Accordingly we studied the effect of intravenous ivabradine on heart rate in this setting .


This was a multicenter randomized double-blind placebo-controlled trial : patients aged @-@ years were randomized after successful primary percutaneous coronary intervention ( PCI ) performed within @ h of STEMI symptom onset .


Patients were in sinus rhythm and with heart rate > @ bpm and systolic blood pressure > @ mm Hg .


They were randomly assigned ( @:@ ratio ) to intravenous ivabradine ( n = @ ) ( @ mg bolus over @ s , followed by @ mg infusion over @ h ) or matching placebo ( n = @ ) .


The primary outcome measure was heart rate and blood pressure .


In both groups , heart rate was reduced over @ h , with a faster and more marked decrease on ivabradine than placebo ( @ @ vs @ @ bpm , p < @ ) .


After treatment discontinuation , heart rate was similar in both groups .


Throughout the study , there was no difference in blood pressure between groups .


There was no difference in cardiac biomarkers ( creatine kinase ( CK-MB ) , troponin T and troponin I ) .


On echocardiography performed at baseline and post treatment ( median @ days ) , final left ventricular volumes were lower in the ivabradine group both for left ventricular end-diastolic volume ( LVEDV ) ( @ @ vs @ @ ml , p = @ ) and left ventricular end-systolic volume ( LVESV ) ( @ @ versus @ @ ml , p = @ ) without differences in volume change or left ventricular ejection fraction .


This pilot study shows that intravenous ivabradine may be used safely to slow the heart rate in STEMI .


Further studies are needed to characterize its effect on infarct size , left ventricular function and clinical outcomes in this population .


The Affordable Care Act provides funding for home-visiting programs to reduce health care disparities , despite limited evidence that existing programs can overcome implementation and evaluation challenges with at-risk populations .


The authors report @-month outcomes of the paraprofessional-delivered Family Spirit home-visiting intervention for American Indian teen mothers and children .


Expectant American Indian teens ( N = @ , mean age = @ years ) from four southwestern reservation communities were randomly assigned to the Family Spirit intervention plus optimized standard care or optimized standard care alone .


Maternal and child outcomes were evaluated at @ and @ weeks gestation and @ , @ , @ , @ , @ , @ , and @ months postpartum .


At baseline the mothers had high rates of substance use ( > @ % ) , depressive symptoms ( > @ % ) , dropping out of school ( > @ % ) , and residential instability ( @ % ) .


Study retention was @ % .


From pregnancy to @ months postpartum , mothers in the intervention group had significantly greater parenting knowledge ( effect size = @ ) and parental locus of control ( effect size = @ ) , fewer depressive symptoms ( effect size = @ ) and externalizing problems ( effect size = @ ) , and lower past month use of marijuana ( odds ratio = @ ) and illegal drugs ( odds ratio = @ ) .


Children in the intervention group had fewer externalizing ( effect size = @ ) , internalizing ( effect size = @ ) , and dysregulation ( effect size = @ ) problems .


The paraprofessional home-visiting intervention promoted effective parenting , reduced maternal risks , and improved child developmental outcomes in the U.S. population subgroup with the fewest resources and highest behavioral health disparities .


The methods and results can inform federal efforts to disseminate and sustain evidence-based home-visiting interventions in at-risk populations .


In nonrandomized trials , neoadjuvant treatment was reported to prolong survival in patients with pancreatic cancer .


As neoadjuvant chemoradiation is established for the treatment of rectal cancer we examined the value of neoadjuvant chemoradiotherapy in pancreatic cancer in a randomized phase II trial .


Radiological staging defining resectability was basic information prior to randomization in contrast to adjuvant therapy trials resting on pathological staging .


Patients with resectable adenocarcinoma of the pancreatic head were randomized to primary surgery ( Arm A ) or neoadjuvant chemoradiotherapy followed by surgery ( Arm B ) , which was followed by adjuvant chemotherapy in both arms .


A total of @ patients were required to detect a @-month improvement in median overall survival ( mOS ) .


The trial was stopped after @ patients ; @ patients were eligible for analysis .


Twenty nine of @ allocated patients received chemoradiotherapy .


Radiotherapy was completed in all patients .


Chemotherapy was changed in @ patients due to toxicity .


Tumor resection was performed in @ vs. @ patients ( A vs. B ) .


The R@ resection rate was @ % ( A ) and @ % ( B , P = @ ) and ( y ) pN@ was @ % ( A ) vs. @ % ( B , P = @ ) , respectively .


Postoperative complications were comparable in both groups .


mOS was @ vs. @ months ( A vs. B ; intention-to-treat analysis ; P = @ ) .


After tumor resection , mOS was @ vs. @ months ( A vs. B ; P = @ ) .


This worldwide first randomized trial for neoadjuvant chemoradiotherapy in pancreatic cancer showed that neoadjuvant chemoradiation is safe with respect to toxicity , perioperative morbidity , and mortality .


Nevertheless , the trial was terminated early due to slow recruiting and the results were not significant .


ISRCTN@ ; NCT@ .


Balance and functional abilities are controlled by both sides of the body .


The role of nonparetic side has never been explored for such skills .


The objective of the present study was to examine the effect of a motor therapy program primarily involving the nonparetic side on balance and function in chronic stroke .


A randomized controlled , double blinded trial was conducted on @ poststroke hemiparetic subjects ( @ , men ; mean age , @ years ; mean poststroke duration , @ months ) .


They were randomly divided into the experimental group ( n = @ ) and control group ( n = @ ) .


The participants received either motor therapy focusing on the nonparetic side along with the conventional program or conventional program alone for @ weeks ( @ session/week , @ minutes each ) .


The balance ability was assessed using Berg Balance Scale ( BBS ) and Functional Reach Test ( FRT ) while the functional performance was measured by Barthel Index ( BI ) .


After intervention , the experimental group exhibited significant ( P < @ ) change on BBS ( @ versus @ ) and BI ( @ versus @ ) scores in comparison to the control group .


The motor therapy program incorporating the nonparetic side along with the affected side was found to be effective in enhancing balance and function in stroke .


To compare the efficacy differences between needle-knife therapy and acupuncture-cupping for treatment of cervical spondylosis ( CS ) of cervical type .


Sixty cases of CS were randomly divided into a needle-knife group ( @ cases ) and an acupuncture-cupping group ( @ cases ) .


The needle-knife therapy was applied at points among superior nuchal line of occipital bone , bilateral neck muscle , neck centerline , trapezius and medial border scapula for only once .


In the acupuncture-cupping group , acupuncture was applied at Fengchi ( GB @ ) , Fengfu ( GV @ ) , Tianzhu ( BL @ ) , Dazhui ( GV @ ) , Jianjing ( GB @ ) , Jiaji ( Ex-B@ , from C@ to C@ ) , Houxi ( SI @ ) and Ashi point , followed by cupping on local skin , once every other day for totally six times .


The score of neck stiffness and visual analogue scale ( VAS ) were observed before and after treatment , in follow-up of @ , @ and @ months after treatment in the two groups , and the efficacy was compared .


In the needle-knife group , @ cases were cured , @ cases were markedly effective , @ cases were effective and @ case was failed ; the total effective rate was @ % ( @/@ ) and the cured and markedly effective rate was @ % ( @/@ ) .


In the acupuncture-cupping group , @ cases were cured , @ cases were markedly effective , @ cases were effective and @ cases were failed ; the total effective rate was @ % ( @/@ ) and the cured and markedly effective rate was @ % ( @/@ ) .


The difference of total effective rate in the two groups was not statistically significant ( P > @ ) , but the cured and markedly effective rate of needle-knife group was significantly superior to that of acupuncture-cupping group ( P < @ ) .


The needle-knife therapy was significantly superior to acupuncture-cupping on improvement of neck stiffness in the follow-up of @ , @ , @ months after treatment ( P < @ , P < @ ) ; both treatments were effective on relief of neck pain , but the needle-knife group had better effects in the follow-up of @ and @ months after treatment compared with acupuncture-cupping group ( both P < @ ) .


The needle-knife therapy has better effects on neck stiffness and pain relief than acupuncture-cupping , and it is more treatment time saving .


We devised a randomised controlled trial to evaluate the effectiveness and efficiency of an intervention based on case management care for frequent emergency department users .


The aim of the intervention is to reduce such patients ' emergency department use , to improve their quality of life , and to reduce costs consequent on frequent use .


The intervention consists of a combination of comprehensive case management care and standard emergency care .


It uses a clinical case management model that is patient-identified , patient-directed , and developed to provide high intensity services .


It provides a continuum of hospital - and community-based patient services , which include clinical assessment , outreach referral , and coordination and communication with other service providers .


We aim to recruit , during the first year of the study , @ patients who visit the emergency department of the University Hospital of Lausanne , Switzerland .


Eligible patients will have visited the emergency department @ or more times during the previous @ months .


Randomisation of the participants to the intervention or control groups will be computer generated and concealed .


The statistician and each patient will be blinded to the patient 's allocation .


Participants in the intervention group ( N = @ ) , additionally to standard emergency care , will receive case management from a team , @ ( ambulatory care ) to @ ( hospitalization ) times during their stay and after @ , @ , and @ months , at their residence , in the hospital or in the ambulatory care setting .


In between the consultations provided , the patients will have the opportunity to contact , at any moment , the case management team .


Participants in the control group ( N = @ ) will receive standard emergency care only .


Data will be collected at baseline and @ , @ , @ , and @ months later , including : number of emergency department visits , quality of life ( EuroQOL and WHOQOL ) , health services use , and relevant costs .


Data on feelings of discrimination and patient 's satisfaction will also be collected at the baseline and @ months later .


Our study will help to clarify knowledge gaps regarding the positive outcomes ( emergency department visits , quality of life , efficiency , and cost-utility ) of an intervention based on case management care .


Different diffusion of different botulinum toxin type A ( BoNTA ) preparations may account for differences in outcomes in cosmetic clinical practice .


A double-blind , randomized , self-controlled study was performed to evaluate the diffusion characteristics of onabotulinumtoxinA and a Chinese type A botulinum toxin ( CBTX-A ) .


Healthy volunteers ( N = @ ) were recruited to receive a @-mL ( @U ) injection of BoTNA at four forehead sites ( medial forehead ( subcutaneous ( SC ) ) and temporal forehead ( intradermal ( ID ) ) ) .


On day @ , the Minor 's iodine starch test was performed and photographs were taken for calculating the area and dimensions of anhydrotic area .


When BoNTAs were different , the anhidrosis ID area was significantly greater with CBTX-A than onabotulinumtoxinA , the vertical dimension was significantly longer with CBTX-A ID than onabotulinumtoxinA ID and the horizontal dimension was significantly greater with CBTX-A ID than onabotulinumtoxinA ID .


The area of anhidrosis SC was significantly greater with CBTX-A than onabotulinumtoxinA .


