` Being convinced that having no health problem makes the individual feel safe and not at risk of getting cancer ' was the major reason for not doing a routine health check-up .


The low levels of awareness about cancer , as well as the low use of the screening methods were crucial outcomes of this study .


Thus , raising the awareness among health care providers and policy makers in the country about older adults ' perception of cancer is a high priority .


Patients undergoing bariatric surgery are at high risk of postoperative nausea and vomiting ( PONV ) .


Despite triple PONV prophylaxis , up to @ % of patients require antiemetic rescue medication ( AERM ) .


This prospective , randomized study was conducted from November @ to October @ .


In the Classic group ( n = @ ) , patients underwent general anaesthesia with volatile anaesthetics and opioids .


In the Total i.v. anaesthesia ( TIVA ) group ( n = @ ) , patients underwent opioid-free TIVA with propofol , ketamine , and dexmedetomidine .


The severity of PONV was assessed using a Likert scale ( none , mild , moderate , and severe ) .


Patients in both groups had similar clinical characteristics , surgical procedure , and PONV risk scores and required similar amounts of postoperative opioid .


In the Classic group , @ patients ( @ % ) reported PONV compared with @ patients ( @ % ) in the TIVA group -LSB- P = @ ; risk @ ( @-@ @ ) -RSB- .


The absolute risk reduction was @ % ( number-needed-to-treat = @ ) .


The severity of nausea was statistically different in both groups ( P = @ ) .


The severity of PONV was significantly worse in the Classic group .


There was no difference either in the number of patients requiring AERM in the postoperative period or in the number of AERM doses required .


This prospective randomized study demonstrates that opioid-free TIVA is associated with a large reduction in relative risk of PONV compared with balanced anaesthesia .


Clinical trial registration NCT @ ( ClinicalTrials.gov ) .


Helicobacter pylori ( H pylori ) is strongly associated with the development of gastritis , duodenal and gastric ulcers , gastric mucosa-associated lymphoid tissue ( MALT ) lymphomas and gastric carcinoma .


Emerging antibiotic resistance and patients ' poor compliance with modern therapies have resulted in increasing eradication failure .


The current trial was conducted to evaluate the efficacy of current quadruple and phytomedicine-based therapies for the eradication of H pylori infection and relief of its associated symptoms in Pakistan .


The study was a randomized , controlled , multicenter clinical trial .


Setting The study was conducted in high-risk areas of Pakistan , including at Shifa-Ul-Mulk Memorial Hospital in Karachi , at Bahawalpur Victoria Hospital in Bahawalpur , and at Nawaz Salik Hospital in Rawalpindi .


The study enrolled @ patients who tested positive for H pylori , @ males and @ females .


Participants were divided into @ groups according to treatment regimens .


One group of participants received quadruple therapy-@ mg of omeprazole , @g of amoxicillin , @ mg of metronidazole , and @ mg of bismuth compound-that was prescribed for @ d , and another group received an alternate , phytomedicine-based , quadruple formulation-@ mg of Pylorex Plus-that was prescribed for @ d.


The eradication rate for H pylori was the primary outcome measure .


Eradication was considered to be achieved on the basis of a negative C-urea breath test ( UBT ) and a negative stool antigen test for H pylori ( HpSAg ) at @ wk after the end of treatment .


The secondary outcome measure was the improvement in the clinical features as assessed by dyspepsia scores .


In an intention-to-treat ( ITT ) analysis , the study found that H pylori was eradicated in @ of the @ participants in the quadruple therapy group who completed the study ( @ % ) and in @ of the @ participants in the Pylorex Plus group who completed the study ( @ % ) .


Therefore , Pylorex Plus had an eradication rate comparable with quadruple therapy .


However , Pylorex Plus had significantly reduced gastrointestinal ( GI ) symptoms at the second wk and at @ mo after treatment , both for participants in whom H pylori was eradicated and for those in whom it was not eradicated .


The quadruple therapy group also showed reduced GI symptoms at the second wk and at @ mo after treatment , but that result occurred only for those participants in whom H pylori was eradicated , and no significant improvement was observed for participants in whom it was not eradicated .


Current quadruple and alternate therapies yielded poor eradication rates ( < @ % ) , but the latter produced marked symptomatic improvement , both for participants in whom H pylori was eradicated and for those in whom it was not eradicated , pointing out its potential use with patients with functional dyspepsia ( FD ) who are both positive and negative for H pylori .


Effective communication is needed for optimal cancer pain management .


This study assessed the efficacy of a general communication skills training program for oncology nurses on communication about pain management .


A total of @ nurses were randomly assigned to a training group ( TG ) or control group ( CG ) .


The assessment included the recording of interviews with a simulated cancer patient at baseline for both groups and after training ( TG ) or @ months after baseline ( CG ) .


Two psychologists rated the content of interview transcripts to assess cancer pain management communication .


Group-by-time effects were measured using a generalized estimating equation .


Trained nurses asked the simulated patient more questions about emotions associated with pain ( relative rate -LSB- RR -RSB- = @ , p = @ ) and cognitions associated with pain treatment ( RR = @ , p < @ ) and used less paternalistic statements about cancer pain management ( RR = @ , p = @ ) compared with untrained nurses .


The general communication skills training program improved only a few of the communication strategies needed for optimal cancer pain management in nursing .


General communication skills training programs should be consolidated using specific modules focusing on communication skills related to cancer pain management .


Early and adequate atropine administration in organophosphorus ( OP ) or carbamate insecticide poisoning improves outcome .


However , some authors advise that oxygen must be given before atropine due to the risk of inducing ventricular dysrhythmias in hypoxic patients .


Because oxygen is frequently unavailable in district hospitals of rural Asia , where the majority of patients with insecticide poisoning present , this guidance has significant implications for patient care .


The published evidence for this advice is weak .


We therefore performed a patient cohort analysis to look for early cardiac deaths in patients poisoned by anticholinesterase pesticides .


We analysed a prospective Sri Lankan cohort of OP or carbamate-poisoned patients treated with early atropine without the benefit of oxygen for evidence of early deaths .


The incidence of fatal primary cardiac arrests within @ h of admission was used as a sensitive ( but non-specific ) marker of possible ventricular dysrhythmias .


The cohort consisted of @ patients .


The incidence of a primary cardiac death within @ h of atropine administration was @ ( @ % ) of @ patients .


The majority of deaths occurred at a later time point from respiratory complications of poisoning .


We found no evidence of a high number of early deaths in an observational study of @ patients routinely given atropine before oxygen that might support guidance that oxygen must be given before atropine .


The published literature indicates that early and rapid administration of atropine during resuscitation is life-saving .


Therefore , whether oxygen is available or not , early atropinisation of OP - and carbamate-poisoned patients should be performed .


Moderate acute malnutrition ( MAM ) , defined as weight-for-length z score between -@ and -@ or midupper arm circumference between @ and @ cm , affects @ million children aged < @ y worldwide .


The objective was to compare the effects of @ dietary supplements for the treatment of MAM .


Twelve community health centers in rural Mali were randomly assigned to provide to @ MAM children aged @-@ mo one of @ dietary supplements containing @ kcal/d for @ wk : @ ) ready-to-use , lipid-based supplementary food ( RUSF ) ; @ ) special corn-soy blend ( CSB + + ) ; @ ) locally processed , fortified flour ( Misola ) ; or @ ) locally milled flours plus oil , sugar , and micronutrient powder ( LMF ) .


In total , @ children ( @ % ) completed the study .


The adjusted mean ( @ % CI ) change in weight ( kg ) from baseline was greater with RUSF than with the locally processed blends and was intermediate with CSB + + -LSB- @ ( @ , @ ) for RUSF , @ ( @ , @ ) for CSB + + , @ ( @ , @ ) for Misola , and @ ( @ , @ ) for LMF ; P < @ -RSB- .


For length change , RUSF and CSB + + differed significantly from LMF .


Sustained recovery rates were higher with RUSF ( @ % ) than with Misola ( @ % ) and LMF ( @ % ) , P < @ ; CSB + + recovery rates ( @ % ) did not differ from any of the other groups .


RUSF was more effective , but more costly , than other dietary supplements for the treatment of MAM ; CSB + + yielded intermediate results .


The benefits of treatment should be considered in relation to product costs and availability .


To research the curative effect of Chinese herbs for clearing away heat , promoting diuresis , nourishing the kidney , and consolidating essence in children with Henoch-Schonlein purpura nephritis ( HSPN ) with internal accumulation of damp-toxin using randomized controlled observations on large samples .


To seek the mechanism of the therapy and its scope of indications .


Overall , @ children with HSPN were randomly divided into two groups : treatment group ( n = @ ) treated with Chinese herbs for clearing heat and promoting diuresis and a control group ( n = @ ) treated with Western Medicine .


The treatment was carried out for three courses of @ weeks each .


We recorded changes in patient urine routines , @ h urinary protein , blood-coagulating series , immunoglobulin and T-cell subgroups , and improvements in main symptoms .


We evaluated the alleviation of clinical symptoms and the improvement of proteinuria , hematuria , and other laboratory test results .


Finally , we analyzed the patient population suitable for this therapy according to the relationship between the grouping of patient body weight and curative effect .


Damp-heat syndrome improved in the treatment group , with a significant difference in total effective rate after a @-week treatment ( chi@ = @ , P = @ ) and in curative rate after a @-week treatment ( chi@ = @ , P = @ ) , compared to those in the control group .


The curative effect in the treatment group was greater than that in the control group but there was no statistical difference between the two groups .


The curative effect after a @-week treatment of patients in the treatment group weighing @ kg or less based on Traditional Chinese Medicine ( TCM ) signs and urinary protein was significantly greater than that in the control group .


However , there was no statistical difference in the curative effect on urinary red cells and various indexes after a @-week treatment between the two groups .


Therapy for clearing away heat , promoting diuresis , nourishing the kidney , and consolidating essence using TCM is effective in children with HSPN from internal accumulation of damp-toxin .


The therapy is especially suitable for patients weighing @ kg or less .


The curative effect may be related to the improvement of immune function and blood-coagulation .


Cognitive behavioural therapy ( CBT ) is recommended for the treatment of depression and anxiety .


However , access is limited .


Low-intensity approaches such as guided CBT self-help ( bibliotherapy ) can increase access to treatment and is recommended by UK guidelines .


No previous research has explored the provision of group-based guidance/support for a bibliotherapy approach for depression and anxiety in community settings .


The objective was to carry out a pilot study of a group guided self-help intervention , using community based recruitment methods .


A randomised controlled trial comparing an @week CBT group guided self-help intervention to usual care .


Recruitment and the delivery of the intervention were carried out in Glasgow and Derry/Londonderry in partnership with national depression charities .


Fifty-three people were randomised , however we refer only to the forty-six participants who provided baseline data : @ males and @ females , aged @ or over , with a PHQ-@ score of@ , were recruited from the community .


