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BACKGROUND | Although whole-body vibration ( WBV ) has sparked tremendous research interest in neurorehabilitation , the cardiovascular responses to WBV in people with stroke remain unknown . |
OBJECTIVE | The aim of this study was to determine the acute effects of different WBV protocols on oxygen consumption ( Vo2 ) , heart rate ( HR ) , rate of perceived exertion ( RPE ) , blood pressure ( BP ) , and rate-pressure product ( RPP ) during the performance of 6 different exercises among people with chronic stroke ( time since onset 6 months ) . |
METHODS | A repeated-measures design was used . |
METHODS | Each of the 48 participants experienced all 3 WBV protocols in separate sessions : ( 1 ) no WBV , ( 2 ) low-intensity WBV ( peak acceleration = 0.96 unit of gravity of Earth [ g ] ) , and ( 3 ) high-intensity WBV ( 1.61 g ) . |
METHODS | The order in which they encountered the WBV protocols was randomized , as was the order of exercises performed during each session . |
METHODS | Oxygen consumption , HR , and RPE were measured throughout the study . |
METHODS | Blood pressure and RPP were measured before and after each session . |
RESULTS | Low-intensity and high-intensity WBV induced significantly higher Vo2 by an average of 0.69 and 0.79 mL/kg/min , respectively , compared with the control condition . |
RESULTS | These protocols also increased HR by an average of 4 bpm . |
RESULTS | The 2 WBV protocols induced higher RPE than the control condition during static standing exercise only . |
RESULTS | Although the diastolic and systolic BP and RPP were increased at the end of each exercise session , the addition of WBV had no significant effect on these variables . |
CONCLUSIONS | The results are generalizable only to ambulatory and community-dwelling people with chronic stroke . |
CONCLUSIONS | Addition of high - and low-intensity WBV significantly increased the Vo2 and HR , but the increase was modest . |
CONCLUSIONS | Thus , WBV should not pose any substantial cardiovascular hazard in people with chronic stroke . |
###26154787 | null |
BACKGROUND | Little is known about the effect of specific anti-interleukin-23 therapy , as compared with established anti-tumor necrosis factor therapies , for the treatment of moderate-to-severe plaque psoriasis . |
METHODS | In a 52-week , phase 2 , dose-ranging , randomized , double-blind , placebo-controlled , active-comparator trial , we compared guselkumab ( CNTO 1959 ) , an anti-interleukin-23 monoclonal antibody , with adalimumab in patients with moderate-to-severe plaque psoriasis . |
METHODS | A total of 293 patients were randomly assigned to receive guselkumab ( 5 mg at weeks 0 and 4 and every 12 weeks thereafter , 15 mg every 8 weeks , 50 mg at weeks 0 and 4 and every 12 weeks thereafter , 100 mg every 8 weeks , or 200 mg at weeks 0 and 4 and every 12 weeks thereafter ) through week 40 , placebo , or adalimumab ( standard dosage for psoriasis ) . |
METHODS | At week 16 , patients in the placebo group crossed over to receive guselkumab at a dose of 100 mg every 8 weeks . |
METHODS | The primary end point was the proportion of patients with a Physician 's Global Assessment ( PGA ) score of 0 ( indicating cleared psoriasis ) or 1 ( indicating minimal psoriasis ) at week 16 . |
RESULTS | At week 16 , the proportion of patients with a PGA score of 0 or 1 was significantly higher in each guselkumab group than in the placebo group : 34 % in the 5-mg group , 61 % in the 15-mg group , 79 % in the 50-mg group , 86 % in the 100-mg group , and 83 % in the 200-mg group , as compared with 7 % in the placebo group ( P0 .002 for all comparisons ) . |
RESULTS | Moreover , the proportion was significantly higher in the 50-mg , 100-mg , and 200-mg guselkumab groups than in the adalimumab group ( 58 % ) ( P < 0.05 for all comparisons ) . |
RESULTS | At week 16 , the proportion of patients with at least a 75 % improvement in Psoriasis Area and Severity Index scores was significantly higher in each guselkumab group than in the placebo group ( P < 0.001 for all comparisons ) . |