When injection depths were different , the mean horizontal dimension was significantly greater with onabotulinumtoxinA SC than ID .


Comparing the dimension of the same BoNTA and injection method , the vertical dimension was significantly greater than the horizontal dimension .


OnabotulinumtoxinA diffuses less than CBTX-A .


ID injection technique may result in less diffusion than SC .


Balance and strength training can reduce seniors ' fall risk up to @ % .


Available evidence suggests that acute bouts of neuromuscular and endurance exercise deteriorate postural control .


High-intensity endurance training has been successfully applied in different populations .


Thus , it seemed valuable to examine the acute effects of high-intensity interval training ( HIIT ) on neuromuscular performance in seniors and young adults .


The acute impact of a HIIT session on balance performance and muscle activity after exercise cessation and during post-exercise recovery was examined in young and old adults .


We intended to investigate whether a transient exercise-induced fall-risk may occur in both groups .


@ healthy seniors ( age @ ( SD @ ) years ) and young adults ( age @ ( SD @ ) years ) were examined on @ days .


After exhaustive ramp-like treadmill testing in order to determine maximal heart rate ( HRmax ) on the first day , either a @ @ min HIIT at @ % of HRmax or a control condition ( CON ) was randomly performed on the second and third day , respectively .


Balance performance ( postural sway ) was assessed during single limb stance with open eyes ( SLEO ) and double limb stance with closed eyes ( DLEC ) .


EMG was recorded for the soleus ( SOL ) , anterior tibialis ( TIB ) , gastrocnemius ( GM ) and peroneus longus ( PL ) muscles at the dominant leg .


All measures were collected before , immediately as well as @ , @ and @ min after HIIT and CON , respectively .


Compared to CON , HIIT induced significant increases of postural sway immediately after exercise cessation during SLEO in both groups ( adults : p < @ , = +@ % sway ; seniors : p = @ , = +@ % sway ) .


Increased sway during DLEC was only found for seniors immediately and @ min after HIIT ( post : p = @ , = +@ % sway , @ min post : p = @ , = +@ % sway ) .


Muscle activity was increased during SLEO for TIB until @ min post in seniors ( @ < p < @ ) and immediately after HIIT in adults ( p < @ ) .


HIIT training may cause an acute ` open-fall-window ' with a transient impairment of balance performance for at least @ min after exercise cessation in both groups .


Occluded vision in seniors seems to prolong this period up to @ min .


Thus , the advantage of HIIT with regard to time efficiency seems debatable when considering transient HIIT-induced impairments of neuromuscular function .


Cognitive Behaviour Therapy ( CBT ) based self-help has been found to be effective for treating depression and anxiety .


There is some evidence to suggest that CBT needs to be culturally adapted for it to be effective in non-Western cultures .


CBT is not widely used in low and middle income countries and there is a need to test its effectiveness in different settings and formats , including self-help .


We describe a RCT of a Culturally adapted CBT ( CaCBT ) based self-help manual in Pakistan .


The trial was conducted in psychiatry departments in three cities .


Assessments were carried out at baseline and at @ weeks , using Hospital Anxiety and Depression Scale , Bradford somatic Inventory and brief disability Questionnaire .


At the end of the trial CaCBT based self-help was found to be effective against care as usual in reducing the symptoms of depression and anxiety , as well as somatic symptoms and disability .


This study was conducted only in secondary care and required either patient or a carer to be able to read and write .


This is the first study outside West of a CBT based self-help intervention for depression .


This study highlights the importance of using cost effective interventions in developing world in low intensity formats .


Future studies should focus on trying these resources in different settings , like primary care , and with the use of audio/video or multimedia resources to improve compliance in patients with lower literacy .


To evaluate whether provision of fixed dose combination treatment improves adherence and risk factor control compared with usual care of patients at high risk of cardiovascular disease in primary care .


Open label randomised control trial : IMPACT ( IMProving Adherence using Combination Therapy ) .


@ general practices in the Auckland and Waikato regions of New Zealand , July @ to August @ .


@ adults ( including @ indigenous Mori ) at high risk of cardiovascular disease ( established cardiovascular disease or five year risk @ % ) who were recommended for treatment with antiplatelet , statin , and two or more blood pressure lowering drugs .


@ ( @ % ) completed @ months ' follow-up .


Participants were randomised to continued usual care or to fixed dose combination treatment ( with two versions available : aspirin @ mg , simvastatin @ mg , and lisinopril @ mg with either atenolol @ mg or hydrochlorothiazide @ mg ) .


All drugs in both treatment arms were prescribed by their usual general practitioners and dispensed by local community pharmacists .


Primary outcomes were self reported adherence to recommended drugs ( antiplatelet , statin , and two or more blood pressure lowering agents ) and mean change in blood pressure and low density lipoprotein cholesterol at @ months .


Adherence to all four recommended drugs was greater among fixed dose combination than usual care participants at @ months ( @ % v @ % ; relative risk @ , @ % confidence interval @ to @ , P < @ ; number needed to treat @ , @ % confidence interval @ to @ ) .


Adherence for each drug type at @ months was high in both groups but especially in the fixed dose combination group : for antiplatelet treatment it was @ % fixed dose combination v @ % usual care ( P < @ ) , for statin @ % v @ % ( P = @ ) , for combination blood pressure lowering @ % v @ % ( P < @ ) , and for any blood pressure lowering @ % v @ % ( P = @ ) .


Self reported adherence was highly concordant with dispensing data ( dispensing of all four recommended drugs @ % fixed dose combination v @ % usual care , relative risk @ , @ % confidence interval @ to @ , P < @ ) .


There was no statistically significant improvement in risk factor control between the fixed dose combination and usual care groups over @ months : the difference in systolic blood pressure was -@ mm Hg ( -@ v -@ , @ % confidence interval -@ to @ , P = @ ) , in diastolic blood pressure -@ mm Hg ( -@ v -@ , -@ to @ , P = @ ) and in low density lipoprotein cholesterol -@ mmol/L ( -@ v -@ , -@ to @ , P = @ ) .


The number of participants with cardiovascular events or serious adverse events was similar in both treatment groups ( fixed dose combination @ v usual care @ ( P = @ ) , @ v @ ( P = @ ) , respectively ) .


Fixed dose combination treatment was discontinued in @ participants ( @ % ) .


The most commonly reported reason for discontinuation was a side effect ( @/@ , @ % ) .


Overall , @ % ( @/@ ) of fixed dose combination participants ' general practitioners completed a post-trial survey , and the fixed dose combination strategy was rated as satisfactory or very satisfactory for starting treatment ( @/@ , @ % ) , blood pressure control ( @/@ , @ % ) , cholesterol control ( @/@ , @ % ) , tolerability ( @/@ , @ % ) , and prescribing according to local guidelines ( @/@ , @ % ) .


When participants were asked at @ months how easy they found taking their prescribed drugs , most responded very easy or easy ( @/@ , @ % fixed dose combination v @/@ , @ % usual care , P = @ ) .


At @ months the change in other lipid fractions , difference in EuroQol-@D , and difference in barriers to adherence did not differ significantly between the treatment groups .


Among this well treated primary care population , fixed dose combination treatment improved adherence to the combination of all recommended drugs but improvements in clinical risk factors were small and did not reach statistical significance .


Acceptability was high for both general practitioners and patients , although the discontinuation rate was high .


We investigated the effect of resistance exercise intensity and exercise-induced metabolic stress on the activation of anabolic signaling and expression of myogenic genes in skeletal muscle .


Ten strength-trained athletes performed high-intensity -LSB- HI , @ % of @-repetition maximum ( RM ) -RSB- , middle-intensity ( MI , @ % @RM ) , or middle-intensity ( @ % @RM ) no-relaxation exercise ( MIR ) .


Kinase phosphorylation level and myogenic gene expression in muscle samples were evaluated before , @ min , @ h , and @ h after exercise .


The lactate concentration in MI was approximately @-fold lower than in the @ other sessions , and was highest in MIR .


The phosphorylation level of extracellular kinase @/@Thr@/Tyr@ after exercise was related to metabolic stress .


Metabolic stress induced a decrease in myostatin mRNA expression , whereas mechano-growth factor mRNA level depended on exercise intensity .


This study demonstrates that both intensity and exercise-induced metabolic stress can be manipulated to affect muscle anabolic signaling .


Acne vulgaris is common in Asian populations .


We compared three methods of phototherapy for the treatment of moderate to severe facial acne vulgaris in Chinese patients .


Patients were randomly assigned to receive photodynamic therapy ( PDT ) , intense pulsed light ( IPL ) or blue-red light-emitting diode ( LED ) phototherapy to the right side of the face until the inflammatory lesion count reduced by @ % .


Patients were examined at @ and @ months after the final treatment .


We enrolled @ patients ( @ males ; mean age , @ years ) .


At @ month , @ % clearance or moderate improvement occurred in @/@ ( @ % ) , @/@ ( @ % ) and @/@ ( @ % ) patients in the PDT , IPL and LED groups , respectively ( mean number of sessions required , PDT : @ ; IPL : @ ; LED : @ ) .


Forty-six ( @ % ) patients experienced mild to moderate pain , erythema and edema after PDT , which resolved within @-@ days .


Slight erythema and stinging were reported immediately after IPL and LED , resolving within @h .


After @ months , minimal papules and pustules were observed in @ patients in the PDT group , @ in the IPL group and @ in the LED group , but no nodular pustules recurred .


Phototherapy is efficacious for moderate to severe facial acne vulgaris .


To explore the associations of green tea and rock tea consumption with risk of impaired fasting glucose ( IFG ) and impaired glucose tolerance ( IGT ) .


A multistage , stratified , cluster , random-sampling method was used to select a representative sample from Fujian Province in China .


In total , @ subjects without cardiovascular disease , hypertension , cancer , or pancreatic , liver , kidney , or gastrointestinal diseases were enrolled in the study .


A standard questionnaire was used to gather data on tea ( green , rock , and black ) consumption and other relevant factors .


The assessment of impaired glucose regulation ( IGR ) was using @-g oral glucose tolerance test ( OGTT ) , the diagnostic criteria of normal glucose tolerance was according to American Diabetes Association .


Green tea consumption was associated with a lower risk of IFG , while rock tea consumption was associated with a lower risk of IGT .


The adjusted odds ratios for IFG for green tea consumption of < @ , @-@ , @-@ , and > @ cups per week were @ ( reference ) , @ ( @ % confidence intervals ( CI ) @-@ @ ) , @ ( @ % CI , @-@ @ ) , and @ ( @ % CI , @-@ @ ) , respectively .


The adjusted odds ratios for IGT for rock tea consumption of < @ , @-@ , @-@ , and > @ cups per week were @ ( reference ) , @ ( @ % CI , @-@ @ ) , @ ( @ % CI , @-@ @ ) , and @ ( @ % CI , @-@ @ ) , respectively .


A U-shaped association was observed , subjects who consumed @-@ cups of green or rock tea per week having the lowest odds ratios for IFG or IGT .


