A high adherence can be achieved by individual training of the patient regarding the handling of his disease , the use of telemedical devices and an easy-to-use telemonitoring system .


The majority of the informed self-determined CHF patients NYHA class II/III are adopting telemonitoring and are adherent in the long term .


Improved smoking cessation rates are urgently required if New Zealand is to reach its target of a smokefree nation by @ , during which some @,@ smokers will need to quit .


Nicotine replacement therapy remains a core part of the pharmacological approach to smoking cessation .


Oral nicotine solutions with rapid onset have recently become available .


We have examined the effect of a nicotine spray and a nicotine patch on smoking cessation for @ months .


We enrolled potential participants-smokers wanting to quit aged @-@ years , who smoked @ cigarettes per day-with Fagerstrm Test of Nicotine Dependence score @ in a double-blind trial in @ trial sites .


Smokers were randomized to a nicotine or placebo spray for @ months , and all received nicotine patches daily for @ months .


They were followed at regular intervals for @ months .


A total of @,@ subjects were randomized to nicotine oral spray ( @mg of nicotine free base per spray ) plus nicotine patch or a placebo spray and nicotine patch .


The nicotine mouth spray plus nicotine patch showed significant improvements in prolonged abstinence for all measures to @ months ( @ consecutive days at each visit for @ months : @ % vs. @ % ; p = @ ) for the combination versus placebo and nicotine patch .


Thereafter , the differences were not significant .


The addition of a nicotine mouth spray to a nicotine replacement patch in a population of smokers receiving a low level of behavioral support improved early quitting , but the effects were not sustained .


Improving the carbohydrate quality of the diet by replacing the common cereal staple white rice ( WR ) with brown rice ( BR ) could have beneficial effects on reducing the risk for diabetes and related complications .


Hence we aimed to compare the effects of BR , WR , and BR with legumes ( BRL ) diets on @-h glycemic and insulinemic responses among overweight Asian Indians .


Fifteen overweight ( body mass index , @ kg/m ( @ ) ) Asian Indians without diabetes who were @-@ years old participated in a randomized crossover study .


Test meals ( nonisocaloric , ad libitum ) were identical except for the type of rice and the addition of legumes ( @ g/day ) and were provided for @ consecutive days .


Glucose profiles were assessed using the Medtronic MiniMed ( Northridge , CA ) iPro@ continuous glucose monitoring device .


The mean positive change from baseline glucose concentration was calculated as the daily incremental area under the curve ( IAUC ) on each test day for @ days and averaged .


Fasting serum insulin was measured prior to and at the end of each test diet .


The percentage difference in @-day average IAUC was @ % lower in the BR group than in the WR group ( P = @ ) .


BRL further decreased the glycemic response ( @ % lower compared with WR ( P = @ ) .


The @-day percentage change in fasting insulin was @ % lower ( P = @ ) for the BR group and @ % lower for the BRL group compared with the @-day percentage change observed in the WR group .


The glycemic and insulinemic responses to the BR and BRL diets were not significantly different .


Consumption of BR in place of WR can help reduce @-h glucose and fasting insulin responses among overweight Asian Indians .


To investigate the effects of combination cathodal transcranial direct current stimulation ( tDCS ) and virtual reality ( VR ) therapy for upper extremity ( UE ) training in patients with subacute stroke .


Pilot randomized controlled trial .


Patients were randomly assigned to @ of @ groups : group A received cathodal tDCS , group B received VR , and group C received combination therapy ( cathodal tDCS was simultaneously applied during VR therapy ) .


University hospital .


Patients ( N = @ ) with impaired unilateral UE motor function after stroke .


Fifteen sessions of treatment over a @-week period .


The Modified Ashworth Scale , manual muscle test ( MMT ) , Manual Function Test ( MFT ) , Fugl-Meyer Scale ( FMS ) , and Box and Block Test were used to assess UE function .


To evaluate activities of daily living , the Korean-Modified Barthel Index ( K-MBI ) was used .


All outcomes were measured before and immediately after treatment .


After treatment , all groups demonstrated significant improvements in MMT , MFT , FMS , and K-MBI scores .


The change in MFT and FMS scores was different between the @ groups .


Post hoc analysis revealed that the improvement of MFT and FMS scores in group C was significantly higher than those of the other @ groups .


In the present pilot study , the combination of brain stimulation using tDCS and peripheral arm training using VR could facilitate a stronger beneficial effect on UE impairment than using each intervention alone .


This combination therapy might be a helpful method to enhance recovery of the paretic UE in patients with stroke .


To evaluate the safety and efficacy of once-weekly subcutaneous rilonacept @ mg for prevention of gout flares in patients initiating or continuing urate-lowering therapy ( ULT ) .


This phase III study was conducted in the United States , South Africa , Europe , and Asia .


Adults ( n = @ , @-@ yrs ) with gout , who were initiating or continuing ULT , were randomized to treatment with weekly subcutaneous injections of rilonacept @ mg or placebo for @ weeks followed by a @-week safety followup .


The primary endpoint was safety , assessed by adverse events ( AE ) and laboratory values .


Efficacy was a secondary endpoint .


Demographic and clinical characteristics were similar between treatments ; predominantly male ( @ % ) , mean age @ @ years .


Patients with @ AE were @ % with rilonacept versus @ % placebo , with slightly more AE-related withdrawals with rilonacept ( @ % vs @ % ) because of the greater incidence of injection site reactions ( @ % rilonacept , @ % placebo ) .


Serious AE were similar in both groups , as were serious infections ( @ % placebo , @ % rilonacept ) ; no tuberculosis or opportunistic infections occurred .


Most common AE were headache , arthralgia , injection site erythema , accidental overdose , and pain in extremity .


Of the @ deaths , only @ in the placebo group was considered treatment-related .


At Week @ , rilonacept resulted in @ % fewer gout flares per patient ( p < @ ) , fewer patients with @ and @ gout flares ( p < @ ) , and @ % fewer gout flare days ( p < @ ) relative to placebo .


Weekly subcutaneous administration of rilonacept @ mg showed no new safety signals .


The safety profile was consistent with previous studies .


Rilonacept also significantly reduced the risk of gout flares .


Clinicaltrials.gov identifier NCT@ ; EudraCT No. @-@-@ .


Haemodiafiltration ( HDF ) with high reinfusion volumes is the most effective technique for clearing uraemic toxins .


There are various modalities depending on the location where the replacement volume is administered in the extracorporeal circuit : pre-dilution , mixed or mid-dilution and post-dilution , in which the infusion is carried out pre-dilution , pre - and post-dilution simultaneously and post-dilution , respectively .


Compare the clearance of small , medium-sized and protein-bound molecules and the convective volume administered in online HDF ( OL-HDF ) in post-dilution and mixed ( pre-post-dilution ) infusion .


A prospective , randomised , crossover study comparing post-dilution and mixed OL-HDF .


Patients ( n = @ ) were randomly assigned to receive @ sessions in each technique .


We conducted @ sessions , of which @ were at a scheduled time ( ST ) and @ at an effective time ( ET ) .


We determined the reduction rate ( RR ) percentages for various substances and the infusion volumes .


The RR study was performed using ET .


The KT value obtained was greater with post-dilution OL-HDF -LSB- @ ( @ ) compared to @ ( @ ) litres -RSB- ( P = @ ) when patients were dialysed at ST. This difference disappeared when dialysis was performed at ET .


The difference between ST and ET was greater in mixed HDF than in post-dilution HDF -LSB- @ ( @ ) compared to @ ( @ ) minutes , P = @ -RSB- .


We found no differences in the RR of the substances analysed .


Mixed OL-HDF is not inferior to post-dilution OL-HDF either in the clearance of small and medium-sized molecules or in the clearance of protein-bound molecules at the same ET .


Prescribing inhalers without imparting adequate education regarding proper technique of their usage may result in suboptimal clinical improvement and wastage of medication .


Training interventions using a standard check-list may help improve faulty techniques and enhance drug efficacy .


Patients using metered dose inhaler ( MDI ) were included in the study .


Inhaler technique was first evaluated at baseline using a standard check-list of recommended steps ( National Institute of Health guidelines ; see Table ) and scores were given for each step correctly performed .


Those who could not perform all steps correctly were given training intervention .


The patients were assigned to two methods of educational intervention ; one group was trained by providing written material giving step-wise instructions while the other group was given an actual physical demonstration using a placebo device .


The technique was re-evaluated and scored following each educational session , and continued till the patient achieved a full score , or for a maximum of @ sessions , whichever occurred earlier .


Median score was calculated after each session and was compared between the two groups .


Each patient was followed up after two months and the re-evaluated the same way .


One hundred and seventeen subjects were enrolled in the study ( @ in the written group and @ in the practical demonstration group ) .


At baseline , only @ of the @ subjects could perform all the steps of inhaler usage correctly .


This patient was , therefore , not provided the inhaler technique education .


The overall median ( range ) score of the whole group was @ ( range @-@ ) .


This score rose to @ , @ and @ after each of the three subsequent educational intervention sessions .


At one-month follow-up , the median score dropped to @ and improved with a repeat educational session as previously done .


A significant difference was observed in the median score improvement achieved in the practical demonstration group compared with the written instruction group ( @ versus @ respectively , p < @ ) .


Inhalation technique of patients improves after imparting systematic educational intervention .


A practical demonstration of all the steps proved more effective than simple verbal/written advice .


In view of increasing errors being committed over a period of time , repeated demonstration of the proper technique using a standard check-list significantly improves the errors committed during inhaler use .


Cigarette smoking leads to upregulation of nicotinic acetylcholine receptors ( nAChRs ) in the human brain , including the common @ * nAChR subtype .


While subjective aspects of tobacco dependence have been extensively examined as predictors of quitting smoking with treatment , no studies to our knowledge have yet reported the relationship between the extent of pretreatment upregulation of nAChRs and smoking cessation .


To determine whether the degree of nAChR upregulation in smokers predicts quitting with a standard course of treatment .


Eighty-one tobacco-dependent cigarette smokers ( volunteer sample ) underwent positron emission tomographic ( PET ) scanning of the brain with the radiotracer @-FA followed by @ weeks of double-blind , placebo-controlled treatment with nicotine patch ( random assignment ) .


Pretreatment specific binding volume of distribution ( VS/fP ) on PET images ( a value that is proportional to @ * nAChR availability ) was determined for @ brain regions of interest , and participant-reported ratings of nicotine dependence , craving , and self-efficacy were collected .


Relationships between these pretreatment measures , treatment type , and outcome were then determined .


The study took place at academic PET and clinical research centers .


Posttreatment quit status after treatment , defined as a participant report of @ or more days of continuous abstinence and an exhaled carbon monoxide level of @ ppm or less .


Smokers with lower pretreatment VS/fP values ( a potential marker of less severe nAChR upregulation ) across all brain regions studied were more likely to quit smoking ( multivariate analysis of covariance , F@ ,@ = @ ; P < @ ) , regardless of treatment group assignment .


