The modified water swallowing test was conducted to assess the efficacy before treatment , 10 days after treatment and 30 days after treatment in each group separately .


The clinical efficacy , score of water swallowing test and improvement in water swallow test were compared among the groups .


After 10-day treatment , the differences in efficacy and score of water swallow test were not significant in each group ( all P > 0.05 ) .


After 30-day treatment , the effective rate ( 94.29 % , 33/35 ) in the comprehensive treatment group was apparently better than 68.75 % ( 22/32 ) in the acupoint injection group , 80.00 % ( 32/40 ) in the neural electrical stimulation group , 67.50 % ( 27/40 ) in the swallowing training group and 42.86 % ( 12/28 ) in the blank group separately .


The score in water swallow test in the comprehensive treatment group was lower than that in each of the other groups ( 1.37 0.60 vs 2.03 1.00 , 1.90 0.90 , 2.20 0.72 , 2.71 0.90 , all P < 0.05 ) .


The differences in the effective rate and score in water swallow test were not significant among the acupoint injection group , neural electrical stimulation group and swallowing training group ( all P > 0.05 ) , which indicated that the improvement in swallowing function in the comprehensive treatment group was significantly superior to the other groups ( all P < 0.05 ) .


The comprehensive therapy of acupoint injection and neural electrical stimulation achieves the much better efficacy on post-stroke dysphagia .


To evaluate the impact of a 91-day extended regimen combined oral contraceptive ( 150 g levonorgestrel [ LNG ] / 30 g ethinylestradiol [ EE ] for 84 days , followed by 10 g EE for seven days [ Treatment 1 ] ) compared with two traditional 21/7 regimens ( 21 days 150 g LNG/30 g EE [ Treatment 2 ] or 150 g desogestrel [ DSG ] / 30 g EE [ Treatment 3 ] , both with seven days ' hormone free ) , on several coagulation factors and thrombin formation markers .


Randomised , open-label , parallel-group comparative study involving healthy women ( 18-40 years ) .


The primary endpoint was change from baseline in prothrombin fragment 1 + 2 ( F1 + 2 ) levels over six months .


A total of 187 subjects were included in the primary analysis .


In all groups , mean F1 + 2 values were elevated after six months of treatment .


Changes were comparable between Treatments 1 and 2 ( least squares mean change : 170 pmol/L and 158 pmol/L , respectively ) but noticeably larger after Treatment 3 ( least squares mean change : 592 pmol/L ) .


The haemostatic effects of Treatment 1 were comparable to those of Treatment 2 and noninferior to those of Treatment 3 ( lower limit of 95 % confidence interval [ - 18.3 pmol/L ] > - 130 pmol/L ) .


The LNG/EE regimens had similar effects on F1 + 2 .


Noninferiority was demonstrated between extended regimen LNG/EE and DSG/EE .


To investigate whether the type of anesthetic agent administered affects the antitussive effect of remifentanil .


Prospective randomized study .


Operating room of a university hospital .


78 ASA physical status 1 and 2 women , aged 20 to 65 years , who were scheduled to undergo a thyroidectomy .


Patients were randomly assigned to three groups to receive anesthesia with propofol ( Group P ) , sevoflurane ( Group S ) , or desflurane ( Group D ) .


The main anesthetics were titrated to maintain a target Bispectral Index for hypnosis of 40 to 60 .


Remifentanil was administered via effect-site target-controlled infusion ( TCI ) .


To determine the effective remifentanil effect-site concentration ( Ce ) to suppress coughing in each group , the up-and-down sequential allocation design was used .


The half maximal effective concentration ( EC50 ) values of remifentanil for preventing coughing in the groups were estimated using isotonic regression and compared among the groups .


The EC50 of remifentanil for cough suppression in Group P [ 1.60 ng/mL ( 98.3 % CI , 0.92-1 .75 ng/mL ) ] was statistically lower than in Group D [ 1.96 ng/mL ( 98.3 % CI , 1.81-2 .50 ng/mL ) ] .


The EC50 in Group S was 1.75 ng/mL ( 98.3 % CI , 1.39-2 .13 ng/mL ) , which was higher than in Group P and lower than in Group D , but did not differ significantly from either group .


Remifentanil administration for cough suppression during emergence should be customized to the anesthetic agent .


It is important that patients are well-informed about risks and benefits of therapies to help them decide whether to accept medical therapy .


Different numerical formats can be used in risk communication but It remains unclear how the different formats affect decisions made by real-life patients .


To compare the impact of using Prolongation Of Life ( POL ) and Absolute Risk Reduction ( ARR ) information formats to express effectiveness of cholesterol-lowering therapy on patients ' redemptions of statin prescriptions , and on patients ' confidence in their decision and satisfaction with the risk communication .


Cluster-randomised clinical trial in general practices .


Thirty-four Danish GPs from 23 practices participated in a primary care-based clinical trial concerning use of quantitative effectiveness formats for risk communication in health prevention consultations .


GPs were cluster-randomised ( treating practices as clusters ) to inform patients about cardiovascular mortality risk and the effectiveness of statin treatment using either POL or ARR formats .


Patients ' redemptions of statin prescriptions were obtained from a regional prescription database .


The COMRADE questionnaire was used to measure patients ' confidence in their decision and satisfaction with the risk communication .


Of the 240 patients included for analyses , 112 were allocated to POL information and 128 to ARR .


Patients redeeming a statin prescription totalled six ( 5.4 % ) when informed using POL , and 32 ( 25.0 % ) when using ARR .


The level of confidence in decision and satisfaction with risk communication did not differ between the risk formats .


Patients redeemed statin prescriptions less often when their GP communicated treatment effectiveness using POL compared with ARR .


Although hydroxyethyl starch ( HES ) is commonly used as an intravascular volume expander in surgical patients , recent studies suggest that it may increase the risk of renal failure in critically ill patients .


We hypothesized that patients undergoing radical prostatectomy and receiving HES would be more likely to develop markers of renal failure , such as increasing urinary neutrophil gelatinase-associated lipocalin ( u-NGAL ) , creatinine clearance ( C ( crea ) ) , and decreasing urine output ( UO ) .


In a randomized , double-blinded , placebo-controlled study , 40 patients referred for radical prostatectomy received either 6 % HES 130/0 .4 or saline 0.9 % ; 7.5 mL/kg during the first hour of surgery and 5 mL/kg in the following hours ; u-NGAL , urine albumin , C ( crea ) , UO , arterial blood pressure , and plasma concentrations of creatinine , renin , angiotensin II , aldosterone , and vasopressin were measured before , during , and after surgery .


Thirty-six patients completed the study .


u-NGAL , C ( crea ) , UO , plasma neutrophil gelatinase-associated lipocalin , p-creatinine , urine albumin , and arterial blood pressure were the same in both groups .


Blood loss was higher in the HES group ( HES 1250 vs saline 750 mL ) , while p-albumin was reduced to a significantly lower level .


P-renin and p-angiotensin-II increased in both groups , whereas p-aldosterone and p-vasopressin increased significantly in the saline group .


We found no evidence of nephrotoxicity after infusion of 6 % HES 130/0 .4 in patients undergoing prostatectomy with normal preoperative renal function .