The mean age of the sample was @ ( sd = @ ) and @ % of participants had suffered from low mood for a year or more .


There was effective recruitment , randomisation , uptake and adherence with @ Immediate Access ( IA ) and @ Delayed Access Control ( DAC ) participants .


The intervention was highly acceptable to participants attending on average @ of the @ sessions ( sd @ ) , @ % attended more than half of all sessions .


The mean satisfaction on the Client Satisfaction Questionnaire was @ out of @ ( sd @ ) .


The provisional results in the pilot suggest the intervention may improve both anxiety and depression .


At three months , data collection was achieved from @ % of participants .


The trial successfully provided estimates of the sample size needed for the future planned trial .


Low-intensity group-based classes may offer an alternative method of managing depression and anxiety and warrant further research .


To compare larvicidal regimens of fenbendazole and moxidectin for reduction and suppression of cyathostomin fecal egg counts ( FEC ) in a transient herd of embryo transfer-recipient mares .


Randomized , complete block , clinical trial .


@ mares from @ states , residing on @ farm .


An initial fecal sample was collected from each mare ; mares with an FEC @ eggs/g were assigned to treatment groups .


Eighty-two horses received fenbendazole ( @ mg/kg -LSB- @ mg/lb -RSB- , PO , q @ h for @ days ) or moxidectin ( @ mg/kg -LSB- @ mg/lb -RSB- , PO , once ) ; FEC data were analyzed @ , @ , and @ days after treatment .


Mean FEC reduction was @ % for moxidectin-treated mares and @ % for fenbendazole-treated mares @ days after treatment .


By @ days , mean FEC of fenbendazole-treated mares exceeded pretreatment counts ; however , FECs of moxidectin-treated mares remained suppressed below pretreatment values for the duration of the @-day study .


Fecal egg counts were significantly different between groups at @ , @ , and @ days after treatment .


Failure of the @-day regimen of fenbendazole to adequately reduce or suppress FEC suggested inadequate adulticidal and larvicidal effects .


In contrast , a single dose of moxidectin effectively reduced and suppressed FEC for an extended period .


Given the diverse geographic origins of study mares , these results are likely representative of cyathostomin-infected mares in much of the United States , confirming previous findings indicating that fenbendazole resistance in cyathostomins is widespread and that moxidectin remains an effective treatment for control of these important parasites .


The aim of the present study was to investigate the effects of the consumption of two cloudy apple juices with different polyphenol and vitamin C contents on antioxidant status , cardiometabolic and inflammation markers in healthy young adults .


Twenty subjects , aged @-@ years , completed a randomized crossover study .


At each @-week intervention period , the volunteers randomly consumed two glasses ( @ @ mL/day ) of either a vitamin C-rich apple juice ( VCR ) ( @ mg/L vitamin C and @ mg catechin equivalent/L ) or a polyphenol-rich ( PR ) juice ( @ mg/L vitamin C and @ mg catechin equivalent/L ) .


Blood and urine samples were collected throughout the study , and markers of antioxidant status , glucose metabolism , lipid profile and inflammation were measured .


The comparison of the post-intervention minus pre-intervention change revealed differential results in HOMA index , total cholesterol , ICAM-@ and VCAM-@ ( P < @ ) across juices .


During the VCR period , plasma antioxidant activity ( FRAP ) increased ( P = @ ) , while ICAM-@ and total cholesterol showed a trend to decrease ( P = @ and P = @ , respectively ) .


During the PR period , plasma insulin and HOMA increased , and total glutathione decreased ( P < @ ) .


A joint consumption of apple juice natural antioxidants such as vitamin C and polyphenols might provide mild favorable effects on cardiometabolic markers , as compared to apple polyphenols alone .


To compare the differences of clinical effects on primary hypertension between acupuncture combined with auricular point sticking and western medicine .


Ninety patients with primary hypertension were randomly divided into a medication group and a combination group , @ cases in each group .


In the medication group , captopril tablets were treated with oral administration , @ mg each time , twice a day ; in the combination group , acupuncture and auricular point sticking were used , and acupuncture was applied at Renying ( ST @ ) , Fengchi ( GB @ ) and Baihui ( GV @ ) , while auricular point sticking was adopted at Shenmen ( TF@ ) , Xin ( CO@ ) , Jiangyagou and Jiaogan ( AH@a ) , once a day for continuous @ weeks .


After treatment , the changes of @ h ambulatory blood pressure , angiotensin II ( Ang II ) level , creatinine level and syndrome scores were observed and the clinical efficacy was assessed in the two groups .


After @ weeks ' treatment , the @ h ambulatory blood pressure was both improved compared with that before treatment in the two groups ( P < @ , P < @ ) .


The reducing of @ h ambulatory blood pressure in the combination group was superior to that in the medication group ( P < @ ) .


There were reducing tendencies about coefficients of variation ( CVs ) of the two groups , and in the combination group , the CVs of @ h ambulatory blood pressure and systolic pressure acquired more obvious reducing range compared with the medication group ( both P < @ ) .


Serum Ang II level and plasma creatinine level of the patients in the two groups after treatment were both decreased ( both P < @ ) and the reducing of Ang II level and creatinine level of the combination group was more obvious than that of the medication group ( both P < @ ) .


The syndrome scores of the two groups after treatment were both remarkably decreased ( both P < @ ) , and the reducing of the syndrome scores of the combination group was more marked than that of the medication group ( P < @ ) .


The total effective rate of the combination group was @ % ( @/@ ) , which was superior to @ % ( @/@ ) of the medication group ( P < @ ) .


Acupuncture combined with auricular point sticking for primary hypertension has reliable effect .


It is better than captopril for the improvement of @ h ambulatory blood pressure , AngII level and creatinine level , and can improve dizzy , palpitation and other clinical symptoms .


To evaluate the effects of fluoride varnish vs a combination of chlorhexidine-thymol varnish plus a gel containing chlorhexidine and fluoride on oral hygiene and caries prevention in disabled children .


Ninety patients aged @-@ years who were treated under general anaesthesia were randomly assigned into three groups as follows : group @ : Fluor Protector ( @ % fluoride varnish ) ; group @ : Cervitec Plus ( @ % chlorhexidine - @ % thymol varnish ) + Cervitec Gel ( @ % chlorhexidine-@ @ % sodium fluoride ) ; group @ : control ( toothbrushing only ) .


Mutans streptococci ( MS ) and lactobacilli ( LB ) levels , visible plaque index ( VPI ) and gingival bleeding index ( GBI ) were evaluated at four stages : T@ , before general anaesthesia ; T@ , one month after treatment ; T@ , six months after treatment ; T@ , twelve months after treatment .


The data were evaluated using Kruskal-Wallis and Mann-Whitney U-tests ( P < @ ) .


Groups @ and @ showed significantly lower scores than group @ for all parameters at T@ and T@ .


No statistically significant difference was detected among any of the the groups at T@ ( P > @ ) .


The use of materials that include both fluoride and chlorhexidine as routine treatment of children with disability may increase the success of restorations by improving oral hygiene , reduce the need for future restorative treatments and thus the need for general anaesthesia .


The Crohn 's Disease Activity Index ( CDAI ) is a measure of disease activity based on symptoms , signs and a laboratory test .


The US Food and Drug Administration has indicated that patient reported outcomes ( PROs ) should be the primary outcome in randomised controlled trials for Crohn 's disease ( CD ) .


As no validated PRO exists for CD , to investigate whether CDAI diary card items could be modified for this purpose .


Data from a trial of rifaximin-extended intestinal release were used to identify cut-points for stool frequency , pain and general well-being using receiver operating characteristic curves with CDAI < @ as criterion .


The operating properties of @ - and @-item PRO were evaluated using data from a trial of methotrexate in CD .


Regression analysis determined PRO@ and PRO@ scores that correspond to CDAI-defined thresholds of @ , @ and @ and changes of @ , @ and @ points .


Optimum cut-points for CDAI remission were mean daily stool frequency @ , abdominal pain @ , and general well-being score of @ ( areas under the ROC curve @ , @ and @ , respectively ) .


The effect estimates were similar using @ - and @-item PROs or CDAI .


PRO@ and PRO@ values corresponding to CDAI scores of @ , @ and @ points were @ , @ , @ and @ , @ , @ .


The corresponding values for CDAI changes of @ , @ and @ , were @ , @ , @ and @ , @ , @ .


Responsiveness to change was similar for both PROs .


Patient reported outcomes derived from CDAI diary items may be appropriate for use in clinical trials for CD .


To determine whether the use of a paclitaxel-coated balloon ( PCB ) improves patency in patients undergoing percutaneous transluminal angioplasty ( PTA ) for recurrent juxtaanastomotic stenosis of radiocephalic arteriovenous fistulas ( RCAVFs ) .


This prospective study recruited hemodialysis patients with two short ( < @ cm ) and separated inflow RCAVF lesions .


After dilation of lesions using a @-mm plain balloon ( PB ) , half of the lesions were randomly selected for treatment with PTA using PCB ( size , @ mm ; length , @ cm ) and PB ( size , @-mm or @-mm ) ( group @ ) , and the other half were treated with PTA using PB alone ( group @ ) .


After the index PTA , dysfunction-driven angiography was performed to confirm target lesion restenosis ( TLR ) .


TLR and lesion patency were compared in the two groups by ( @ ) test , t test , and Kaplan-Meier analysis .


The analysis of @ lesions in @ patients revealed that the TLR-free duration in group @ was significantly longer than the TLR-free duration in group @ ( @ d vs @ d ; P < @ ) .


The patency rate of the target lesion was significantly higher in group @ than in group @ at @ months ( @ % vs @ % ; P < @ ) but not at @ months ( @ % vs @ % ; P > @ ) .


This early study suggests that , for improving short-term patency , PTA with PCB and PB is more effective than PTA with PB alone , warranting further study .


Olfaction plays an important role in mammalian social behavior .


Olfactory deficits are common in schizophrenia and correlate with negative symptoms and low social drive .


Despite their prominence and possible clinical relevance , little is understood about the pathological mechanisms underlying olfactory deficits in schizophrenia and there are currently no effective treatments for these deficits .


The prosocial neuropeptide oxytocin may affect the olfactory system when administered intranasally to humans and there is growing interest in its therapeutic potential in schizophrenia .


To examine this model , we administered @IU of oxytocin and placebo intranasally to @ patients with a schizophrenia spectrum illness and @ age-matched healthy control participants in a randomized , double-blind , placebo-controlled , cross-over study .


On each test day , participants completed an olfactory detection threshold test for two different odors : ( @ ) lyral , a synthetic fragrance compound for which patients with schizophrenia have specific olfactory detection threshold deficits , possibly related to decreased cyclic adenosine @ ' ,@ ' - monophosphate ( cAMP ) signaling ; and ( @ ) anise , a compound for which olfactory detection thresholds change with menstrual cycle phase in women .