Furthermore , pretreatment average VS/fP values provided additional predictive power for likelihood of quitting beyond the self-report measures ( stepwise binary logistic regression , likelihood ratio @ = @ ; P < @ ) .


Smokers with less upregulation of available @ * nAChRs have a greater likelihood of quitting with treatment than smokers with more upregulation .


In addition , the biological marker studied here provided additional predictive power beyond subjectively rated measures known to be associated with smoking cessation outcome .


While the costly , time-consuming PET procedure used here is not likely to be used clinically , simpler methods for examining @ * nAChR upregulation could be tested and applied in the future to help determine which smokers need more intensive and/or lengthier treatment .


The purpose of this study was to describe the process of implementing a diabetes prevention program provided by homecare nurses to residents of public housing communities .


A cluster randomization pilot study was conducted comparing enhanced standard care ( @ interactive classes on diabetes prevention ) to a diabetes prevention program ( @ interactive classes and behavioral support ) .


The sample ( n = @ ) was primarily female ( @ % ) , nonwhite ( @ % ) , unpartnered ( @ % ) , with a mean age of @ years , and an average of @ children .


Mixed methods were used to evaluate the implementation process .


Data were collected on attendance , attrition , and protocol implementation .


Interviews were conducted with nurses and community health workers who assisted with program implementation .


Homecare nurses were able to implement a diabetes prevention program in public housing communities , with a protocol implementation of @ % across classes and groups .


Attendance was suboptimal with @ % for the enhanced standard care group and @ % for the diabetes prevention group .


Nurses and community health workers were resourceful and positive about program implementation .


Linking existing resources , such as a homecare agency with a public housing community , is one approach to disseminate diabetes prevention programs .


Randomized studies have shown optimal medical therapy to be as efficacious as revascularization in stable ischemic heart disease ( IHD ) .


It is not known if these efficacy results are reflected by real-world effectiveness .


To evaluate the comparative effectiveness of routine medical therapy versus revascularization with percutaneous coronary intervention ( PCI ) or coronary artery bypass grafting ( CABG ) in stable IHD .


Observational cohort study .


Stable IHD patients from @ October @ to @ September @ , identified using a Registry of all angiography patients in Ontario , Canada .


Revascularization , defined as PCI/CABG within @ days after index angiography .


Death , myocardial infarction ( MI ) or repeat PCI/CABG .


Revascularization was compared to medical therapy using a ) multivariable Cox-proportional hazard models with therapy strategy treated as a time-varying covariate ; and b ) a propensity score matched analysis .


Post-angiography medication use was determined .


We identified @,@ stable IHD patients , of whom @,@ were treated medically , and @,@ were revascularized ( PCI = @,@ ; CABG = @,@ ) .


Mean follow-up was @ years .


Revascularization was associated with fewer deaths ( HR @ ; @ % CI @-@ @ ; p < @ ) , MIs ( HR @ ; @ % CI @-@ @ ; p < @ ) and repeat PCI/CABG ( HR @ ; @ % CI @-@ @ ; p < @ ) than medical therapy .


In the propensity-matched analysis of @,@ well-matched pairs of revascularized and medical therapy patients , fewer deaths ( @ % vs @ % ; HR @ ; @ % CI @-@ @ ; p < @ ) , MIs ( @ % vs @ % ; HR @ ; @ % CI @-@ @ p < @ ) and repeat PCI/CABG ( @ % vs @ % ; HR @ ; @ % @-@ @ ; p < @ ) occurred in revascularized patients , over the @ years of follow-up .


The revascularization patients had higher uptake of clopidogrel ( @ % vs @ % ; p < @ ) , - blockers ( @ % vs @ % ; p = @ ) , and statins ( @ % vs @ % , p < @ ) in the @-year post-angiogram .


Stable IHD patients treated with revascularization had improved risk-adjusted outcomes in clinical practice , potentially due to under-treatment of medical therapy patients .


Colonoscopy is the most frequent exam used to evaluate colonic mucosa , allowing the diagnosis and treatment of many diseases .


The appropriate bowel preparation is indispensable for the realization of colonoscopy .


Therefore , it is necessary the use of laxative medications , preferentially by oral administration .


To compare two medications used in bowel preparation in adult patients going to ambulatory colonoscopy and to analyze the patients ' profile .


A double-blind prospective study with @ patients , randomized in two groups : one that received polyethilene glycol and another that received lactulose .


The patients answered to questionnaires to data compilation , as tolerance , symptoms and complications related to preparation .


Besides , it was also evaluated the prepare efficacy related to the presence of fecal residue .


Intestinal habit alterations and abdominal pain were the main reasons to realize the exams and hypertension was the most prevalent comorbidity .


Ten percent of the ones who received lactulose did n't get to finish the preparation and @ % considered the taste `` bad , but tolerable '' .


The most common subjective symptom after the medication was nausea , especially after lactulose .


During the exam , most of the patients who used lactulose had a `` light discomfort '' and the ones who used polyethilene glycol considered the discomfort as `` tolerable '' .


The quality of the preparation was good in @ % , undependable of the medication that was used .


Polyethilene glycol was more tolerable when compared to lactulose , without difference on the quality of the preparation .


To compare preservative-free ketotifen @ % ophthalmic solution to olopatadine @ % ophthalmic solution in with the treatment of seasonal allergic conjunctivitis ( SAC ) in clinical practice .


This was a comparative , randomised , investigator-masked , pilot clinical study in adult patients with documented history of SAC and presenting with moderate to severe itching and conjunctival hyperemia .


Eligible patients initiated either ketotifen or olopatadine treatment at a dose of one drop twice daily for @days .


The resolution of ocular signs and symptoms was assessed on day @ and day @ .


Itching was also assessed within @minutes following the first instillation ( day @ ) .


Conjunctival impression cytology was performed at each visit to assess the evolution of ICAM-@ expression ( day @ , @ and @ ) .


Seventy-five patients were randomised ( ketotifen : @ patients ; olopatadine : @ patients ) .


At day @ , the composite score for primary criteria ( itching , tearing , and conjunctival hyperemia ) improved from @ to @ in the Ketotifen group , without statistically significant difference between treatment groups ( P = @ ) .


There was no relevant difference between treatment groups in other efficacy parameters , except a trend for a more rapid resolution of conjunctival hyperemia in the Ketotifen group .


Both drugs were well tolerated , with a trend for a better tolerability reported by patients on ketotifen compared to those on olopatadine at day @ ( P = @ ) .


A rapid and comparable improvement in SAC was achieved after @days of treatment with both preservative-free ketotifen and preserved olopatadine ophthalmic solutions , with a slightly better ocular tolerance with unpreserved ketotifen @ % eye drops .


Adalimumab is a fully human , monoclonal antibody against tumor necrosis factor that is approved in Western countries for the treatment of moderately to severely active ulcerative colitis ( UC ) .


This @-week , phase @/@ , randomized , double-blind study evaluated adalimumab for induction and maintenance treatment in @ anti-TNF-naive Japanese patients with UC who were refractory to corticosteroids , immunomodulators , or both .


Patients received placebo , adalimumab @/@ ( @mg at week @ , then @mg every other week ) , or adalimumab @/@ ( @/@mg at weeks @/@ , then @mg every other week ) in addition to background UC therapy .


At week @ , remission rates were similar among treatment arms , but more patients treated with adalimumab @/@ achieved response ( placebo , @ % ; @/@ , @ % ; @/@ , @ % ; P = @ for @/@ vs placebo ) and mucosal healing ( placebo , @ % ; @/@ , @ % ; @/@ , @ % ; P = @ for @/@ vs placebo ) compared with placebo .


At week @ , more patients receiving adalimumab @mg every other week achieved response ( @ vs @ % ; P = @ ) , remission ( @ vs @ % ; P = @ ) , and mucosal healing ( @ vs @ % ; P = @ ) compared with placebo .


Week @ response to adalimumab was associated with greater rates of response ( @ % ) , remission ( @ % ) , and mucosal healing ( @ % ) at week @ relative to the overall population .


Rates of serious adverse events were similar between treatment arms .


Induction with adalimumab @/@mg led to early response and mucosal healing .


Maintenance adalimumab had greater rates of long-term response , remission , and mucosal healing compared with placebo .


No new safety signals were identified .


Electrical reconnection of the pulmonary veins ( PVs ) plays a key role in the recurrence of atrial fibrillation ( AF ) after ablative treatment .


This randomized controlled study tested the hypothesis that prolonged ablations , on areas that may be critical for left atrial ( LA ) - PV conduction , can significantly reduce the rate of acute PV reconnection and AF recurrence .


Patients with paroxysmal AF were randomly assigned to either a control or an add-on group.Ostial PV isolation ( PVI ) was performed by point-to-point RF ablation ( irrigated tip , @ Watts , @ seconds ) .


An ostial segment was assumed to be critical for LA-PV connection if any of the following reactions occurred during RF application : ( @ ) sudden delay of LA-PV conduction , ( @ ) change of activation sequence , and ( @ ) PVI .


In this case , RF application was prolonged from @ seconds to @ seconds in the add-on group only .


A total of @ patients ( @ @ years , @ female ) were assigned to a control ( n = @ ) and an add-on ( n = @ ) group .


Ablation time was longer in the add-on ( @ @ minutes vs @ @ minutes , P = @ ) .


Acute PV reconnection was observed in @ of @ controls and in eight of @ add-on patients ( @ % vs @ % , P < @ ) .


During a follow-up of @ months , AF recurred in @ of @ controls and in @ of @ add-on patients ( @ % vs @ % , P = @ ) after a single ablation procedure .


Prolonged radiofrequency application on critical segments of LA-PV connection is a safe and effective ablative strategy that significantly reduces acute PV reconnection and AF recurrence rates after a single ablation procedure for paroxysmal AF .


Low-contrast visual acuity ( LCVA ) , a sensitive measure of visual function in multiple sclerosis ( MS ) , demonstrated treatment effects as a secondary outcome measure in the Phase @ trial of natalizumab , AFFIRM .


In these posttrial analyses , we studied the relation of visual function to quality of life ( QOL ) , magnetic resonance imaging ( MRI ) measures , and Expanded Disability Status Scale ( EDSS ) scores .


At baseline and at @ and @ weeks in AFFIRM , patients underwent binocular testing of LCVA ( @ % and @ % contrast ) and high-contrast visual acuity ( HCVA ) .


Vision-specific QOL was assessed by the Impact of Visual Impairment Scale ( IVIS ) , whereas the SF-@ Health Survey and Visual Analog Scale were administered as generic QOL measures and the EDSS as a measure of neurologic impairment .


Among QOL measures , IVIS scores showed the most significant correlations with visual dysfunction at all time points in the trial ( r = -@ to -@ , P < @ for LCVA and HCVA ) .


Higher MRI T@ - and T@-lesion volumes were also associated with worse vision scores at all time points ( P < @ ) .