Hemodynamic stability and infused fluid volume were the same in both groups .


We observed an increased blood loss in the group given 6 % HES 130/0 .4 .


Nasotracheal intubation of patients with temporomandibular joint ( TMJ ) ankylosis is a challenge for anesthesiologists .


Awake fiberoptic intubation ( AFOI ) is the safest technique in patients with difficult airway .


This study compares 3 different techniques of conscious sedation during AFOI in patients with TMJ ankylosis .


This study comprised 54 patients , American Society of Anesthesiologists physical status 1 , scheduled for TMJ surgery .


The patients were randomly allocated to remifentanil group ( n = 18 , 0.75 g/kg over 30 seconds ) , ketamine group ( n = 18 , 0.25 mg/kg over 30 seconds ) , or propofol group ( n = 18 , 0.5 mg/kg over 30 seconds ) for conscious sedation .


The main determinants affecting the patient 's outcome included intubation time , intubation conditions , and patient discomfort , which were determined by scoring system .


In addition , postoperative patient dissatisfaction , hemodynamic stability , and respiratory impairment were measured .


Intubation times were significantly different between groups ( P < 0.001 ) , where remifentanil had the shortest time ( 30.28 seconds ) .


Intubation conditions ( scores 0-3 ) were significantly different between groups ( P < 0.001 ) .


In this context , remifentanil had score 3 ( 2-3 ) , which was higher compared with 2 ( 1-3 ) for ketamine and 2 ( 1-2 ) for propofol .


Patient discomfort score was lowest in the remifentanil group .


Hemodynamic stability was maintained within groups , and its changes were not significant ( P > 0.05 ) .


Postoperative patient 's dissatisfaction was observed in 2 , 3 , and 5 patients in remifentanil , ketamine , and propofol groups , respectively .


Respiratory impairment ( apnea ) recorded lowest in the remifentanil group .


Remifentanil was the best agent for AFOI , because it provided shorter intubation time , better intubation conditions , and least patient 's complaint.Iranian registry no. : IRCT 201208061674N4 ( www.irct.ir ) .


AZD7325 is a novel 2,3 - subtype-selective partial GABA-A-receptor modulator .


This study investigated the pharmacodynamics of single oral doses of AZD7325 2mg and 10mg on the central nervous system ( CNS ) compared with placebo and lorazepam 2mg .


This double-blind , randomized , four way crossover study enrolled 16 healthy males and administered two validated CNS test batteries to measure drug effects on cognitive , neurophysiologic and psychomotor function and subjective feelings .


The pharmacological selectivity of AZD7325 was compared with lorazepam by plotting saccadic peak velocity change from baseline ( SPV ) against body sway ( Sway ) and visual analogue scale for alertness ( VASalertness ) .


This analysis has previously been used to identify 2,3 - subtype-selectivity .


In contrast with the robust impairment caused by lorazepam ( all P < 0.05 vs. placebo ) , neither dose of AZD7325 induced statistically significant effects on any pharmacodynamic measurements .


Lorazepam-induced SPV-reduction was linearly related to changes in other neurophysiologic biomarkers .


In contrast , the slopes of the regression lines were flatter for AZD7325 , particularly for the log ( Sway ) - SPV relation ( estimate slope , AZD7325 10mg vs. lorazepam , difference [ 95 % confidence interval ] , P value -0.00036 vs. -0.00206 , 0.001704 [ 0.000639 , 0.002768 ] , P = 0.0018 ) and the VASalertness - SPV relationship ( 0.01855 vs. 0.08216 , -0.06360 [ -0.1046 , -0.02257 ] , P = 0.0024 ) .


AZD7325 10mg and lorazepam induced different response patterns on VAS ` feeling high ' and electro-encephalography .


The characteristic SPV-relative effect profiles of AZD7325 vs. lorazepam suggest anxio-selectivity related to 2,3 - selective GABAA agonism .


However , exploration of higher doses may be warranted .


The paucity of effects on most CNS-PD parameters also indicates a mitigated side effect pattern , with potentially lower cognitive and neurophysiological side effect burden than non-selective benzodiazepines .


Healthcare providers ( HCPs ) play a critical role in controlling the spread of sexually transmitted infections ( STI ) through early and accurate diagnosis , appropriate treatment and prevention counselling .


This study aimed to assess the effectiveness of an educational intervention about STI on knowledge and reported practice among HCPs and to explore which determinants may influence the intervention 's effects .


A cluster randomized controlled educational intervention was carried out in a rural district , Vietnam .


32 communes of the district were randomized into two arms , with 160 HCPs in an STI intervention arm and 144 in a control arm .


The STI intervention comprised interactive training with basic STI knowledge , case scenarios , and poster distribution .


Questionnaires to evaluate knowledge and reported practice were completed three times : before , during and after the intervention .


Correct answer was scored as 1 ; `` do not know '' , incorrect answer was scored as 0 .


Univariate and multilevel multivariate analyses were applied .


Of the maximum 56 points , the mean knowledge score increased significantly in the STI intervention arm and in the control arm post-intervention ( 37.2 to 48.4 , and 32.7 to 41.7 , respectively ) .


In multivariate regression analysis , knowledge improvement in the intervention arm was significantly higher than that in the control arm ( regression coefficient = 2.97 , p = 0.008 ) .


Other factors which positively influenced the increase in knowledge were being between 35 and 50 years old , having intermediate professional training , being a pharmacist or working at a village level ( regression coefficient : 2.81 , 4.43 , 5.53 and 7.91 , respectively ) .


Post-intervention , the mean reported practice score increased significantly in the STI intervention arm ( from 17.6 to 21.8 ) and insignificantly in the control arm ( maximum 36 points ) .


Factors which positively influenced the increase in reported practice were being between 35 and 50 years old , having intermediate professional training , or working at a pharmacy/drugstore ( regression coefficient : 2.15 , 3.33 and 3.22 , respectively ) .


This study indicates that an educational intervention including interactive training and multi-faceted interventions may be effective in improving STI knowledge and reported practice of HCPs at grassroots level , particularly among pharmacists , HCPs who work in villages or pharmacies/drugstores , and who initially have low STI knowledge .


Long-lasting insecticidal net screens ( LLIS ) fitted to domestic windows and doors in combination with targeted treatment ( TT ) of the most productive Aedes aegypti breeding sites were evaluated for their impact on dengue vector indices in a cluster-randomised trial in Mexico between 2011 and 2013 .


Sequentially over 2 years , LLIS and TT were deployed in 10 treatment clusters ( 100 houses/cluster ) and followed up over 24 months .


Cross-sectional surveys quantified infestations of adult mosquitoes , immature stages at baseline ( pre-intervention ) and in four post-intervention samples at 6-monthly intervals .


Identical surveys were carried out in 10 control clusters that received no treatment .


LLIS clusters had significantly lower infestations compared to control clusters at 5 and 12 months after installation , as measured by adult ( male and female ) and pupal-based vector indices .


After addition of TT to the intervention houses in intervention clusters , indices remained significantly lower in the treated clusters until 18 ( immature and adult stage indices ) and 24 months ( adult indices only ) post-intervention .


These safe , simple affordable vector control tools were well-accepted by study participants and are potentially suitable in many regions at risk from dengue worldwide .


