .


After MB stent implantation , the TIMI flow of the SB was higher in the patients with SB predilation : TIMI flow @ to @ ; @ ( @ % ) versus @ ( @ % ) , P < @ ; and TIMI flow III ; @ ( @ % ) versus @ ( @ % ) , P < @ .


Side branch stenting rates were @ % versus @ % , P = not significant .


In addition , @ patients ( @ % ) from the SB predilation group presented SB residual stenosis by visual inspection < @ % , and TIMI flow III did not require any additional treatment .


The failure rate of SB rewiring , the time of rewiring , the number of wires used , and the incidence of major events were similar in both groups of patients .


Predilation of the SB resulted in improved TIMI flow after MB stenting and less indication to subsequently treat the SB .


If rewiring of the SB is required , predilation did not hinder this maneuver .


This study sought to assess the effectiveness of a secondhand tobacco smoke ( SHS ) prevention program based on an expanded Health Belief Model ( HBM ) incorporating self-efficacy among pregnant women in a hospital setting in Taiwan .


This study utilized a two-group longitudinal randomized controlled trial design .


Participants in the intervention group ( n = @ ) enrolled in a SHS prevention program based on the HBM , while participants in the comparison group ( n = @ ) received standard government-mandated counseling care .


Both groups were given questionnaires as a pre-test , two weeks into the intervention , and one month following the conclusion of the intervention .


The questionnaire and intervention were developed based on the understanding gained through a series of in-depth interviews and a focus-group conducted among pregnant women .


Exhaled carbon monoxide was also measured and used as a proxy for SHS exposure .


Intervention group scores were all significantly higher than comparison group scores ( p < @ ) , indicating a significant increase in knowledge , HBM scores , cues to action , self-efficacy , preventative behaviors , and a significant decrease in smoking exposure .


These differences remained significant at the one-month follow-up assessment ( p < @ ) .


These results should encourage health professionals to educate pregnant women regarding the harms of SHS while both empowering and equipping them with the tools to confront their family members and effectively reduce their SHS exposure while promoting smoke-free social norms .


Isoflavones and exercise have been shown to affect C-reactive protein ( CRP ) and body composition and to act synergistically on trunk and total fat mass ( FM ) , glucose metabolism , and lean body mass in postmenopausal women with a body mass index higher than @ kg/m .


We hypothesized that exercise and isoflavone supplementation ( Ex + ISO ) could reduce inflammation in the same subpopulation of women .


The objective of this study was to investigate if @ months of mixed exercise combined with isoflavones could have greater effects on specific inflammatory markers than exercise alone in overweight or obese postmenopausal women .


Thirty-four postmenopausal women aged @ to @ years were randomly assigned to exercise and placebo ( Ex + PLA ; n = @ ) or Ex + ISO ( n = @ ) .


At baseline and after @ months , waist circumference , hip circumference , total FM , trunk FM , leg FM , and muscle mass index ( MMI ; = total fat free mass -LSB- kg -RSB- / height -LSB- m -RSB- ) were assessed ( dual-energy x-ray absorptiometry ) .


Inflammatory markers ( CRP , tumor necrosis factor - -LSB- TNF - -RSB- , and interleukin-@ ) were obtained by enzyme-linked immunosorbent assay .


T tests were used to compare groups at baseline .


The Ex + PLA group showed significant changes in MMI ( +@ kg/m , P @ ) and FM compartments ( waist circumference , -@ cm ; % FM , -@ % ; P @ ) , whereas inflammation remained unchanged .


However , the Ex + ISO group showed significant changes in total FM ( -@ kg , P < @ ) , FM compartments ( hip circumference -LSB- -@ cm , P = @ -RSB- , leg FM -LSB- -@ kg , P = @ -RSB- , and trunk FM -LSB- -@ kg , P = @ -RSB- ) , MMI ( +@ kg , P = @ ) , and inflammation ( CRP , -@ mg/L , P = @ ; TNF - , +@ pg/mL , P = @ ) .


Despite an increase in TNF - , the use of isoflavones-when body weight remains stable-seems to enhance the beneficial effects of mixed-exercise training on body composition and CRP in overweight or obese postmenopausal women .


Although feedback conversations are an essential component of learning , three challenges make them difficult : the fear that direct task feedback will harm the relationship with the learner , overcoming faculty cognitive biases that interfere with their eliciting the frames that drive trainees ' performances , and time pressure .