Clinically meaningful worsening ( progression ) of LCVA was noted in substantial proportions of patients in AFFIRM and was prevalent even among those without EDSS progression over @ years ( @ % with LCVA progression at @ % contrast ; @ % at @ % contrast ) .


HCVA worsened in only @ % of patients without EDSS progression .


Loss of visual function , particularly as measured by LCVA , was common in AFFIRM , occurring in > @ % of patients .


Both LCVA and HCVA scores reflect vision-specific aspects of QOL , but LCVA provides information about disability progression not entirely captured by the EDSS .


Vision represents a key dimension of outcome assessment for MS and adds valuable information on disability and QOL that can be useful to clinicians .


The objective of this study was to assess and compare the features of the Bemfola , Gonal-f and Puregon injection pens .


Females who intended to undergo hormonal treatment received the three different pens in a randomized , consecutive sequence .


For each of the pens , the potential patients completed an Injection Pen Assessment Questionnaire , as well as a questionnaire comparing the handling , convenience and preference among the three pens .


The mean score on the visual analogue scale ( VAS ) for the Bemfola pen ( BP ) was @ @ ; for the Puregon pen ( PP ) , @ @ ; and for the Gonal-f pen ( GP ) , @ @ .


The BP was superior to both competitor devices in pen size , inconspicuousness , ease of use and dose changing ; no significant differences to both competitor pens were observed in the way the pen looks , the way the pen feels and the ease of injection of the volume .


The ` overall ' assessment was significantly better for the BP when compared to the GP ( p = @ ) , while no significant difference was observed between the BP and the PP .


This study demonstrated significantly higher ratings for pen size , inconspicuousness , ease of use and dose adjustment for the BP compared to other marketed pens .


To investigate the effects , and their reversibility , of multiple oral voriconazole doses on a variety of visual tests in healthy male volunteers .


Single-center , double-blind , randomized , placebo-controlled , parallel-group study in @ volunteers who received voriconazole ( n = @ , @ mg every @ h on day @ , then @ mg every @ h for @ days ) or matched placebo ( n = @ ) .


Electroretinograms ( ERGs ) and ophthalmological examinations were performed at screening , throughout the study and at follow-up .


Fifteen ( @ % ) volunteers treated with voriconazole experienced @ treatment-related visual adverse events ( AEs ) ; these included enhanced visual perceptions , blurred vision , color vision changes and photophobia .


No serious AEs were reported .


Voriconazole reduced from baseline scotopic maximal a - and b-wave amplitude , shortened implicit time and decreased oscillatory potential amplitude compared with placebo .


Under photopic conditions , the @-Hz flicker response amplitude was significantly reduced and was accompanied by a slight but nonsignificant prolongation of peak time .


These effects did not progress in degree over the treatment period , and mean changes from baseline in ERG parameters were similar to placebo by day @ ( @ days after end of treatment ) .


In the first week , color vision discrimination was impaired in the tritan axis , although this resolved by end of treatment and was similar to placebo by day @ .


Mean deviation in the static visual field indicated increased sensitivity following voriconazole treatment , correlating with decreased amplitude in conjunction with shortened implicit time .


Effects of voriconazole on altered visual perception , ERG , color vision and static visual field thresholds are nonprogressive over a treatment period and reversible .


It is hypothesized that voriconazole has a pharmacological effect on rod and cone pathways including a possible mechanism of disinhibition that reversibly puts the retina in a more light-adapted state and leads to increased relative contrast sensitivity .


Acute exacerbations of chronic obstructive pulmonary disease ( AECOP ) are key events in the natural history of the disease .


Patients with more AECOPD have worse prognosis .


There is a need of innovative models of care for patients with severe COPD and frequent AECOPD , and Telehealth ( TH ) is part of these programs .


In a cluster assignment , controlled trial study design , we recruited @ patients , @ in home telehealth ( HT ) and @ in conventional care ( CC ) .


All participants had a prior diagnosis of COPD with a post-bronchodilator forced expiratory volume ( FEV@ ) % predicted < @ % , age @ years , were on long-term home oxygen therapy , and non-smokers .


Patients in the HT group measured their vital signs on a daily bases , and data were transmitted automatically to a Clinical Monitoring Center for followed-up , and who escalated clinical alerts to a Pneumologist .


After @-month of monitoring and follow-up , there was a significant reduction in ER visits ( @ in HT vs. @ in CC ) , hospitalizations ( @ vs. @ ) , length of hospital stay in ( @ vs. @ days ) , and even need for non-invasive mechanical ventilation ( @ vs. @ ) , all p < @ .


Time to the first severe AECOPD increased from @ days in CC to @ days in HT ( K-M p < @ ) .


There was no study withdrawals associated with technology .


All patients showed a high level of satisfaction with the HT program .


We conclude that HT in elderly , severe COPD patients with multiple comorbidities is safe and efficacious in reducing healthcare resources utilization .


To evaluate whether premature infants who received an exclusive human milk ( HM ) - based diet and a HM-derived cream supplement ( cream ) would have weight gain ( g/kg/d ) at least as good as infants receiving a standard feeding regimen ( control ) .


In a prospective noninferiority , randomized , unmasked study , infants with a birth weight @-@ g were randomly assigned to the control or cream group .


The control group received mother 's own milk or donor HM with donor HM-derived fortifier .


The cream group received a HM-derived cream supplement if the energy density of the HM tested < @ kcal/oz using a near infrared HM analyzer .


Infants were continued on the protocol until @ weeks postmenstrual age .


Primary outcomes included growth velocities and amount of donor HM-derived fortifier used .


The hypothesis of noninferiority was established if the lower bound of the one-sided @ % CI for the difference in weight velocities exceeded -@ g/kg/day .


There were no differences between groups in baseline demographics for the @ infants studied except racial distribution ( P = @ ) .


The cream group ( n = @ ) had superior weight ( @ @ vs @ @ g/kg/d , P = @ ) and length ( @ @ vs @ @ cm/wk , P = @ ) velocity compared with the control group ( n = @ ) .


There were no significant differences in amount of fortifier used between study groups .


The @-sided @ % lower bound of the CI for the difference in mean velocity ( cream-control ) was @ g/kg/d .


Premature infants who received HM-derived cream to fortified HM had improved weight and length velocity compared with the control group .


HM-derived cream should be considered an adjunctive supplement to an exclusive HM-based diet to improve growth rates in premature infants .


Serum markers are used before pelvic imaging to improve specificity and positive predictive value ( PPV ) of ovarian cancer multimodal screening strategies .


We conducted a randomized controlled pilot trial to estimate surgical PPV of a `` @ of @ tests positive '' screening rule , and to compare use of HE@ as a first-line ( Arm @ ) versus a second-line ( Arm @ ) screen , in women at high and elevated risk for epithelial ovarian cancer ( EOC ) at five study sites .


Semiannual screening was offered to @ women ages @ to @ years with deleterious BRCA germline mutations and to @ women ages @ to @ years with pedigrees suggesting inherited susceptibility .


Annual screening was offered to @ women ages @ to @ years ( Risk Group @ ) with epidemiologic and serum marker risk factors .


Rising marker levels were identified using the parametric empirical Bayes algorithm .


Both strategies yielded surgical PPV above @ % .


Protocol-indicated surgery was performed in @ women , identifying two ovarian malignancies and yielding a surgical PPV in both arms combined of @ % ( @ % confidence interval : @ % -@ % ) , @ % in Arm @ and @ % in Arm @ .


Surgical consultation was recommended for @ women ( @ in Arm @ and @ in Arm @ ) .


On the basis of @ women with at least @ of @ tests positive ( CA@ , HE@ , or imaging ) , an intent-to-treat analysis yielded PPV of @ % in Arm @ and @ % in Arm @ .


Positive screens were more frequent when HE@ was included in the primary screen .


HE@ may be useful as a confirmatory screen when rising CA@ is used alone as a primary screen .


Following traumatic brain injury ( TBI ) , individuals may experience chronic problems with irritability or aggression , which may need treatment to minimize the negative impact on their relationships , home life , social interactions , community participation , and employment


: To test the a priori hypothesis that amantadine reduces irritability ( primary hypothesis ) and aggression ( secondary hypothesis ) among individuals greater than @ months post-TBI METHODS : : A total of @ individuals greater than @ months post-TBI referred for irritability management were enrolled in a parallel-group , randomized , double-blind , placebo-controlled trial of amantadine ( n = @ ) versus placebo ( n = @ ) .


Study participants were randomly assigned to receive amantadine hydrochloride @ mg twice daily versus equivalent placebo for @ days .


Symptoms of irritability and aggression were measured before and after treatment using the Neuropsychiatric Inventory Irritability ( NPI-I ) and Aggression ( NPI-A ) domains , as well as the NPI-Distress for these domains


: In the amantadine group , @ % improved at least @ points on the NPI-I , compared with @ % in the group that received placebo ( P = @ ) .


Mean change in NPI-I was -@ in the amantadine group and -@ in the placebo group ( P = @ ) .


When excluding individuals with minimal to no baseline aggression , mean change in NPI-A was -@ in the amantadine group and -@ in the placebo group ( P = @ ) .


Mean changes in NPI-I and NPI-A Distress were not statistically significant between the amantadine and placebo groups .


Adverse event occurrence did not differ between the @ groups


: Amantadine @ mg every morning and at noon appears an effective and safe means of reducing frequency and severity of irritability and aggression among individuals with TBI and sufficient creatinine clearance .


To investigate the effect of aerobic exercise training ( AET ) and cognitive-behavioral therapy ( CBT ) on chronic fatigue in patients with facioscapulohumeral muscular dystrophy ( FSHD ) .


We performed a multicenter , assessor-blinded , randomized clinical trial ( RCT ) .


Fifty-seven patients with FSHD type @ with severe chronic fatigue were randomly allocated to AET , CBT , or usual care ( UC ) .


Outcomes were assessed before treatment , following @ weeks of intervention , and after a @-week follow-up .


A linear mixed model for repeated measurements was used to study the estimated group differences .


Following treatment , both the AET ( @ participants ) and CBT ( @ participants ) intervention groups had less fatigue relative to the UC group ( @ participants ) , with a difference of -@ for AET ( @ % confidence interval -LSB- CI -RSB- -@ to -@ ) and -@ for CBT ( @ % CI -@ to -@ ) .


These beneficial effects lasted through follow-up , with a difference of -@ for AET ( @ % CI -@ to -@ ) and -@ for CBT ( @ % CI -@ to -@ ) .


The patients who received CBT had an increase in registered and experienced physical activity , sleep quality , and social participation .


The patients who received AET had an increase in registered physical activity only .


The increase in registered physical activity in both groups and the improvement in social participation following CBT were still present at follow-up .


This RCT shows that AET and CBT can ameliorate chronic fatigue in patients with FSHD .