To compare remifentanil and morphine-midazolam for use in nonurgent endotracheal intubation in neonates .


In this prospective noninferiority randomized trial , newborns of gestational age 28 weeks admitted in the neonatal intensive care unit requiring an elective or semielective endotracheal intubation were divided into 2 groups .


One group ( n = 36 ) received remifentanil ( 1 g/kg ) , and the other group ( n = 35 ) received morphine ( 100 g/kg ) and midazolam ( 50 g/kg ) at a predefined time before intubation ( different in each group ) , to optimize the peak effect of each drug .


Both groups also received atropine ( 20 g/kg ) .


The primary outcome was to compare the conditions of intubation , and the secondary outcome was to compare the duration of successful intubation , physiological variables , and pain scores between groups for first and second intubation attempts .


Adverse events and neurologic test data were reported .


Intubation with remifentanil was not inferior to that with morphine-midazolam .


At the first attempted intubation , intubation conditions were poor in 25 % of the remifentanil group and in 28.6 % of the morphine-midazolam group ( P = .471 ) .


For the second attempt , conditions were poor in 28.6 % of the remifentanil group , compared with 10 % of the morphine-midazolam group ( P = .360 ) .


The median time to successful intubation was 33 seconds ( IQR , 24-45 seconds ) for the remifentanil group versus 36 seconds ( IQR , 25-59 seconds ) for the morphine-medazolam group ( P = .359 ) at the first attempt and 45 seconds ( IQR , 35-64 seconds ) versus 56 seconds ( IQR , 44-68 seconds ) , respectively , for the second attempt ( P = .302 ) .


No significant between-group difference was reported for hypotension , bradycardia , or adverse events .


In our cohort , remifentanil was at least as effective as the morphine-midazolam regimen for endotracheal intubation .


Thus , premedication using this very-short-acting opioid can be considered in urgent intubations and is advantageous in rapid extubation .


To evaluate the efficacy and safety of the combination therapy of tamsulosin and solifenacin for mild and moderate benign prostatic hyperplasia ( BPH ) with overactive bladder ( OAB ) .


We randomly divided 166 patients with BPH and concomitant OAB into a mild obstruction symptom group ( n = 88 ) and a moderate obstruction symptom group ( n = 78 ) , 48 of the former group treated with 0.2 mg tamsulosin + 5 mg solifenacin and the other 40 with 0.2 mg tamsulosin ; 36 of the latter group treated with 0.2 mg tamsulosin + 5 mg solifenacin and the other 42 with 0.2 mg tamsulosin , all administered once daily for 12 weeks .


We obtained the International Prostate Symptom Score ( IPSS ) , urine storage period symptom score ( USPSS ) , voiding symptom score ( VSS ) , Qmax , residual urine volume , OAB symptom score ( OABSS ) and adverse reactions , and compared them among different


Among the patients with mild obstruction symptoms , the combination of tamsulosin and solifenacin achieved remark-groups .


able improvement in IPSS , USPSS , Qmax and OABSS as compared with the baseline ( P < 0.05 ) , but made no significant difference in the residual urine volume ( P > 0.05 ) , while tamsulosin improved IPSS only ( P < 0.05 ) .


The combination therapy exhibited an obvious superiority over tamsulosin alone in improving IPSS ( 9.7 micro 3.0 vs 15.8 micro 3.3 ) , USPSS ( 8.1 micro 1.7 vs 12.3 micro 3.1 ) , Qmax ( [ 18.6 micro 2.3 ] ml/s vs [ 14.2 micro 2.3 ] ml/s ) , and OABSS ( 5.3 micro 1.3 vs 9.7 micro 2.7 ) ( P < 0.05 ) , but there were no obvious differences in residual urine , urine routine test results and adverse events between the two therapies ( P > 0.05 ) .


In those with moderate obstruction symptoms , the combination therapy significantly improved IPSS , VSS , Qmax and OABSS ( P < 0.05 ) but not the residual urine ( P > 0.05 ) in comparison with the baseline .


The tamsulosin therapy achieved obvious improvement in IPSS , VSS , Qmax , OABSS and residual urine .


The combination therapy showed a better effect than tamsulosin only in OABSS ( 4.8 + / -1.5 vs 6.5 + / -2.5 , P < 0.05 ) , but no significant differences from the latter in IPSS , Qmax , VSS , routine urine test results , and adverse


Combination therapy of tamsulosin and solifenacin is obviously safe and efficacious in the treatment ( P > 0.05 ) .


eventsof bothmild and moderate BPH with concomitant OAB , and it is superior to tamsulosin alone .


Circular excision by secondary-intention healing is useful for small skin defects ( diameter < 10 mm ) .


But the injection pain as the local anesthesia is administered one of the patients ' biggest concerns .


Buffered lidocaine can effectively relieve the injection pain , but it might increase the potential complications .


This study examined the effect of buffered lidocaine on wound healing .


Patients undergoing circular excision by secondary-intention healing were divided into 2 groups and were administered buffered or unbuffered lidocaine as the local anesthesia .


Comparative parameters included injection pain , postoperative pain , complication rate , scar width , and scar quality at 6 months .


Statistical differences between the 2 agents were assessed .


The patients in the buffered group experienced 0.9 fewer scaled injection pain units than did the patients in the unbuffered group ( p = 0.009 ) .


Complication rates and scar appearance did not show any statistical difference between the 2 groups .


Buffered lidocaine is useful to relieve the injection pain during the secondary-intention healing , and it is safe to use if it is applied properly .


Different techniques have been used for filler injection of the tear trough and palpebromalar groove .


Most patients report good results ; however , some patients here experienced variable degrees of side effects .


To assess if previous estimation of the bony orbit depth could affect the choice between bolus and serial puncture technique , and thereby the procedure outcome .


In 32 patients , the periosteum depth was measured by using a 28 G needle at 2 points : Point A at the midpupillary line and Point B at the outer canthus .


The bolus technique was performed in the right side , and serial puncture technique was done on the left side .


There was a significant difference in the degree of improvement between both sides in 71 % of patients : 40 % had better improvement on the right side , whereas 31 % had better improvement on the left side .


Cases with skin-to-periosteum depth less than 0.5 cm showed better results with serial puncture technique , whereas those with more than 0.5 cm depth showed better results with bolus technique .


Assessment of bony orbit depth could offer new tool for selecting infraorbital groove injection technique .


A randomized controlled trial to confirm the non-inferiority of laparoscopic surgery to open surgery in terms of overall survival was conducted , and short-term surgical outcomes are demonstrated .


The efficacy and safety outcome of laparoscopic surgery for clinical stages II/III colon cancer undergoing Japanese D3 dissection are still unclear .


Eligibility criteria included colon cancer ; tumor located in the cecum , ascending , sigmoid , or rectosigmoid colon ; T3 or T4 without involvement of other organs ; N0-2 ; and M0 .


Patients were randomized preoperatively and underwent tumor resection with D3 dissection .


Safety analyses were conducted by per-protocol set .


A total of 1057 patients were randomized between October 2004 and March 2009 .


By per-protocol set , 524 patients who underwent open surgery and 533 patients who underwent laparoscopic surgery were analyzed .