Decades of research on developmental conversations suggest solutions to these challenges : hold generous inferences about learners , subject one 's own thinking to test by making it public , and inquire directly about learners ' cognitive frames .


The authors conducted a randomized , controlled trial to determine whether a @-h educational intervention for anesthesia faculty improved feedback quality in a simulated case .


The primary outcome was an analysis of the feedback conversation between faculty and a simulated resident ( actor ) by using averages of six elements of a Behaviorally Anchored Rating Scale and an objective structured assessment of feedback .


Seventy-one Harvard faculty anesthesiologists from five academic hospitals participated .


The intervention group scored higher when averaging all ratings .


Scores for individual elements showed that the intervention group performed better in maintaining a psychologically safe environment ( @ @ vs. @ @ ; P = @ ) , identifying and exploring performance gaps ( @ @ vs. @ @ ; P = @ ) , and they more frequently emphasized the professionalism error of failing to call for help over the clinical topic of anaphylaxis ( @ vs. @ % ; P = @ ) .


Quality of faculty feedback to a simulated resident was improved in the interventional group in a number of areas after a @-h educational intervention , and this short intervention allowed a group of faculty to overcome enough discomfort in addressing a professionalism lapse to discuss it directly .


The effect of ibuprofen on pain tolerance during exercise is controversial , and its effects on endurance performance have been poorly investigated .


To investigate the effect of prophylactic administration of the nonsteroidal anti-inflammatory drug ibuprofen on the time until the self-report of fatigue ( tlim ) in runners with exercise-induced muscle damage .


Randomized controlled clinical trial .


Laboratory .


Twenty healthy male long-distance runners ( age = @ @ years , maximal oxygen consumption = @ @ mLkg ( -@ ) min ( -@ ) ) .


Participants were assigned to @ groups ( ibuprofen group = @ , placebo group = @ ) to perform tlim trials ( speed corresponded to their previously determined secondventilatory thresholds ) @ hours before and @ hours after the induction of a lower limb muscle-damage protocol ( isokinetic dynamometry ) .


One hour before the second tlim trial , the ibuprofen group received @ g ibuprofen , and the placebo group received lactose orally .


Time until self-reported fatigue , heart rate , respiratory quotient , oxygen consumption , and perceived exertion were recorded during each tlim test .


Both groups reported increases in muscle pain in the knee extensors and flexors @ hours after the muscle-damage protocol .


We observed a reduction in the endurance performance of both groups ( P < @ ) but no difference between groups ( P = @ ) .


Ibuprofen did not reduce the effect of muscle damage and pain on performance .


Prophylactic use of nonsteroidal anti-inflammatory drugs did not have an ergogenic effect on running performance after exercise-induced muscle damage in male long-distance runners .


Caregivers of people with chronic conditions are more likely than non-caregivers to have depression and emotional problems .


Few studies have examined the effectiveness of mindfulness-based stress reduction ( MBSR ) in improving their mental well-being .


Caregivers of persons with chronic conditions who scored @ or above in the Caregiver Strain Index were randomly assigned to the @-week MBSR group ( n = @ ) or the self-help control group ( n = @ ) .


Validated instruments were used to assess the changes in depressive and anxiety symptoms , quality of life , self-efficacy , self-compassion and mindfulness .


Assessments were conducted at baseline , post-intervention and at the @-month follow-up .


Compared to the participants in the control group , participants in the MBSR group had a significantly greater decrease in depressive symptoms at post-intervention and at @ months post-intervention ( p < @ ) .


The improvement in state anxiety symptoms was significantly greater among participants in the MBSR group than those of the control group at post-intervention ( p = @ ) , although this difference was not statistically significant at @ months post-intervention ( p = @ ) .


There was also a statistically significant larger increase in self-efficacy ( controlling negative thoughts ; p = @ ) and mindfulness ( p = @ ) among participants in the MBSR group at the @-month follow-up compared to the participants in the control group .


No statistically significant group effects ( MBSR vs. control ) were found in perceived stress , quality of life or self-compassion .


MBSR appears to be a feasible and acceptable intervention to improve mental health among family caregivers with significant care burden , although further studies that include an active control group are needed to make the findings more conclusive .


Pilot studies have suggested benefit from intravenous administration of bone marrow mononuclear stem cells ( BMSCs ) in stroke .


We explored the efficacy and safety of autologous BMSCs in subacute ischemic stroke .