This study provides Class III evidence that , in patients with FSHD type @ and severe chronic fatigue , AET or CBT reduces the severity of chronic fatigue .


To compare intraindividually two macrocyclic contrast agents - gadobutrol and gadoterate meglumine ( Gd-DOTA ) - for dynamic and quantitative assessment of relative enhancement ( RE ) in benign and malignant breast lesions .


This was an ethically approved , prospective , single-centre , randomized , crossover study in @ women with suspected breast lesions referred for magnetic resonance imaging ( MRI ) .


Each patient underwent one examination with gadobutrol and one with Gd-DOTA ( @ mmol/kg BW ) on a @ T system @ - @ days apart .


Dynamic , T@-weighted , @D gradient echo sequences were acquired under identical conditions .


Quantitative evaluation with at least three regions of interest ( ROI ) per lesion was performed .


Primary endpoint was RE during the initial postcontrast phase after the first and second dynamic acquisition , and peak RE .


All lesions were histologically proven ; differences between the examinations were evaluated .


Forty-five patients with a total of @ benign and @ malignant lesions were assessed .


Mean RE was significantly higher for gadobutrol than Gd-DOTA ( p < @ ) .


Gadobutrol showed significantly less washout ( @ % ) than Gd-DOTA ( @ % ) in malignant lesions ( p = @ ) CONCLUSIONS : Gadobutrol has higher RE values compared with Gd-DOTA , whereas Gd-DOTA shows more marked washout in malignant lesions .


This might improve the detection of breast lesions and influence the specificity of breast MRI-imaging .


The Maastricht , Asia-Pacific consensus guidelines strongly recommend eradication of Helicobacter pylori in patients who have a history of gastric cancer .


This open-label , single-center , randomized controlled trial was conducted to investigate the appropriate timing of eradication for patients undergoing gastrectomy .


One hundred and fifty patients scheduled to undergo gastrectomy were allocated to either a preoperative or a postoperative group .


The eradication regimen was a common triple therapy : lansoprazole , amoxicillin , and clarithromycin .


Patients in the preoperative group were treated with the regimen , followed by surgery , and patients in the postoperative group were treated after postoperative day @ .


The primary end point was the proportion of patients achieving successful eradication in the remnant stomach .


The definition of successful eradication was negativity in both the C@ urea breath test and for the antigen in feces at @ months after surgery .


Eight patients were excluded , and the remaining one hundred and forty-two , @ in the preoperative group and @ in the postoperative group , were included on an intention to treat basis .


The procedures used were gastrectomy with Billroth I , Roux-en-Y , and pylorus-preserving gastrectomy in @ , @ , and @ patients , respectively .


The proportion of patients showing successful eradication hardly differed between the @ groups , @ % vs @ % ( p = @ ) in the pre - and postoperative groups , respectively .


Subgroup analysis also demonstrated no significant difference among the reconstruction methods used .


Preoperative H pylori eradication therapy for gastric cancer patients scheduled for gastrectomy is not necessary , regardless of the planned reconstruction procedure .


Although there has been growing evidence for the efficacy of mindfulness-based cognitive therapy ( MBCT ) for different clinical populations , its effectiveness as a public mental health intervention has not been studied .


The present study evaluates a community-based MBCT intervention for adults with mild to moderate depressive symptomatology in a large multi-site , pragmatic randomized controlled trial .


The participants with mild to moderate depressive symptomatology were recruited from the general population and randomized to the MBCT intervention ( n = @ ) or to a waiting list control group ( n = @ ) .


Participants completed measures before and after the intervention .


Participants in the experimental condition also completed these measures at a @-month follow-up .


In the experimental condition significant reductions in depression , anxiety , and experiential avoidance , and improvements in mindfulness and emotional - and psychological mental health were found , compared to the waiting list ( effect sizes Cohen 's d = @-@ @ ) .


These effects were sustained at the @-month follow-up .


The likelihood of a clinically significant change in depressive symptoms was significantly higher for the MBCT group -LSB- odds ratio ( OR ) @ , p < @ at post-treatment ; NNT = @ -RSB- .


MBCT as a public mental health intervention for adults with mild to moderate depressive symptoms seems effective and applicable in a natural setting .


To determine whether acute migraine treatment outcome is different in migraine with aura compared with migraine without aura .


We examined pooled outcome data for sumatriptan treatment of migraine with and without aura from the sumatriptan/naratriptan aggregate patient database .


We also examined similar outcome data for inhaled dihydroergotamine ( DHE ) from a single , large randomized controlled study .


The pooled pain-free rates @ hours postdose for sumatriptan @ mg were significantly higher in patients treating attacks without aura ( @ % ) compared with the group who treated attacks with aura ( @ % ) ( p < @ ) .


The relative risk for pain freedom @ hours postdose for attacks without aura was @ ( @ % confidence interval : @-@ @ ) .


The number needed to treat for @ hours of pain freedom was @ for attacks without aura and @ for attacks with aura .


For the clinical trial of DHE , the @-hour pain-free rates did not differ between patients treating attacks without aura ( @ % ) compared with those who treated attacks with aura ( @ % ; p = @ ) .


The relative risk for pain freedom @ hours postdose for attacks without aura vs with aura was @ ( @ % confidence interval : @-@ @ ) .


The number needed to treat for @ hours pain free was @ for attacks without aura and @ for attacks with aura .


This post hoc analysis of pooled data from multiple randomized trials indicates that sumatriptan is less effective as acute therapy for migraine attacks with aura compared with attacks without aura .


In the single study of inhaled DHE , the treatment had similar efficacy for migraine attacks with and without aura .


Different responses of migraine with vs without aura to acute therapies may provide insight into underlying migraine mechanisms and influence the choice of acute therapies for different types of migraine attacks .


Adjuvanted influenza vaccines can overcome the poor antibody response of conventional non-adjuvanted vaccines in the elderly .


We evaluated the immunogenicity , safety and clinical effectiveness of an MF@ ( ) - adjuvanted trivalent influenza vaccine ( aTIV ) compared with a non-adjuvanted vaccine ( TIV ) in subjects @ years old , with or without co-morbidities .


In @-@ , subjects ( N = @ ) were randomized to receive one dose of aTIV or TIV .


Co-primary objectives were to assess lot-to-lot consistency of aTIV , non-inferiority , superiority and immunogenicity @ days after vaccination .


Clinical effectiveness , reactogenicity and serious adverse events were monitored up to Day @ .


The immunological equivalence of three lots of aTIV was demonstrated .


aTIV was not only non-inferior to TIV but also elicited significantly higher antibody responses at Day @ than TIV against all homologous and heterologous strains , even in subjects with co-morbidities .


Superiority was not established .


Reactogenicity was higher in the aTIV group , but reactions were mild to moderate and transient .


aTIV elicited a significantly higher antibody response than TIV , especially against A/H@N@ strains , although superiority by pre-defined criteria was not formally met .


The study demonstrates potential immunological benefits of MF@-adjuvanted influenza vaccines for the elderly .


This trial was registered with www.clinicaltrials.gov ( NCT@ ) .


Enhancing physical activity in overweight and obese individuals is an important means to promote health in this target population .


The Health Action Process Approach ( HAPA ) , which was the theoretical framework of this study , focuses on individual self-regulation variables for successful health behavior change .


One key self-regulation variable of this model is action control with its three subfacets awareness of intentions , self-monitoring and regulatory effort .


The social context of individuals , however , is usually neglected in common health behavior change theories .


In order to integrate social influences into the HAPA , this randomized controlled trial investigated the effectiveness of a dyadic conceptualization of action control for promoting physical activity .


This protocol describes the design of a single-blind randomized controlled trial , which comprises four experimental groups : a dyadic action control group , an individual action control group and two control groups .


Participants of this study are overweight or obese , heterosexual adult couples who intend to increase their physical activity .


Blocking as means of a gender-balanced randomization is used to allocate couples to conditions and partners to either being the target person of the intervention or to the partner condition .


The ecological momentary intervention takes place in the first @ days after baseline assessment and is followed by another @ days diary phase without intervention .


Follow-ups are one month and six months later .


Subsequent to the six-months follow-up another @ days diary phase takes place.The main outcome measures are self-reported and accelerometer-assessed physical activity .


Secondary outcome measures are Body Mass Index ( BMI ) , aerobic fitness and habitual physical activity .


This is the first study examining a dyadic action control intervention in comparison to an individual action control condition and two control groups applying a single-blind randomized control trial .


Challenges with running couples studies as well as advantages and disadvantages of certain design-related decisions are discussed .


This RCT was funded by the Swiss National Science Foundation ( PP@P@_@ / @ ) and was registered on @/@/@ at http://www.isrctn.com/ISRCTN@ .


We sought to examine changes in intraocular pressure ( IOP ) in the immediate period after clear corneal micro-incision cataract surgery ( MICS ) and after small-incision cataract surgery ( SICS ) .


Sixty-eight eyes of @ patients scheduled for coaxial phacoemulsification were randomized into one of two groups : ( a ) eyes that were to undergo a @-mm MICS , and ( b ) a @-mm SICS .


At the conclusion of surgery , the IOP was adjusted to the range between @-@mmHg with stromal hydration .


The IOP was measured using a rebound tonometer preoperatively , at the conclusion of surgery , and at @ , @ , @ , @ , and @min postoperatively .


The Seidel test and anterior segment-optical coherence tomography were performed at @min postoperatively .


Mean IOP at the conclusion of surgery was @ mmHg in the MICS group and @ mmHg in the SICS group ( p = @ ) .


In both groups , mean IOP decreased to the preoperative level within @min postoperatively and did not change significantly for up to @min .


Mean IOP was similar between the MICS and SICS groups throughout the observation period ( p@ @ ) .


Hypotony ( @mmHg ) , positive Seidel test , and loss of wound coaptation were not detected in all eyes .


After adjusting the IOP to a relatively high level at the conclusion of surgery , the IOP decreased within @min and was stable within @min without hypotony .


The IOP was comparable between eyes after MICS and SICS , and both incisions virtually closed within @min postoperatively .


Buprenorphine/naloxone ( BUP/NX ) , an effective treatment for opioid dependence , has been implicated in hepatic toxicity .


However , as persons taking BUP/NX have multiple hepatic risk factors , comparative data are needed to quantify the risk of hepatoxicity with BUP/NX .


We compared rates of alanine aminotransferase ( ALT ) elevationgrade @ ( ALT@ @ times the upper limit of normal ) and graded bilirubin elevations in HIV-negative opioid injectors randomized to long-term ( @ weeks ) or short-term ( @ days ) medication assisted treatment ( LT-MAT and ST-MAT , respectively ) with BUP/NX in a multisite trial conducted in China and Thailand .


ALT and bilirubin were measured at baseline , @ , @ , @ and @ weeks , times temporally remote from BUP/NX exposure in the ST-MAT participants .


Among@ subjects with at least one laboratory follow-up measurement , @ ( @ % ) participants experienced ALT elevationgrade @ .