D3 dissection was performed in 521 ( 99.4 % ) patients in the open surgery arm and 529 ( 99.2 % ) patients in the laparoscopic surgery arm .


Conversion to open surgery was needed for 29 ( 5.4 % ) patients .


Patients assigned to laparoscopic surgery had less blood loss ( P < 0.001 ) , although laparoscopic surgery lasted 52 minutes longer ( P < 0.001 ) .


Laparoscopic surgery was associated with a shorter time to pass first flatus , decreased use of analgesics after 5 postoperative days , and a shorter hospital stay .


Morbidity [ 14.3 % ( 76/533 ) vs 22.3 % ( 117/524 ) , P < 0.001 ] was lower in the laparoscopic surgery arm .


Short-term surgical safety and clinical benefits of laparoscopic D3 dissection were demonstrated .


The primary endpoint will be reported after the primary analysis , planned for 2014 .


The objective of this study is to understand the effectiveness of foam rolling ( FR ) as a recovery tool after exercise-induced muscle damage , analyzing thigh girth , muscle soreness , range of motion ( ROM ) , evoked and voluntary contractile properties , vertical jump , perceived pain while FR , and force placed on the foam roller .


Twenty male subjects ( 3 yr of strength training experience ) were randomly assigned into the control ( n = 10 ) or FR ( n = 10 ) group .


All the subjects followed the same testing protocol .


The subjects participated in five testing sessions : 1 ) orientation and one-repetition maximum back squat , 2 ) pretest measurements , 10 10 squat protocol , and POST-0 ( posttest 0 ) measurements , along with measurements at 3 ) POST-24 , 4 ) POST-48 , and 5 ) POST-72 .


The only between-group difference was that the FR group performed a 20-min FR exercise protocol at the end of each testing session ( POST-0 , POST-24 , and POST-48 ) .


FR substantially reduced muscle soreness at all time points while substantially improving ROM .


FR negatively affected evoked contractile properties with the exception of half relaxation time and electromechanical delay ( EMD ) , with FR substantially improving EMD .


Voluntary contractile properties showed no substantial between-group differences for all measurements besides voluntary muscle activation and vertical jump , with FR substantially improving muscle activation at all time points and vertical jump at POST-48 .


When performing the five FR exercises , measurements of the subjects ' force placed on the foam roller and perceived pain while FR ranged between 26 and 46 kg ( 32 % -55 % body weight ) and 2.5 and 7.5 points , respectively .


The most important findings of the present study were that FR was beneficial in attenuating muscle soreness while improving vertical jump height , muscle activation , and passive and dynamic ROM in comparison with control .


FR negatively affected several evoked contractile properties of the muscle , except for half relaxation time and EMD , indicating that FR benefits are primarily accrued through neural responses and connective tissue .


Biochemical modulation of 5-fluorouracil ( 5-FU ) by leucovorin ( LV ) enhances antitumor activity .


LV is thus often added to 5-FU-based regimens for the treatment of metastatic colorectal cancer ( mCRC ) .


A combination of S-1 , oxaliplatin , and LV ( SOL ) was shown to be feasible , effective , and safe in a previous phase I trial .


We therefore conducted a randomized phase II trial to evaluate efficacy and safety of SOL compared with mFOLFOX6 .


Patients with mCRC and no prior chemotherapy were randomly assigned to receive either SOL or mFOLFOX6 .


SOL consisted of S-1 ( 40-60mg bid ) plus oral LV ( 25mg bid ) for 1week and oxaliplatin ( 85mg/m ( 2 ) ) on day 1 , repeated every 2weeks .


Among 107 patients enrolled from July 2008 through July 2009 , 105 ( 56 in the SOL group and 49 in the mFOLFOX6 group ) were eligible and evaluated .


The median progression-free survival was 9.6 months in the SOL group and 6.9 months in the mFOLFOX6 group [ hazard ratio ( HR ) 0.83 , 95 % confidence interval ( CI ) 0.49-1 .40 ] .


The median overall survival was 29.9 and 25.9 months , respectively ( HR 0.91 , 95 % CI 0.55-1 .49 ) .


The response rate was 55 % in both groups .


Grade 3 or 4 adverse drug reactions were neutropenia ( 20 % with SOL vs 41 % with mFOLFOX6 ) , sensory neuropathy ( 20 vs 2.0 % ) , anorexia ( 13 vs 7.8 % ) , fatigue ( 11 vs 5.9 % ) , and diarrhea ( 11 vs 3.9 % ) .


SOL demonstrated promising efficacy and acceptable toxicity as first-line chemotherapy for mCRC .


Further studies of SOL combined with molecular target agents are warranted .


To test the hypothesis that the GH receptor ( GHR ) exon 3 deleted ( d3 ) / full-length ( fl ) polymorphism influences anthropometry and body composition in the general population .


The Swedish Obese Subjects ( SOS ) reference study is a cross-sectional population-based study , randomly selected from a population registry .


A subgroup of the population-based Malm Diet and Cancer study ( MDC-CC ) was used as a replication cohort .


The SOS reference study comprises 1135 subjects ( 46.2 % men ) , with an average age of 49.5 years .


The MDC-CC includes 5451 successfully genotyped subjects ( 41.5 % men ) , with an average age of 57.5 years .


GHR d3/fl genotypes were determined using TagSNP rs6873545 .


Linear regression analyses were used to test for genotype-phenotype associations .


In the SOS reference study , subjects homozygous for the d3-GHR weighed 4kg more ( P = 0.011 ) , and had larger waist-to-hip ratio ( WHR , P = 0.036 ) , larger waist circumference ( P = 0.016 ) , and more fat-free mass estimated from total body potassium ( P = 0.026 ) than grouped fl/d3 and fl/fl subjects ( d3-recessive genetic model ) .


The association with WHR was replicated in the MDC-CC ( P = 0.002 ) , but not those with other anthropometric traits .


In this population-based study , the GHR d3/fl polymorphism was found to be of functional relevance and associated with central adiposity , such that subjects homozygous for the d3-GHR showed an increased abdominal obesity .


Appropriate use criteria ( AUC ) for transthoracic echocardiography ( TTE ) were developed to address concerns regarding inappropriate use of TTE .


A previous pilot study suggests that an educational and feedback intervention can reduce inappropriate TTEs ordered by physicians in training .


It is unknown if this type of intervention will be effective when targeted at attending level physicians in a variety of clinical settings .


The aim of this international , multicenter study is to evaluate the hypothesis that an AUC-based educational and feedback intervention will reduce the proportion of inappropriate echocardiograms ordered by attending physicians in the ambulatory environment .


In an ongoing multicentered , investigator-blinded , randomized controlled trial across Canada and the United States , cardiologists and primary care physicians practicing in the ambulatory setting will be enrolled .


The intervention arm will receive ( 1 ) a lecture outlining the AUC and most recent available evidence highlighting appropriate use of TTE , ( 2 ) access to the American Society of Echocardiography mobile phone app , and ( 3 ) individualized feedback reports e-mailed monthly summarizing TTE ordering behavior including information on inappropriate TTEs and brief explanations of the inappropriate designation .


The control group will receive no education on TTE appropriate use and order TTEs as usual practice .


The Echo WISELY ( Will Inappropriate Scenarios for Echocardiography Lessen Significantly in an education RCT ) study is the first multicenter randomized trial of an AUC-based educational intervention .