Consumption of green or rock tea may protect against the development of type @ diabetes mellitus in Chinese men and women , particularly in those who drink @-@ cups per week .


Convenient dosing , potency , and low toxicity support use of tenofovir disoproxil fumarate ( TDF ) as preferred nucleotide reverse transcriptase inhibitor ( NRTI ) for HIV-@ treatment .


However , renal and metabolic safety of TDF compared to other NRTIs has not been well described in resource-limited settings .


This was a secondary analysis examining the occurrence of renal abnormalities ( RAs ) and renal and metabolic serious non-AIDS-defining events ( SNADEs ) through study follow-up between participants randomized to zidovudine ( ZDV ) / lamivudine / efavirenz and TDF/emtricitabine/efavirenz treatment arms within A@/PEARLS trial .


Exact logistic regression explored associations between baseline covariates and RAs .


Response profile longitudinal analysis compared creatinine clearance ( CrCl ) over time between NRTI groups .


Twenty-one of @,@ participants developed RAs through @ weeks follow-up ; there were @ out of @ in the TDF arm ( P = @ ) .


Age @ years or older ( odds ratio -LSB- OR -RSB- , @ ; @ % CI , @-@ @ ) , his - tory of diabetes ( OR , @ ; @ % CI , @-@ ) , and lower baseline CrCl ( OR , @ per @ mL/min decline ; @ % CI , @-@ @ ) were associated with development of RAs .


Renal SNADEs occurred in @ participants ; @ were urinary tract infections and @ were renal failure/insufficiency ; one event was attributed to TDF .


Significantly lower CrCl values were maintained among patients receiving TDF compared to ZDV ( repeated measures analysis , P = @ ) , however worsening CrCl from baseline was not observed with TDF exposure over time .


Metabolic SNADEs were rare , but were higher in the ZDV arm ( @ vs @ ; P < @ ) .


TDF is associated with lower serious metabolic toxicities but not higher risk of RAs , serious renal events , or worsening CrCl over time compared to ZDV in this randomized multinational study .


To observe clinical curative effect of cake-separated moxibustion on impaired glucose regulation ( IGR ) and explore its action mechanism .


Sixty cases were randomly divided into a simple lifestyle intervention group ( control group ) and a cake-separated moxibustion combined with lifestyle intervention group ( observation group ) , @ cases in each one .


The control group was treated with lifestyle intervention .


Based on lifestyle intervention , cake-separated moxibustion at Pishu ( BL @ ) , Weishu ( BL @ ) and Yishu ( EX-B @ ) was applied to the observation group .


Fast plasma glucose ( FPG ) , two hours plasma glucose after oral glucose tolerance test ( OGTT@hPG ) , fasting insulin ( FINS ) , homa insulin resistance index ( HOMA-IR ) , blood lipid , body mass index ( BMI ) and waist circumference ( WC ) were observed in the two groups before and after treatment .


After treatment , the OGTT@hPG and FPG were both decreased significantly ( both P < @ ) in the two groups , compared between the two groups , the differences of FPG -LSB- ( @ + / - @ ) mmol/L vs ( @ + / - @ ) mmol/L -RSB- and OGTT@hPG -LSB- ( @ + / - @ ) mmol/L vs ( @ + / - @ ) mmol/L -RSB- were both statistically significant .


There were no significant changes in FINS , HOMA-IR , blood lipid , BMI and WC in the control group before and after treatment ( all P > @ ) , but FINS , HOMA-IR levels , triglycerides ( TG ) , total cholest-erol ( TC ) , low density lipoprotein ( LDL-C ) , BMI and WC in the observation group were decreased obviously after treatment ( all P < @ ) , which had statistical differences between the two groups ( all P < @ ) .


The cake-separated moxibustion combined with lifestyle intervention can obviously control blood glucose levels , improve insulin resistance and blood lipid levels , decrease BMI and WC .


Previous research shows that the internet can be used in the rehabilitation of hearing-aid users .


By further developing the online program , it might be possible to foster behavioral changes that will positively affect hearing-aid users .


A randomized controlled study with two groups of participants .


The intervention group underwent a five-week online intervention while the control group was referred to a waiting list .


Questionnaires were used as outcome measures .


Seventy-six experienced hearing-aid users participated in the study , ranging in age from @ to @ years ( mean @ years ) .


The findings showed significant improvements in the intervention group after the intervention , measured by the hearing handicap inventory for the elderly .


The effects were maintained and improved at the follow-up .


Furthermore , the results indicated that the participants in the intervention group improved at two items of the international outcome inventory for hearing aids , and the effects were partly maintained at the follow-up .


Finally , significant improvements in the domain of psychosocial wellbeing were found at the follow-up .


This study provides further evidence that the internet can be used to deliver intervention of rehabilitation to hearing-aid users .


A train-of-four ratio ( TOFR ) @ measured by quantitative neuromuscular monitoring is accepted as an indication of sufficient neuromuscular recovery for extubation , even though many postsynaptic acetylcholine receptors may still be inhibited .


We investigated whether antagonism with sugammadex after spontaneous recovery to TOFR@ @ further improves muscle function or subjective well-being .


Following recovery to TOFR@ @ and emergence from anaesthesia , @ patients randomly received either sugammadex @ mg kg ( -@ ) or placebo .


Fine motor function ( Purdue Pegboard Test ) and maximal voluntary grip strength were measured before and after surgery ( before and after test drug administration ) .


At discharge from the postanaesthesia care unit , well-being was assessed with numerical analogue scales and the Quality-of-Recovery Score @ ( QoR-@ ) .


Patients ' fine motor function -LSB- @ ( sd @ ) vs @ ( @ ) pegs ( @ s ) ( -@ ) , P < @ -RSB- and maximal voluntary grip strength ( @ ( @ ) vs @ ( @ ) N , P < @ ) were significantly lower after anaesthesia compared with the pre-anaesthesia baseline .


After sugammadex or placebo , motor function was significantly improved in both groups but did not reach the preoperative level .


There was no difference between groups at any time .


Global well-being was unaffected ( QoR-@ : placebo , @ vs @ ; sugammadex , @ vs @ , P > @ ) .


Antagonizing rocuronium at TOF@ @ with sugammadex @ mg kg ( - ) ( @ ) did not improve patients ' motor function or well-being when compared with placebo .


Our data support the view that TOFR@ @ measured by electromyography signifies sufficient recovery of neuromuscular function .


We aimed to compare the incidence of contrast-induced nephropathy ( CIN ) between atorvastatin versus rosuvastatin in patients with ST-segment elevation myocardial infarction ( STEMI ) undergoing primary coronary angioplasty .


One hundred ninety-two consecutive patients , who underwent primary percutaneous intervention ( p-PCI ) with the diagnosis of STEMI , were included in the study .


The patients were randomized to take atorvastatin @ mg ( n = @ ) or rosuvastatin @ mg ( n = @ ) before the procedure .


Biochemical and complete blood count measurements were done at baseline and at @ hours following admission .


The incidence of CIN was @ % ( n = @ ) in the entire groups .


The analysis performed between the statin groups revealed no statistical difference in any of the renal dysfunction indicators -LSB- baseline creatinine , baseline estimated glomerular filtration rate ( eGFR ) , creatinine at @ h , eGFR at @ h , difference between baseline and @ h creatinine , the per cent increase in the creatinine at @ hours relative to basal creatinine -RSB- .


In STEMI patients undergoing primary PCI , only the amount of the contrast agent administered was determined to be an independent predictor for CIN ( OR and @ % CI : @ ( @ - @ ) , P < or = @ ) .


Left ventricular ejection fraction exhibited borderline statistical significance ( OR and @ % CI : @ ( @-@ @ ) , P = @ ) .


Atorvastatin and rosuvastatin had similar efficacy in preventing CIN in patients with STEMI undergoing P-PCI .


The primary aim of this study was to examine the impact of physical activity ( PA ) in the natural environment ( eg , `` green exercise '' ) on resting autonomic function in the Walks@Work intervention .


A secondary aim was to assess the feasibility of Walks@Work in terms of adherence , change in PA levels , and cardiovascular health parameters .


In an @-week randomized control trial , @ office workers in an international company were allocated to one of three groups : control , nature ( NW ) , or built ( BW ) lunchtime walking route .


Both walking groups were required to undertake two lunchtime walks each week .


The NW route centered around trees , maintained grass , and public footpaths .


In contrast , the BW consisted of pavement routes through housing estates and industrial areas .


Data were collected at baseline and following the intervention .


To investigate the impact of the intervention , mixed-design analysis of variance ( ANOVA ) were performed .


A total of @ participants completed the intervention ( drop-out rate of @ % ) .


No difference was observed in resting autonomic function between the groups .


Self-reported mental health improved for the NW group only .


PA levels increased at the intervention mid-point for all groups combined but adherence to the intervention was low with rates of @ % and @ % within the BW and NW groups , respectively .


Accompanying a guideline of two active lunchtimes per week with low facilitator input appears inadequate for increasing the number of active lunchtimes and modifying cardiovascular health parameters in an office population .


However , this population fell within normal ranges for cardiovascular measures and future research should consider investigating at-risk populations , particularly hypertensive individuals .


Piriformis syndrome ( PS ) , which is characterized by pain radiating to the gluteal region and posterior leg , is accepted as one of the causes of sciatalgia .


Although the importance of local piriformis muscle injections whenever PS is clinically suspected has been shown in many studies , there are not enough studies considering the clinical efficacy of these injections .


To investigate the differences between local anesthetic ( LA ) and LA + corticosteroid ( CS ) injections in the treatment of PS .


A prospective , double-blinded , randomized controlled trial .


Physical medicine and rehabilitation department of a university hospital .


Fifty-seven patients having unilateral hip and/or leg pain with positive FAIR test and tenderness and/or trigger point at the piriformis muscle were evaluated .


Out of @ patients randomly assigned to @ groups , @ patients whose pain resolved at least @ % from the baseline after the injection were diagnosed as having PS .


The first group ( n = @ ) received @ mL of lidocaine @ % while the second group ( n = @ ) received @ mL of lidocaine @ % + @ mL of betametazone under the guidance of ultrasound .


Numeric Rating Scale ( NRS ) and Likert Analogue Scale ( LAS ) .


No statistically significant difference ( P > @ ) was detected between the groups in NRS score values at resting ( P = @ ) , night ( P = @ ) , and in motion ( P = @ ) , and LAS values with long duration of sitting ( P = @ ) , standing ( P = @ ) , and lying ( P = @ ) with evaluations at baseline , first week , and first and third months after the injection .


A statistically highly significant ( P < @ ) reduction of pain was evaluated through NRS scores at resting ( P = @ ) , in motion ( P = @ ) , and at night ( P = @ ) and LAS values with long duration of sitting ( P = @ ) , standing ( P = @ ) , and lying ( P = @ ) in both of the groups .