In an intent-to-treat analysis , the risk of ALT events was similar in participants randomized to LT-MAT compared with ST-MAT ( adjusted hazard ratio @ , @ % confidence interval @ to @ ) .


This finding was supported by an as-treated analysis , in which actual exposure to BUP/NX was considered .


Hepatitis C seroconversion during follow-up was strongly associated with ALT events .


Bilirubin elevationsgrade @ occurred in @ % of subjects , with no significant difference between arms .


Over @-week follow-up , the risk of hepatotoxicity was similar in opioid injectors receiving brief and prolonged treatment with BUP/NX .


These data suggest that most hepatotoxic events observed during treatment with BUP/NX are due to other factors .


Patients with type @ diabetes face heightened risk of hypoglycemia after exercise .


Subsequent overfeeding , as a preventative measure against hypoglycemia , negates the energy deficit after exercise .


Patients are also required to reduce the insulin dose administered with postexercise foods to further combat hypoglycemia .


However , the insulin dose is dictated solely by the carbohydrate content , even though postprandial glycemia is vastly influenced by glycemic index ( GI ) .


With a need to control the postexercise energy balance , appetite responses after meals differing in GI are of particular interest .


We assessed the appetite response to low-glycemic index ( LGI ) and high-glycemic index ( HGI ) postexercise meals in type @ diabetes patients .


This assessment also offered us the opportunity to evaluate the influence of GI on appetite responses independently of insulinemia , which confounds findings in individuals without diabetes .


Ten physically active men with type @ diabetes completed @ trials in a randomized crossover design .


After @ min of treadmill exercise at @ % of the peak oxygen uptake , participants consumed an LGI ( GI @ ) or HGI ( GI @ ) meal with a matched macronutrient composition , negligible fiber content , and standardized insulin-dose administration .


The postprandial appetite response was determined for @ min postmeal .


During this time , circulating glucose , insulin , glucagon , and glucagon-like peptide-@ ( GLP-@ ) concentrations and subjective appetite ratings were determined .


The HGI meal produced an @ % greater postprandial glucose area under the curve ( AUC ) than did the LGI meal ( P = @ ) .


Insulin , glucagon , and GLP-@ did not significantly differ between trials ( P > @ ) .


The fullness AUC was @ % greater after the HGI meal than after the LGI meal ( P < @ ) , whereas hunger sensations were @ % lower after the HGI meal than after the LGI meal ( P = @ ) .


Under conditions of matched insulinemia and fiber , an HGI postexercise meal suppresses feelings of hunger and augments postprandial fullness sensations more so than an otherwise equivalent LGI meal in type @ diabetes patients .


This study sought to evaluate the prognostic value of routine stress myocardial perfusion scintigraphy ( MPS ) @ years after percutaneous coronary intervention ( PCI ) .


Current appropriate use criteria define routine cardiac stress imaging < @ years after PCI as inappropriate and > @ years as uncertain in asymptomatic patients .


All @ of @ BASKET ( Basel Stent Kosteneffektivitts Trial ) @-year survivors ( @ % ) consenting to undergo protocol-mandated MPS and subsequent evaluation irrespective of symptoms were followed for major adverse cardiac events ( MACE ) ( cardiac death , myocardial infarction -LSB- MI -RSB- , or revascularization ) .


For MPS , summed perfusion scores were calculated and perfusion defects were related to treated-vessel or remote myocardial areas .


Patients were @ @ years of age , @ % were female , and @ % were free of angina .


MPS findings were abnormal in @ of @ patients ( @ % ) with complete follow-up .


During @ @ years , there were @ cardiac deaths , @ MIs , and @ revascularizations , resulting in a MACE rate of @ % and a cardiac mortality rate of @ % per year .


Patients with abnormal MPS findings had higher hazard ratios ( HR ) for MACE ( HR : @ ; @ % confidence interval -LSB- CI -RSB- : @ to @ ; p = @ ) , and cardiac death/MI ( HR : @ ; @ % CI : @ to @ ; p = @ ) than patients with normal MPS finding .


MACE rates were similar in patients with symptomatic and silent ischemia ( p = @ ) but higher than in patients with normal MPS findings ( p < @ for both comparisons ) .


MACE rates were independently predicted by remote ischemia but not by treated-vessel ischemia or scar .


Abnormal MPS findings @ years after PCI are frequent irrespective of symptoms .


The predictive power of abnormal MPS lies more in the detection of persistent or progressing coronary artery disease in remote vessel areas than in the diagnosis of late intervention-related problems in treated vessels .


Patients with posttraumatic stress disorder ( PTSD ) have significant medical morbidity , which may be mediated by hypothalamic pituitary axis ( HPA ) dysfunction and reflected in cortisol output .


Many veterans with PTSD are hesitant to engage in trauma-focused exposure treatments ; therefore briefer , non-exposure-based treatments are needed ; one such promising approach is an abbreviated Primary Care brief Mindfulness Program ( PCbMP ) .


This study investigated the relationship between dose-response to participation in a veterans PCbMP program and diurnal cortisol .


Cortisol reflects HPA function and PTSD is associated with HPA dysregulation .


Veterans with PTSD were identified in PC and randomly assigned to treatment as usual ( TAU , n = @ ) or participation in brief @-week Mindfulness Based Stress Reduction program ( n = @ ) .


Veterans ( n = @ ) ( mean age , @ y ; @ % men ) with PTSD referred through their VA PC provider and randomly assigned to PCbMP or TAU .


As an objective indicator of HPA function , salivary diurnal cortisol was measured from samples collected across @ consecutive days at baseline and follow-up .


Analyses revealed that significant changes in cortisol were associated with PCbMP treatment engagement and dosing ( number of mindfulness program sessions completed ) .


Veterans completing @ mindfulness-based meditation sessions significantly reduced their cortisol awakening response ( P@ @ ) ; and had significant changes in cortisol area under the curve increase compared with TAU participants ( P@ @ ) .


Results indicate that PCbMP has a beneficial physiological impact on veterans with PTSD with a minimum of @ weeks of practice .


To compare intraocular pressure ( IOP ) measurements with the Goldmann applanation tonometer ( GAT ) and the ICare rebound tonometer ( RBT ) in high myopic eyes .


This randomized prospective study included @ eyes of @ patients with high myopia .


All patients ' central corneal thickness ( CCT ) , anterior chamber depth ( ACD ) , axial length ( AXL ) , keratometry , and refractive measurements were recorded and followed by IOP measurement with RBT and GAT .


The average CCT , AXL , and ACD were determined to be @ @ m , @ @ mm , and @ @ mm , respectively .


Mean K was @ @ D and mean spherical equivalent was -@ @ D.


The mean IOP values obtained by RBT and GAT were @ @ mmHg and @ @ mmHg , respectively .


The deviations of RBT readings from corrected GAT values were highly correlated with CCT values ( r = @ , P = @ ) .


The mean corrected GAT reading was @ @ mmHg .


Linear regression analysis showed that a CCT change of @ m resulted in an RBT reading deviation of @ mmHg .


The Bland-Altman scatter-plot and McNemar test showed a clinically good level of agreement between the two tonometers .


This study found a good agreement level between the two tonometers in high myopic patients and that RBT measurements are influenced by CCT variations .


To explore the clinical effectiveness of continuous blood purification ( CBP ) in combination with ulinastatin for the treatment of thermoplegia .


Forty patients ( @ men and @ women ) with severe heat stroke were admitted to our hospital 's ICU department from June @ to August @ .


The patients were randomized into a treatment group ( n = @ ; @ men and six women , with an average age of @ years ) and control group ( n = @ ; @ men and six women , with an average age of @ years ) .


Patients in the control group underwent treatments of oxygen inhalation , dynamic ECG monitoring , physical cooling methods ( ice caps or ice application ) , whereas patients in the treatment group , in addition to this treatment , were further treated with continuous blood purification in combination with ulinastatin .


During administration , the content of one vial was dissolved in @ mL of physiological saline for intravenous dripping for @ hours .


There were @ cured cases , one case of sequelae of mild neurological disorders , and two deaths in the treatment group , with the cure rate of @ % .


In comparison , there were @ cured cases , three cases of sequelae of mild neurological disorders , and four deaths in the control group , with the cure rate of @ % .


The overall response rates of rectal temperature drop were determined to be @ % and @ % for the treatment group and the control group , respectively .


Based on the treatment outcomes data , multiple organ dysfunction syndrome ( MODS ) recovery , deaths and survival outcomes of patients in the treatment group was more favorable than that of the control group .


This difference was statistically significant ( p < @ ) .


Continuous blood purification in combination with ulinastatin is effective in treating thermoplegia and warrants further investigation .


The potential for telehealth-based interventions to provide remote support , education and improve self-management for long-term conditions is increasingly recognised .


This trial aims to determine whether an intervention delivered through an easy-to-use tablet computer can improve the quality of life of patients with chronic obstructive pulmonary disease ( COPD ) by providing personalised self-management information and education .


The EDGE ( sElf management anD support proGrammE ) for COPD is a multicentre , randomised controlled trial designed to assess the efficacy of an Internet-linked tablet computer-based intervention ( the EDGE platform ) in improving quality of life in patients with moderate to very severe COPD compared with usual care .


Eligible patients are randomly allocated to receive the tablet computer-based intervention or usual care in a @:@ ratio using a web-based randomisation system .


Participants are recruited from respiratory outpatient clinics and pulmonary rehabilitation courses as well as from those recently discharged from hospital with a COPD-related admission and from primary care clinics .


Participants allocated to the tablet computer-based intervention complete a daily symptom diary and record clinical symptoms using a Bluetooth-linked pulse oximeter .


Participants allocated to receive usual care are provided with all the information given to those allocated to the intervention but without the use of the tablet computer or the facility to monitor their symptoms or physiological variables .


The primary outcome of quality of life is measured using the St George 's Respiratory Questionnaire for COPD patients ( SGRQ-C ) baseline , @ and @ months .


Secondary outcome measures are recorded at these intervals in addition to @ months .


To evaluate the efficacy and safety of human glucagon-like peptide-@ analogue liraglutide in newly diagnosed type @ diabetes mellitus ( T@DM ) with glycosylated hemoglobin A@c ( HbA@c ) > @ % .


This was an open-labelled , randomized , parallel-group , treat-to-target trial .


Newly diagnosed T@DM patients with HbA@c > @ % were enrolled .


These patients were treated with metformin with repaglinide and randomized to receive once-daily liraglutide ( LIRA , n = @ ) or the insulin glargine ( IGla , n = @ ) at bedtime .


Efficacy and safety were assessed and compared after @-month treatment .


( @ ) Compared with the baseline , patients with LIRA had significantly reduced mean body weight , BMI and waist circumference ( P < @ ) , whereas , the above indexes were increased ( P < @ ) in patients treated with IGla .