On the placebo test day , patients with schizophrenia did not significantly differ from healthy controls in detection of either odor .


We found that oxytocin administration significantly and selectively improved olfactory detection thresholds for lyral but not for anise in patients with schizophrenia .


In contrast , oxytocin had no effect on detection of either odor in healthy controls .


Our data indicate that oxytocin administration may ameliorate olfactory deficits in schizophrenia and suggest the effects of intranasal oxytocin may extend to influencing the olfactory system .


Given that oxytocin has been found to increase cAMP signaling in vitro a possible mechanism for these effects is discussed .


Group reminiscence therapy is a brief and structured intervention in which participants share personal past events with peers .


This approach has been shown to be promising for improving wellbeing and reducing depressive symptoms among institutionalized older adults .


However , despite the considerable interest in reminiscence group therapy , controlled studies to determine its specific benefits as compared to generic social interactions with peers ( group conversations about everyday subjects ) are still lacking .


We have designed a randomized controlled trial aimed at comparing the effects of group reminiscence therapy with those of group recreational activity on the psychological wellbeing of an institutionalized sample of older adults .


The study includes two groups of @ hospitalized elderly participants : the experimental group and the control group .


Participants included in the experimental group will receive six sessions of group reminiscence therapy , while the control group will participate in a recreational group discussion .


A repeated-measures design will be used post-intervention and three months post-intervention to evaluate changes in self-reported outcome measures of depressive symptoms , self-esteem , life satisfaction , and quality of life from baseline .


The protocol of a study aimed at examining the specific effects of group reminiscence therapy on psychological wellbeing , depression , and quality of life among institutionalized elderly people is described .


It is expected that the outcomes of this trial will contribute to our knowledge about the process of group reminiscence , evaluate its effectiveness in improving psychological wellbeing of institutionalized individuals , and identify the best conditions for optimizing this approach .


Elevated serum low-density lipoprotein ( LDL ) cholesterol is a predictor of cardiovascular disease events , and the quality of dietary fat is known to influence serum concentrations of LDL cholesterol in children .


Interindividual differences in response to diet exist , but the underlying genetic factors remain largely unknown .


We aimed to identify genetic variants that modify the variation in serum lipid response to dietary fat quality .


We used data from @ longitudinal Finnish cohorts designed to study risk factors for cardiovascular diseases .


Large-scale genotyping was performed with Metabochip in a long-term randomized controlled dietary intervention trial , the Special Turku Coronary Risk Factor Intervention Project ( STRIP ) , for discovery of genetic polymorphisms .


The observational Cardiovascular Risk in Young Finns Study ( YFS ) with genome-wide genetic data was used as a replication sample for the initial findings .


Dietary records were used to calculate the ratio of unsaturated to saturated fats .


Interaction models and multiple follow-ups were used in the analysis .


In the STRIP cohort , a variant within the PARK@ locus , rs@ , showed moderate interaction with dietary fat quality and a consistent direction of effect in both scans on serum LDL-cholesterol concentration in children aged @ and @ y ( P < @ and P < @ , respectively ) .


In the YFS cohort , we were unable to replicate the initial discovery signal , but rs@ within the PARK@ locus and dietary lipid quality had a stronger interaction effect on serum LDL-cholesterol concentration ( P < @ @ ( -@ ) ) than did rs@ in children aged @ y.


This genotyping study involving @ cohorts of healthy Finnish children indicates a possible interaction between PARK@ variants and dietary fat quality on serum LDL-cholesterol concentration .


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


To compare the efficacy of panretinal photocoagulation ( PRP ) and intravitreal ranibizumab injection with PRP alone in patients with treatment-naive bilateral non-high-risk proliferative diabetic retinopathy .


Sixty eyes of @ patients were randomized either to the study group ( SG ) receiving PRP plus @ ranibizumab injections or to the control group ( CG ) receiving PRP alone .


Mean change in best-corrected visual acuity and in optical coherence tomography were compared at baseline and @ , @ , and @ months .


Best-corrected visual acuity was significantly better at @ months in the SG ; however , there was decrease in best-corrected visual acuity in the CG .


Central macula thickness decreased significantly at @ months in SG when compared with baseline ( -@ m , P < @ ) and did not reveal significant difference in the CG .


In eyes with diabetic macular edema , best-corrected visual acuity increased by @ letters ( P = @ ) in the SG and decreased by @ letters in the CG ( P = @ ) .


Central macula thickness decreased by @ m ( P = @ ) in the SG and decreased by @ m ( P = @ ) in the CG .


Intravitreal ranibizumab in combination with PRP can be an effective treatment in eyes with non-high-risk proliferative diabetic retinopathy and diabetic macular edema .


Central blood pressure ( CBP ) and carotid intima-media thickness ( CIMT ) are surrogate measures of cardiovascular risk .


Allopurinol reduces serum uric acid and oxidative stress and improves endothelial function and may therefore reduce CBP and CIMT progression .


This study sought to ascertain whether allopurinol reduces CBP , arterial stiffness and CIMT progression in patients with ischaemic stroke or transient ischaemic attack ( TIA ) .


We performed a randomised , double-blind , placebo-controlled study , examining the effect of @-year treatment with allopurinol ( @mg daily ) , on change in CBP , arterial stiffness and CIMT progression at @year and change in endothelial function and circulating inflammatory markers at @months .


Patients aged over @years with recent ischaemic stroke or TIA were eligible .


Eighty participants were recruited , mean age @ years ( SD @ ) .


Systolic CBP -LSB- -@ mmHg ( @ % CI -@ to -@ ) , p = @ -RSB- and augmentation index -LSB- -@ % ( @ % CI -@ to -@ ) , p = @ -RSB- were each lower following allopurinol treatment compared with placebo at @months .


Progression in mean common CIMT at @year was less in allopurinol-treated patients compared with placebo -LSB- between-group difference -LSB- -@ mm ( @ % CI -@ to -@ ) , p = @ -RSB- .


No difference was observed for measures of endothelial function .


Allopurinol lowered CBP and reduced CIMT progression at @year compared with placebo in patients with recent ischaemic stroke and TIA .


This extends the evidence of sustained beneficial effects of allopurinol to these prognostically significant outcomes and to the stroke population , highlighting the potential for reduction in cardiovascular events with this treatment strategy .


Malnutrition is a common complication in patients at the palliative stage of cancer .


During the curative phase of cancer , optimal enteral or parenteral nutrition intake can reduce morbidity and mortality , and improve quality of life .


When the main goal of treatment becomes palliative , introduction of artificial nutrition is controversial .


Although scientific societies do not recommend the introduction of artificial nutrition in all cases of malnutrition , especially in hypophagic patients if their life expectancy is shorter than @ months , considerable differences in the use of parenteral nutrition in nonsurgical oncology practice are noted around the world .


One explanation is a paucity of well-conducted randomized controlled trials in these situations , and consequently , the risk/benefit ratio of parenteral nutrition and its impact on quality of life in palliative care remains uncertain .


The ALIM-K study is a French national multicenter randomized controlled trial designed to evaluate the effectiveness of parenteral nutrition , versus an exclusive oral-feeding supply , on the quality of life of malnourished patients who have a functional digestive tube and who are at the palliative phase of advanced cancer with a life expectancy of more than @ months .


This article presents the methodologic options chosen for our study , and in particular , the choice of the Zelen method of randomization , the definition of the main end point ( quality of life ) , the choice of comparator ( oral feeding ) , and the inclusion criteria ( life expectancy of more than @ months ) , which are all critical points in building a randomized controlled trial in the setting of palliative care .


Hospital cooling improves outcome after cardiac arrest , but prehospital cooling immediately after return of spontaneous circulation may result in better outcomes .


To determine whether prehospital cooling improves outcomes after resuscitation from cardiac arrest in patients with ventricular fibrillation ( VF ) and without VF .


A randomized clinical trial that assigned adults with prehospital cardiac arrest to standard care with or without prehospital cooling , accomplished by infusing up to @ L of @C normal saline as soon as possible following return of spontaneous circulation .


Adults in King County , Washington , with prehospital cardiac arrest and resuscitated by paramedics were eligible and @ patients ( @ with VF and @ without VF ) were randomized between December @ , @ , and December @ , @ .


Patient follow-up was completed by May @ , @ .


Nearly all of the patients resuscitated from VF and admitted to the hospital received hospital cooling regardless of their randomization .


The primary outcomes were survival to hospital discharge and neurological status at discharge .


The intervention decreased mean core temperature by @ C ( @ % CI , -@ C to -@ C ) in patients with VF and by @ C ( @ % CI , -@ C to -@ C ) in patients without VF by hospital arrival and reduced the time to achieve a temperature of less than @C by about @ hour compared with the control group .


However , survival to hospital discharge was similar among the intervention and control groups among patients with VF ( @ % -LSB- @ % CI , @ % -@ % -RSB- vs @ % -LSB- @ % CI , @ % -@ % -RSB- , respectively ; P = @ ) and among patients without VF ( @ % -LSB- @ % CI , @ % -@ % -RSB- vs @ % -LSB- @ % CI , @ % -@ % -RSB- , respectively ; P = @ ) .


The intervention was also not associated with improved neurological status of full recovery or mild impairment at discharge for either patients with VF ( @ % -LSB- @ % CI , @ % -@ % -RSB- of cases had full recovery or mild impairment vs @ % -LSB- @ % CI , @ % -@ % -RSB- of controls ; P = @ ) or those without VF ( @ % -LSB- @ % CI , @ % -@ % -RSB- of cases vs @ % -LSB- @ % CI ,@ % -@ % -RSB- of controls ; P = @ ) .


Overall , the intervention group experienced rearrest in the field more than the control group ( @ % -LSB- @ % CI , @ % -@ % -RSB- vs @ % -LSB- @ % CI , @ % -@ % -RSB- , respectively ; P = @ ) , as well as increased diuretic use and pulmonary edema on first chest x-ray , which resolved within @ hours after admission .


Although use of prehospital cooling reduced core temperature by hospital arrival and reduced the time to reach a temperature of @C , it did not improve survival or neurological status among patients resuscitated from prehospital VF or those without VF .


Improving management of patients suffering from cerebral malaria is needed to reduce the devastating mortality and morbidity of the disease in endemic areas .


Intravenous artesunate is currently the first-line treatment , but the lack of material and skills in the field make it difficult to implement in endemic areas .


Intranasal route provides a very easy and direct gateway to blood and brain to deliver medications , by-passing the brain blood barrier .


Therefore , it could be helpful and suitable to administer artesunate in the context of cerebral malaria , especially in young children .


In this study , intranasal administration of artesunate to rescue from cerebral malaria using a murine model was tested .