Presumed limitations of this study include having a relatively small sample .


LA injections for the PS were found to be clinically effective .


However , addition of CS to LA did not give an additional benefit .


This gives us the idea that PS is mostly muscular in origin and responds well to both LA and LA+CS injections .


Patient information in cancer clinical trial is challenging .


The value of audio-recording interventions for patients considering participating in clinical trials is unclear .


The primary aim of this randomized study was to investigate effects of audio-recorded information on knowledge and understanding in patients considering participation in a clinical trial .


Patients scheduled for information about a phases @ or @ trial by one of the @ participating oncologists at the Department of Oncology during the study period ( @-@ ) were eligible .


The intervention consisted of an audio-recording on compact disc ( CD ) of the information at the medical consultation in which the patients were informed about a trial .


Knowledge and understanding was measured by the questionnaire , Quality of Informed Consent .


A total of @ patients were randomized , @ % of the calculated sample size ( n = @ ) .


Sixty-seven patients were randomized to the intervention .


In total , @ patients ( @ % ) completed questionnaires .


No statistical significant differences were found between the groups with respect to knowledge and understanding .


The level of knowledge was relatively high , with the exceptions of the risks associated with , and the unproven nature of , the trial .


Overall , patients who declined participation scored statistically significant lower on knowledge .


The present study was underpowered and the results should therefore be interpreted with caution .


Still , @ patients were included with a response rate of @ % .


A CD including the oral information about a clinical trial did not show any effects on knowledge or understanding .


However , the levels of knowledge were high , possible due to the high levels of education in the study group .


Information on risks associated with the trial is still an area for improvement .


To evaluate the long-term durability of the efficacy of alogliptin compared with glipizide in combination with metformin in people with type @ diabetes inadequately controlled on stable-dose metformin .


This multicentre , double-blind , active-controlled study randomized @ patients aged @-@ years to @ weeks of treatment with metformin in addition to alogliptin @ mg once daily ( n = @ ) , alogliptin @ mg once daily ( n = @ ) or glipizide @ mg once daily , titrated to a maximum of @ mg ( n = @ ) .


The primary endpoint was least square mean change from baseline in HbA@c level at @ weeks .


The mean patient age was @ years , the mean diabetes duration was @ years and the mean baseline HbA@c was @ % .


HbA@c reductions at week @ were -@ % , -@ % and -@ % for alogliptin @ and @ mg and glipizide , respectively -LSB- both doses met the criteria for non-inferiority to glipizide ( p < @ ) ; alogliptin @ mg met superiority criteria ( p = @ ) -RSB- .


Fasting plasma glucose concentration decreased by @ and @ mmol/l for alogliptin @ and @ mg , respectively , and increased by @ mmol/l for glipizide ( p < @ for both comparisons with glipizide ) .


Mean weight changes were -@ , -@ and @ kg for alogliptin @ and @ mg and glipizide , respectively ( p < @ for both comparisons with glipizide ) .


Hypoglycaemia occurred in @ % of patients in the glipizide group vs. @ and @ % of patients in the alogliptin @ and @ mg groups , respectively .


Pancreatitis occurred in one patient in the alogliptin @ mg group and three in the glipizide group .


Alogliptin efficacy was sustained over @ years in patients with inadequate glycaemic control on metformin alone .


To study differences in outcomes of medication reconciliation ( MR ) when performed by clinical pharmacists compared to nurses .


@ patients ( @-@ years ) admitted to the Department of Cardiology at the University Hospital of North Norway , autumn @ , were randomized into a pharmacist group ( PG ) and a nurse group ( NG ) .


The nurses and the pharmacists were trained for performing the MR process by an independent clinical pharmacist .


Medication discrepancies ( MDs ) were discussed with the physicians .


Time spent during the MR was recorded .


An independent expert group rated clinical relevance of the MDs retrospectively .


At least one MD was identified in @ % and @ % of patients in PG and NG , respectively ( P = @ ) with a mean number of MDs per patient @ ( SD @ ) and @ ( SD @ ) , respectively ( P = @ ) .


Mean time spent/patient on the MR process was @ min ( SD @ ) in the PG and @ min ( SD @ ) in the NG ( P < @,@ ) .


Physicians agreed significantly more often to act upon the MDs presented by pharmacists compared to nurses ( P = @ ) .


The expert group finally assessed @ % and @ % of the MDs to be of the clinical relevance in the PG and the NG , respectively .


By applying a structured method for MR , a small however not statistically significant difference in identified MDs between nurses and clinical pharmacists was revealed .


The pharmacists spent significantly less time than the nurses , and physicians agreed significantly more often with the pharmacist that action should be taken on the MDs .


This is important in the discussion of who to perform MR.


The premotor cortex plays a major role in motor planning and control , exhibiting hierarchical importance comparable to that of the primary motor cortex ( M@ ) .


In this study , we compared the effects of cPMd modulation , which was achieved using inhibitory repetitive transcranial magnetic stimulation ( rTMS ) , with those of contralesional M@ ( cM@ ) modulation , to elucidate the roles of both regions on longitudinal motor recovery following a stroke .


Forty-four patients who had sustained hemiplegia for @ to @ months were randomly allocated to a cPMd group , cM@ group , or sham group and received @ sessions of @-Hz rTMS .


The Medical Research Council ( MRC ) Scale , Fugl-Meyer Assessment ( FMA ) , Wolf Motor Function Test ( WMFT ) , and a cortical excitability test were administered pre - and post - rTMS intervention .


cPMd modulation yielded significant improvements in MRC , FMA , and WMFT scores compared with sham stimulation and a significant effect on cortical excitability suppression equivalent to that of cM@ modulation , but engendered effects on motor improvement inferior to those of cM@ modulation .


In patients with chronic stroke , the cPMd can fulfill a role similar to that of the cM@ in interhemispheric imbalance , which can be ameliorated by applying inhibitory rTMS to achieve substantial motor restoration .


The aim of the present clinical study was to compare early and late outcomes after inguinal hernia repair with the heavyweight mesh ( HW ) and lightweight mesh ( LW ) during a @ year follow-up period .


@ patients were randomized into LW and HW mesh groups , both of which underwent unilateral primary inguinal hernia repair via the Lichtenstein technique .


Wound complications ( infection , hematoma , seroma ) , hernia recurrence , pain and feeling of foreign body in inguinal area were determined in patients .


Pain was measured by visual analogue scale .


No statistical difference has been found between LW and HW groups by wound complication ( P = @ ) .


One case of hernia recurrence has been mentioned in both groups one year after hernioplasty .


But there was no detectable difference between the two groups .


No significant difference has been found between LW and HW groups by frequency of chronic pain @ days , @ and @ months , @ , @ , and @ years after surgery .


As for the feeling of foreign body in groin it is similar in both groups after @ and @ months .


Level of feeling of foreign body was significantly lower in LW group @ , @ , and @ years after surgery , than in HW group ( P = @ , P = @ , P = @ , respectively ) .


Our research shows no significant difference in wound complications , hernia recurrence and chronic pain after Lichtenstein hernioplasty , by using of LW and HW meshes .


The usage of the LW mesh was associated with less feeling of foreign body than that of the HW mesh , what can be considered as prevalence of LW mesh hernioplasty .


The present pharmacoeconomic study compared the direct and indirect costs of using frovatriptan versus rizatriptan in the acute treatment of migraine .


Data on the cost-efficacy of the two triptans were derived from a recently published Italian , multicenter , randomized , double-blind , cross-over patient preference study , comparing frovatriptan versus rizatriptan .


The direct costs were obtained by calculating the drug consumption , both of triptans and rescue medications .


Prices of currently marketed drugs were obtained from Italian Drug Agency price list .


The indirect costs were those related to absenteeism from the workplace due to migraine .


@ of the @ patients with a current history of migraine randomized to the two study drugs and completing the study were analyzed .


The number of attacks treated with only @ dose of study drug was higher with frovatriptan ( @ vs. @ ) , whereas the number of attacks treated with @ doses of study medication was higher with rizatriptan ( @ vs. @ and @ vs. @ , respectively ) .


However , more patients treated with frovatriptan took a rescue medication ( @ vs. @ ) .


The total direct cost per attack ( including study drug rescue medication ) was @ for frovatriptan and @ for rizatriptan ( p < @ between-treatments ) .


As for indirect costs , in the group of patients treated with frovatriptan the mean number of lost working hours was significantly ( p < @ ) lower ( @ h ) compared to the subjects who used rizatriptan ( @ h ) .


Based on the earned income per unit of work , indirect costs per attack resulted to be @ for frovatriptan and @ for rizatriptan .


Overall , the total costs , including direct and indirect costs , were evaluated to be @ for frovatriptan and @ for rizatriptan , respectively .


Within the limitations of this model analysis , frovatriptan was found to be significantly more cost-effective than rizatriptan .


This outcome can be explained by the lower acquisition cost of frovatriptan , the need for fewer doses , and the loss of fewer working hours .


This finding could drive selection of the most appropriate oral treatment for acute migraine attacks based on both individual patient 's needs and the cost-effectiveness of the available drugs .


To assess an intervention to limit community-associated methicillin-resistant Staphylococcus aureus ( MRSA ) dissemination .


Randomized , controlled trial .


County Jail , Dallas , Texas .


A total of @,@ detainees in @ detention tanks .


Tanks were randomly assigned to @ of @ groups : in group @ , detainees received cloths that contained chlorhexidine gluconate ( CHG ) to clean their entire skin surface @ times per week for @ months ; group @ received identical cloths containing only water ; and group @ received no skin treatment .


During the study , all newly arrived detainees were invited to enroll .


Nares and hand cultures were obtained at baseline and from all current enrollees at @ and @ months .


At baseline , S. aureus was isolated from @ % and MRSA from @ % ( nares and/or hand ) of @ enrollees .


The average participation rate was @ % .


At @ months , MRSA carriage was @ % in group @ and @ % in group @ tanks ( estimated absolute risk reduction -LSB- @ % confidence interval ( CI ) -RSB- , @ % -LSB- -@ % to @ % -RSB- ; P = @ ) .


At @ months , carriage of any S. aureus was @ % in group @ , @ % in group @ ( absolute risk reduction -LSB- @ % CI -RSB- , @ % -LSB- @ % -@ % -RSB- ; P = @ ) , and @ % ( absolute risk reduction -LSB- @ % CI -RSB- , @ % -LSB- -@ % to @ % -RSB- ; P = @ ) in group @ .


Skin cleaning with CHG for @ months in detainees , compared with no intervention , significantly decreased carriage of S. aureus , and use of water cloths produced a nonsignificant but similar decrease .


A nonsignificant decrease in MRSA carriage was found with CHG cloth use .


Health and social care professionals are well positioned to identify and intervene in cases of elder financial abuse .


An evidence-based educational intervention was developed to advance practitioners ' decision-making in this domain .


The objective was to test the effectiveness of a decision-training educational intervention on novices ' ability to detect elder financial abuse .