RESULTS | At week 40 , the proportion of patients with a PGA score of 0 or 1 remained significantly higher in the 50-mg , 100-mg , and 200-mg guselkumab groups than in the adalimumab group ( 71 % , 77 % , and 81 % , respectively , vs. 49 % ) ( P < 0.05 for all comparisons ) . |
RESULTS | Between week 0 and week 16 , infections were observed in 20 % of the patients in the guselkumab groups , 12 % in the adalimumab group , and 14 % in the placebo group . |
CONCLUSIONS | The results of this phase 2 trial suggest that guselkumab may be an effective therapy for plaque psoriasis and that control of psoriasis can be achieved with specific anti-interleukin-23 therapy . |
CONCLUSIONS | ( Funded by Janssen Research and Development ; X-PLORE ClinicalTrials.gov number , NCT01483599 . ) |
###26323937 | null |
BACKGROUND | The role of trypanocidal therapy in patients with established Chagas ' cardiomyopathy is unproven . |
METHODS | We conducted a prospective , multicenter , randomized study involving 2854 patients with Chagas ' cardiomyopathy who received benznidazole or placebo for up to 80 days and were followed for a mean of 5.4 years . |
METHODS | The primary outcome in the time-to-event analysis was the first event of any of the components of the composite outcome of death , resuscitated cardiac arrest , sustained ventricular tachycardia , insertion of a pacemaker or implantable cardioverter-defibrillator , cardiac transplantation , new heart failure , stroke , or other thromboembolic event . |
RESULTS | The primary outcome occurred in 394 patients ( 27.5 % ) in the benznidazole group and in 414 ( 29.1 % ) in the placebo group ( hazard ratio , 0.93 ; 95 % confidence interval [ CI ] , 0.81 to 1.07 ; P = 0.31 ) . |
RESULTS | At baseline , a polymerase-chain-reaction ( PCR ) assay was performed on blood samples obtained from 1896 patients ; 60.5 % had positive results for Trypanosoma cruzi on PCR . |
RESULTS | The rates of conversion to negative PCR results ( PCR conversion ) were 66.2 % in the benznidazole group and 33.5 % in the placebo group at the end of treatment , 55.4 % and 35.3 % , respectively , at 2 years , and 46.7 % and 33.1 % , respectively , at 5 years or more ( P < 0.001 for all comparisons ) . |
RESULTS | The effect of treatment on PCR conversion varied according to geographic region : in Brazil , the odds ratio for PCR conversion was 3.03 ( 95 % CI , 2.12 to 4.34 ) at 2 years and 1.87 ( 95 % CI , 1.33 to 2.63 ) at 5 or more years ; in Colombia and El Salvador , the odds ratio was 1.33 ( 95 % CI , 0.90 to 1.98 ) at 2 years and 0.96 ( 95 % CI , 0.63 to 1.45 ) at 5 or more years ; and in Argentina and Bolivia , the odds ratio was 2.63 ( 95 % CI , 1.89 to 3.66 ) at 2 years and 2.79 ( 95 % CI , 1.99 to 3.92 ) at 5 or more years ( P < 0.001 for interaction ) . |
RESULTS | However , the rates of PCR conversion did not correspond to effects on clinical outcome ( P = 0.16 for interaction ) . |
CONCLUSIONS | Trypanocidal therapy with benznidazole in patients with established Chagas ' cardiomyopathy significantly reduced serum parasite detection but did not significantly reduce cardiac clinical deterioration through 5 years of follow-up . |
CONCLUSIONS | ( Funded by the Population Health Research Institute and others ; ClinicalTrials.gov number , NCT00123916 ; Current Controlled Trials number , ISRCTN13967269 . ) |
###25787999 | null |
BACKGROUND | Emotional eating in children has been related to the consumption of energy-dense foods and obesity , but the development of emotional eating in young children is poorly understood . |
OBJECTIVE | We evaluated whether emotional eating can be induced in 5-7-y-old children in the laboratory and assessed whether parental use of overly controlling feeding practices at 3-5 y of age predicts a greater subsequent tendency for children to eat under conditions of mild stress at ages 5-7 y. |
METHODS | Forty-one parent-child dyads were recruited to participate in this longitudinal study , which involved parents and children being observed consuming a standard lunch , completing questionnaire measures of parental feeding practices , participating in a research procedure to induce child emotion ( or a control procedure ) , and observing children 's consumption of snack foods . |