This was a phase II , multicenter , parallel group , randomized trial with blinded outcome assessment that included @ patients .


Patients with subacute ischemic stroke were randomly assigned to the arm that received intravenous infusion of autologous BMSCs or to control arm .


Coprimary clinical efficacy outcomes were Barthel Index score and modified Rankin scale at day @ .


Secondary outcomes were change in infarct volume , National Institute of Health Stroke Scale ( NIHSS ) at day @ and @ .


Main safety outcomes were adverse events , any new area of ( @ ) fluorodeoxyglucose positron emission tomography uptake in any body part over @ days .


Fifty-eight patients received a mean of @ million BMSCs at median of @ days after stroke onset .


There was no significant difference between BMSCs arm and control arm in the Barthel Index score ( @ versus @ ; P = @ ) , modified Rankin scale shift analysis ( P = @ ) or score > @ ( @ % versus @ % ; P = @ ) , NIHSS score ( @ versus @ ; P = @ ) , change in infarct volume ( -@ versus -@ ; P = @ ) at day @ .


Adverse events were also similar in the @ arms , and no patient showed any new area of ( @ ) fluorodeoxyglucose uptake .


With the methods used , results of this hitherto first randomized controlled trial indicate that intravenous infusion of BMSCs is safe , but there is no beneficial effect of treatment on stroke outcome .


This investigation examined the ergogenic effect of short-term oral N-acetylcysteine ( NAC ) supplementation and the associated changes in redox balance and inflammation during intense training .


A double-blind randomized placebo-controlled crossover design was used to assess @ d of oral NAC supplementation ( @ mgd ) in @ well-trained triathletes .


For each supplement trial ( NAC and placebo ) , baseline venous blood and urine samples were taken , and a presupplementation cycle ergometer race simulation was performed .


After the loading period , further samples were collected preexercise , postexercise , and @ and @ h after the postsupplementation cycle ergometer race simulation .


Changes in total antioxidant capacity , ferric reducing ability of plasma , reduced glutathione , oxidized glutathione , thiobarbituric acid-reactive substances , interleukin @ , xanthine oxidase , hypoxanthine , monocyte chemotactic protein @ , nuclear factor B , and urinary @-isoprostane F@t concentration were assessed .


The experimental procedure was repeated with the remaining supplement after a @-wk washout .


Eight participants completed both supplementation trials .


NAC improved sprint performance during the cycle ergometer race simulation ( P < @ , p = @ ) .


Supplementation with NAC also augmented postexercise plasma total antioxidant capacity ( P = @ , p = @ ) , reduced exercise-induced oxidative damage ( plasma thiobarbituric acid-reactive substances , P = @ , p = @ ; urinary @-isoprostane F@t concentration , P = @ , p = @ ) , attenuated inflammation ( plasma interleukin @ , P = @ , p = @ ; monocyte chemotactic protein @ , P = @ , p = @ ) , and increased postexercise nuclear factor B activity ( P < @ , p = @ ) .


Oral NAC supplementation improved cycling performance via an improved redox balance and promoted adaptive processes in well-trained athletes undergoing strenuous physical training .


We investigated the prevalence , incidence and predictors of new peripheral neuropathy episodes in previously untreated , symptomatic HIV-infected Ugandan/Zimbabwean adults initiating zidovudine-based antiretroviral therapy ( ART ) .


An open-label , multicentre , randomized trial .


Peripheral neuropathy was self-reported at @-weekly clinic visits .


Cox regression models ( excluding participants reporting preexisting peripheral neuropathy at ART initiation ) , considered sex ; pre-ART WHO stage , age and CD@ ( + ) cell count ; CD@ ( + ) cell count versus no CD@ ( + ) cell count monitoring ; and time-updated CD@ ( + ) cell count , weight and use of stavudine , isoniazid and didanosine .


Four hundred and twenty-one out of @ ( @ % ) patients reported preexisting peripheral neuropathy at ART initiation .


Median ( interquartile range , IQR ) follow-up in @ participants without preexisting peripheral neuropathy was @ ( @-@ @ ) years .


Three hundred and fifty-four ( @ % ) took stavudine as first-line substitution and @ ( @ % ) took isoniazid during follow-up .


Two hundred and ninety ( @ % ) participants developed a new peripheral neuropathy episode , an incidence of @ per @ person-years .


Eighteen ( @ % ) had a grade @/@ episode .