The research was funded by an E.S.R.C. grant reference RES-@-@-@ .


A parallel-group , randomised controlled trial was conducted using a judgement analysis approach .


Each participant used the World Wide Web to judge case sets at pre-test and post-test .


The intervention group was provided with training after pre-test testing , whereas the control group were purely given instructions to continue with the task .


@ pre-registration health and social care practitioners were randomly allocated to intervention ( n@ ) or control ( n@ ) .


The intervention comprised of written and graphical descriptions of an expert consensus standard explaining how case information should be used to identify elder financial abuse .


Participants ' ratings of certainty of abuse occurring ( detection ) were correlated with the experts ' ratings of the same cases at both stages of testing .


At pre-test , no differences were found between control and intervention on rating capacity .


Comparison of mean scores for the control and intervention group at pre-test compared to immediate post-test , showed a statistically significant result .


The intervention was shown to have had a positive moderate effect ; at immediate post-test , the intervention group 's ratings had become more similar to those of the experts , whereas the control 's capacity did not improve .


The results of this study indicate that the decision-training intervention had a positive effect on detection ability .


This freely available , web-based decision-training aid is an effective evidence-based educational resource .


Health and social care professionals can use the resource to enhance their ability to detect elder financial abuse .


It has been embedded in a web resource at http://www.elderfinancialabuse.co.uk .


Imiquimod , a synthetic Toll-like receptor @ agonist enhanced immunogenicity of influenza vaccine in a mouse model .


We hypothesized that topical imiquimod before intradermal influenza vaccination ( TIV ) would produce similar effect in human .


We performed a prospective @-year follow-up , double-blind , randomized , controlled trial with adults with comorbidities .


Participants were randomized to @ of the following @ vaccinations : topical @ % @ mg imiquimod ointment followed by intradermal TIV , topical aqueous-cream followed by intradermal TIV , or topical aqueous-cream followed by intramuscular TIV .


Patients and investigators were blinded to the type of topical treatment applied .


Hemagglutination inhibition ( HI ) and microneutralization antibody titers were measured .


The primary outcome was the day @ seroconversion rate .


Ninety-one recruited participants completed the study .


The median age was @ years .


On day @ , @/@ ( @ % ) patients who received imiquimod and intradermal TIV achieved seroconversion against the H@N@ strain by HI , compared with @/@ ( @ % ) who received aqueous-cream and intramuscular TIV ( P < @ ) , and @/@ ( @ % ) who received aqueous-cream and intradermal TIV ( P < @ ) .


The seroconversion , seroprotection , and geometric mean titer-fold increase were met in all @ strains in the imiquimod and intradermal TIV group @ weeks earlier , and the better seroconversion rate was sustained from day @ to year @ ( P @ ) .


The better immunogenicity was associated with fewer hospitalizations for influenza or pneumonia ( P < @ ) .


All adverse reactions were self-limited .


Pretreatment with topical imiquimod significantly expedited , augmented , and prolonged the immunogenicity of influenza vaccination .


This strategy for influenza immunization should be considered for the elderly population .


Midurethral slings have become the most preferred surgical treatment for female urinary incontinence .


To compare the efficacy and safety of two midurethral sling procedures with a different technique of sling insertion @ yr after intervention .


Multicenter randomized clinical trial conducted in seven public hospitals in Finland including primary cases of stress urinary incontinence .


Surgical treatment with the retropubic tension-free vaginal tape ( TVT ) procedure or the transobturator tension-free vaginal tape ( TVT-O ) procedure .


Objective treatment success criteria were a negative stress test , a negative @-h pad test , and no retreatment for stress incontinence .


Patient satisfaction was assessed by condition-specific quality-of-life questionnaires .


A total of @ % of the included women could be assessed according to the protocol @ yr after surgery .


The objective cure rate was @ % in the TVT group and @ % in the TVT-O group , with no statistical difference between the groups .


Subjective treatment satisfaction was @ % in the TVT group and @ % in the TVT-O group , with no difference between groups .


Complication rates were low , with no difference between groups .


Both objective and subjective cure rates were > @ % in both groups even when women lost to follow-up were included as failures .


The complication rates were low , with no difference between the groups .


No late-onset adverse effects of the tape material were seen .


Female urinary stress incontinence can be treated surgically with minimally invasive midurethral sling procedures .


Two main approaches of sling placement have been developed : the retropubic and the transobturatory .


We compared both approaches and followed the patients for @ yr .


We found no difference in cure rate between the procedures , and patient satisfaction was high .


Telmisartan and atenolol are widely used in the management of essential hypertension .


This study was conducted to compare the efficacy of these two drugs in management of patients of essential hypertension .


Diagnosed patients of essential hypertension were selected .


Therapeutic option ( telmisartan/atenolol ) was allocated to the patients by lottery method and they were divided into two groups .


The patients were followed on subsequent visits ( @ in total ) and their sitting systolic and diastolic blood pressures were recorded .


Total number of @ patients were divided into two treatment groups ( i.e. , telmisaran and atenolol ) .


Forty percent were male and @ % were female .


Majority of the patients were of age group @-@ years .


Telmisartan reduced systolic and diastolic blood pressure significantly compared to atenolol at the end of @ weeks of treatment ( p = @ and @ respectively ) .


Telmisartan @ mg once daily is more effective than atenolol @ mg once daily in lowering systolic and diastolic blood pressure at the end of @ weeks of treatment .


To evaluate the effect of early enteral nutrition ( EEN ) on immune response and clinical outcomes after esophageal cancer operation .


Sixty patients with esophageal cancer undergoing radical operation between March @ and July @ were randomly divided into two groups using envelope method : EEN group ( n = @ , administration of water and enteral nutrition early after operation ) and TPN group ( n = @ , administration of total parenteral nutrition ) .


Two groups both received @-day nutrition support .


Immune indexes ( CD@ ( + ) , CD@ ( + ) , CD@ ( + ) , CD@ ( + ) / CD@ ( + ) ) and serum nutritional indexes ( albumin , pre-albumin , transferrin ) were measured before operation and @ - , @ - , and @-day after operation .


The time to first flatus , length of postoperative hospital stay , total hospitalization cost , and postoperative complication were recorded .


As compared to TPN group , the time to first flatus was significantly shorter in EEN group -LSB- ( @ ) h vs. ( @ ) h , P < @ -RSB- , as was hospital stay -LSB- ( @ ) d vs. ( @ ) d , P < @ -RSB- .


Total hospitalization cost -LSB- ( @@ ) yuan vs. ( @@ ) yuan , P < @ -RSB- was lower in EEN group as compared to TPN group .


There was no significant difference in postoperative complication rate between the two groups -LSB- @ % ( @/@ ) vs. @ % ( @/@ ) , P > @ -RSB- .


The levels of CD@ ( + ) , CD@ ( + ) , CD@ ( + ) / CD@ ( + ) , albumin , prealbumin and transferrin were significantly higher in EEN group as compared to TPN group on postoperative day @ and @ ( all P < @ ) , while CD@ ( + ) was significantly lower in EEN group ( P < @ ) .


EEN can promote early recovery of gastrointestinal function , improve nutritional and immune function , and therefore lead to fast postoperative recovery in esophageal cancer patients .


Dietary intake assessment with diet records ( DR ) is a standard research and practice tool in nutrition .


Manual entry and analysis of DR is time-consuming and expensive .


New electronic tools for diet entry by clients and research participants may reduce the cost and effort of nutrient intake estimation .


To determine the validity of electronic diet recording , we compared responses to @-day DR kept by Tap & Track software for the Apple iPod Touch and records kept on the Nutrihand website to DR coded and analyzed by a research dietitian into a customized US Department of Agriculture ( USDA ) nutrient analysis program , entitled GRAND ( Grand Forks Research Analysis of Nutrient Data ) .


Adult participants ( n = @ ) enrolled in a crossover-designed clinical trial .


During each of two washout periods , participants kept a written @-day DR. In addition , they were randomly assigned to enter their DR in a Web-based dietary analysis program ( Nutrihand ) or a handheld electronic device ( Tap & Track ) .


They completed an additional @-day DR and the alternate electronic diet recording methods during the second washout .


Entries resulted in @ daily diet records or @ for each of @ participants .


Means of nutrient intake were calculated for each method .


Concordance of the intake estimates were determined by Bland-Altman plots .


Coefficients of determination ( R ( @ ) ) were calculated for each comparison to assess the strength of the linear relationship between methods .


No significant differences were observed between the mean nutrient values for energy , carbohydrate , protein , fat , saturated fatty acids , total fiber , or sodium between the recorded DR analyzed in GRAND and either Nutrihand or Tap & Track , or for total sugars comparing GRAND and Tap & Track .


Reported values for total sugars were significantly reduced ( P < @ ) comparing Nutrihand to GRAND .


Coefficients of determination ( R ( @ ) ) for Nutrihand and Tap & Track compared to DR entries into GRAND , respectively , were energy @ , @ ; carbohydrate @ , @ ; total fiber @ , @ ; sugar @ , @ ; protein @ , @ ; fat @ , @ ; saturated fatty acids @ , @ ; sodium @ , @ ; and for Nutrihand only for cholesterol @ ; vitamin A @ ; vitamin C @ ; calcium @ ; and iron @ .


Bland-Altman analysis demonstrates high variability in individual responses for both electronic capture programs with higher @ % limits of agreement for dietary intake recorded on Tap & Track .


In comparison to dietitian-entered @-day DR , electronic methods resulted in no significant difference in mean nutrient estimates but exhibited larger variability , particularly the Tap & Track program .


However , electronic DR provided mean estimates of energy , macronutrients , and some micronutrients , which approximated those of the dietitian-analyzed DR and may be appropriate for dietary monitoring of groups .


Electronic diet assessment methods have the potential to reduce the cost and burden of DR analysis for nutrition research and clinical practice .


To test in the primary care setting the short - and long-term efficacy of a behavioral intervention that simultaneously targeted an overweight child and parent versus an information control ( IC ) targeting weight control only in the child .


Two - to @-year-old children who had BMI @th percentile and an overweight parent ( BMI > @ kg/m@ ) were randomized to Intervention or IC , both receiving diet and activity education over @ months ( @ sessions ) followed by @-month follow-up ( @ sessions ) .


Parents in the Intervention group were also targeted for weight control and received behavioral intervention .


Pediatricians in @ practices enrolled their patients with the assistance of embedded recruiters ( Practice Enhancement Assistants ) who assisted with treatment too .


A total of @ of the @ children randomized ( Intervention n = @ ; IC n = @ ) started the program and had data at baseline .


Children in the Intervention experienced greater reductions in percent over BMI ( group months ; P = @ ) and z-BMI ( group months ; P < @ ) compared with IC throughout treatment and follow-up .


Greater BMI reduction was observed over time for parents in the Intervention compared with IC ( P < @ ) throughout treatment and follow-up .