( @ ) After @ months of treatment , fasting plasma glucose ( FPG ) , @-hour plasma glucose after a @g oral glucose load ( @hPG ) and HbA@c were significantly improved in all patients ( P < @ ) , with @hPG , mean blood glucose ( MBG ) , the largest amplitude of glycemic excursions ( LAGE ) , mean amplitude of glycemic excursions ( MAGE ) were significantly lower in LIRA group than in IGla group ( all P < @ ) .


( @ ) HOMA-IR decreased in both groups ( P < @ ) .


However , I@/G@ , AUCCP@ and Matsuda index were only significantly increased in patients treated with LIRA ( respectively , @ @ vs @ , @ @ vs @ @ , @ @ vs @ @ , all P < @ ) , while HOMA-IR reduced ( @ @ vs @ @ , P < @ ) .


But in IGla group only HOMA-IR was reduced ( @ @ vs @ @ , P < @ ) .


The index of I@/G@ , AUCCP@ and Matsuda index in LIRA group are higher than those of indexes in IGla group ( respectively , @ @ vs @ @ , @ @ vs @ @,@ @ vs @ @ , all P < @ ) , while HOMA-IR is lower ( @ @ vs @ @ , P < @ ) .


( @ ) The rate of HbA@c @ % and the dosages of oral anti-diabetic drugs in LIRA group were significantly better than that in IGla group .


( @ ) No significant differences were observed in hypoglycemic episodes and adverse events between two groups .


It seems that liraglutide is superior to insulin glargine in newly diagnosed T@DM patients with HbA@c > @ % in improving beta-cell function , insulin sensitivity and glucose homeostasis .


This primary objective of this pilot randomized , controlled trial was to determine whether a brief video intervention delivered after a pediatric office visit could improve inhaler technique in children with asthma immediately and one month later .


The intervention 's effect on children 's inhaler self-efficacy and asthma control was also evaluated .


Children ( n = @ ) ages @-@ years with persistent asthma were recruited at two pediatric practices in North Carolina .


Eligible children demonstrated their inhaler technique for metered dose inhalers ( MDIs ) either with or without a spacer .


A trained research assistant used a validated inhaler technique checklist to record which steps children performed correctly .


After a regularly scheduled office visit , children were randomized to watch either a @-min MDI video ( intervention group ) or a nutrition video ( control group ) in English or Spanish .


Children 's technique was assessed again after watching the video and one month later .


Children were primarily male ( @ % ) and non-White ( @ % ) .


When compared with the control group , children in the intervention group demonstrated a significant improvement in MDI technique post-intervention -LSB- mean = @ steps , @ % CI ( @ , @ ) -RSB- but the improvement was not sustained at @-month follow-up .


The intervention did not lead to significant improvements in inhaler self-efficacy or asthma control .


A brief video intervention offered during pediatric clinic visits can lead to immediate improvements in children 's inhaler technique .


Future studies should evaluate whether booster training videos can help maintain improvements in children 's inhaler technique over time .


It has been reported that dexmedetomidine ( DEX ) can be used for conscious sedation in awake craniotomy , but few data exist to compare DEX versus propofol ( PRO ) .


To compare the efficacy and safety of DEX versus PRO for conscious sedation in awake craniotomy .


Thirty patients of American Society of Anesthesiologists grade I-II scheduled for awake craniotomy , were randomized into @ groups each containing @ subjects .


Group D received DEX and group P received PRO .


Two minutes after tracheal intubation ( T@ ) , PRO ( target plasma concentration ) was titrated down to @ to @ g/mL in group P.


In group D , PRO was discontinued and DEX was administered @ g/kg followed by a maintenance dose of @ to @ g/kg/h .


The surgeon preset the anticipated awake point-in-time ( T@ ) preoperatively .


Ten minutes before T@ ( T@ ) , DEX was titrated down to @ g/kg/h in group D , PRO was discontinued and normal saline ( placebo ) @ mL/h was infused in group P. Arousal time , quality of revival and adverse events during the awake period , degree of satisfaction from surgeons and patients were recorded .


Arousal time was significantly shorter in group D than in group P ( P < @ ) .


The quality of revival during the awake period in group D was similar to that of group P ( P = @ ) .


The degree of satisfaction of surgeons was significantly higher in group D than in group P ( P < @ ) , but no difference was found between the @ groups with respect to patient satisfaction ( P = @ ) .


There was no difference between the @ groups in the incidence of adverse events during the awake period ( P > @ ) .


Either DEX or PRO can be effectively and safely used for conscious sedation in awake craniotomy .


Comparing the two , DEX produced a shorter arousal time and a higher degree of surgeon satisfaction .


In the last @ decades , the effectiveness of cricoid pressure ( CP ) in occluding the esophageal entrance has been questioned .


Recent magnetic resonance imaging studies yielded conflicting conclusions .


We used real-time visual and mechanical means to assess the patency of the esophageal entrance with and without CP in anesthetized and paralyzed adult patients .


One hundred seven , nonobese ASA physical status I and II patients were recruited for the study .


A cricoid force of @ N was used .


This force was standardized by using a weighing scale before application of CP in each patient .


After oxygen administration , anesthetic induction , neuromuscular blockade , and establishment of manual ventilation with FIO@ = @ , the view of the glottis and esophageal entrance was visualized , and video recordings were obtained by using a Glidescope video laryngoscope .


Attempts to insert @ gastric tubes ( GTs ) , size @ and @ F , into the esophagus were made by a `` blinded '' operator without and with CP , the timing of which was randomized .


A successful insertion of a GT in the presence of CP was considered evidence of a patent esophageal entrance ( ineffective CP ) , whereas an unsuccessful insertion of a GT was considered evidence of an occluded esophageal entrance ( effective CP ) .


After the attempts to insert the GTs were completed , tracheal intubation was performed while CP was applied .


The position of the esophageal entrance in relation to the glottis ( midline versus lateral ) was assessed from the video recordings , with and without CP .


We stopped the study when @ patients ( @ men and @ women ) qualified for and completed the study ( @-sided Clopper-Pearson confidence interval ( CI ) @ % to @ % , n = @ ) .


Advancement of either size GT into the esophagus could not be accomplished during CP in any patient but was easily done in all subjects when CP was not applied .


This occurred whether the esophageal entrance was in a midline position or in a left or right lateral position relative to the glottis .


Esophageal patency was visually observed in the absence of CP , whereas occlusion of the esophageal entrance was observed during CP in all patients .


Without CP , the esophageal entrance was in a left lateral position in relation to the glottis in @ % ( -LSB- @ % CI , @ % -@ % ) -RSB- of patients , at midline in @ % ( CI , @ % -@ % ) , and in a right lateral position in @ % ( CI , @ % -@ % ) .


The position did not change with CP .


The current study provides additional visual and mechanical evidence supporting a success rate of at least @ % by using a cricoid force of @ N to occlude the esophageal entrance in anesthetized and paralyzed normal adult patients .


The efficacy of the maneuver was independent of the position of the esophageal entrance relative to the glottis , whether midline or lateral .


The polymorphic angiotensinogen ( AGT ) gene is one of the most promising candidates for essential hypertension .


The aim of this study was to examine the association between the A-@G variant of the AGT gene and the blood pressure response to angiotensin-converting enzyme ( ACE ) inhibitors in hypertensive subjects .


Five hundred and nine mildly to moderately hypertensive subjects received ACE inhibitors for six weeks after a two-week run-in period .


AGT genotyping was performed by direct polymerase chain reaction amplification and deoxyribonucleic acid ( DNA ) nucleotide sequencing from peripheral blood .


The AA genotype , AG genotype , and GG genotype were present in @ ( @ % ) , @ ( @ % ) , and @ ( @ % ) of patients , respectively .


As compared with patients carrying the AA or AG genotype , those carrying the GG genotype had significantly greater reductions in systolic blood pressure , diastolic blood pressure , pulse pressure and mean arterial pressure ( p = @ , @ , @ and @ , respectively ) .


Moreover , stepwise multiple linear regression analysis showed that the A-@G genotype was a significant predictor of systolic blood pressure and pulse pressure reductions ( p = @ and @ , respectively ) .


Our study indicates that the A-@G variant of the AGT gene may be an important determinant of interindividual variation in the response to ACE inhibitors .


Contradictory results have been reported on the effects of nesiritide on renal function in patients with acute decompensated heart failure .


We studied the effects of nesiritide on renal function during hospitalization for acute decompensated heart failure and associated outcomes .


A total of @ patients were randomized to receive either nesiritide or placebo and creatinine was recorded in @ patients at baseline , after infusion , discharge , peak/nadir levels until day @ .


Worsening renal function was defined as an increase of serum creatinine > @ mg/dL and a change of @ % .


Median ( @ ( th ) -@ ( th ) percentile ) baseline creatinine was @ ( @-@ @ ) mg/dL and median baseline blood urea nitrogen was @ ( @-@ ) mmol/L .


Changes in both serum creatinine and blood urea nitrogen were similar in nesiritide-treated and placebo-treated patients ( P = @ and P = @ ) from baseline to discharge .


In a multivariable model , independent predictors of change from randomization to hospital discharge in serum creatinine were a lower baseline blood urea nitrogen , higher systolic blood pressure , lower diastolic blood pressure , previous weight gain , and lower baseline potassium ( all P < @ ) .


The frequency of worsening renal function during hospitalization was similar in the nesiritide and placebo group ( @ % and @ % , respectively ; odds ratio with nesiritide @ ; confidence interval , @-@ @ ; P = @ ) and was not associated with death alone and death or rehospitalization at @ days .


However , baseline , discharge , and change in creatinine were associated with death alone and death or rehospitalization for heart failure ( all tests , P < @ ) .


Nesiritide did not affect renal function in patients with acute decompensated heart failure .


Baseline , discharge , and change in renal function were associated with @-day mortality or rehospitalization for heart failure .


Activated charcoal is commonly used to manage overdose or accidental ingestion of medicines .


This study evaluated the effect of activated charcoal on apixaban exposure in human subjects .


This was an open-label , three-treatment , three-period , randomized , crossover study of single-dose apixaban ( @ mg ) administered alone and with activated charcoal given at @ or @ h post-dose to healthy subjects .


Blood samples for assay of plasma apixaban concentration were collected up to @ h post-dose .


Pharmacokinetic parameters , including peak plasma concentration ( Cmax ) , time to Cmax ( Tmax ) , area under the concentration-time curve from time @ to infinity ( AUCINF ) , and terminal half-life ( T ) , were derived from apixaban plasma concentration-time data .


A general linear mixed-effect model analysis of Cmax and AUCINF was performed to estimate the effect of activated charcoal on apixaban exposure .


A total of @ subjects were treated and completed the study .


AUCINF for apixaban without activated charcoal decreased by @ and @ % , respectively , when charcoal was administered at @ and @ h post-dose .


Apixaban Cmax and Tmax were similar across treatments .


The mean T for apixaban alone ( @ h ) decreased to ~ @ h when activated charcoal was administered at @ or @ h post-dose .