Independent predictors of peripheral neuropathy were current stavudine use -LSB- adjusted hazard ratio ( a ) HR @ ( @ % confidence interval , @ % CI @-@ @ -RSB- , current isoniazid use -LSB- aHR @ ( @ % CI @-@ @ ) -RSB- and current didanosine use -LSB- aHR @ ( @ % CI @-@ @ ) -RSB- .


Higher risks were independently associated with higher pre-ART weight -LSB- aHR ( per +@ kg ) @ ( @ % CI @-@ @ ) -RSB- and older age aHR ( per @ years older ) @ ( @ % CI @-@ @ ) , but there was no significant effect of sex ( P = @ ) , pre-ART CD@ ( + ) cell count ( P = @ ) or CD@ ( + ) cell count monitoring ( P = @ ) .


Current stavudine , didanosine or isoniazid use continue to increase peripheral neuropathy risks , as does older age and weight at ART initiation ; however , we found no evidence of increased risk in women in contrast to previous studies .


The incidence of peripheral neuropathy may now be lower in ART programmes , as stavudine and didanosine are no longer recommended .


All patients receiving isoniazid , either as part of antituberculosis ( TB ) chemotherapy or TB-preventive therapy , should receive pyridoxine as recommended in national guidelines .


To observe the effects of different maintain doses of Dexmedetomidine on plasma cortisol and glucose during anesthesia recovery period in patients undergoing uvulopalatopharyngoplasty under sevoflurane inhalation anesthesia .


In this prospective , randomized , double-blind study , @ ASA I and II patients undergoing selective uvulopalatopharyngoplasty under general anesthesia were included .


The patients were randomly allocated to three groups ( n = @ ) : Dexmedetomidine low maintain dose group ( D@ ) , Dexmedetomidine high maintain dose group ( group D@ ) and control group ( group C ) .


The Dexmedetomidine groups and control group were given Dexmedetomidine @ microg/kg and normal saline in @ ml within @ min just before induction of anesthesia .


Then Dexmedetomidine were maintained at @ microg x kg ( -@ ) x h ( -@ ) and @ microg x kg ( -@ ) x h ( -@ ) in group D@ and group D@ and were withdrawed @ min before the end of operation , the same maintained speed of normal saline was given in group C. BIS value was maintained at @-@ by adjusting the inhaled concentration of sevoflurane .


Anesthetic was withdrawed @ min before the end of operation .


Thus , plasma cortisol concentration and blood glucose was needed to be detected just before anesthesia ( T@ ) , tracheal extubation ( T@ ) , @ min after extubation ( T@ ) and @ min after extubation ( T@ ) .


Duration of operation and anesthesia , consumption of sevoflurane , emergence time , extubation time , the occurrence of dysphoria , bucking and hypoxemia ( SpO@ < @ % ) during extubation were recorded .


Compared with group C , MAP and HR at T@ , plasma cortisol concentration and blood glucose at T@ - T@ were all significantly lower in group D@ and group D@ ( P < @ ) , and so were the consumption of sevoflurane and the occurrence of dysphoria ( P < @ ) .


The emergence time and extubation time were significantly prolonged in group D@ compared with group D@ and group C ( P < @ ) .


There was no significant difference in the occurrence of bucking and hypoxemia in three groups ( P > @ ) .


In the patients undergoing UPPP under sevoflurane inhalation anesthesia , Dexmedetomidine infused at @ microg x kg ( -@ ) x h ( -@ ) maintains a stable hemodynamics without respiratory depression , alleviates stress response during extubation and reduces both the consumption of sevoflurane and the occurrence of dysphoria without prolonging emergence time and extubation time .


We aimed to identify those patients with hepatitis C virus who benefit most from prophylactic treatment with selective serotonin reuptake inhibitors ( SSRIs ) during antiviral therapy .


We performed post hoc analyses on a prospective randomized controlled trial ( n = @ ) of escitalopram versus placebo during antiviral therapy with pegylated interferon and ribavirin , conducted between August @ and June @ .


Our primary outcome measure was the association of baseline characteristics with the development of depression and/or depressive symptoms .


Further , we studied effects of prophylactic escitalopram on depressive symptoms .


Presence of a major depression was diagnosed using Mini-International Neuropsychiatric Interview ( MINI ) , a short , structured interview used to diagnose DSM-IV-TR and ICD-@ disorders .