The study will examine whether an education and feedback intervention will reduce the rate of outpatient inappropriate TTEs ordered by attending level cardiologists and primary care physicians ( www.clinicaltrials.gov identifier NCT02038101 ) .


Poststroke cognitive impairment is common and identification of prognostic factors associated with it and its relationship with other functional outcomes may help in developing preventative strategies .


Previously independent patients with acute stroke , enrolled into the ongoing `` Efficacy of Nitric Oxide in Stroke '' trial , were assessed by telephone on day 90 for cognitive impairment using modified versions of `` Mini Mental State Examination '' ( MMSE-M ) and `` Telephone Instrument for Cognitive Status '' ( TICS-M ) scales and category fluency .


The relationship of cognitive impairment with baseline prognostic factors and other functional outcomes at day 90 were studied .


The analysis included 1572 patients , mean age 69years ( standard deviation , 12 ) , and female 40 % .


By 90days , 246 patients had died , and cognitive impairment was present in 38 % .


Increasing age , stroke severity , heart rate , and presence of cerebral atrophy on baseline neuroimaging were associated with cognitive impairment ( all P < .001 ) .


Hypertension and atrial fibrillation were also associated with category fluency and MMSE-M , respectively .


Cognition was significantly related to other functional outcomes , TICS-M with dependency ( modified Rankin Scale , rs = -.562 , P < .001 ) ; disability ( Barthel Index , rs = .577 , P < .001 ) ; mood ( Zung Depression Score , rs = -.542 , P < .001 ) ; and quality of life ( Euro Quality of life-5 Descriptor , rs = .519 , P < .001 ) .


In previouslyindependent individuals , cognitive impairment was common 3months after stroke and related to increasing age , stroke severity , hypertension , atrial fibrillation , and cerebral atrophy on brain scanning .


Cognition was related to dependency , disability , low mood , and quality of life .


Hence , treatment directed toward reducing dependency might also reduce cognitive impairment .


Diabetes , a highly prevalent , chronic disease , is associated with increasing frailty and functional decline in older people , with concomitant personal , social , and public health implications .


We describe the rationale and methods of the multi-modal intervention in diabetes in frailty ( MID-Frail ) study .


The MID-Frail study is an open , randomised , multicentre study , with random allocation by clusters ( each trial site ) to a usual care group or an intervention group .


A total of 1,718 subjects will be randomised with each site enrolling on average 14 or 15 subjects .


The primary objective of the study is to evaluate , in comparison with usual clinical practice , the effectiveness of a multi-modal intervention ( specific clinical targets , education , diet , and resistance training exercise ) in frail and pre-frail subjects aged 70years with type 2 diabetes in terms of the difference in function 2 years post-randomisation .


Difference in function will be measured by changes in a summary ordinal score on the short physical performance battery ( SPPB ) of at least one point .


Secondary outcomes include daily activities , economic evaluation , and quality of life .


The MID-Frail study will provide evidence on the clinical , functional , social , and economic impact of a multi-modal approach in frail and pre-frail older people with type 2 diabetes .


ClinicalTrials.gov : NCT01654341 .


We devised a 1-step posterior reconstruction technique that opposes the median dorsal raphe only to the posterior counterpart of the detrusor apron rather than to Denonvilliers ' fascia .


In a retrospective study we previously found that during robot-assisted laparoscopic prostatectomy this new technique could significantly shorten continence recovery time .


We designed a prospective clinical trial to confirm this .


We designed a single-blind , parallel group , randomized , controlled trial .


A total of 100 men who underwent robot-assisted laparoscopic prostatectomy performed by a single surgeon at a referral center were randomly allocated to the intervention group ( 50 ) or the control group ( 50 ) from October 2012 through August 2013 .


The intervention group underwent posterior reconstruction with this new technique before vesicourethral anastomosis .


All patients in each group were treated with anterior reconstruction .


The study primary end point was time to continence recovery , defined as no pad use .


Secondary outcomes were time to recovery of social continence , defined as 0 or 1 pad used per day .


One control was excluded from analysis due to open conversion and 4 patients were excluded since they withdrew from participation .


Median time to complete continence recovery did not differ significantly between the intervention and control groups ( 106 and 119 days , respectively , p = 0.890 ) .


However , time to social continence recovery was significantly shorter in the intervention group than in controls ( median 18 vs 30 days , p = 0.024 ) .


One-step posterior reconstruction did not significantly shorten time to complete continence recovery .


However , it seemed to have a marginal benefit on early recovery of social continence .


To assess ( 1 ) plasma levels of antidiuretic hormone ( ADH ) and brain natriuretic peptide ( BNP ) and urinary levels of electrolytes in children with sleep disordered breathing ( SDB ) , with or without nocturnal enuresis ( NE ) , and ( 2 ) the effect of adenotonsillectomy ( T&A ) on urinary electrolytes and the secretion of ADH and BNP in children with NE and SDB .


We previously reported post-T & A improvements in plasma levels of BNP and ADH in children with SDB and NE .


However , the differences in plasma concentration of these hormones in SDB children with and without NE , and their relationships with urinary electrolytes , have not yet been addressed .


This prospective study compared concentrations of urinary electrolytes and plasma ADH and BNP in ( 1 ) children with SDB and NE ( study group ) and an age - and sex-matched control group of children with SDB without NE , and ( 2 ) the study group before and 1-month after T&A .


Compared with the control group ( n = 31 ) , the study group ( n = 37 ) exhibited significantly lower ADH ( P = .04 ) and higher BNP ( P = .009 ) plasma levels .


The differences in urinary electrolytes were not significant .


Post-T & A , the study group showed significantly decreased BNP ( P = .018 ) , urinary sodium-to-creatinine ratio ( P = .02 ) , and urinary calcium-to-creatinine ratio ( P = .007 ) compared with the pre-T & A values .


Post-T & A changes in urinary calcium were significantly correlated with changes in sodium excretion ( P = .002 ) and in plasma levels of BNP ( P < .001 ) .


The presence of NE is associated with altered ADH and BNP levels in children with SDB .


T&A led to normalization of ADH and BNP , probably through a calcium - and sodium-dependent mechanism .


We compared intra-procedural neonatal pain , agitation and sedation scale ( N-PASS ) scores between a novel ` continuous arteriovenous exchange ' ( CAVE ) and conventional pull-push ( PP ) techniques of partial exchange transfusion ( PET ) among neonates with polycythemia .


Neonates > 32-0/7 weeks gestation , requiring PET for polycythemia , were randomized to PP or CAVE techniques .


The procedure was video-recorded and edited to mask the technique .


Intra-procedural N-PASS scores assigned by two trained and masked neonatal fellows were compared .


Twenty-two neonates were randomized to CAVE ( n = 12 ) or PP ( n = 10 ) method .


The area under curve for cumulative N-PASS scores was significantly lesser in CAVE group ( mean difference-11 .9 ( 95 % CI = -4.2 , -19.6 ) , P = 0.005 ) ) .


Decrease in hematocrit and complications of PET were comparable .


Time for PET was longer with CAVE technique ( 16 ( 9 , 29 ) min vs 10 ( 6 , 12 ) min , P = 0.016 ) .