RESULTS | Children at ages 5-7 y who were exposed to a mild emotional stressor consumed significantly more calories from snack foods in the absence of hunger than did children in a control group . |
RESULTS | Parents who reported the use of more food as a reward and restriction of food for health reasons with their children at ages 3-5 y were more likely to have children who ate more under conditions of negative emotion at ages 5-7 y. |
CONCLUSIONS | Parents who overly control children 's food intake may unintentionally teach children to rely on palatable foods to cope with negative emotions . |
CONCLUSIONS | Additional research is needed to evaluate the implications of these findings for children 's food intake and weight outside of the laboratory setting . |
CONCLUSIONS | This trial was registered at clinicaltrials.gov as NCT01122290 . |
###24388839 | null |
OBJECTIVE | To compare the effects of trimethoprim-sulfamethoxazole vs placebo in reducing the risk of recurrences of Toxoplasma gondii retinochoroiditis . |
METHODS | Single-center , prospective randomized double-masked clinical trial . |
METHODS | A total of 95 patients from Campinas , Brazil , with active recurrent Toxoplasma gondii retinochoroiditis were included . |
METHODS | The initially active toxoplasmosis lesions were successfully treated in all cases using trimethoprim-sulfamethoxazole ( 800 mg/160 mg ) twice daily for 45 days . |
METHODS | Subsequently , 5 patients dropped out of the study . |
METHODS | The remaining patients were randomized to Group 1 ( trimethoprim/sulfamethoxazole tablet every 2 days ) or Group 2 ( identical placebo tablet every 2 days ) . |
METHODS | Randomization was 1:1 , was stratified by sex , and used block sizes of 4 . |
METHODS | The primary outcome was recurrent toxoplasmosis retinochoroiditis within 1 year , and the secondary outcome was a 1-year change in best-corrected visual acuity ( BCVA ) ( ETDRS chart ) . |
RESULTS | The incidence of recurrent toxoplasmosis retinochoroiditis within 12 months was 0 of 46 ( 0 % ) and 6 of 47 ( 12.80 % ) in the trimethoprim-sulfamethoxazole and placebo groups , respectively ( P = .026 ) . |
RESULTS | Visual acuity improvements in the 2 groups were similar . |
RESULTS | No treatment-limiting toxicity was observed . |
CONCLUSIONS | Trimethoprim/sulfamethoxazole therapy resulted in a 100 % reduction in the recurrence of Toxoplasma gondii retinochoroiditis over 1 year of treatment . |
###24626738 | null |
OBJECTIVE | Antisocial personality is a common adult problem that imposes a major public health burden , but for which there is no effective treatment . |
OBJECTIVE | Affected individuals exhibit persistent antisocial behavior and pervasive antisocial character traits , such as irritability , manipulativeness , and lack of remorse . |
OBJECTIVE | Prevention of antisocial personality in childhood has been advocated , but evidence for effective interventions is lacking . |
METHODS | The authors conducted two follow-up studies of randomized trials of group parent training . |
METHODS | One involved 120 clinic-referred 3 - to 7-year-olds with severe antisocial behavior for whom treatment was indicated , 93 of whom were reassessed between ages 10 and 17 . |
METHODS | The other involved 109 high-risk 4 - to 6-year-olds with elevated antisocial behavior who were selectively screened from the community , 90 of whom were reassessed between ages 9 and 13 . |
METHODS | The primary psychiatric outcome measures were the two elements of antisocial personality , namely , antisocial behavior ( assessed by a diagnostic interview ) and antisocial character traits ( assessed by a questionnaire ) . |
METHODS | Also assessed were reading achievement ( an important domain of youth functioning at work ) and parent-adolescent relationship quality . |
RESULTS | In the indicated sample , both elements of antisocial personality were improved in the early intervention group at long-term follow-up compared with the control group ( antisocial behavior : odds ratio of oppositional defiant disorder = 0.20 , 95 % CI = 0.06 , 0.69 ; antisocial character traits : B = -4.41 , 95 % CI = -1.12 , -8.64 ) . |
RESULTS | Additionally , reading ability improved ( B = 9.18 , 95 % CI = 0.58 , 18.0 ) . |