CBA/J mice infected with Plasmodium berghei ANKA strain received artesunate ( @ mg/kg ) or a placebo solution intranasally , either on day @ , @ or @ post-infection , during a controlled , blinded , randomized trial .


Primary endpoint was mortality on day @ post-infection .


Secondary endpoints were parasitaemia and clinical stage .


Pharmacokinetics data following administration were collected in blood and brains of treated mice .


Local toxicity was evaluated by histopathologic examination of brain and nasal sections in blinded manner .


Intranasal administration of artesunate dramatically reduced the mortality rate ( p < @ ) , preventing death in most cases .


Parasitaemia loads decreased by @ % ( @-@ % ) within @ hours after administration .


Symptoms of cerebral malaria were prevented or reversed .


Dihydroartemisinin was detected in mice blood and brain within @ minutes of intranasal administration .


No direct nasal or brain toxicity was detected .


Intranasal delivery is an efficient route to timely and efficiently administer artesunate and therefore may contribute to decreasing malaria-related mortality .


There is concern about public understanding of overdiagnosis in breast cancer screening , and uncertainty about the likely impact on screening participation .


In a population-based survey of @ women , we assessed understanding of overdiagnosis and screening intentions before and after exposure to an explanation of overdiagnosis , and one of the three information formats providing an estimate of the rate of overdiagnosis based on the findings of the UK Independent Review .


Subjective and objective comprehension of overdiagnosis was moderate across information formats ( @ % and @ % , respectively ) .


Following overdiagnosis information , @ % of women showed a decrease in screening intention , with a stronger effect among women below screening age ( < @ years ) , and receiving the estimate of the rate of overdiagnosis in a simple ratio format ( one life saved to three overdiagnoses ) .


Brief written information on overdiagnosis was incompletely understood , but reduced breast screening intentions in a proportion of women , regardless of comprehension .


Subjective comprehension was lower among women who had not yet reached screening age but the deterrent effect was higher .


Tetrahydrobiopterin ( BH@ ) , a cofactor of nitric oxide synthase , might have a role in the treatment of portal hypertension ( PHT ) as its administration improves endothelial nitric oxide generation and hepatic endothelial dysfunction , and reduces portal pressure in experimental models of cirrhosis .


Sapropterin is an oral synthetic analogue of BH@ recently approved for the treatment of phenylketonuria .


This study evaluated the safety and effects of sapropterin on hepatic and systemic hemodynamics in patients with cirrhosis and PHT .


Forty patients with cirrhosis and PHT ( hepatic venous pressure gradient ( HVPG ) @mmHg ) were randomly allocated to receive sapropterin ( n = @ ) for @ weeks ( @mg/kg/day increased to @ at day @ ) or placebo ( n = @ ) in a double-blind multicenter clinical trial .


Randomization was stratified according to concomitant treatment with - adrenergic blockers .


We studied at baseline and post-treatment splanchnic ( HVPG and hepatic blood flow ( HBF ) ) and systemic hemodynamics , endothelial dysfunction and oxidative stress markers ( von Willebrand factor and malondialdehyde ) , liver function tests , and safety variables .


HVPG was not modified by either sapropterin ( @ vs. @ mmHg ) or placebo ( @ vs. @ mmHg ) .


HBF , systemic hemodynamics , endothelial dysfunction markers , and liver function tests remained unchanged .


Sapropterin was well tolerated ( no patient required dose adjustment or withdrawal ) , and adverse events were mild and similar between groups .


Sapropterin , an oral synthetic analogue of BH@ , at the used dose did not reduce portal pressure in patients with cirrhosis .


Sapropterin was safe and no serious adverse effects or deleterious systemic hemodynamic effects were observed .


Multiple sclerosis ( MS ) is the most common cause of progressive neurological disability .


The prevalence of MS is much more common in women than men .


The women are exposed to a variety of symptoms including fatigue .


Acupressure is a noninvasive procedure that can be used to control symptoms including fatigue .


The aim of the study was to evaluate the effect of acupressure on fatigue in women with multiple sclerosis .


A randomized clinical trial was conducted on @ women with MS at Tehran MS Association .


The subjects were equally allocated to experimental group and a placebo group ( @ women per group ) by blocking randomization method .


The experimental group were received acupressure , at the true points ( ST@ , SP@ , LI@ ) and the placebo group , were received touching at the same points .


Fatigue was measured by a Fatigue Severity Scale ( FSS ) in the groups at immediately prior to , two and four weeks after the beginning of the intervention .


The data was analyzed using descriptive and inferential statistics by SPSS version @ .


The findings indicated no differences in demographic characteristics and the severity of fatigue at the baseline in two groups ( p = @ ) .


But there were significant reductions of the mean score of fatigue in the experimental group compared to the placebo group immediately , two and four weeks after the intervention respectively ( p = @ , p ?


@/@ , p = @ ) .


According to the findings , the study provided an alternative method for health care providers including nurses to train acupressure to the clients with MS to managing their fatigue .


Intra-articular injection of local anaesthetics is a technique commonly used to enhance postoperative analgesia following arthroscopic surgery .


However , the potential for cartilage damage due to toxicity of intra-articular local anaesthetics is a concern .


Most studies indicate that the toxic effect is drug and time dependent .


The objective of this study is to compare the in-vitro chondrotoxic effect of levobupivacaine on human cartilage with saline and bupivacaine .


An experimental study .


University hospital .


Adult patients undergoing knee surgery .


Human articular cartilage was harvested and removed from five patients during knee replacement surgery .


Chondrocytes were cultured and divided into three groups exposed to bupivacaine @ % , levobupivacaine @ % or physiological saline for @ , @ or @min .


Viability of human cartilage cells after contact with the different study drugs at different durations of exposure using two techniques : live/dead cell viability flow cytometry analysis and trypan blue exclusion assay .


At @h of exposure , chondrocyte mortality in cartilage explants was significantly greater after treatment with levobupivacaine or bupivacaine than with saline ( @ % @ , @ % @ and @ % @ , respectively ) .


No differences between groups were found when exposure to the experimental drug was limited to @ or @min .


In-vitro @ % levobupivacaine is more chondrotoxic than saline in human articular cartilage after @h of exposure .


Bupivacaine seems to be less chondrotoxic than levobupivacaine .


With shorter exposures , no clear chondrotoxic effect was shown .


To examine the efficacy and safety of combined phaco-trabeculectomy in patients with cataract and controlled , open-angle advanced glaucoma and to identify preoperative predictive factors of postoperative glaucoma course .


Departments of Ophthalmology , University of Athens , and General Hospital of Lamia , Greece .


Prospective , interventional , parallel , cluster ( units = examinations ) , randomized clinical study .


@ patients with visually significant cataract , visual field Mean Deviation ( MD ) worse than -@ dB , and preoperative intraocular pressure ( IOP ) , controlled ( consistently below @ mmHg ) on topical medications and with no previous ocular surgery , were randomly allocated ( @:@ ) to phacoemulsification alone or phaco-trabeculectomy group .


Intention-to-treat analysis was performed to compare the postoperative outcome and adjusted multivariate longitudinal linear regression analysis was performed to identify predictive factors of the main outcome measures , with postoperative visual field MD change up to two years postoperatively .


Participant recruiters and data collectors were masked to group assignment .


@ and @ patients were randomized to phacoemulsification alone and phaco-trabeculectomy groups , respectively .


Patients assigned to the phaco-trabeculectomy group experienced a @ mmHg -LSB- @ % CI : -@ to -@ -RSB- reduction in IOP , a @ dB -LSB- @ % CI : -@ to @ -RSB- improvement in visual fields MD , a @ -LSB- @ % CI : -@ to -@ -RSB- reduction in the number of glaucoma medications needed postoperatively , while the visual acuity improvement was similar between the two groups .


Best predictors for visual field MD : degree of nuclear sclerosis , relative afferent pupilary defect ( RAPD ) , preoperative MD deviation from -@ dB and preoperative cup-disc ratio deviation from @ .


The phacoemulsification group experienced more IOP spikes ( > @ mmHg ) with Odds Ratio ( OR ) of @ -LSB- @ % CI : @-@ @ -RSB- .


No patient lost light perception .


Phaco-trabeculectomy in advanced , controlled , open-angle glaucoma patients with cataract results in better postoperative visual field MD with no major adverse events .


To evaluate the effects of orally administered dehydrated garlic powder on cytokine excretion in the urinary tract .


A total of @ healthy volunteers , randomized into @ groups , were given a single oral dose of @ g or @ g of dehydrated garlic powder or placebo .


Urine samples were obtained @ and @ h after garlic intake and assayed for interleukin-@ ( IL-@ ) , interleukin - @ ( IL-@ ) , tumor necrosis factor-alpha ( TNF - ) , diallyl disulfide ( DADS ) and diallyl sulfide ( DAS ) .


Significant increases in IL-@ levels over baseline were noted in urine samples obtained after oral intake of @ g and @ g of garlic powder ( P < @ ) .


In the @ g and @ g garlic powder treatment groups , time-dependent variations in IL-@ levels over the study period were significantly different from the placebo group ( P < @ ) .


In both garlic treatment groups , urinary levels of IL-@ and TNF - were not significantly different from baseline and placebo levels ( P > @ ) .


DADS and DAS were not detected in the urine samples at any time after garlic powder intake .


Oral intake of doses of garlic traditionally used for daily supplementation increases urinary levels of IL-@ , which is a potent stimulator of T helper cell @ ( Th-@ ) immune responses .


This observation encourages further studies investigating the immunostimulatory role of garlic in the urinary tract .


Greater exposure to an orosensory cue could increase habituation rate .


This investigation examined salivary habituation during @ lemon juice trials providing exposure via olfactory , gustatory , and combined systems .


Healthy , normal-weight , unrestrained females ( age = @ @ year , body mass index -LSB- BMI -RSB- = @ @ kg/m ( @ ) , @ % white ) were randomly assigned to @ of @ conditions : olfactory ( SMELL : n = @ ) , gustatory ( TASTE : n = @ ) , or olfactory + gustatory ( SMELL+TASTE : n = @ ) .


All conditions completed @ , @-minute , trials ( trials @-@ : water -LSB- baseline -RSB- ; trials @-@ : lemon juice ) , in which salivation was measured .


In conditions with taste exposure , @ ml of the stimulus was placed on the tongue .


In conditions with smell exposure , @ g of the stimulus was held @ in from the nose .


Salivation was measured using dental rolls and mean salivation of every two trials was the dependent variable .


A mixed-factor ANCOVA , controlling for baseline differences between the conditions in lemon juice hedonics , found a significant ( p < @ ) interaction of condition x trial .


SMELL+TASTE significantly ( p < @ ) increased salivation from baseline to lemon juice exposure , and decreased salivation by the last two mean trials .


TASTE had a significant ( p < @ ) increase in salivation from baseline to lemon juice , with no decrease .