CAVE technique of PET was associated with lesser procedure-related pain ( N-PASS scores ) as compared with PP technique among neonates > 32 weeks gestation .


Multicomponent school-based interventions have the potential to reduce the age-related decline in adolescents ' physical activity ( PA ) , yet there is not consistent evidence to guide non-curricular and school environment interventions .


The aim of this study was to assess the effectiveness of a multicomponent environmental school-based intervention , designed to reduce the age-related decline in PA among adolescents .


A cluster randomized controlled trial was conducted with 7 intervention and 7 control schools .


Baseline measurements were carried out in spring 2010 with 2 years of follow-up .


A total of 1,348 students ( 11-13 years , in grade 5 and 6 ) enrolled in the study at baseline .


The 14 schools included in the study were located in the Region of Southern Denmark .


The intervention consisted of organizational and physical changes in the school environment with a total of 11 intervention components .


The primary outcome measure was overall PA ( cpm , counts per minute ) and was supported by analyses of time spent in MVPA , and time spent sedentary .


Furthermore , a secondary outcome measure was PA in school time and during recess .


PA was measured using accelerometer ( Actigraph GT3X ) .


A total of 797 students completed the trial and had valid accelerometer data .


No significant difference was found for overall PA with an adjusted difference of -19.1 cpm ( 95 % CI : -93 , 53 ) or for school time activity with an adjusted difference of 6 cpm ( 95 % CI : -73 , 85 ) .


A sensitivity analysis revealed a positive significant intervention effect of PA in recess with an adjusted difference of 95 cpm .


No evidence was found of the overall effect of a non-curricular multicomponent school-based intervention on PA among Danish adolescents .


The intervention was positively associated with PA during school time and recess , however , with small estimates .


Lack of effect on overall PA could be due to both program theory and different degrees of implementation .


www.Controlled-Trials.com ISRCTN79122411 .


Randomized , controlled clinical trial .


Bladder and bowel management may cause serious autonomic dysreflexia ( AD ) in subjects with high spinal cord injury ( SCI ) .


We aimed at investigating autonomic responses to digital rectal evacuation ( DE ) , transanal irrigation ( TAI ) with 500ml and filling cystometry ( FC ) in SCI .


Aarhus University Hospital , Denmark .


Eight subjects with SCI ( AIS A ) at or above T6 ( high SCI ) and a previous history of AD were compared with three subjects with SCI ( AIS A ) between T10 and L2 ( low SCI ) .


In randomized order , DE , TAI and FC were performed .


AD was defined as an acute rise in systolic blood pressure ( sBP ) of 30mmHg above baseline .


Blood levels of norepinephrine and epinephrine were determined before and shortly after the procedures .


During all three procedures , AD occurred in all patients with high SCI but not in those with low SCI .


In high SCI subjects , DE increased median sBP from 127 ( range : 86-154 ) to 188 ( range : 140-206 ) mmHg ( P < 0.02 ) , TAI from 126 ( range : 91-146 ) to 163 ( range : 130-188 ) mmHg ( P < 0.02 ) and FC from 125 ( range : 106-149 ) to 200 ( range : 179-220 ) mmHg ( P < 0.01 ) .


The sBP increase was lower during TAI than during DE ( P < 0.05 ) or FC ( P < 0.02 ) .


In high SCI subjects , the blood levels of norepinephrine , but not those of epinephrine , increased significantly during all three stimuli ( all P < 0.05 ) .


Bowel and bladder management caused AD in high SCI .


The response is less severe during TAI than during FC or DE .


In high-resource settings , obstetric ultrasound is a standard component of prenatal care used to identify pregnancy complications and to establish an accurate gestational age in order to improve obstetric care .


Whether or not ultrasound use will improve care and ultimately pregnancy outcomes in low-resource settings is unknown .


This multi-country cluster randomized trial will assess the impact of antenatal ultrasound screening performed by health care staff on a composite outcome consisting of maternal mortality and maternal near-miss , stillbirth and neonatal mortality in low-resource community settings .


The trial will utilize an existing research infrastructure , the Global Network for Women 's and Children 's Health Research with sites in Pakistan , Kenya , Zambia , Democratic Republic of Congo and Guatemala .


A maternal and newborn health registry in defined geographic areas which documents all pregnancies and their outcomes to 6 weeks post-delivery will provide population-based rates of maternal mortality and morbidity , stillbirth , neonatal mortality and morbidity , and health care utilization for study clusters .


A total of 58 study clusters each with a health center and about 500 births per year will be randomized ( 29 intervention and 29 control ) .


The intervention includes training of health workers ( e.g. , nurses , midwives , clinical officers ) to perform ultrasound examinations during antenatal care , generally at 18-22 and at 32-36 weeks for each subject .


Women who are identified as having a complication of pregnancy will be referred to a hospital for appropriate care .


Finally , the intervention includes community sensitization activities to inform women and their families of the availability of ultrasound at the antenatal care clinic and training in emergency obstetric and neonatal care at referral facilities .


In summary , our trial will evaluate whether introduction of ultrasound during antenatal care improves pregnancy outcomes in rural , low-resource settings .


The intervention includes training for ultrasound-nave providers in basic obstetric ultrasonography and then enabling these trainees to use ultrasound to screen for pregnancy complications in primary antenatal care clinics and to refer appropriately .


Clinicaltrials.gov ( NCT # 01990625 ) .


Substance use and childhood maltreatment experience are linked , but little is known about the association with polydrug use patterns .


Latent class analyses ( LCA ) were performed on eight illicit drugs in a random population sample of young Danes separated by sex ( males : n = 1,555 ; females : n = 1,425 ) .


Logistic regressions explored associations of polydrug use patterns and childhood maltreatment .


A three-class solution best described patterns of polydrug use in both the male and female samples .


Across all LCA models , Class 1 was characterized by individuals who represented wide-range polydrug users , endorsing many of the drug types ( males = 8 % ; females = 2 % ) .


Class 2 was characterized by amphetamine , cannabis , cocaine , and amyl nitrate users ( males = 18 % ; females = 7 % ) .


Class 3 was characterized by individuals who endorsed either low-level use of cannabis only or no drug use ( males = 74 % ; females = 91 % ) .


For males , having been a child-protection case was associated with Classes 1 and 2 and for females with Class 2 , compared with Class 3 .


Alcohol problems were associated with Classes 1 and 2 for both sexes .


Sexual abuse was associated with Classes 1 and 2 for females but not males , whereas physical abuse was associated with Classes 1 and 2 for males but not females , as compared with Class 3 .


Separate sex analyses are important ; although patterns of polydrug use are broadly similar , females are less frequently polydrug users .


In addition , different relationships exist for the sexes , such that polydrug use patterns are associated with sexual abuse in females , whereas such patterns are associated with physical abuse in young males .


Recombinant human bone morphogenetic protein ( rhBMP ) -2 has been used in some craniofacial centers worldwide .


However , its influence on nasal morphology is unknown .


Thus , the objective of this investigation was to assess the effect of maxillary alveolar reconstruction on nasal position and symmetry in unilateral complete cleft lip patients who underwent traditional iliac crest bone grafting transferring versus reconstruction using rhBMP-2 .