RESULTS | Parental expressed emotion was warmer ( B = 0.86 , 95 % CI = 0.20 , 1.41 ) and supervision was closer ( B = -0.43 , 95 % CI = -0.11 , -0.75 ) , but direct observation of parenting showed no differences . |
RESULTS | Teacher-rated and self-rated antisocial behavior were unchanged . |
RESULTS | In contrast , in the selective high-risk sample , early intervention was not associated with improved long-term outcomes . |
CONCLUSIONS | Early intervention with severely antisocial children for whom treatment is indicated may prevent the development of antisocial personality in adolescence and may improve academic performance . |
CONCLUSIONS | In contrast , early intervention with selective high-risk samples may be ineffective . |
###25675682 | null |
OBJECTIVE | The authors compared the baby enclosed afferent reservoir ( Baby EAR ) with the Jackson-Rees ( JR ) anesthesia circuit for the minimal fresh gas flow ( FGF ) requirement with no and clinically acceptable rebreathing in spontaneous breathing anesthesia among pediatric patients . |
METHODS | The present study was a randomized crossover study . |
METHODS | Twenty patients , weighing 5 to 20 kg with ASA physical status I-II were enrolled . |
METHODS | They were allocated to group 1 ( EAR-JR ) starting with Baby EAR then switching to JR or group 2 ( JR-EAR ) , reversedpattern . |
METHODS | After induction and intubation , anesthesia was maintainedwith a N2O/O2 combination with sevoflurane 1 to 3 % and fentanyl . |
METHODS | Starting with the first circuit , all patients were spontaneously ventilated with FGF 500 mL/kg/min for 10 minutes , and then gradually decreased by 50 mL/kg/min every five minutes . |
METHODS | End-tidal CO2 ( ETCO ) and inspired minimum CO2 ( imCO ) were recorded until rebreathing ( imCO2 > 2 mmHg ) occurred and continued until rebreathing was not clinically acceptable ( imCO2 > 6 mmHg ) . |
METHODS | The anesthesia breathing circuit was switched and the procedure repeated . |
RESULTS | The minimal FGF at no rebreathing of Baby EAR and JR were 192.576.6 and 347.5108.2 mL/kg/min ; p < 0.001 . |
RESULTS | At acceptable rebreathing , the values were 117.546.7 and 227.690.6 mL/kg/min ; p < 0.001 . |
CONCLUSIONS | Baby EAR can be used safely , effectively , and requires less FGF than JR in pediatric anesthesia in patients weighing 5 to 20 kg . |
###25008873 | null |
OBJECTIVE | To study the effects of extensively hydrolyzed protein formula ( eHF ) on the feeding and growth in preterm infants through a multicenter controlled clinical study . |
METHODS | Preterm infants admitted to eight upper first-class hospitals in China between February 2012 and December 2013 were randomly selected . |
METHODS | They were divided into two observation groups and two control groups . |
METHODS | The first observation group consisted of preterm infants with a gestational age of < 32 weeks , who were fed with eHF for 10-14 days after birth and then with standard preterm formula ( SPF ) until discharge . |
METHODS | The second observation group consisted of preterm infants with a gestational age of 32-34 weeks , who were fed with SPF after birth , but were switched to eHF ( 7-14 days ) if suffering feeding intolerance at 6-8 days after birth . |
METHODS | The two control groups with corresponding gestational ages kept to be fed with SPF after birth . |
METHODS | Clinical data were recorded to compare feeding condition , physical growth , blood biochemical indices , and major complications between different groups . |
RESULTS | A total of 328 preterm infants were enrolled . |
RESULTS | Preterm infants with a gestational age of < 32 weeks in the observation group had a significantly shorter meconium evacuation time than in the corresponding control group ( P < 0.05 ) . |
RESULTS | They also had significantly lower levels of serum total bilirubin at weeks 1 and 2 after birth compared with the control group ( P < 0.05 ) . |
RESULTS | The observation group needed more time in reaching enteral nutrition ( EN ) basic energy uptake of 50 kcal / ( kgd ) , partial parenteral nutrition ( PPN ) , hospitalization , and corrected gestational age at discharge compared with the controlled infants ( P < 0.05 ) . |