Repeated exposure to an orosensory cue by combined olfactory and gustatory systems produced a faster habituation rate than exposure by the gustatory system alone .


Thus , food cues that combine exposure to the olfactory and gustatory systems may enhance satiation .


To study the effectiveness of sublingual misoprostol for cervical ripening before MVA in women aged between @ and @ years old .


Women aged between @ and @ years old who had indications for endometrial sampling were recruited .


Exclusion criteria were gross pathology of cervix , pregnancy , allergy to misoprostol , and abnormal coagulopathy .


Eighty women who had indication for MVA were then assigned by randomization ( block of four ) .


Participants were treated with either sublingual @ microg of misoprostol ( study group ) or placebo ( controlled group ) for cervical priming at two hours before procedure .


The largest diameter of the Hegar 's dilator through internal so without any resistance before MVA was the primary collected data .


Secondary data were operating time , immediate pain score , satisfactory score , complications , and side effects .


Mean age of misoprostol and controlled group were @ + / - @ and @ + / - @ years old , respectively .


One third of both groups had previously experienced uterine curettage .


The initial cervical diameter before MVA of individuals receiving misoprostol and controlled group were @ + / - @ and @ + / - @ mm , respectively .


The MVA time in misoprostol group was significantly shorter than controlled group ( @ + / - @ vs. @ + / - @ min , p < @ ) .


The additional analgesia was not different in both groups .


Side effect before MVA were more significantly found in misoprostol group ( p = @ ) .


Lower post MVA pain and satisfactory score were better reported in misoprostol group than placebo 's ( p < @ ) .


Two hundred micrograms of sublingual misoprostol administration prior to MVA gave significantly effective result of cervical priming .


Satisfactory and pain scores were more favorable in misoprostol group with manageable side effects .


To observe the effect of Qingfei Peiyuan Micro-pill ( QPM ) on HIV/AIDS patients with pulmonary infection of phlegm heat obstructing lung syndrome ( PHOLS ) .


Totally @ HIV/AIDS patients with pulmonary infection of PHOLS were randomly assigned to the treatment group ( @ cases ) and the control group ( @cases ) .


On the basis of Western medicine , patients in the treatment group took QPM .


The therapeutic course for all was @ days .


The improvement of symptoms and signs was observed .


The body temperature ( BT ) , chest X ray , and white blood cells ( WBCs ) were detected .


The Chinese medical syndrome score was lower in the treatment group than in the control group at the @th , @st , and @th day of treatment , showing statistical difference ( P < @ ) .


The efficacy was better in the treatment group than in the control group at the @th , @st , and @th day of treatment , showing statistical difference ( P < @ ) .


The BT was lower in the treatment group than in the control group on the @th day .


There was no statistical difference in the patient number with normal WBCs on the @th day ( P > @ ) .


But there was statistical difference in the patient number with normal WBCs on the @th , @st , and @th day of treatment ( P < @ ) .


There was no statistical difference in the patient number with normal chest X ray on the @th and @th day of treatment ( P > @ ) .


But there was statistical difference in the patient number with normal chest X ray on the @th and @ st day of treatment ( P < @ ) .


QPM had certain complementary effect on HIV/AIDS patients with pulmonary infection of PHOLS .


Bone allografts used for interbody spinal fusion are often preserved through either freeze drying or lowtemperature freezing , each having disadvantages related to graft preparation time and material properties .


In response , a glycerol preservation treatment has been developed to maintain the biomechanical properties of allografts at ambient temperatures , requiring no thawing or rehydration and minimal rinsing prior to implantation .


The authors conducted a prospective randomized study to compare the clinical results of glycerol-preserved Cloward dowels and those of freezedried Cloward dowels in anterior cervical discectomy and fusion .


The primary outcome measures were evidence of fusion and graft subsidence , and the secondary outcome measures included adverse events , pain , and neck disability scores .


Of @ patients , @ ( @ levels of surgery ) were randomly assigned to the glycerol-preserved graft group and @ ( @ levels of surgery ) to the freeze-dried graft group .


Subsidence was assessed at @ and @ months after implantation .


Evidence of fusion was evaluated radiographically at @ months postimplantation .


Subsidence was quantitatively assessed based on physical measurements obtained from radiographs by using calibrated comparators , whereas fusion was also evaluated visually .


Surgeons were blinded to treatment type during visual and physical assessments of the patients and the radiographs .


No one in either group had evidence of complete nonunion according to radiographic evaluation at the @-month follow-up .


Average subsidence for all graft-treated levels was @ mm for the glycerol-preserved group and @ mm for the freeze-dried group at the @-month follow-up and @ and @ mm at the @-month follow-up , respectively .


The @ treatment groups were statistically equivalent ( p = @ and @ for the @ - and @-month follow-up , respectively ) .


No differences were noted between the graft types in terms of adverse event incidence or severity .


Glycerol-preserved bone allografts exhibit fusion results and subsidence values similar to those of their freeze-dried counterparts , potentially more favorable biomechanical properties , and significantly shorter preparation times .


To compare the variations of cardiovascular responses and vascular angiotensin II ( AngII ) in hypertensive patients during tracheal intubation with intubating laryngeal mask airway ( ILMA ) versus direct laryngoscope ( DLS ) .


A total of @ hypertensive patients undergoing abdominal surgery were randomly divided into @ groups , i.e.intubating laryngeal mask airway ( Group I ) and direct laryngoscope ( Group D ) .


Variations of invasive arterial blood pressure and angiotensin II were compared between two groups before and after intubation .


The variations of cardiovascular responses and vascular angiotensin II ( AngII ) during tracheal intubation used of ILMA ( T@ ) and DLS ( T@ ) in an instant , tracheal intubation were immediately accomplished in two groups ( T@ ) .


The variations of group I were significantly lower than those of group D ( P < @ ) .


And statistical significance existed between two groups .


Tracheal intubation with intubating laryngeal mask airway ( ILMA ) can significantly reduce violent cardiovascular reactions and avoid cardiovascular accidents .


Bacterial vaginosis ( BV ) is the most common reason for abnormal vaginal discharge in reproductive-age women and one of its most important causative agents is the gram-variable bacterium Gardnerella vaginalis .


BV is not accompanied by significant local inflammation , whereas the `` fishy odor '' test is always positive .


In contrast , aerobic vaginitis ( AV ) is predominantly associated with Escherichia coli , but Streptococcus agalactiae and Staphylococcus aureus are also involved .


Standard treatment of BV consists of oral or intravaginal antibiotics , although these are unable to spontaneously restore normal flora characterized by a high concentration of lactobacilli .


The main limitation is the inability to offer a long-term defensive barrier , thus facilitating relapses and recurrences .


This study was undertaken firstly to assess the ability of selected lactobacilli to in vitro antagonize G. vaginalis to determine an association with a strain able to inhibit E. coli , thus identifying a possible use in AV .


The second step of the study was to conduct a human pilot trial in women affected by BV using an association of the most promising and active bacteria .


For this purpose , neutralized supernatants of individual lactobacilli were tested at percentages ranging from @ % to @ % to determine their ability to hinder the growth of G. vaginalis American Type Culture Collection @ .


The bacterium that was able to exert the strongest inhibition was subsequently tested with Lactobacillus plantarum LP@ in a human intervention , placebo-controlled , pilot trial involving @ female subjects ( aged between @ and @ , mean @ , no menopausal women ) diagnosed with BV .


The @ microorganisms Lactobacillus fermentum LF@ ( DSM @ ) and L. plantarum LP@ ( LMG P-@ ) were delivered to the vagina by means of slow-release vaginal tablets , also containing @ mg of tara gum .


The amount of each strain was @ million live cells per dose .


The women were instructed to apply a vaginal tablet once a day for @ consecutive nights , followed by @ tablet every @ nights for a further @-week application ( acute phase ) and , finally , @ tablet per week to maintain a long-term vaginal colonization against possible recurrences .


A clinical examination was performed and the Nugent score was quantified for each patient at enrollment ( d@ ) , after @ days ( d@ ) , and at the end of the second month of relapse prevention ( d@ ) .


A statistical comparison was made between d@ , or d@ , and d@ , and between d@ and d@ to quantify the efficacy against possible recurrences .


L. fermentum LF@ showed the strongest in vitro inhibitory activity towards G. vaginalis American Type Culture Collection ( ATCC ) @ after both @ and @ hours .


In the human trial , the @ lactobacilli selected , namely L. fermentum LF@ and L. plantarum LP@ , significantly reduced the Nugent score below the threshold of @ after @ days in @ patients of @ in the active group ( @ % , P < @ ) .


Eight women ( @ % ) recorded a Nugent score between @ and @ , evidence of an intermediate situation , whereas the remaining @ ( @ % ) showed a score < @ , therefore suggesting the restoration of physiological vaginal microbiota .


At the end of the second month , only @ women registered a Nugent score > @ , definable as BV ( @ % , P = @ compared with d@ ) .


In the placebo group , no significant differences were recorded at any time .


BV , also known as vaginal bacteriosis is the most common cause of vaginal infection in women of childbearing age .


Furthermore , BV is often asymptomatic as about @ % of women with this condition have no symptoms at all and the prevalence rate in apparently healthy women is around @ % .


This study suggests the ability of the @ strains L. fermentum LF@ and L. plantarum LP@ to counteract acute Gardnerella infections effectively and significantly improve the related uncomfortable symptoms in a very high percentage of women .


This could be partially attributed to the presence of tara gum , which is able to create a mechanical barrier against Gardnerella on the surface of vaginal mucosa as a primary mechanism .


Furthermore , long-term physiological protection seems to be established , thanks to the integration of the @ lactobacilli into the vaginal microbiota and to their adhesion to the epithelial cells of the mucosa .


In the light of the additional in vitro inhibitory activity against E. coli , their prospective use in AV could also prove interesting .


The mainstay of treatment for Gaucher 's disease type @ is alternate-week infusion of enzyme replacement therapy ( ERT ) .


We investigated whether patients stable on such treatment would remain so after switching to oral eliglustat , a selective inhibitor of glucosylceramide synthase .


In this phase @ , randomised , multinational , open-label , non-inferiority trial , we enrolled adults ( aged @ years ) who had received ERT for @ years or more for Gaucher 's disease .


Patients were randomly allocated @:@ at @ clinics ( stratified by ERT dose ; block sizes of four ; computer-generated centrally ) to receive either oral eliglustat or imiglucerase infusions for @ months .


Participants and investigators were aware of treatment assignment , but the central reader who assessed organ volumes was masked .


The composite primary efficacy endpoint was percentage of patients whose haematological variables and organ volumes remained stable for @ months ( ie , haemoglobin decrease not more than @ g/L , platelet count decrease not more than @ % , spleen volume increase not more than @ % , and liver volume increase not more than @ % , in multiples of normal from baseline ) .


The non-inferiority margin was @ % for eliglustat relative to imiglucerase , assessed in all patients who completed @ months of treatment .