Child weight changes were correlated with parent weight changes at @ and @ months ( r = @ and @ ; P < @ and P = @ ) .


Concurrently targeting preschool-aged overweight and obese youth and their parents in primary care with behavioral intervention results in greater decreases in child percent over BMI , z-BMI , and parent BMI compared with IC .


The difference between Intervention and IC persists after @ months of follow-up .


To evaluate the effects of intravenous ( IV ) golimumab @ mg/kg + methotrexate ( MTX ) on patient-reported measures of health-related quality of life ( HRQOL ) in patients with active rheumatoid arthritis ( RA ) despite prior MTX therapy .


In this randomized , multicenter , double-blind , placebo-controlled , phase III trial , adults with RA were randomly assigned to receive IV placebo ( n = @ ) or golimumab @ mg/kg ( n = @ ) infusions at Week @ , Week @ , and every @ weeks thereafter .


All patients continued stable oral MTX ( @-@ mg/wk ) .


HRQOL assessments included Health Assessment Questionnaire-Disability Index ( HAQ-DI ; physical function ) , Medical Outcomes Study Short Form-@ questionnaire physical/mental component summary ( SF-@ PCS/MCS ) scores , EQ-@D assessment of current health state , Functional Assessment of Chronic Illness Therapy-Fatigue ( FACIT-Fatigue ) questionnaire , and disease effect on productivity -LSB- @-cm visual analog scale ( VAS ) -RSB- .


Mean HAQ-DI improvements from baseline were significantly greater with golimumab + MTX than placebo + MTX at Week @ and Week @ ( p < @ ) .


Significantly greater improvements in all @ individual SF-@ subscores and both the SF-@ PCS and MCS scores ( p < @ ) also accompanied golimumab + MTX therapy .


Improved EQ-@D and EQ-@D VAS ( p < @ ) and FACIT-Fatigue ( p < @ ) scores were also observed for golimumab + MTX-treated patients at Week @ , Week @ , and Week @ , and greater proportions of golimumab + MTX-treated patients had clinically meaningful improvements in these measures .


Greater reductions in disease effect on productivity were observed with golimumab + MTX versus placebo + MTX at Week @ ( p < @ ) .


Improvements in physical function , HRQOL , fatigue , and productivity significantly correlated with disease activity improvement .


In active RA , IV golimumab + MTX significantly improved physical function , HRQOL , fatigue , and productivity using multiple measurement tools ; all correlated with improvements in disease activity ( NCT@ , EudraCT @-@-@ ) .


Previous studies have shown that heating the insulin injection site may accelerate insulin absorption .


We investigated the pharmacological profile of insulin administered with InsuPatch , a local skin-heating device .


In this randomized , crossover study carried out in @ subjects with type @ diabetes treated with insulin pump -LSB- mean age @ years ; @ women ; HbA@c :@ % ( @ mmol/mol ) ( mean + / - standard deviation ) -RSB- .


Euglycemic glucose clamps were performed after administration of @ units/kg of short-acting insulin analogues .


Each subject underwent three clamp procedures : two with the InsuPatch device ( day @ and day @ ) and one without the device ( day @ control ) .


The primary endpoints were the following : ( @ ) the change in the area under the curve ( AUC ) of insulin during the first @ min post-insulin bolus on day @ with the InsuPatch device versus day @ control and ( @ ) parameters to assess the safety of using the device .


The area under the curve of insulin during the initial @ min ( insulin AUC ( @-@ ) ) after insulin bolus was increased by @ % on day @ InsuPatch versus day @ control ( p < @ ) .


Maximal post-insulin bolus concentration was @ mU/L on day @ InsuPatch versus @ mU/L on day @ control ( p < @ ) .


On day @ InsuPatch , insulin AUC ( @-@ ) was increased by @ % versus day @ InsuPatch ( p < @ ) .


Maximal insulin concentration was @ mU/L versus @ mU/L , respectively ( p = @ ) .


The use of the heating device upon administration of short-acting insulin analogues in pump-treated type @ diabetic patients was found to enhance insulin absorption .


This heating device may therefore serve to achieve better meal insulin coverage .


Diagnosis of different parkinsonian syndromes is linked with high misdiagnosis rates and various confounding factors .


This is particularly problematic in its early stages .


With this in mind , the current pilot study aimed to distinguish between Idiopathic Parkinson 's Disease ( iPD ) , other Parkinsonian syndromes ( non-iPD ) and healthy subjects , by a breath test that analyzes the exhaled volatile organic compounds using a highly sensitive nanoarray .


Breath samples of @ iPD , @ non-iPD patients and @ healthy controls were collected .


The samples were passed over a nanoarray and the resulting electrical signals were analyzed with discriminant factor analysis as well as by a K-fold cross-validation method , to test the accuracy of the model .


Comparison of non-iPD with iPD states yielded @ % sensitivity , @ % accuracy , and @ % Receiver Operating Characteristic area under the curve in the training set samples with known identity .


The validation set of this comparison scored @ % sensitivity and accuracy and @ % negative predictive value .


Comparison between atypical parkinsonism states and healthy subjects scored @ % sensitivity and @ % accuracy in the training set samples with known identity .


The validation set of this comparison scored @ % sensitivity and @ % accuracy .


The obtained results were not affected by l-Dopa or MAO-B inhibitor treatment .


Exhaled breath analysis with nanoarray is a promising approach for a non-invasive , inexpensive , and portable technique for differentiation between different Parkinsonian states .


A larger cohort is required in order to establish the clinical usefulness of the method .


To compare treatment with metformin alone , metformin plus insulin and insulin alone in women with gestational diabetes ( GDM ) .


A total of @ gestational diabetic patients who fulfilled the eligibility criteria were included in this prospective randomized control open labeled study .


A risk factor based screening was done followed by a GCT and then local GTT criteria from antenatal clinics .


They were initially divided into two groups with odd numbers assigned to metformin treatment and even numbers to insulin treatment .


Metformin and/or insulin treatment was given and target blood sugar levels aimed at FBS @ mg/dl and postprandial levels @ mg/dl .


Supplemental insulin was added to metformin treatment group to maintain the glycemic targets if required .


Patients were followed until delivery and maternal fetal outcomes and pharmacotherapeutic characteristics were recorded on a performa .


Less maternal weight gain was found in the metformin treated groups ( @ @ kg -LSB- metformin alone -RSB- vs. @ @ kg -LSB- metformin plus insulin -RSB- vs. @ @ kg -LSB- insulin alone -RSB- P < @ ) .


Preeclampsia was significantly less in metformin treated groups .


There were no perinatal deaths in the study .


Mean birth weight was significantly less in metformin treated groups ( @ @ kg vs. @ @ kg vs. @ @ kg P < @ ) .


Less neonatal morbidity was observed in metformin groups .


@ % of patients required supplemental insulin ( mean dose of @ @ units ) in the metformin group .


Mean gestational age at which insulin was added was @ @ weeks .


Metformin is an effective and cheap treatment option for women with gestational diabetes with or without supplemental insulin .


To study the effect of vasonit on the structural/functional state of erythrocyte cytoplasmic membrane in patients with ischemic stroke ( @ ) using atomic-power microscopy in vitro .


We examined @ patients with II .


Patients of the main group ( n = @ ) received vasonit and standard treatment , @ patients of the comparison group received only standard treatment .


To assess the severity of patient 's condition , we used the NIH stroke scale , modified Rankin scale , the Barthel index and the Rivermead Mobility index .


Dried erythrocyte preparations were made to study erythrocyte cytoplasmic membrane .


Scanning was performed using an atomic-power microscope manufactured by `` SOLVER P@-Pro '' ( NT-MDT , Russia ) .


A statistically significant positive dynamics of neurological deficit and patient 's functional state was found in the @ '' day of the study .


A significant decrease in Young 's modulus value was identified in the main group that suggested the increase in the elasticity of erythrocyte cytoplasmic membrane .


Metformin is used to reduce pregnancy complications in women with polycystic ovary syndrome ( PCOS ) , although it is not approved for this indication and solid evidence is lacking .


Midpregnancy Doppler ultrasound is one of the best methods for prediction of adverse pregnancy outcome .


The objectives of the study were to investigate the following : @ ) whether metformin treatment influenced the midpregnancy pulsatility index ( PI ) of the uterine artery ; @ ) whether metabolic or endocrine factors affect the PI of the uterine artery of PCOS women ; and @ ) whether PI predicted adverse pregnancy outcome in PCOS woman .


This is a substudy of a randomized , placebo-controlled , double-blind , multicenter study conducted at @ secondary care centers .


We randomly assigned @ pregnancies to receive metformin or placebo , from the first trimester of pregnancy to delivery .


In the present substudy , @ pregnancies are included , ie , those who completed the ultrasound examinations .


Midpregnancy PI in the uterine artery related to metformin use , androgen levels , an oral glucose tolerance test , and insulin levels was measured .


We found no difference in the PI between the metformin and placebo groups .


In multivariate analyses , fasting serum glucose of the first and second trimester correlated positively to the midpregnancy PI .


Only in univariate analyses a weak correlation between androstenedione and PI was seen .


Metformin treatment did not affect uterine artery blood flow , measured by PI .


High fasting blood glucose correlated inversely to uterine artery blood flow .


The midpregnancy PI correlated positively to preeclampsia , hypertension , and gestational diabetes mellitus in PCOS pregnancies .


Androgen levels correlated only to PI in univariate analyses .


Erlotinib is a highly active epidermal growth factor receptor ( EGFR ) kinase inhibitor that is approved for first-line use in lung cancers harboring EGFR mutations .


Anecdotal experience suggests that this drug may provide continued disease control after patients develop objective progression of disease ( PD ) , although this has not been systematically studied to date .


Patients who had Response Evaluation Criteria In Solid Tumors-defined PD who were participating in @ prospective trials of first-line erlotinib in advanced lung cancer were studied retrospectively , and the progression characteristics were compared between patients with and without EGFR-sensitizing mutations .


Factors were studied that influenced the time until treatment change ( TTC ) , defined as the time from PD to the start of a new systemic therapy or death .


The rate of tumor progression was assessed by comparing tumor measurements between the computed tomography scan obtained at the time of PD and the preceding scan .


In total , @ eligible patients were studied , including @ with and @ without an EGFR-sensitizing mutation .


The EGFR-mutant cohort had a slower rate of progression ( P = @ ) and a longer TTC ( P < @ ) .


Among the patients with EGFR-mutant cancers , @ ( @ % ) continued single-agent erlotinib after PD , and @ ( @ % ) were able to delay a change in systemic therapy for > @ months ; only @ patients received local debulking therapy during that period .


Multivariate analysis of the patients with EGFR-mutant tumors demonstrated that a longer time to progression , a slower rate of progression , and a lack of new extrathoracic metastases were associated with a longer TTC .