Nineteen unilateral complete cleft lip patients were randomly divided into two groups .


In group 1 , patients underwent traditional iliac crest bone grafting transferring ( n = 11 ) and in group 2 , patients underwent alveolar reconstruction using collagen matrix with lyophilized rhBMP-2 ( n = 8 ) .


Computerized tomography ( CT ) imaging was performed preoperatively and at 6 months postoperatively using a previously standardized protocol .


Linear distances using anatomic landmarks were performed using tridimensional CT data reformatted by the OsiriX ( ) software .


Quantitative and qualitative measurements to assess intra - and inter-group nasal position modifications were performed .


Intra-group pre - and postoperative comparisons showed significant differences ( p < 0.05 ) in two linear measurements of group 1 , while group 2 did not present a difference ( p > 0.05 ) .


Group 2 presented significant postoperative enhancement ( p < 0.05 ) in the quantitative nasal symmetry in one measurement .


Qualitative analysis showed postoperative nasal symmetry enhancement in 75 % of the measurements of group 2 and 36 % of group 1 .


There was no statistically significant difference in the inter-group comparisons .


Our study demonstrated that both groups showed similar effect on nasal symmetry .


Connective Tissue Massage ( CTM ) or Manipulation is a bodywork technique which lies at the interface between alternative approaches .


The autonomic balancing responses to CTM can be useful in the treatment of anxiety .


This study was planned to investigate the effects of connective tissue mobilization ( CTM ) on quality of life and emotional status in healthy subjects .


Design ; Prospective trial , Setting ; Treatment and Population .


The study was conducted on 100 volunteers ( students ) .


Students in second class were in CTM group ( 20,491,37 years ) and students ( 19,501,15 years ) educating in class 1 were in control group .


Participants were assessed before and after CTM according to flexibility of trunk flexion , hamstring muscles , trunk hyperextension and lateral flexion .


It was used The SF-36 Health-Related Quality of Life Inventory ( SF-36 ) to assess general health status and Beck Depression Scale was used for assessing emotional status .


It was observed a significant increase at lateral flexion to the right of trunk ( p = 0,03 ) in CTM group after application .


It was found a significant difference ( p = 0,009 ) in emotional status between groups .


It was found differences at general health level ( p = 0,001 ) , limitations in emotional role ( p = 0,016 ) in SF-36 .


It was some differences in depression status and some subscales of SF-36 ( general health , social status , emotional well-being , pain and energy levels ) in favour of control group before application .


It was no difference between groups after application .


CTM could be used for minimizing depressive symptoms , improving quality of life in healthy young subjects .


Occupational sedentary behaviour is an important contributor to overall sedentary risk .


There is limited evidence for effective workplace interventions to reduce occupational sedentary time and increase light activity during work hours .


The purpose of the study was to determine if participatory workplace interventions could reduce total sedentary time , sustained sedentary time ( bouts > 30 minutes ) , increase the frequency of breaks in sedentary time and promote light intensity activity and moderate/vigorous activity ( MVPA ) during work hours .


A randomised controlled trial ( ANZCTR NUMBER : ACTN12612000743864 ) was conducted using clerical , call centre and data processing workers ( n = 62 , aged 25-59 years ) in 3 large government organisations in Perth , Australia .


Three groups developed interventions with a participatory approach : ` Active office ' ( n = 19 ) , ` Active Workstation ' and promotion of incidental office activity ; ` Traditional physical activity ' ( n = 14 ) , pedometer challenge to increase activity between productive work time and ` Office ergonomics ' ( n = 29 ) , computer workstation design and breaking up computer tasks .


Accelerometer ( ActiGraph GT3X , 7 days ) determined sedentary time , sustained sedentary time , breaks in sedentary time , light intensity activity and MVPA on work days and during work hours were measured before and following a 12 week intervention period .


For all participants there was a significant reduction in sedentary time on work days ( -1.6 % , p = 0.006 ) and during work hours ( -1.7 % , p = 0.014 ) and a significant increase in number of breaks/sedentary hour on work days ( 0.64 , p = 0.005 ) and during work hours ( 0.72 , p = 0.015 ) ; there was a concurrent significant increase in light activity during work hours ( 1.5 % , p = 0.012 ) and MVPA on work days ( 0.6 % , p = 0.012 ) .


This study explored novel ways to modify work practices to reduce occupational sedentary behaviour .


Participatory workplace interventions can reduce sedentary time , increase the frequency of breaks and improve light activity and MVPA of office workers by using a variety of interventions .


Australian New Zealand Clinical Trials Registry ACTN12612000743864 .


To study postoperative pain relief in major gynaecological surgery by perioperative parecoxib administration in Thammasat University Hospital .


This double-blind randomized controlled clinical trial was conducted in Thammasat University Hospital , Pathumthani , Thailand from October 2013 to May 2014 .


One hundred and twenty patients who underwent elective gynaecological surgery were randomized assigned to study and control groups .


Study group ( n = 60 ) received 40 mg parecoxib and control group ( n = 60 ) received placebo at 1 hour before surgery .


The postoperative visual analog scale ( VAS ) at 3 , 6 , 12 and 24 hours , frequency of meperidine consumption in 24 hours and side effects of parecoxib were recorded .


VAS of study group after operation at 3 , 6 , 12 and 24 hours was significantly lower than control group .


Meperidine consumption in placebo group was significantly higher than study group ( 27.50 19.36 and 48.75 28.15 mg , respectively ; p < 0.001 ) .


There was no side effect from parecoxib in this study .


Intravenous postoperativeparecoxib injection could relief pain and reduced meperidine consumption .


Parecoxib could be safely used in gynaecological surgery for postoperative pain relief


Efficacy of burping in lowering colic and regurgitation episodes in healthy term babies lacks evidence in literature .


We conducted a randomized controlled trial to compare efficacy of burping versus no-burping in 71 mother-baby dyads in community setting .


Primary outcome was reduction in event rates of colic and regurgitation episodes over 3 months .


Baseline characteristics were similar in two groups .


Difference in incidence rates of colic between the control and burping group was 1.57 episodes/infant/100 weeks [ 95 % confidence interval ( CI ) : -0.63 to 3.76 ] .


There was statistically no significant reduction in colic episodes between burping and non-burping study subjects during 3 months of follow-up ( adjusted relative risk 0.64 ; 95 % CI : 0.22-1 .86 , P-value 0.41 ) .


Incidence rate difference of regurgitation episodes/infant/week between burping and control group was 4.36 ( 95 % CI : 4.04 to 4.69 ) and there was statistically significant increase in burping group ( adjusted relative risk 2.05 ; 95 % CI : 1.92-2 .18 , P-value < 0.0001 ) .


Although burping is a rite of passage , our study showed that burping did not significantly lower colic events and there was significant increase in regurgitation episodes in healthy term infants up to 3 months of follow-up .


To test a novel social network HIV risk-reduction intervention for MSM in Russia and Hungary , where same-sex behavior is stigmatized and men may best be reached through their social network connections .


A two-arm trial with 18 sociocentric networks of MSM randomized to the social network intervention or standard HIV/STD testing/counseling .


St. Petersburg , Russia and Budapest , Hungary .