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


Between Sept @ , @ , and Nov @ , @ , we randomly allocated @ ( @ % ) patients to eliglustat and @ ( @ % ) to imiglucerase .


In the per-protocol population , @ ( @ % ) of @ patients who completed eliglustat treatment and @ ( @ % ) of @ patients who completed imiglucerase treatment met the composite primary endpoint ( between-group difference -@ % ; @ % CI -@ to @ ) .


The lower bound of the @ % CI of -@ % was within the prespecified threshold for non-inferiority .


Dropouts occurred due to palpitations ( one patient on eliglustat ) , myocardial infarction ( one patient on eliglustat ) , and psychotic disorder ( one patient on imiglucerase ) .


No deaths occurred .


@ ( @ % ) of @ patients in the eliglustat group had treatment-emergent adverse events , as did @ ( @ % ) of @ in the imiglucerase group ( mostly mild or moderate in severity ) .


Oral eliglustat maintained haematological and organ volume stability in adults with Gaucher 's disease type @ already controlled by intravenous ERT and could be a useful therapeutic option .


To investigate the association of the rate of weight gain ( Ratemax_wt ) between the age of @ years and the age of maximum lifetime weight gain with indicators of subclinical coronary artery disease ( CAD ) at the time of diagnosis of type @ diabetes ( T@D ) .


We studied @,@ consecutive Korean subjects aged @ years with recently diagnosed ( within @ months ) T@D and one or more cardiovascular risk factors to investigate the association of Ratemax_wt with subclinical CAD .


We used @-slice cardiac computed tomography angiography to evaluate the degree of coronary artery stenosis , multivessel involvement , plaque characteristics , and coronary artery calcium score ( CACS ) .


Body weight at age @ years ( Wt@y ) was obtained from participant records .


Participants recalled their maximum weight ( Wtmax ) before T@D diagnosis and age at maximum weight ( Agemax_wt ) .


The Ratemax_wt was calculated as ( Wtmax - Wt@y ) / ( Agemax_wt - @ years ) .


The prevalence of coronary artery stenosis ( @ % ) , multivessel involvement ( two or more vessels ) , plaque characteristics , and CACS @ were @ % , @ % , @ % , and @ % , respectively .


Mean Wt@y and Wtmax were @ @ and @ @ kg , respectively .


Mean Agemax_wt was @ @ years , and Ratemax_wt was @ @ kg/year .


After adjusting for cardiovascular risk factors , including current BMI , the highest quarter of prior weight gain was significantly associated with coronary artery stenosis , multivessel involvement , and plaque characteristics , particularly mixed and noncalcified plaque .


The findings suggest that a greater rate of prior weight gain may accelerate the development of subclinical vascular complications in patients with newly diagnosed T@D .


Studies suggest that the observation of others ' actions leads to enhanced motor skill learning .


We examined whether others ' or self-action observation is effective for standing balance learning .


In addition , we examined cortical activation during action observation using functional near-infrared spectroscopy .


Thirty-nine healthy young subjects were assigned randomly to the Control , Other-Observation ( O-O ) , and Self-Observation ( S-O ) groups .


The subjects learned to stand on a tilting platform while maintaining a horizontal position .


The Control group alternated each trial with a rest period .


The O-O and S-O groups were provided with information related to their performance during the rest period : the O-O group observed another person , while the S-O group observed their previous performance .


Cortical activation was assessed by changes of hemoglobin oxygenation ( oxyHb ) .


A @-way analysis of variance with repeated measures on balance performance revealed a significant difference in post-training ( p < @ ) and retention ( p < @ ) only in the S-O group .


And an increase of oxyHb levels at post-training in the S-O group was observed in the supplementary motor area .


Self-action observation improved standing balance and brain activity during training and at @ h after training .


To verify the eventual efficacy of lactoferrin ( LF ) , an iron-binding glycoprotein , to decrease the amniotic concentration of interleukin-@ ( IL-@ ) .


We prospectively enrolled @ Caucasian patients at the @th week of their singleton physiological gestation .


A vaginal compound containing @ mg of LF was administered randomly @ or @ h prior to amniocentesis , as to obtain @ groups : A , @ untreated patients ; B , @ treated @ h before amniocentesis ; C , @ treated @ h before amniocentesis .


A normal karyotype was registered in all cases .


The comparison of the distribution of IL-@ among the @ groups showed a highly significant difference ( p = @ ) .


The difference between mean values of group B and both groups C and A was shown to be highly significant ( p = @ and p = @ , respectively ) .


In contrast , there was no significant difference between mean values of groups A and C.


Vaginal LF administration decreases amniotic IL-@ concentration .


We therefore suggest that the glycoprotein may exert a protective role against ominous pregnancy complications linked to an increased level of the cytokine , such as abortion secondary to amniocentesis .


Anemia is a frequent condition in patients with chronic kidney disease due to a reduction in the production of erythropoietin .


Patients with inflammation respond less well to treatment with erythropoietin , possibly because the increased production of hepcidin reduces the availability of iron for hematopoiesis .


Some studies suggest that pentoxifylline has anti-inflammatory properties and could be used as adjuvant therapy in the treatment of anemia .


The aim of this study was to analyze the effect of pentoxifylline on serum hepcidin in chronic hemodialysis patients with inflammation .


@ adult patients on hemodialysis with C-reactive protein ( CRP ) @ mg/dl in screening tests ; patients were randomized to the treatment group ( oral pentoxifylline @ mg/thrice-weekly ) or the control group for @ months follow-up .


During the study , a decrease in hemoglobin , transferrin saturation , and hepcidin was observed in both groups .


However , these reductions were related to the time and not to the drug .


There was no difference in the concentrations of CRP , ferritin , and albumin over time in either group .


The use of this amount of pentoxifylline did not modify the serum levels of hepcidin in this population .


To investigate the quality of reporting for randomised controlled trials of acupuncture for neurological disorders conducted in China before and after the implementation of the Consolidated Standards of Reporting Trials ( CONSORT ) and Standards for Reporting Interventions in Controlled Trials of Acupuncture ( STRICTA ) guidelines .


The quality of reporting for included papers was assessed against a subset of criteria adapted from CONSORT and STRICTA .


CONSORT and STRICTA were developed in @ and @ , respectively .


Thus , for the date of publication we selected @-year periods , at @-yearly intervals : @-@ ; @-@ ; @-@ and @-@ .


These selections cover the periods before the publication dates of both guidelines ( @ , @ ) and at least @years afterwards , and provide reasonably up-to-date data .


We calculated the total score for each guideline and compared reported differences during different date ranges .


For CONSORT items ( maximum score @ ) , there was evidence of a slight improvement in reporting between @-@ and @-@ combined ( @ ) and @-@ and @-@ combined ( @ ) ( difference @ , @ % CI @ to @ ) .


For STRICTA items ( maximum score @ ) , there was evidence of a slight improvement in reporting between @-@ and @-@ combined ( @ ) and @-@ and @-@ combined ( @ ) ( difference @ , @ % CI @ to @ ) .


The quality of reporting for studies of acupuncture for neurological disorders has generally improved since the implementation of STRICTA and CONSORT guidelines .


ADAMTS @ , sP-Selectin and HSP@ have been investigated as potential prognostic markers in patients with hemorrhagic shock .


This study was part of a double-blind , randomized , parallel-group , controlled trial and included seventeen trauma patients presented to ED with severe hemorrhagic .


The sera for testing were collected from these patients at the time of admission .


Investigators and laboratory personnel performing testing were blinded to the patients ' identity and clinical course .


The prognostic value of ADAMTS@ , sP-Selectin , and HSP@ was compared to prognostic value of systolic blood pressure ( SBP ) , base deficit estimation ( BD ) , heart rate ( HR ) , shock index ( SI ) and tissue oxygen saturation ( StO@ ) by constructing the receiver operation characteristics ( ROC ) .


The area under the curve ( AUC ) of the ROC for HSP@ ( @ ) was greater than for SBP ( @ ) , BD ( @ ) , HR ( @ ) , SI ( @ ) and StO@ ( @ ) .


AUC for sP-Selectin ( @ ) and for ADAMTS@ antigen ( @ ) were comparable with BD one , but greater than for the rest of currently used tests .


Serum concentrations of ADAMTS@ , HSP@ and sP-Selectin measured during the admission , appear to be comparable to or better than SBP , BD , SI , HR and StO@ in predicting MODS and death after hemorrhage from trauma .


These potential new markers deserve further investigation .


Phone-based tobacco cessation program effectiveness has been established and randomized controlled trials have provided some support for Web-based services .


Relatively little is known about who selects different treatment modalities and how they engage with treatments in a real-world setting .


This paper describes the characteristics , Web utilization patterns , and return rates of tobacco users who self-selected into a Web-based ( Web-Only ) versus integrated phone/Web ( Phone/Web ) cessation program .


We examined the demographics , baseline tobacco use , Web utilization patterns , and return rates of @,@ adult tobacco users who self-selected into a Web-Only or integrated Phone/Web cessation program through @ of @ state quitlines from August @ through July @ .


For each state , registrants were only included from the timeframe in which both programs were offered to all enrollees .


Utilization data were limited to site interactions occurring within @ months after registration .


Most participants selected the Phone/Web program ( @,@ / @,@ , @ % ) .


After enrollment in Web services , Web-Only were more likely to log in compared to Phone/Web ( @,@ / @,@ , @ % vs @,@ / @,@ , @ % ; P < @ ) , but less likely to return after their initial log-in ( @/@ ,@ , @ % vs @,@ / @,@ , @ % ; P < @ ) .


In bivariate and multivariable analyses , those who chose Web-Only were younger , healthier , more highly educated , more likely to be uninsured or commercially insured , more likely to be white non-Hispanic and less likely to be black non-Hispanic , less likely to be highly nicotine-addicted , and more likely to have started their program enrollment online ( all P < @ ) .


Among both program populations , participants were more likely to return to Web services if they were women , older , more highly educated , or were sent nicotine replacement therapy ( NRT ) through their quitline ( all P < @ ) .


Phone/Web were also more likely to return if they had completed a coaching call , identified as white non-Hispanic or `` other '' race , or were commercially insured ( all P < @ ) .


Web-Only were less likely to return if they started their enrollment online versus via phone .


The interactive Tobacco Tracker , Cost Savings Calculator , and Quitting Plan were the most widely used features overall .


Web-Only were more likely than Phone/Web to use most key features ( all P < @ ) , most notably the @ Quitting Plan behaviors .


Among quitlines that offered NRT to both Phone/Web and Web-Only , Web-Only were less likely to have received quitline NRT .


This paper adds to our understanding of who selects different cessation treatment modalities and how they engage with the program in a real-world setting .


Web-Only were younger , healthier smokers of higher socioeconomic status who interacted more intensely with services in a single session , but were less likely to re-engage or access NRT benefits .