A change in systemic therapy commonly can be delayed in patients with EGFR-mutant lung cancer who objectively progress on first-line erlotinib , particularly in those with a longer time to progression , a slow rate of progression , and a lack of new extrathoracic metastases .


The effectiveness of noninvasive positive pressure ventilation delivered by helmet ( H-NPPV ) as a weaning approach in patients with acute respiratory failure is unclear .


We randomly and evenly assigned @ patients intubated for acute respiratory failure to conventional weaning with invasive mechanical ventilation ( IMV ) or H-NPPV .


The primary end point was a reduction in IMV duration by @ days between the @ groups .


Secondary end points were the occurrence of ventilator-associated pneumonia and major complications , duration of mechanical ventilation and weaning , intensive care unit and hospital length of stay , and survival .


The mean duration of IMV was significantly reduced in the H-NPPV group compared with the IMV group ( P < @ ) , without significant difference in duration of weaning ( P = @ ) and total ventilatory support ( P = @ ) .


In the H-NPPV group , the incidence of major complications was less than the IMV group ( P = @ ) .


Compared with the H-NPPV group , the IMV group was associated with a greater incidence of VAP ( P = @ ) and an increased risk of nosocomial pneumonia ( P = @ ) .


The mortality rate was similar between the groups , with no significant difference in overall intensive care unit ( P = @ ) or hospital length of stay ( P = @ ) .


H-NPPV was well tolerated and effective in patients who were difficult to wean .


In laboratory studies , exercise immediately before sexual stimuli improved sexual arousal of women taking antidepressants -LSB- @ -RSB- .


We evaluated if exercise improves sexual desire , orgasm , and global sexual functioning in women experiencing antidepressant-induced sexual side effects .


Fifty-two women who were reporting antidepressant sexual side effects were followed for @ weeks of sexual activity only .


They were randomized to complete either three weeks of exercise immediately before sexual activity ( @/week ) or @ weeks of exercise separate from sexual activity ( @/week ) .


At the end of the first exercise arm , participants crossed to the other .


We measured sexual functioning , sexual satisfaction , depression , and physical health .


Exercise immediately prior to sexual activity significantly improved sexual desire and , for women with sexual dysfunction at baseline , global sexual function .


Scheduling regular sexual activity significantly improved orgasm function ; exercise did not increase this benefit .


Neither regular sexual activity nor exercise significantly changed sexual satisfaction .


Scheduling regular sexual activity and exercise may be an effective tool for the behavioral management of sexual side effects of antidepressants


Overweight and obesity during pregnancy represents a considerable health burden .


While research has focused on interventions to limit gestational weight gain , there is little information describing their impact on neonatal health .


Our aim was to investigate the effect on a range of pre-specified secondary neonatal outcomes of providing antenatal dietary and lifestyle advice to women who are overweight or obese .


We report a range of pre-specified secondary neonatal outcomes from a large randomised trial in which antenatal dietary and lifestyle advice was provided to women who were overweight or obese .


Pregnant women were eligible for participation with a body mass index of @ kg/m ( @ ) or over , and singleton gestation between @ ( +@ ) and @ ( +@ ) weeks .


Outcome measures included gestational age at birth ; Apgar score below @ at @ minutes of age ; need for resuscitation at birth ; birth weight above @ kg or below @ kg ; birth weight , length and head circumference ( and Z-scores ) ; admission to the nursery ; respiratory distress syndrome ; and postnatal length of stay .


Data relating to the primary outcome ( large for gestational age infants defined as birth weight above the @th centile ) and birth weight above @ kg have been reported previously .


Analyses used intention-to-treat principles .


In total , @,@ infants were included in the analyses .


Infants born to women following lifestyle advice were significantly less likely to have birth weight above @ kg ( @ % versus @ % ; adjusted risk ratio ( aRR ) = @ ; @ % confidence interval ( CI ) @ to @ ; P = @ ) , or respiratory distress syndrome ( @ % versus @ % ; aRR = @ ; @ % CI @ to @ ; P = @ ) , particularly moderate or severe disease , and had a shorter length of postnatal hospital stay ( @ days versus @ days ; adjusted ratio of means @ ; @ % CI @ to @ ; P = @ ) compared with infants born to women who received Standard Care .


For women who are overweight or obese , antenatal dietary and lifestyle advice has health benefits for infants , without an increase in the risk of harm .


Continued follow-up into childhood will be important to assess the longer-term effects of a reduction in high infant birth weight on risk of child obesity .


Please see related articles : http://www.biomedcentral.com/@-@/@/@ and http://www.biomedcentral.com/@-@/@/@ .


Preclinical and clinical studies indicate that the administration of glucocorticoids may promote fear extinction processes .


In particular , it has been shown that glucocorticoids enhance virtual reality based exposure therapy of fear of heights .


Here , we investigate whether glucocorticoids enhance the outcome of in vivo exposure-based group therapy of spider phobia .


In a double blind , block-randomized , placebo-controlled , between-subject study design , @ patients with specific phobia of spiders were treated with two sessions of in vivo exposure-based group therapy .


Cortisol ( @ mg ) or placebo was orally administered @ hr before each therapy session .


Patients returned for a follow-up assessment one month after therapy .


Exposure-based group therapy led to a significant decrease in phobic symptoms as assessed with the Fear of Spiders Questionnaire ( FSQ ) from pretreatment to immediate posttreatment and to follow-up .


The administration of cortisol to exposure therapy resulted in increased salivary cortisol concentrations and a significantly greater reduction in fear of spiders ( FSQ ) as compared to placebo at follow-up , but not immediately posttreatment .


Furthermore , cortisol-treated patients reported significantly less anxiety during standardized exposure to living spiders at follow-up than placebo-treated subjects .


Notably , groups did not differ in phobia-unrelated state-anxiety before and after the exposure sessions and at follow-up .


These findings indicate that adding cortisol to in vivo exposure-based group therapy of spider phobia enhances treatment outcome .


To investigate whether interventions that have positive effects on psychological symptoms and quality of life compared with usual care would also reduce days on sick leave .


A randomized controlled trial .


A large primary health care centre in Stockholm , Sweden .


Intervention .


Patients with common mental disorders were recruited by their GPs and randomized into one of two group interventions that took place in addition to usual care .


These group interventions were : ( a ) group cognitive behavioural therapy ( CBT ) , and ( b ) group multimodal intervention ( MMI ) .


Both types of intervention had previously shown significant effects on quality of life , and MMI had also shown significant effects on psychological symptoms .


Of the @ randomized patients , @ were employed and had taken sick leave periods of at least two weeks in length during the study period of two years .


They comprised the study group .


The odds , compared with usual care , for being sick-listed at different times relative to the date of randomization .


The mean number of days on sick leave increased steadily in the two years before randomization and decreased in the two years afterwards , showing the same pattern for all three groups .


The CBT and MMI interventions did not show the expected lower odds for sick-listing compared with usual care during the two-year follow-up .


Reduction in psychological symptoms and increased well-being did not seem to be enough to reduce sickness absence for patients with common mental problems in primary care .


The possibility of adding workplace-oriented interventions is discussed .


Medical nonpersistence is a worldwide problem of striking magnitude .


Although many fields of studies including epidemiology , sociology , and psychology try to identify determinants for medical nonpersistence , comprehensive research to explain medical nonpersistence from an economics perspective is rather scarce .


The aim of the study was to develop a conceptual framework that augments standard economic choice theory with psychological concepts of behavioral economics to understand how patients ' preferences for discontinuing with therapy arise over the course of the medical treatment .


The availability of such a framework allows the targeted design of mechanisms for intervention strategies .


Our conceptual framework models the patient as an active economic agent who evaluates the benefits and costs for continuing with therapy .


We argue that a combination of loss aversion and mental accounting operations explains why patients discontinue with therapy at a specific point in time .


We designed a randomized laboratory economic experiment with a student subject pool to investigate the behavioral predictions .


Subjects continue with therapy as long as experienced utility losses have to be compensated .


As soon as previous losses are evened out , subjects perceive the marginal benefit of persistence lower than in the beginning of the treatment .


Consequently , subjects start to discontinue with therapy .


Our results highlight that concepts of behavioral economics capture the dynamic structure of medical nonpersistence better than does standard economic choice theory .


We recommend that behavioral economics should be a mandatory part of the development of possible intervention strategies aimed at improving patients ' compliance and persistence behavior .


The aim of this placebo-controlled study was to evaluate the effects of pulsed and continuous ultrasound treatments combined with splint therapy on patients with mild and moderate idiopathic carpal tunnel syndrome .


The study included @ carpal tunnel syndrome patients who were randomly divided into @ groups .


The first group ( n = @ ) received a @ W/cm@ ultrasound treatment ( placebo ) ; the second group ( n = @ ) received a @ W/cm@ continuous ultrasound treatment and the third group ( n = @ ) received a @ W/cm@ @:@ pulsed ultrasound treatment @ days a week for a total of @ sessions .


All patients also wore night splints during treatment period .


Pre-treatment and post-treatment Visual Analogue Scale , Symptom Severity Scale and Functional Status Scale scores , median nerve motor conduction velocity and distal latency and sensory conduction velocities of the median nerve in the @nd finger and palm were compared .


Clinicaltrials.gov : NCT@ .


There were significant improvements in all groups in terms of the post-treatment Functional Status Scale score ( p < @ for all groups ) , Symptom Severity Scale score ( first group : p < @ , second group : p < @ , third group : p < @ ) and Visual Analogue Scale score ( first and third groups : p < @ , second group : p < @ ) .


Sensory conduction velocities improved in the second and third groups ( p < @ ) .


Distal latency in the @nd finger showed improvement only in the third group ( p < @ ) and action potential latency in the palm improved only in the second group ( p < @ ) .


The results of this study suggest that splinting therapy combined with placebo and pulsed or continuous ultrasound have similar effects on clinical improvement .


Patients treated with continuous and pulsed ultrasound showed electrophysiological improvement ; however , the results were not superior to those of the placebo .


Information about symptomatic toxicities of anticancer treatments is not based on direct report by patients , but rather on reports by clinicians in trials .


Given the potential for under-reporting , our aim was to compare reporting by patients and physicians of six toxicities ( anorexia , nausea , vomiting , constipation , diarrhea , and hair loss ) within three randomized trials .


In one trial , elderly patients with breast cancer received adjuvant chemotherapy ; in two trials , patients with advanced non-small-cell lung cancer received first-line treatment .


Toxicity was prospectively collected by investigators ( graded by National Cancer Institute Common Toxicity Criteria -LSB- version @ -RSB- or Common Terminology Criteria for Adverse Events -LSB- version @ -RSB- ) .


At the end of each cycle , patients completed the European Organisation for Research and Treatment of Cancer quality-of-life questionnaires , including toxicity-related symptom items .


Possible answers were `` not at all , '' `` a little , '' `` quite a bit , '' and `` very much . ''


Analysis was limited to the first three cycles .


