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We will also be able to confirm if the effects of acupuncture are equivalent to those of the conventional drug cetirizine hydrochloride .

Probiotics are microbial supplements that have shown efficacy in a wide range of applications .

To assess the safety and effects of enteral probiotics in critically ill neonates .

A double-blind , randomized controlled trial was conducted in 100 full-term infants with critical illness according to scores of neonatal acute physiology .

Fifty neonatal intensive care patients were randomly assigned to receive probiotics three times daily after birth for 8 days , and fifty patients were not given probiotics , but who received a placebo .

The incidence of sepsis , multiple organ dysfunction syndrome ( MODS ) , nosocomial pneumonia , and necrotizing enterocolitis were recorded .

The prognosis of probiotic treatment was determined based on the rate of recovery and hospital days .

Serum IgA , IgG , and IgM concentrations were measured on days 4 and 8 .

Infants in the probiotics group showed a significantly reduced rate of nosocomial pneumonia ( 18 % versus 36 % ) and multiple organ dysfunction syndrome ( 6 % versus 16 % ) compared with the placebo group ( p < 0.05 ) .

Significant results were demonstrated in favour of the probiotics for days of hospital stay ( 13 3.5 d versus 15.8 5.3 d ) ( p < 0.05 ) .

However , there were no significant differences in the occurrence of sepsis , necrotizing enterocolitis , and recovery rate .

Patients given probiotics had significantly greater levels of IgA than those in the placebo group ( p < 0.05 ) .

No serious adverse effects in the study population were noted .

Supplements of probiotics to critically ill neonates could enhance immune activity , decrease occurrence of nosocomial pneumonia and MODS , and reduce days in hospital .

Recently , there have been investigations that have targeted improving the relatively poor validity and reliability of attentional bias measures .

These studies have demonstrated that individuals show elevated attentional bias to stimuli associated with their drinking history , although to date , the predictive utility of these measures has yet to be assessed .

The current study aimed to investigate the predictive value of an individualised alcohol Stroop task compared to that of an alcohol Stroop task with general alcohol-related words in a sample of non-dependent undergraduate drinkers .

48 undergraduate social drinkers completed questionnaire measures of alcohol consumption and hazardous drinking which were combined to get an alcohol involvement measure .

Participants also completed three blocked format Stroop tasks , a control Stroop ( containing soft drink-related words ) , a general alcohol Stroop ( containing a mixture of alcohol-related words ) and an individualised Stroop that contained words relating to the participants ' favourite alcoholic drink .

Although there was no significant difference in participants ' performance across the three different Stroop tasks , only performance on the individualised Stroop was associated with alcohol involvement .

Notably , the individualised Stroop predicted variance in drinking after controlling for demographics and general alcohol Stroop performance .

This study indicates that adopting individualised stimuli into attentional bias tasks may increase their predictive validity .

Following acute coronary syndrome ( ACS ) , the risk for future cardiovascular events is high and is related to levels of low-density lipoprotein cholesterol ( LDL-C ) even within the setting of intensive statin treatment .

Proprotein convertase subtilisin/kexin type 9 ( PCSK9 ) regulates LDL receptor expression and circulating levels of LDL-C .

Antibodies to PCSK9 can produce substantial and sustained reductions of LDL-C .

The ODYSSEY Outcomes trial tests the hypothesis that treatment with alirocumab , a fully human monoclonal antibody to PCSK9 , improves cardiovascular outcomes after ACS .

This Phase 3 study will randomize approximately 18,000 patients to receive biweekly injections of alirocumab ( 75-150 mg ) or matching placebo beginning 1 to 12 months after an index hospitalization for acute myocardial infarction or unstable angina .

Qualifying patients are treated with atorvastatin 40 or 80 mg daily , rosuvastatin 20 or 40 mg daily , or the maximum tolerated and approved dose of one of these agents and fulfill one of the following criteria : LDL-C 70 mg/dL , non-high-density lipoprotein cholesterol 100 mg/dL , or apolipoprotein B 80 mg/dL .

The primary efficacy measure is time to first occurrence of coronary heart disease death , acute myocardial infarction , hospitalization for unstable angina , or ischemic stroke .

The trial is expected to continue until 1613 primary end point events have occurred with minimum follow-up of at least 2 years , providing 90 % power to detect a 15 % hazard reduction .

Adverse events of special interest include allergic events and injection site reactions .

Interim analyses are planned when approximately 50 % and 75 % of the targeted number of primary end points have occurred .

ODYSSEY Outcomes will determine whether the addition of the PCSK9 antibody alirocumab to intensive statin therapy reduces cardiovascular morbidity and mortality after ACS .

Intrauterine growth restriction may be reduced by supplementing maternal diets during pregnancy , but few studies have assessed the impact of combined prenatal and postnatal interventions on child growth .

We tested a hypothesis that provision of small-quantity lipid-based nutrient supplements ( SQ-LNSs ) to mothers in pregnancy and 6 mo postpartum and to their infants from 6 to 18 mo of age would promote infant and child growth in the study area in rural Malawi .