Further research should examine the efficacy of different engagement techniques and services with different subpopulations of tobacco users .


The dose-response effects of exercise training on insulin sensitivity , metabolic risk , and quality of life were examined .


Sixty-one healthy , sedentary ( VOmax : @ @ ml/kg/min ) , moderately overweight ( BMI : @ @ ) , young ( age : @ @ years ) men were randomized to sedentary living ( sedentary control group ; n = @ ) , moderate ( moderate dose training group -LSB- MOD -RSB- : @ kcal/day , n = @ ) , or high ( high dose training group -LSB- HIGH -RSB- : @ kcal/day , n = @ ) dose physical exercise for @ weeks .


The return rate for post-intervention testing was @-@ % across groups .


Weekly exercise amounted to @,@ @ and @,@ @ kcal , respectively , in MOD and HIGH .


Cardiorespiratory fitness increased ( P < @ ) @ @ % in MOD and @ @ % in HIGH , and fat percentage decreased ( P < @ ) similarly in both exercise groups ( MOD : @ @ to @ @ % ; HIGH : @ @ to @ @ % ) .


Peripheral insulin sensitivity increased ( P < @ ) ( MOD : @ @ % ; HIGH : @ @ % ) and the homeostasis model assessment of insulin resistance decreased ( P < @ ) ( MOD : -@ @ % ; HIGH : -@ @ % ) .


The number of subjects meeting the criteria of the metabolic syndrome decreased by @ % in MOD ( P < @ ) and by @ % in HIGH ( P < @ ) .


General health assessed by questionnaire increased similarly in MOD ( P < @ ) and HIGH ( P < @ ) .


Only minor additional health benefits were found when exercising @,@ as opposed to @,@ kcal/week in young moderately overweight men .


This finding may have important public health implications .


We aimed to evaluate clinical symptoms in subjects with irritable bowel syndrome receiving Saccharomyces cerevisiae in a randomized double-blind placebo-controlled clinical trial .


Overall , @ adults with irritable bowel syndrome ( Rome III criteria ) were randomized to receive once daily @ mg of Saccharomyces cerevisiae , delivered by one capsule ( n = @ , F : @ % , age : @ @ ) , or placebo ( n = @ , F : @ % , age : @ @ ) for @ weeks followed by a @-week washout period .


After a @-week run-in period , cardinal symptoms ( abdominal pain/discomfort , bloating/distension , bowel movement difficulty ) and changes in stool frequency and consistency were recorded daily and assessed each week .


A safety assessment was carried out throughout the study .


The proportion of responders , defined by an improvement of abdominal pain/discomfort , was significantly higher ( p = @ ) in the treated group than the placebo group ( @ % vs @ % , OR = @ , @ % , CI : @-@ @ ) in the last @ weeks of treatment .


A non-significant trend of improvement was observed with Saccharomyces cerevisiae for the other symptoms .


Saccharomyces cerevisiae was well tolerated and did not affect stool frequency and consistency .


Saccharomyces cerevisiae is well tolerated and reduces abdominal pain/discomfort scores without stool modification .


Thus , Saccharomyces cerevisiae may be a new promising candidate for improving abdominal pain in subjects with irritable bowel syndrome .


This study provides data on the psychometric properties of a newly developed measure of treatment fidelity in Family-Based Treatment ( FBT ) for adolescent anorexia nervosa ( AN ) .


The Family Therapy Fidelity and Adherence Check ( FBT-FACT ) was created to evaluate therapist adherence and competency on the core interventions in FBT .


Participants were @ adolescents and their families sampled from three randomized clinical trials evaluating treatment for AN .


Trained fidelity raters evaluated @ therapists across @ early session recordings using the FBT-FACT .


They also rated an additional @ session @ recordings of an alternate form of family therapy-Systemic Family Therapy for the purpose of evaluating discriminant validity of the FBT-FACT .


The process of development and the psychometric properties of the FBT-FACT are presented .


Overall fidelity ratings for each session demonstrated moderate to strong inter-rater agreement .


Internal consistency of the measure was strong for sessions @ and @ and poor for session @ .


Principal components analysis suggests sessions @ and @ are distinct interventions .


The FBT-FACT demonstrates good reliability and validity as a measure of treatment fidelity in the early phase of FBT .


This study sought to determine the efficacy of low rate fluoroscopy at @ frames/s ( FPS ) versus conventional @ FPS for reduction of operator and patient radiation dose during diagnostic coronary angiography ( DCA ) and percutaneous coronary intervention ( PCI ) via the transradial approach ( TRA ) .


TRA for cardiac catheterization is potentially associated with increased radiation exposure .


Low rate fluoroscopy has the potential to reduce radiation exposure .


Patients undergoing TRA diagnostic angiography ad-hoc PCI were randomized to fluoroscopy at @ FPS versus @ FPS prior to the procedure .


Both @ and @ FPS fluoroscopy protocols were configured with a fixed dose per pulse of @ nGy .


Primary endpoints were operator radiation dose ( measured with dosimeter attached to the left side of the thyroid shield in Sievert -LSB- Sv -RSB- ) , patient radiation dose ( expressed as dose-area product in Gycm ( @ ) ) , and fluoroscopy time .


From October @ , @ to August @ , @ , from a total of @ patients , @ underwent DCA and @ underwent PCI .


Overall , fluoroscopy at @ FPS compared with @ FPS was associated with a significant reduction in operator dose ( @ % relative reduction -LSB- RR -RSB- , p < @ ) ; and in patient 's dose-area product ( @ % RR ; p = @ ) .


When stratified by procedure type , @ FPS compared with @ FPS was associated with significant reduction in operator dose during both DCA ( @ % RR ; p < @ ) and PCI ( @ % RR ; p = @ ) .


Fluoroscopy at @ FPS , compared with @ FPS , was also associated with substantial reduction in patients ' dose-area product during DCA ( @ % RR ; p = @ ) and during PCI ( @ % RR ; p = @ ) .


Fluoroscopy time was similar in @ FPS and @ FPS groups for DCA ( @ @ min vs. @ @ min ; p = @ ) and PCI ( @ @ min vs. @ @ min ; p = @ ) , respectively .


Fluoroscopy at @ FPS , compared with @ FPS , is a simple and effective method in reducing operator and patient radiation dose during TRA DCA and PCI .


The protective effect of beta-blockers , ACE inhibitors , and ARBs on anthracycline cardiotoxicity has already been demonstrated , but the effect of aldosterone antagonism , which inhibits the last step of the renin-angiotensin-aldosterone system ( RAAS ) , was questioned .


This study sought to investigate whether spironolactone protects the heart against anthracycline-induced cardiotoxicity .


Eighty-three female patients who were diagnosed with breast cancer were included in the study .


The study population was randomized into spironolactone and control groups .


A dose of @ mg/day spironolactone was administered to the patients in the spironolactone group .


There were @ patients ( mean age @ years ) in the spironolactone group and @ patients ( mean age @ years ) in the control group .


LVEF decreased from @ to @ ( P = @ ) in the spironolactone group , and from @ to @ in the control group ( P < @ ) .


When the general linear model was applied , the interaction of LVEF decrease between groups was significantly lower in the spironolactone group than in the control group ( P < @ ) .


The diastolic functional grade of subjects in the spironolactone group was protected ( P = @ ) , whereas it deteriorated in the control group ( P < @ ) .


We showed that spironolactone administration used simultaneously with anthracycline group chemotherapeutics protects both myocardial systolic and diastolic functions .


Spironolactone can be used to protect against anthracycline-induced cardiotoxicity .


Foot pain is highly prevalent in older people and in many cases is associated with inappropriate footwear .


This study evaluated the effectiveness of off-the-shelf , extra-depth footwear in reducing foot pain .


Community-dwelling older people with disabling foot pain ( @ men and @ women aged @ to @ years ; mean age @ -LSB- SD @ -RSB- ) were randomly allocated to an intervention group ( n = @ ) or control group ( n = @ ) .


The intervention group was provided with off-the-shelf , extra-depth footwear .


Participants in the control group received their footwear at the completion of the study .


Both groups continued to receive usual podiatry care for the study period .


The primary outcome measure was the Foot Health Status Questionnaire ( FHSQ ) , measured at baseline and @ weeks .


There was a significant improvement in the FHSQ pain domain ( ANCOVA-adjusted mean difference @ points , @ % confidence interval @ to @ , p = @ ) and FHSQ function domain ( @ points , @ to @ , p = @ ) in the intervention group compared to the control group .


The intervention group also developed fewer keratotic lesions ( mean difference -@ , -@ to -@ , p = @ ) , were less likely to report the use of co-interventions ( relative risk -LSB- RR -RSB- @ , @ to @ , p = @ ) and were more likely to report that their foot pain had moderately or markedly improved during the study ( RR = @ , @ to @ , p < @ ; number needed to treat = @ , @ to @ ) .


Off-the-shelf , extra-depth footwear significantly reduces foot pain , improves foot function and is associated with the development of fewer keratotic lesions in older people .


Video-assisted thoracic surgery is gradually replacing conventional open thoracotomy as the method of choice for the treatment of early-stage non-small cell lung cancers , and thoracic surgical trainees must learn and master this technique .


Simulation-based training could help trainees overcome the first part of the learning curve , but no virtual-reality simulators for thoracoscopy are commercially available .


This study aimed to investigate whether training on a laparoscopic simulator enables trainees to perform a thoracoscopic lobectomy .


Twenty-eight surgical residents were randomized to either virtual-reality training on a nephrectomy module or traditional black-box simulator training .


After a retention period they performed a thoracoscopic lobectomy on a porcine model and their performance was scored using a previously validated assessment tool .


The groups did not differ in age or gender .


All participants were able to complete the lobectomy .


The performance of the black-box group was significantly faster during the test scenario than the virtual-reality group : @ min ( SD @ min ) versus @ min ( SD @ min ) .


No difference existed between the two groups when comparing bleeding and anatomical and non-anatomical errors .


Simulation-based training and targeted instructions enabled the trainees to perform a simulated thoracoscopic lobectomy .


Traditional black-box training was more effective than virtual-reality laparoscopy training .


Thus , a dedicated simulator for thoracoscopy should be available before establishing systematic virtual-reality training programs for trainees in thoracic surgery .


A study was conducted to evaluate and compare the effectiveness of two different spot-on topical flea products to control flea infestations on naturally infested dogs and cats in Tampa , FL USA .


Thirty-two dogs and @ cats with natural flea infestations living in @ homes were treated topically with a @ % w/w spot-on formulation of indoxacarb .


Another thirty dogs and @ cats living in @ different homes were treated topically with either fipronil ( @ % w/w ) / ( s ) - methoprene ( @ % w/w ) or fipronil ( @ % w/w ) / ( s ) - methoprene ( @ % w/w ) , respectively .