Overall , apixaban was well tolerated in this healthy population , and most adverse events were consistent with the known profile of activated charcoal .


Administration of activated charcoal up to @ h after apixaban reduced apixaban exposure and facilitated the elimination of apixaban .


These results suggest that activated charcoal may be useful in the management of apixaban overdose or accidental ingestion .


The purpose of this study was to assess the efficacy and safety of FOLFOX@ , comprising infusional @-fluorouracil ( @-FU ) / leucovorin ( LV ) and oxaliplatin , with cetuximab compared with UFOX , comprising UFT , an oral prodrug of @-FU , LV , and oxaliplatin , with cetuximab as first-line treatment for mCRC .


Patients , unselected by tumor KRAS status , were randomized @:@ to FOLFOX@ with cetuximab or UFOX with cetuximab .


Treatment was continued until disease progression or unacceptable toxicity .


The primary end point , assessed in the intention-to-treat population , was progression-free survival ( PFS ) .


Secondary end points included tumor response , overall survival , and safety .


Outcome according to KRAS mutation status was investigated .


Recruitment was curtailed at @ patients after reporting of the importance of tumor KRAS mutation status for cetuximab activity .


Baseline characteristics were balanced between treatment groups .


PFS was significantly longer in the FOLFOX@ with cetuximab group compared with UFOX with cetuximab group ( median @ vs. @ months ; hazard ratio , @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ; P = @ ) .


The response rate was also significantly greater in the FOLFOX@ with cetuximab group ( @ % vs. @ % , respectively ; odds ratio , @ ; @ % CI , @-@ @ ; P = @ ) , although overall survival was comparable .


In the KRAS wild type subgroup , efficacy outcomes were similar to those in the intention-to-treat population .


Side effect profiles were manageable and consistent with expectations .


In the first-line treatment of mCRC , UFOX with cetuximab had an acceptable safety profile but inferior activity compared with FOLFOX@ with cetuximab in relation to PFS and response .


The regimens were comparable with regard to overall survival .


To observe the effect of Xingnaojing Injection combined with minimally invasive percutaneous drainage on brain edema and content of serum aquaporin-@ ( AQP@ ) in patients with moderate hypertensive basal ganglia hemorrhage , and discuss the treatment mechanism of Xingnaojing injection combined with minimally invasive percutaneous drainage for cerebral hemorrhage .


Forty-two patients with moderate ( @-@ mL ) hypertensive basal ganglia hemorrhage ( < @ h ) were selected and randomly divided into two groups : the observation group ( n = @ ) and the control group ( n = @ ) .


The neurological severity score were evaluated by the NIHSS ( national institutes of health stroke scale ) , the volume of brain edemas were measured by head CT , the serum levels of AQP@ were determined by ELISA method on admission and @ and @ weeks after treatment .


On admission , there was no significant difference in the scores of NIHSS , the volume of brain edemas and the level of serum AQP@ between the observation group and the control group .


At the end of the first week after the treatment , the score of NIHSS of the observation group were lower than that of the control group , with significant different ( P < @ ) ; the observation group showed reduced volume of brain edemas than that on admission ( P < @ ) , whereas the control group the control group showed increased volume of brain edemas than that on admission ; the control group displayed increased level of serum AQP@ than that on admission , but without significant difference ; the observation group displayed decreased level of serum AQP@ than that on admission ( P < @ ) .


At the end of the second week after the treatment , the control group showed decreased score of NIHSS than that on admission and at the end of the first week after treatment ( P < @ ) .


Compared with the control group , the observation group showed a much lower score of NIHSS ( P < @ ) , the control group displayed reduced volume of brain edemas than that on admission and at the end of the first week after treatment , but the observation group was even lower than the control group .


Both of observation and control groups displayed significantly reduced level of AQP@ ( P < @ ) , but the observation group showed a lower AQP@ level than that of the control group ( P < @ ) .


The therapy of Xingnaojing injection combined with minimally invasive percutaneous drainage could remarkably reduce brain edema , and promote neural functional recovery , thus could be selected as a therapeutic regimen for patients with moderate hypertensive basal ganglia hemorrhage .


To compare the efficacy between acupuncture and ondansetron in the prevention of delayed chemotherapy induced nausea and vomiting ( CINV ) .


@ patients were randomized to receive either @ ) acupuncture at P@ point before chemotherapy infusion or @ ) ondansetron @ mg intravenously @ min before chemotherapy infusion in their first cycle with cross-over of antiemetic regimen in the consecutive cycle .


All patients received dexamethasone @mg orally twice a day for @ days .


Patients were given additional does of ondansetron @ mg orally every @h if they experienced emesis .


Emetic episode , severity of nausea score of @-@ and adverse events were recorded .


Complete response was defined as no nausea , no vomiting and no requirement of additional antiemetic drugs .


FACT-G scale was used to evaluate quality of life ( QOL ) @ days after each cycle of chemotherapy .


The acupuncture group had a significantly higher rate of complete response in the prevention of delayed CINV ( @ % and @ % , P = @ ) .


Compared to another group , the acupuncture group reported significantly lower delayed nausea ( @ % and @ % , P = @ ) , nausea score ( P < @ ) and fewer dosages of additional oral ondansetron ( P = @ ) .


Adverse effects were also significantly lower in the acupuncture group with less frequent constipation ( P = @ ) and insomnia ( P = @ ) .


Overall FACT-G scores were significantly higher in the acupuncture group .


Acupuncture is effective in preventing delayed CINV and in promoting better QOL .


With fewer adverse effects , it may be used as an alternative treatment option for CINV .


The aim of this study was to assess associations between patient characteristics , intensification of blood glucose-lowering treatment through oral glucose-lowering therapy and/or insulin and effective glycaemic control in type @ diabetes .


@ patients from the Action in Diabetes and Vascular disease : preterAx and diamicroN-MR Controlled Evaluation ( ADVANCE ) trial who were randomized to intensive glucose control or standard glucose control and followed up for a median of @years were categorized into two groups : effective glycaemic control -LSB- haemoglobin A@c ( HbA@c ) @ % or a proportionate reduction in HbA@c over @ % -RSB- or ineffective glycaemic control ( HbA@c > @ % and a proportionate reduction in HbA@c less than or equal to @ % ) .


Therapeutic intensification was defined as addition of an oral glucose-lowering agent or commencement of insulin .


Pooled logistic regression models examined the associations between patient factors , intensification and effective glycaemic control .


A total of @ patients ( @ % ) , including @ in the standard treatment group achieved effective glycaemic control .


Compared to patients with ineffective control , patients with effective glycaemic control had shorter duration of diabetes and lower HbA@c at baseline and at the time of treatment intensification .


Treatment intensification with addition of an oral agent or commencement of insulin was associated with a @ % -LSB- odds ratio , OR : @ ( @ % confidence interval , CI : @-@ @ ) -RSB- and @ % -LSB- OR : @ ( @ % CI : @-@ @ ) -RSB- greater chance of achieving effective glycaemic control , respectively .


These associations were robust after adjustment for several baseline characteristics and not modified by the number of oral medications taken at the time of treatment intensification .


Effective glycaemic control was associated with treatment intensification at lower HbA@c levels at all stages of the disease course and in both arms of the ADVANCE trial .


Panitumumab , a fully human anti-epidermal growth factor receptor monoclonal antibody ( mAb ) , has demonstrated efficacy in patients with wild-type KRAS metastatic colorectal cancer ( mCRC ) .


Rilotumumab and ganitumab are investigational , fully human mAbs against hepatocyte growth factor ( HGF ) / scatter factor and IGF@R , respectively .


Here we evaluate combining rilotumumab or ganitumab with panitumumab in previously treated patients with wild-type KRAS mCRC .


Part @ was a phase Ib dose-finding study of panitumumab plus rilotumumab .


The primary endpoint was the incidence of dose-limiting toxicities ( DLT ) .


Part @ was a randomized phase II trial of panitumumab in combination with rilotumumab , ganitumab , or placebo .


The primary endpoint was objective response rate ( ORR ) ; safety , progression-free survival ( PFS ) , and overall survival ( OS ) were secondary endpoints .


Archival tissue specimens were collected for exploratory correlative work .


In part @ , no DLTs were reported .


A recommended phase II dose of @ mg/kg rilotumumab was selected .


In part @ , for the panitumumab plus rilotumumab ( n = @ ) , panitumumab plus ganitumab ( n = @ ) , and panitumumab plus placebo arms ( n = @ ) , the ORRs were @ % , @ % , and @ % , respectively .


The median PFS was @ , @ , and @ months and median OS @ , @ , and @ months , respectively .


Adverse events were tolerable .


Exploratory biomarker analyses , including MET and IGF-related protein expression , failed to indicate conclusive predictive evidence on efficacy endpoints .


Panitumumab plus rilotumumab met the prespecified criterion for improvement in ORR whereas ganitumab did not .


This is the first study to suggest a benefit for combining an HGF inhibitor ( rilotumumab ) with panitumumab in previously treated patients with wild-type KRAS mCRC .


To evaluate femtosecond laser-assisted and manual clear corneal incisions and their effect on surgically induced astigmatism ( SIA ) and corneal higher-order aberrations ( HOAs ) .


In a prospective randomized study , conventional phacoemulsification with a @-mm clear corneal incision using a disposable keratome was performed in @ eyes of @ patients ( manual group ) , and femtosecond laser-assisted cataract surgery with a @-mm biplanar clear corneal tunnel created by a femtosecond laser ( LenSx ; Alcon Laboratories , Inc. , Aliso Viejo , CA ) was performed in @ eyes of @ patients ( femtosecond laser group ) .


Corneal topography readings and corneal wavefront aberrations ( diameter : @ mm ) were obtained using a Scheimpflug camera ( Pentacam HR ; Oculus Optikgerate , Wetzlar , Germany ) preoperatively and @ months postoperatively .


There was no significant difference in SIA between the groups ( femtosecond laser group : @ @ vs manual group : @ @ ; P = @ ) , but the axis deviation of the SIA axis from the previously planned axis was significantly smaller in the femtosecond laser group compared to the manual group ( @ @ vs @ @ , respectively ; P = @ ) .


Corneal HOAs increased significantly in both groups ( femtosecond laser group : @ @ to @ @ , P = @ ; manual group : @ @ to @ @ , P = @ ) , but preoperative and postoperative values did not differ significantly between them ( P = @ and @ , respectively ) .


Lower-order and total corneal aberration values remained stable in both groups ( P > @ ) .


There was no difference in SIA and induced HOAs between manual and femtosecond laser-created clear corneal incisions .


Opioid-induced hyperalgesia is well known complication of acute high dose and chronic opioid therapy .


In this study , we evaluated development of opioid-induced hyperalgesia following intraoperative short-term use of - opioid agonist fentanyl after coronary artery bypass surgery .


@ patients undergoing elective coronary artery bypass graft surgery is divided into two groups .