We enrolled 869 pregnant women in a randomized trial in Malawi .

During pregnancy and 6 mo thereafter , the women received daily 1 capsule of iron-folic acid ( IFA ) , 1 capsule containing 18 micronutrients ( MMN ) , or one 20-g sachet of SQ-LNS [ lipid-based nutrient supplements ( LNS ) , containing 21 MMN , protein , carbohydrates , essential fatty acids , and 118 kcal ] .

Children in the IFA and MMN groups received no supplementation ; children in the LNS group received SQ-LNSs from 6 to 18 mo. .

Primary outcome was child length at 18 mo. .

At 18 mo , the mean length in the IFA , MMN , and LNS groups was 77.0 , 76.9 , and 76.8 cm ( P = 0.90 ) , respectively , and the prevalence of stunting was 32.7 % , 35.6 % , and 37.9 % ( P = 0.54 ) , respectively .

No intergroup differences were found in the mean weight , head circumference , or midupper arm circumference or the proportions with low z scores for these variables ( P > 0.05 ) .

Covariate adjustment did not change the analysis results , and the associations between the intervention and child length were not modified by maternal parity , age , or nutritional status ( P > 0.10 ) .

The findings do not support a hypothesis that provision of SQ-LNSs to women in pregnancy and postpartum and to children from 6 to 18 mo of age would promote child growth in this Malawian study area .

This trial was registered at clinicaltrials.gov as NCT01239693 .

Femoral nerve block ( FNB ) with varying concentrations of bupivacaine is often used for postoperative analgesia after anterior cruciate ligament ( ACL ) reconstruction .

To determine whether FNB using 0.25 % or 0.5 % bupivacaine provided better analgesia with less effect on quadriceps strengths after ACL reconstruction .

One hundred patients were randomized to receive FNB with 20 mL of 0.25 % or 0.5 % bupivacaine .

Data regarding demographic , effectiveness of FNB , time to first pain , time to first analgesic , pain scores , morphine use , and recovery of sensory and motor function were recorded .

Median time to first morphine requirement was 12 hours in 0.5 % bupivacaine group and 10 hours in 0.25 % bupivacaine group ( p = 0.048 ) .

Pain score at 18 hours was lower in 0.5 % bupivacaine group compared with 0.25 % bupivacaine group ( p = 0.001 ) .

When specify to the patellar tendon graft subgroup , the patients requiring morphine were 70 % in 0.5 % bupivacaine group and 90 % in 0.25 % bupivacaine group ( p = 0.03 ) .

No differences were found in demographic data , effectiveness of FNB , time to first pain , morphine consumption , and recovery of sensorimotor function .

FNB with 0.5 % bupivacaine provided longer time to first analgesic and lower narcotic requirements after patellar tendon graft ACL reconstruction when compared to 0.25 % bupivacaine .

Both concentrations showed similar effect on quadriceps strengths .

To establish a preoperative deep venous thrombosis predictor score for patients with fresh lower extremity fractures by statistical analysis .

From January 2011 to December 2012 , 1 705 patients with fresh lower extremity fractures were admitted to department of orthopaedic trauma , Beijing Jishuitan Hospital .

They were randomly divided into two groups , the group 1 ( n = 879 ) was used to screen risk factors and derived a predictive models based on logistic regression , the group 2 ( n = 826 ) validated the models .

Among the patients , there were 1 106 male and 599 female patients , with an average age of ( 50 18 ) years.Variables related to preoperative deep venous thrombosis were age , length of time before surgery , cause of injury , low/high-energy injury , location of injury , history of cardiovascular and cerebrovascular diseases , and D-Dimer .

The scores based on OR were : age 35 years : 1 point , > 35 - < 65 years : 4 points , 65 years : 6 points ; length of time before surgery , < 8 days :1 point , 8 days :2 points ; low-energy injury :1 point , high energy injury :3 points ; location of injury , foot and ankle :1 point , calf :3 points , around the knee : 5 points , femoral diaphysis and proximal femur :7 points , pelvis and acetabulum :4 points , 2 sites :6 point ; history of cardiovascular and cerebrovascular diseases , yes :2 points , no :1 point .

D-Dimer < 600 g/L :1 point , 600 g/L :3 points .

Area under receiver operating characteristic curve was 0.79 , critical point 15.5 points , sensitivity was 77.00 % , specificity was 68.17 % .

The score can predict the preoperative deep venous thrombosis for patients with fresh lower extremity fractures , but limited .

To investigate if baseline depression moderated response to Media Smart , an 8-lesson school-based program previously found to achieve a long-term risk reduction effect in young adolescents .

540 Grade 8 students ( M age = 13.62 years , SD = .37 ) from 4 schools participated with 11 classes receiving the Media Smart program ( 126 girls ; 107 boys ) and 13 comparison classes receiving their normal lessons ( 147 girls ; 160 boys ) .

Shape and weight concern , media internalization , body dissatisfaction , dieting , ineffectiveness , and perceived pressure were the outcome variables .