All products were applied according to label directions by study investigators on day @ and again between days @ and @ .


Flea populations on pets were assessed using visual area counts and premise flea infestations were assessed using intermittent-light flea traps on days @ , @ , @ , @ , @-@ , @-@ , and @-@ .


A single application of the indoxacarb or fipronil ( s ) - methoprene formulations reduced flea populations on pets by @ % and @ % , respectively within @ days .


One month ( @-@ days ) after treatment the indoxacarb and fipronil ( s ) - methoprene formulations reduced on-animal flea burdens by @ % and @ % , respectively .


Following two monthly applications of either the indoxacarb or fipronil ( s ) - methoprene formulations , pet flea burdens were reduced by @ % and @ % , respectively , by days @-@ .


At the end of the two month study , @ % and @ % of the dogs and cats in the indoxacarb and fipronil ( s ) - methoprene treatment groups , respectively were flea free .


Flea numbers in the indoor-premises were markedly reduced in both treatment groups by days @-@ , with @ % and @ % reductions in intermittent-light flea trap counts in the indoxacarb and fipronil ( s ) - methoprene treatment groups , respectively .


This in-home investigation conducted during the summer of @ in subtropical Tampa , FL , is the first published U.S field investigation of the indoxacarb topical formulation .


The indoxacarb formulation was able to effectively control flea populations in heavily flea infested pets and homes .


The efficacy achieved by the fipronil ( s ) - methoprene formulation against flea infestations on these pets was lower than in previous investigations using the same study design .


Immune thrombocytopenia is characterised by immune-mediated destruction and suboptimum production of platelets .


Despite the absence of supporting evidence , rituximab is frequently used off-label in patients with immune thrombocytopenia .


We aimed to assess the efficacy of rituximab as compared with placebo as a splenectomy-sparing treatment in patients who were previously treated with corticosteroids .


In this multicentre , randomised , double-masked , placebo-controlled trial , we enrolled corticosteroid unresponsive adult patients ( aged @ years ) with primary immune thrombocytopenia and a platelet count of less than @ ( @ ) platelets per L. Patients were randomly assigned ( @:@ ) to four weekly infusions of @ mg/m ( @ ) rituximab or placebo .


Concurrent treatment with corticosteroids only was allowed during the study .


The primary endpoint was rate of treatment failure within @ weeks -- a composite of splenectomy or meeting criteria for splenectomy after week @ if splenectomy was not done , assessed in all patients who received at least one dose of study treatment .


Secondary endpoints were response rates , relapse rates , and duration of response .


Efficacy endpoints were assessed with the Kaplan-Meier method .


Safety endpoints were assessed in all patients who received at least one dose .


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


Between Aug @ , @ , and June @ , @ , we enrolled @ patients .


@ ( @ % ) of @ patients in the rituximab group and @ ( @ % ) of @ patients in the placebo group had treatment failure within @ weeks ( Kaplan-Meier cumulative incidence @ % for rituximab vs @ % for placebo ( hazard ratio -LSB- HR -RSB- @ , @ % CI @-@ ; p = @ ) .


The cumulative incidence of overall response was @ % in the rituximab group versus @ % in the placebo group ( p = @ ) and complete response was @ % in the rituximab group versus @ % in the placebo group ( p = @ ) .


Of those achieving an overall response , @ % relapsed in the rituximab group and @ % relapsed in the placebo group , and of those achieving complete response , @ % relapsed in the rituximab group and @ % relapsed in the placebo group .


Time to relapse in the rituximab group was longer in patients who achieved overall response ( @ vs @ weeks ; p = @ ) but not complete response ( @ vs @ weeks ; p = @ ) .


Rates of bleeding were similar in the two groups ( @ -LSB- @ % -RSB- in the rituximab group vs @ -LSB- @ % -RSB- in the placebo group ; p = @ ) as were rates of infection ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ; p = @ ) .


Despite no reduction in the rate of long-term treatment failure with rituximab , a small benefit can not be ruled out , as suggested by an apparently longer duration of response and numerically higher response rates with rituximab .


The aim of this study was to analyze the effects of inclined treadmill training on the kinematic characteristics of gait in subjects with hemiparesis .


A blind , randomized , controlled study was conducted with @ subjects divided into two groups : the control group , submitted to partial body weight-support treadmill gait training with no inclination , and the experimental group , which underwent partial body weight-support treadmill training at @ % of inclination .


All volunteers were assessed for functional independence , motor function , balance , and gait before and after the @ training sessions .


Both groups showed posttraining alterations in balance ( P < @ ) , motor function ( P < @ ) , and functional independence ( P = @ ) .


Intergroup differences in spatiotemporal differences were observed , where only the experimental group showed posttraining alterations in velocity ( P = @ ) and paretic step length ( P = @ ) .


Angular variables showed no significant differences in either group .


In subjects with hemiparesis , the addition of inclination is a stimulus capable of enhancing the effects of partial body weight-support treadmill gait training .


Sexual assault is a major cause of injury , unplanned pregnancy , HIV infection , and mental health problems worldwide .


In parts of sub-Saharan Africa , sexual assault has reached epidemic proportions .


This study evaluated the efficacy of an empowerment and self-defense intervention for adolescent girls to decrease the incidence of sexual assault and harassment in Nairobi 's large informal settlements .


A prospective cohort of @ adolescents from @ neighborhoods near Nairobi were taught empowerment , deescalation , and self-defense skills in six @-hour sessions .


The standard-of-care ( SOC ) group ( n = @ ) received a life skills class .


Self-reported , anonymous survey data were collected at baseline and @ months after intervention .


Annual sexual assault rates decreased from @ / @ person-years at baseline to @ at follow-up ( rate ratio = @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ; P < @ ) ; there was no significant change in the SOC group ( @ to @ , rate ratio = @ ; @ % CI , @-@ @ , P = @ ) .


Sexual assault disclosure in the intervention group increased from @ % to @ % ( P = @ ) , compared with a constant incidence of disclosure ( @ % ) in the SOC group .


The majority ( @ % ) of adolescents in the intervention group reported using skills learned to stop an assault .


This intervention decreased sexual assault rates among adolescent girls in Kenya .


The intervention was also associated with an increase in the disclosure of assaults , thereby enabling survivors to seek care and support and possibly leading to the identification and prosecution of perpetrators .


This model should be adaptable to other settings both in Africa and globally .


To determine the safety , tolerability and signs of efficacy of MOR@ , a human monoclonal antibody to granulocyte-macrophage colony-stimulating factor ( GM-CSF ) , in patients with rheumatoid arthritis ( RA ) .


Patients with active , moderate RA were enrolled in a randomised , multicentre , double-blind , placebo-controlled , dose-escalation trial of intravenous MOR@ ( @ , @ or @ mg/kg ) once a week for @weeks , with follow-up to @weeks .


The primary outcome was safety .


Of the @ randomised and treated subjects , @ completed the trial ( n = @ , @ , @ and @ for pooled placebo and MOR@ @ , @ and @ mg/kg , respectively ) .


Treatment emergent adverse events ( AEs ) in the MOR@ groups were mild or moderate in intensity and generally reported at frequencies similar to those in the placebo group .


The most common AE was nasopharyngitis .


In two cases , AEs were classified as serious because of hospitalisation : paronychia in a placebo subject and pleurisy in a MOR@ @ mg/kg subject .


Both patients recovered fully .


In exploratory efficacy analyses , subjects in the MOR@ @ and @ mg/kg groups showed significant improvements in Disease Activity Score-@ scores and joint counts and significantly higher European League Against Rheumatism response rates than subjects receiving placebo .


MOR@ @ mg/kg was associated with the largest reductions in disease activity parameters .


MOR@ was well tolerated and showed preliminary evidence of efficacy in patients with active RA .


The data support further investigation of this monoclonal antibody to GM-CSF in RA patients and potentially in those with other immune-mediated inflammatory diseases .


Home visiting nurses ( HVNs ) have long been part of home and community-based care interventions designed to meet the needs of functionally declining older adults .


However , only one of the studies including HVNs that have demonstrated successful impacts on Activities of Daily Living ( ADL ) has reported how those interventions affected individual ADLs such as bathing , instead reporting the effect on means of various ADL indices and scales .


Reporting impacts on means is insufficient since the same mean can consist of many different combinations of individual ADL impairments .


The purpose of our study was to identify which individual ADLs were affected by a specific HVN intervention .


This is a secondary analysis comparing two arms of a randomized controlled study that enrolled Medicare patients ( mean age = @ years ; @ % female ) with considerable ADL impairment .


At baseline difficulty with individual ADLs ranged from a low of @ % with eating to a high of @ % with walking .


Through monthly home visits , the HVN focused on empowering patients and using behavior change approaches to facilitate chronic disease self-management .


Three categories of analyses were used to compare difficulty with and dependence in @ individual ADLs between the HVN ( n = @ ) and care as usual ( n = @ ) groups ( total N = @ ) at @ months after study entry : ( @ ) unadjusted analyses that strictly depend on random assignment , ( @ ) multinomial logistic regression analyses adjusting for baseline risk factors , and ( @ ) multinomial regression analyses that include variables reporting post-randomization healthcare use as well as the baseline risk factors .


Compared to care as usual , patients receiving the HVN intervention had less difficulty performing bathing at @ months .


However , there were no effects for difficulty performing the other @ ADLs .


While no effects were found for lower levels of dependence for any ADLs , impacts were detected for the most dependent levels of @ ADLs : patients experienced less dependence in walking and transferring , a substitution effect for toileting , and more dependence in eating .


Future research is needed to confirm these findings and determine how HVN interventions affect individual ADLs of older adults with multiple ADLs .


Endoscopic submucosal dissection ( ESD ) is the gold standard technique for en bloc resection of large superficial tumors in the upper and lower gastrointestinal tract .


Little is known about the management of epigastric pain after ESD of gastric neoplasms .


This study investigated the utility and safety of single-dose , perioperative , intravenous dexamethasone for epigastric pain relief following ESD .


The efficacy of intravenous dexamethasone @ mg/kg ( DEXA group ) compared with saline-only placebo ( placebo ) for epigastric pain after ESD of early gastric neoplasms was assessed in a double-blinded , placebo-controlled trial .


Patients completed a questionnaire about present pain intensity ( PPI ) and short-form McGill pain ( SF-MP ) categories for immediate and @ - , @ - , and @-h postoperative periods .


The primary outcome variable was PPI at @ h following ESD .


Secondary outcome variables included pain medication , SF-MP scores , complications , second-look endoscopic findings , and length of stay .


A total of @ patients participated in the study .


The mean @-h PPI value was lower ( p < @ ) in the DEXA group ( @ @ ) than in the placebo group ( @ @ ) .


The total @-h SF-MP score , especially the sensory domain , was higher ( p = @ ) in the placebo group ( @ @ ) than in the DEXA group ( @ @ ) .