For each toxicity , agreement between patients and physicians and under-reporting by physicians ( ie , toxicity reported by patients but not reported by physicians ) were calculated .


Overall , @,@ patients ( @,@ cycles ) were included .


Agreement between patients and physicians was low for all toxicities .


Toxicity rates reported by physicians were always lower than those reported by patients .


For patients who reported toxicity ( any severity ) , under-reporting by physicians ranged from @ % to @ % .


Examining only patients who reported `` very much '' toxicity , under-reporting by physicians ranged from @ % to @ % .


Subjective toxicities are at high risk of under-reporting by physicians , even when prospectively collected within randomized trials .


This strongly supports the incorporation of patient-reported outcomes into toxicity reporting in clinical trials .


A randomized controlled trial showed that patients with grade III or IV internal hemorrhoids had similar symptomatic relief of symptoms up to @ months following dearterialization with mucopexy or hemorrhoidectomy albeit with less postoperative pain after the former .


This study aimed to compare hemorrhoidal recurrence and chronic complications at @-year follow-up .


This study was carried out on @ patients with grade III or IV internal hemorrhoids previously enrolled to a randomized trial comparing dearterialization to hemorrhoidectomy .


Recurrence was defined as internal hemorrhoids diagnosed on proctoscopy .


Chronic complications were nonresolving adverse events related to surgery .


Outcome measures included patient-reported outcomes and quality of life measured by brief pain inventory ( BPI ) , SF-@ , and fecal incontinence surveys .


At median follow-up of @ ( @-@ ) months , @ patients ( @ % ) were lost to follow-up .


Patient-reported outcomes suggested no difference between dearterialization and hemorrhoidectomy in persistent symptoms , occurring in @ ( @ % ) vs. @ ( @ % ) patients ( p = @ ) and in symptom recurrence , occurring in @ ( @ % ) vs. @ ( @ % ) patients ( p = @ ) .


On proctoscopy , recurrence was seen in @ ( @ % ) vs. @ ( @ % ) patients ( p = @ ) , all with index grade IV disease .


One patient in each arm required reoperation ( p = @ ) .


Chronic complications were not seen in the dearterialization arm while they occurred in @ ( @ % ) hemorrhoidectomy patients ( p = @ ) and included unhealed wound ( n = @ ) , anal fissure ( n = @ ) and fecal incontinence ( n = @ ) .


There was a trend toward more patient reported than actual recurrence on proctoscopy ( @ vs. @ , p = @ ) .


There was no difference in BPI , SF-@ , and fecal incontinence quality of life scores .


Recurrence rates did not differ significantly at @-year follow-up and occurred in patients with index grade IV hemorrhoids .


Chronic complications occurred only after hemorrhoidectomy .


Premature discontinuation of antidepressant drugs is a frequent clinical problem .


Adverse effects are common , occur early on in treatment and are reported to be one of the main reasons for discontinuation of antidepressant treatment .


To investigate the association between adverse effects occurring in the first @weeks of antidepressant treatment and discontinuation by @weeks as the outcome .


To investigate the time profile of adverse effects induced by the selective serotonin reuptake inhibitor citalopram and the noradrenaline reuptake inhibitor reboxetine over @weeks of treatment .


Six hundred andone depressed individuals were randomly allocated to either citalopram ( @mg daily ) or reboxetine ( @mg twice daily ) .


A modified version of the Toronto Side Effects Scale was used to measure @ physical symptoms at baseline ( medication free ) and at @ , @ and @weeks after randomisation .


Individuals randomised to reboxetine reported a greater number of adverse effects and were more likely to stop treatment than individuals receiving citalopram .


Dizziness ( OR @ ; @ % CI @ , @ ; p = @ ) and the total number of adverse effects ( OR @ ; @ % CI @ , @ ; p = @ ) reported at @weeks were associated with discontinuation from overall antidepressant treatment by @weeks .


Reports of adverse effects tended to reduce throughout the @weeks for both antidepressants .


The majority of adverse effects were not individually associated with discontinuation from antidepressant treatment .


Reports of physical symptoms tended to reduce over time .


The physical symptoms that did not reduce over time may represent symptoms of depression rather than antidepressant-induced adverse effects .


To compare the effect of slight and usual sedation on the prognosis and inflammatory marker levels in patients receiving mechanical ventilation in ICU .


We enrolled @ critically ill adult patients who were undergoing mechanical ventilation and were expected to need ventilation for more than @ h.


The patients were prospectively and randomly assigned to receive : slight sedation ( Richmond Agitation Sedation Score -@ to @ , n = @ patients ) or usual sedation ( Richmond Agitation Sedation Score -@ to -@ , n = @ patients ) .


Sedative dosages , duration of mechanical ventilation , length of ICU stay , complications ( ventilator-associated pneumonia , tracheotomy ) , adverse reactions ( accidental extubation , reintubation , barotrauma ) and levels of inflammatory markers on the day of sedation time for @ h were recorded .


When compared with the usual sedation group , duration of mechanical ventilation ( d ) ( @ @ vs @ @ , P < @ ) and length of ICU stay ( d ) ( @ @ vs @ @ , P < @ ) were significantly shorter in the slight sedation group .


The total doses of midazolam ( mg ) , propofol ( mg ) and fentany ( g ) were lower in the slight sedation group than those in the usual sedation group ( @ @ vs @ @ , @ @ @ @ vs @ @ @ @ and @ @ @ @ vs @ @ @ @ , P < @ ) .


Accidental extubation ( @ % vs @ % ) , reintubation ( @ % vs @ % ) and barotraumas ( @ % vs @ % ) showed no differences between the @ groups ( P > @ ) .


In the slight sedation group , the incidences of ventilator-associated pneumonia ( @ % vs @ % ) and tracheotomy ( @ % vs @ % ) were significantly decreased compared with those in the usual group .


The levels of IL-@ ( @ @ vs @ @ , P < @ ) ng/L , IL-@ ( @ @ vs @ @ , P < @ ) ng/L , TNF - ( @ @ vs @ @ , P < @ ) ng/L and CRP ( @ @ vs @ @ , P < @ ) mg/L were also lower in the slight sedation group than those in the conventional group .


There were no differences in ICU mortality and @ d-survival rate between the @ groups .


Slight sedation was shown to reduce the length of mechanical ventilation and ICU stay .


It also decreased the levels of inflammatory markers while did n't increase the incidence of adverse reactions .


Combination antiretroviral therapy ( ART ) for HIV-@-infected individuals prevents sexual transmission if viral load is suppressed .


Participants were HIV-@-infected partners randomized to early ART ( CD@ @-@ ) in HPTN@ ( n = @ , median follow-up = @ years ) , a clinical trial of early ART to prevent sexual transmission of HIV-@ in serodiscordant couples at @ sites in @ countries .


Adherence was assessed through pill count ( dichotomized at < @ % ) and through self-report items .


Predictors of adherence were mental health and general health perceptions , substance use , binge drinking , social support , sexual behaviors , and demographics .


Viral suppression was defined as HIV plasma viral load < @ copies per milliliter .


Adherence counseling and couples ' counseling about safer sex were provided .


Logistic and linear regression models using generalized estimating equation for repeated measurements were used .


Through pill count , @ % of participants were adherent at @ month and @ % at @ year .


Mental health was the only psychosocial variable associated with adherence -LSB- pill count , odds ratios ( OR ) = @ , @ % confidence intervals ( CIs ) : @ to @ ; self-report parameter estimate , OR = @ , @ % CI : @ to @ -RSB- , although regional differences emerged .


Pill count ( OR = @ , @ % CI : @ to @ ) and self-report ( OR = @ , @ % CI : @ to @ ) adherence were associated with viral suppression .


Although adherence was high among individuals in stable relationships taking ART for prevention , mental health and adherence covaried .


Assessing and intervening on mental health in the context of promoting adherence to ART as prevention should be explored .


Adherence and couples ' counseling , feedback about viral suppression , and/or altruism may also help explain the magnitude of adherence observed .


To compare the difference of clinical efficacy on sleeping disorder in the children with encephalopathy between the combined therapy of acupuncture at head points and seed-pressure at ear points and the simple acupuncture at head points .


Thirty cases of sleeping disorder induced by encephalopathy werei randomized into an observation group and a control group , @ cases in each one .


In the observation group , the combined therapy of acupuncture at head points and seed-pressure at ear points was adopted .


The head points in cluded Sishencong ( EX-HN @ ) , Shenting ( GV @ ) and Benshen ( GB @ ) .


The ear points were the positive reactive sites in the cymba and cavum conchae .


In the control group , acupuncture was applied simply to the acupoints on the head .


The treatment was given once on every Tuesday and Friday a week separately , @ min each time .


Totally , @ treatments were required .


Children 's sleeping habit questionnaire ( CSHQ ) was used to observe the sleep improvements and the efficacy in the patients of the two groups .


In the observation group , the results of sleep resistance , sleep anxiety , night sleep wake , parasomnias , sleep dyspnea , daytime somnolence and the total score after treatment were all improved apparently as compared with those before treatment ( all P < @ ) .


In the control group , the results of night sleep wake , parasomnias , daytime somnolence and the total score after treatment were improved apparently than those before treatment ( all P < @ ) .


In the observation group , the results of sleep resistance , sleep dyspnea and the total score after treatment were better than those in the control group ( all P < @ ) and the scores of sleep anxiety and daytime somnolence in the control group were better than those in the observation group after treatment ( both P < @ ) .


The combined therapy of acupuncture at head points and seed-pressure at the positive reactive sites in the cymba and cavum conchae achieves the superior efficacy on sleep resistance and sleep dyspnea as compared with the simple acupuncture .


The efficacy of simple acupuncture is more satisfactory on sleep anxiety and daytime somnolence .


Lenalidomide , a weak substrate of P-glycoprotein ( P-gp ) in vitro , is an oral anticancer drug eliminated predominantly via renal excretion as unchanged compound .


The role of P-gp in lenalidomide disposition and the associated clinical relevance were evaluated .


Two phase I , crossover studies were conducted in healthy volunteers .


In Study @ , subjects received lenalidomide ( @ mg @ days ) alone or with the P-gp substrate digoxin ( @ mg on Day @ ) .


In Study @ , subjects received lenalidomide ( a single @ mg dose ) alone , the P-gp inhibitor quinidine ( @-@ mg twice-daily @ days ) plus lenalidomide ( on Day @ ) , the P-gp inhibitor/substrate temsirolimus ( a single @ mg dose ) alone , or lenalidomide plus temsirolimus .


Pharmacokinetic and safety data were collected for lenalidomide and the co-administrated drugs .


There were no significant changes in the maximum concentration ( C max ) and area under the plasma concentration-time curve ( AUC ) of lenalidomide when co-administered with quinidine , digoxin , or temsirolimus .


Neither the rate nor the capacity of lenalidomide renal excretion was affected by quinidine or temsirolimus , in addition lenalidomide absorption rate and bioavailability remained unchanged .