Moderation was indicated by significant interaction effects for group ( Media Smart ; Control ) moderator ( high depression ; low depression ) time ( post-program ; 6-month follow-up ; 2.5-year follow-up ) , with baseline entered as a covariate .

Such effects were found for shape and weight concern , media internalization , body dissatisfaction , ineffectiveness and perceived pressure .

Post-hoc testing found high depression Media Smart participants scored significantly lower than their control counterparts at post-program on shape and weight concern , media internalization and dieting , whereas low depression Media Smart participants scored significantly lower on shape and weight concern at 2.5-year follow-up .

Media Smart achieved a reduction in eating disorder risk factors for high-depression participants and a reduced rate of growth in risk factor scores for low-depression participants .

Trial registry name : Australian New Zealand Clinical Trials Registry .

URL : http://www.anzctr.org.au .

Registration identification number : ACTRN12608000545369 .

The purpose of this study was to determine the effects of early outpatient exercise on muscle mass , function , and fractional synthetic rate in severely burned children .

Forty-seven children with 40 % total body surface area burn performed a 12-wk standard of care rehabilitation ( SOC , n = 23 ) or rehabilitative exercise training ( RET , n = 24 ) immediately after hospital discharge .

Dual-energy x-ray absorptiometry was used to assess lean body mass ( LBM ) at discharge , posttreatment , and 12 months post-burn .

Muscle function was evaluated with a Biodex Isokinetic Dynamometer , and peak aerobic fitness ( VO2peak ) was measured using a modified Bruce treadmill protocol posttreatment .

Stable isotope infusion studies were performed in a subset of patients ( SOC , n = 13 ; RET , n = 11 ) at discharge and posttreatment to determine mixed-muscle fractional synthetic rate .

Relative peak torque ( RET , 138 9 Nmkg , vs SOC , 106 9 Nmkg ) and VO2peak ( RET , 32 1 mLkgmin , vs SOC , 28 1 mLkgmin ) were greater at posttreatment with RET compared with those with SOC .

In addition , RET increased whole-body ( 9 % 2 % ) and leg ( 17 % 3 % ) LBM compared with SOC .

Furthermore , the percentage change in whole-body ( 18 % 3 % ) and leg ( 31 % 4 % ) LBM from discharge to 12 months post-burn was greater with RET compared to SOC .

Muscle fractional synthetic rate decreased from discharge to posttreatment in both groups ( 6.9 % 1.1 % per day vs 3.4 0.4 % per day ) ; however , no differences were observed between treatment groups at each time point .

Early outpatient exercise training implemented at hospital discharge represents an effective intervention to improve muscle mass and function after severe burn injury .

This study compared generalized complex fractionated atrial electrograms ( CFAE ) ablation versus a selective CFAE ablation strategy targeting areas of continuous electric activity .

Subjects with symptomatic , persistent/high-burden paroxysmal atrial fibrillation ( AF ) were enrolled at 6 centers ( n = 86 ) and randomized to 1 of 2 arms .

For group I , all CFAE regions with an interval confidence level > 7 were ablated followed by pulmonary vein isolation ( PVI ) .

For group II , only CFAE sites with continuous electric activity were ablated followed by PVI .

For PVI , all 4 PV antra were isolated with confirmed entrance block .

Subjects were followed for 1 year with a visit , ECG , and 48-hour Holter every 3 months .

Symptoms were confirmed by loop recording .

The primary end point was freedom from arrhythmia > 30 seconds at 1 year .

For both group I and II , CFAE ablation prolonged AF cycle length ( 2533 versus 2333 ms ; P = 0.78 ) and resulted in similar rates of AF termination ( 37 % versus 28 % ; P = 0.42 ) .

Radiofrequency duration during CFAE ablation was significantly less in group II ( 2320 versus 3820 minutes ; P = 0.002 ) .

At 1-year follow-up , freedom from AF/atrial flutter/atrial tachycardia recurrence was significantly higher in group I versus group II after 1 procedure ( 50 % versus 28 % ; P = 0.03 ) .

There were also significantly fewer repeat procedures in group I ( 13 % versus 36 % ; P = 0.021 ) .

Continuous electric activity ablation + PVI result in a similar incidence of acute AF termination with significantly less radiofrequency time .

However , incidence of repeat procedures and long-term recurrence of AF/atrial flutter/atrial tachycardia are significantly lower using generalized CFAE ablation + PVI .

Clinical Trial Registration - URL : http://www.clinicaltrials.gov .

Unique identifier : NCT00926783 .

To determine if the use of a Bakri balloon at cesarean delivery ( CD ) for placenta previa is associated with a reduced need for additional surgical or pharmacologic measures and less blood loss than usual practices .

In a randomized controlled trial , 52 women undergoing CD for placenta previa were randomly allocated 1:1 into an intervention arm ( prophylactic Bakri balloon immediately following placental delivery ) or a control arm ( use of any usual surgical/pharmacologic measures to achieve hemostasis ) .