In group I ( low dose ) , anesthesia was induced with propofol @-@ @ mg/kg and fentanyl @ mcg/kg , in group II ( high dose ) fentanyl @-@ mcg/kg was used .


In group I , propofol @-@ mg/kg/h , fentanyl @-@ mcg/kg/h , in group II fentanyl @-@ mcg/kg/h was used for maintenance of anesthesia .


The tactile and thermal thresholds were measured before surgery and in @st , @rd and @th postoperative days by using Von Frey filaments and a thermal source , respectively .


Tactile thresholds were significantly decreased at the first ( @,@ and @ g ; p < @ ) and third ( @ and @ g ; p < @ ) postoperative days compared to baseline preoperative values ( @ , and @ g ; p = @ ) in two groups .


Postoperative @st ( @ and @ sec ; p < @ ) and @rd day ( @ and @ sec ; p < @ ) assessments showed a statistically significant thermal hyperalgesia compared to the preoperative baseline values ( @ and @ sec ; p = @ ) in two groups .


This decrease in both tactile and thermal thresholds returned to baseline control values at the @th day of measurement .


Our results showed that patients undergoing coronary artery bypass surgery receiving fentanyl anesthesia developed postoperative tactile allodynia and thermal hyperalgesia and this was more prominent in high dose group .


Rates of preventive asthma care after an asthma emergency department ( ED ) visit are low among inner-city children .


The objective of this study was to test the efficacy of a clinician and caregiver feedback intervention ( INT ) on improving preventive asthma care following an asthma ED visit compared to an attention control group ( CON ) .


Children with persistent asthma and recent asthma ED visits ( N = @ ) were enrolled and randomized into a feedback intervention or an attention control group and followed for @ months .


All children received nurse visits .


Data were obtained from interviews , child salivary cotinine levels and pharmacy records .


Standard t-test , chi-square and multiple logistic regression tests were used to test for differences between the groups for reporting greater than or equal to two primary care provider ( PCP ) preventive care visits for asthma over @ months .


Children were primarily male , young ( @-@ years ) , African American and Medicaid insured .


Mean ED visits over @ months was high ( @ visits ) .


No difference by group was noted for attending two or more PCP visits/@ months or having an asthma action plan ( AAP ) .


Children having an AAP at baseline were almost twice as likely to attend two or more PCP visits over @ months while controlling for asthma control , group status , child age and number of asthma ED visits .


A clinician and caregiver feedback intervention was unsuccessful in increasing asthma preventive care compared to an attention control group .


Further research is needed to develop interventions to effectively prevent morbidity in high risk inner-city children with frequent ED utilization .


The New Forest Parenting Programme ( NFPP ) is a home-delivered , evidence-based parenting programme to target symptoms of attention-deficit/hyperactivity disorder ( ADHD ) in preschool children .


It has been adapted for use with ` hard-to-reach ' or ` difficult-to-treat ' children .


This trial will compare the adapted-NFPP with a generic parenting group-based programme , Incredible Years ( IY ) , which has been recommended for children with preschool-type ADHD symptoms .


This multicentre randomized controlled trial comprises three arms : adapted-NFPP , IY and treatment as usual ( TAU ) .


A sample of @ parents of preschool-aged children with a research diagnosis of ADHD enriched for hard-to-reach and potentially treatment-resistant children will be allocated to the arms in the ratio @:@:@ .


Participants in the adapted-NFPP and IY arms receive an induction visit followed by @ weekly parenting sessions of @hours ( adapted-NFPP ) or @hours ( IY ) over @ years .


Adapted-NFPP will be delivered as a one-to-one home-based intervention ; IY , as a group-based intervention .


TAU participants are offered a parenting programme at the end of the study .


The primary objective is to test whether the adapted-NFPP produces beneficial effects in terms of core ADHD symptoms .


Secondary objectives include examination of the treatment impact on secondary outcomes , a study of cost-effectiveness and examination of the mediating role of treatment-induced changes in parenting behaviour and neuropsychological function .


The primary outcome is change in ADHD symptoms , as measured by the parent-completed version of the SNAP-IV questionnaire , adjusted for pretreatment SNAP-IV score .


Secondary outcome measures are : a validated index of behaviour during child 's solo play ; teacher-reported SNAP-IV ( ADHD scale ) ; teacher and parent SNAP-IV ( ODD ) Scale ; Eyberg Child Behaviour Inventory - Oppositional Defiant Disorder scale ; Revised Client Service Receipt Inventory - Health Economics Costs measure and EuroQol ( EQ@D ) health-related quality-of-life measure .


Follow-up measures will be collected @months after treatment for participants allocated to adapted-NFPP and IY .


This trial will provide evidence as to whether the adapted-NFPP is more effective and cost-effective than the recommended treatment and TAU .


It will also provide information about mediating factors ( improved parenting and neuropsychological function ) and moderating factors ( parent and child genetic factors ) in any increased benefit .


Approximately @ % of all bone injuries are foot metatarsal fractures .


Metatarsal V basis fractures occur most frequently .


The classification is done into the tuberosity avulsion fractures , Jones fractures and stress fractures of the proximal diaphysis .


The treatments of non-displaced fractures are generally conservative .


The indication for surgical treatment depends on the load and the associated refracture rate .


There are different types of treatment of these fractures .


We present a possible approach to conservative treatments and show how different therapies affect healing of metatarsal V basis fractures and social reintegration of patients .


A retrospective study consisted of @ patients analysed during a @-year period , whereas for a prospective analysis @ patients were included for a period of @ years .


The treatment was performed using either a splint , closed bandage of theankle or special Gttinger Anklesplint bandage , with immediate pain-oriented full load in all groups .


The subjective and objective treatment results were analysed accoding the Gttinger Phillips score .


In retrospect , the fracture consolidation was observed after @ weeks full load-bearing was achieved after @ weeks on average .


In the prospective analysis , the osseous consolidation occurred after @ weeks , and the full load was applied after @ weeks .


After @ weeks the treatment with the Anklesplint bandage was assessed with @ points of a maximum @ points of the Phillips score .


The Anklesplint bandage was also the cheapest option in the cost comparison .


Using the immobilisation of the metatarsal supination with the Anklesplint bandage the metatarsal V basis fractures can heal in a regular way .


The functional outcome is better in comparison to the that with other treatments and it is a cost-effective treatment .


Epidural administration of dexamethasone might reduce postoperative pain in adults .


We evaluated whether a caudal block of @ mg kg ( -@ ) dexamethasone combined with ropivacaine improves analgesic efficacy in children undergoing day-case orchiopexy .


This randomized , double-blind study included @ children aged @ months to @ yr who underwent day-case , unilateral orchiopexy .


Patients received either @ ml kg ( -@ ) of @ % ropivacaine ( Group C ) or @ ml kg ( -@ ) of @ % ropivacaine in which dexamethasone of @ mg kg ( -@ ) was mixed ( Group D ) for caudal analgesia .


Postoperative pain scores , rescue analgesic consumption , and side-effects were evaluated @ h after operation .


Postoperative pain scores at @ and @ h post-surgery were significantly lower in Group D than in Group C. Furthermore , the number of subjects who remained pain free up to @ h after operation was significantly greater in Group D -LSB- @ of @ ( @ % ) -RSB- than in Group C -LSB- four of @ ( @ % ) ; P < @ -RSB- .


The number of subjects who received oral analgesic was significantly lower in Group D -LSB- @ of @ ( @ % ) -RSB- than in Group C -LSB- @ of @ ( @ % ) ; P = @ -RSB- .


Time to first oral analgesic administration after surgery was also significantly longer in Group D than in Group C ( P = @ ) .


Adverse events after surgery including vomiting , fever , wound infection , and wound dehiscence were comparable between the two groups .


The addition of dexamethasone @ mg kg ( -@ ) to ropivacaine for caudal block can significantly improve analgesic efficacy in children undergoing orchiopexy .


Clinical trial registration NCT@ .


Gastrointestinal ( GI ) discomfort , e.g. bloating or rumbling , is a common symptom in otherwise healthy adults .


Approximately @ % of the population , particularly women suffer from gastrointestinal discomfort and this affects quality of life .


Recent studies discovered a link between the body and mind , called the gut-brain axis .


Psychosocial factors , such as e.g. daily stress may cause altered gut physiology leading to ileum contractions and consequently gastrointestinal symptoms .


In vitro and ex vivo studies clearly showed that a Perilla frutescens extract combines prokinetic , antispasmodic and anti-inflammatory effects .


The aim of the intervention was to investigate the effects of the proprietary Perilla extract on GI discomfort in healthy subjects with gastrointestinal discomfort and reduced bowel movements in comparison to a placebo product .


The pilot study was performed according to a double-blind , randomized , placebo-controlled parallel design .


Fifty healthy subjects with gastrointestinal discomfort and reduced bowel movements , @-@ years , documented their GI symptoms , stool frequency and consistency daily during a @-week run-in phase and a @-week intervention phase with Perilla frutescens extract or placebo .


GI symptoms were assessed on a @-point scale daily and average scores over @ days intervals were calculated .


All GI symptoms were significantly improved over time by Perilla frutescens extract during the intervention phase ( bloating : -@ , p = @ ; passage of gas : -@ , p = @ ; GI rumbling : -@ , p = @ ; feeling of fullness : -@ , p = @ ; abdominal discomfort : -@ , p = @ ) , whereas in the placebo group only abdominal discomfort was significantly improved ( -@ , p = @ ) .


In the subgroup of women results were strengthened and a subscore out of bloating and abdominal discomfort was significantly improved against placebo ( @ % CI @ to @ ; p = @ ) .


The demonstrated effects of Perilla frutescens extract to improve GI complaints offer very promising results , taking into consideration the challenging set up of a nutritional human study with healthy subjects and in the area of digestive health , which is known for high placebo effects .


Atherosclerosis is a postprandial phenomenon .


The balanced n-@ / n-@ PUFA ratio contributing to the prevention of atherosclerosis has been well shown , but the effect of the ratio on postprandial metabolism has not been fully investigated .


The aim of this study was to investigate the effects of the n-@ / n-@ PUFAs ratio on postprandial metabolism in hypertriacylglycerolemia patients , comparing them to healthy controls .


Test meals with @ ( high n-@ ) and @ ( low n-@ ) n-@ / n-@ PUFAs ratio were administered in a randomized crossover design to @ healthy and @ hypertriacylglycerolemia subjects .


Blood samples were collected for @ hours after meals to measure triglyceride ( TG ) , total cholesterol ( TC ) , HDL , ApoA , ApoB , glucose , insulin , inflammatory makers including tumor necrosis factor alpha ( TNF - ) and interleukin-@ ( IL-@ ) , endothelial function including nitric oxide ( NO ) and endothelin-@ ( ET-@ ) .


According to repeated-measures ANOVA , the postprandial response of lipid , glucose , insulin , inflammation and endothelial function were not significantly different between meals .