Eighteen ` seeds ' from community venues invited the participation of their MSM friends who , in turn , invited their own MSM friends into the study , a process that continued outward until eighteen three-ring sociocentric networks ( mean size = 35 members , n = 626 ) were recruited .


Empirically identified network leaders were trained and guided to convey HIV prevention advice to other network members .


Changes in sexual behavior from baseline to 3-month and 12-month follow-up , with composite HIV/STD incidence , measured at 12 months to corroborate behavior changes .


There were significant reductions between baseline , first follow-up , and second follow-up in the intervention versus comparison arm for proportion of men engaging in any unprotected anal intercourse ( UAI ) ( P = 0.04 ) ; UAI with a nonmain partner ( P = 0.04 ) ; and UAI with multiple partners ( P = 0.002 ) .


The mean percentage of unprotected anal intercourse acts significantly declined ( P = 0.001 ) , as well as the mean number of UAI acts among men who initially had multiple partners ( P = 0.05 ) .


Biological HIV/STD incidence was 15 % in comparison condition networks and 9 % in intervention condition networks .


Even where same-sex behavior is stigmatized , it is possible to reach MSM and deliver HIV prevention through their social networks .


Children 's nighttime fears are a normal part of child development and are transient for most children , but result in considerable distress for others .


The present study evaluated a 4-week bibliotherapy intervention designed to treat young children with persistent and interfering nighttime fears utilizing a multiple baseline design .


Nine children between 5 and 7 years of age with specific phobia diagnoses were randomized into one of three baseline control conditions ( 1 , 2 , or 3 weeks ) .


The treatment protocol involved parents reading Uncle Lightfoot , Flip that Switch : Overcoming Fear of the Dark , Academic Version ( Coffman , 2012 ) with their children over 4 weeks while engaging in activities prescribed in the book .


Assessments took place at baseline , post treatment , and 1 month following treatment .


Daily and weekly tracking of nighttime behaviors was also obtained .


Pre-post group analyses revealed that eight of the nine children demonstrated clinically significant change in anxiety severity .


In addition , decreases in child-reported nighttime fears were observed , as were parent-reported decreases in separation anxiety and increases in the number of nights children slept in their own bed .


The present study provides initial support for the use of bibliotherapy in the treatment of nighttime fears .


Further replication and evaluation are needed to determine appropriate length of treatment and long-term effects .


Implications of the findings are discussed .


Helicobacter pylori ( H. pylori ) frequently colonizes the stomach .


Gastroesophageal reflux disease ( GERD ) is a common and costly disease .


But the relationship of H. pylori and GERD is still unclear .


This study aimed to explore the effect of H. pylori and its eradication on reflux esophagitis therapy .


Patients diagnosed with reflux esophagitis by endoscopy were enrolled ; based on rapid urease test and Warth-Starry stain , they were divided into H. pylori positive and negative groups .


H. pylori positive patients were randomly given H. pylori eradication treatment for 10 days , then esomeprazole 20 mg bid for 46 days .


The other patients received esomeprazole 20 mg bid therapy for 8 weeks .


After treatment , three patient groups were obtained : H. pylori positive eradicated , H. pylori positive uneradicated , and H. pylori negative .


Before and after therapy , reflux symptoms were scored and compared .


Healing rates were compared among groups .


The 2 test and t-test were used , respectively , for enumeration and measurement data .


There were 176 H. pylori positive ( with 92 eradication cases ) and 180 negative cases .


Healing rates in the H. pylori positive eradicated and H. pylori positive uneradicated groups reached 80.4 % and 79.8 % ( P = 0.911 ) , with reflux symptom scores of 0.22 and 0.14 ( P = 0.588 ) .


Healing rates of esophagitis in the H. pylori positive uneradicated and H. pylori negative groups were , respectively , 79.8 % and 82.2 % ( P = 0.848 ) ; reflux symptom scores were 0.14 and 0.21 ( P = 0.546 ) .


Based on esomeprazole therapy , H. pylori infection and eradication have no significant effect on reflux esophagitis therapy .


Residual walking deficits are common in people after stroke .


Treadmill training can increase walking speed and walking distance .


A new way to increase the challenge of walking is to walk backwards .


Backward treadmill walking may provide advantages by promoting improvement in balance , walking spatiotemporal parameters and quality that may reflect in improving walking distance .


This study will test the hypothesis that backward treadmill walking is superior to forward treadmill walking in improving walking capacity , walking parameters , quality and balance in people with stroke .


A prospective , single-blinded , randomized trial will randomly allocate 88 community-dwelling people after stroke into either an experimental or control group .


The experimental group will undertake 30-min sessions of backward treadmill walking , three-days/week for six-weeks , while the control group will undertake the same dose of forward treadmill walking .


Training will begin at the baseline overground walking speed and will increase each week by 10 % of baseline speed .


The primary outcome will be distance walked in the 6-min Walk Test .


Secondary outcomes will be walking speed , step length , cadence , and one-leg stance time .


Outcomes will be collected by a researcher blinded to group allocation at baseline ( Week 0 ) , at the end of training period ( Week 6 ) , and three-months after the cessation of intervention ( Week 18 ) .


If backward treadmill walking can improve walking capacity more than forward treadmill training in stroke , it may have broader implications because walking capacity has been shown to predict physical activity level and community participation .


Despite its widespread use , the beneficial effect of low-dose fentanyl administered at induction of anesthesia on perioperative outcomes has not been studied in the ambulatory setting .


Therefore , this study was designed to test the hypothesis that administration of small-dose fentanyl vs. saline during induction reduces coughing and movements without adversely affecting recovery after day-surgery .


One hundred consenting outpatients scheduled to undergo superficial surgical procedures under general anesthesia with a laryngeal mask airway ( LMA ) device for airway management were randomly assigned to one of two treatment groups : control ( n = 50 ) or fentanyl ( n = 50 ) .


After administration of 2 ml of the unlabelled study medication containing either fentanyl ( 100 g ) or saline , anesthesia was induced with lidocaine 30-50 mg and propofol 2 mg/kg IV followed by the insertion of an LMA device .


General anesthesia was maintained using a propofol infusion , 75 g/kg/min , and desflurane ( 2-5 % end-tidal ) in 100 % oxygen .


Coughing was observed in six ( 12 % ) and ten ( 20 % ) in the fentanyl and control group , respectively ( P = 0.41 ) .


The incidence of movements during surgery was lower in the fentanyl group ( 18 % vs. 31 % , P < 0001 ) .


There were no significant differences in early and late recovery times or pain scores between the two groups .


Administration of a small-dose of fentanyl at induction of anesthesia significantly reduced purposeful movements during day-surgery under propofol-desflurane anesthesia .


No significant difference was found in coughing or recovery times .


To evaluate phenylalanine plasma profile in preterm newborns fed different human milk diets .


Twenty-four very-low weight preterm newborns were distributed randomly in three groups with different feeding types : Group I : banked human milk plus 5 % commercial fortifier with bovine protein , Group II : banked human milk plus evaporated fortifier derived from modified human milk , Group III : banked human milk plus lyophilized fortifier derived from modified human milk .


The newborns received the group diet when full diet was attained at 15 2 days .


Plasma amino acid analysis was performedon the first and last day of feeding .


Comparison among groups was performed by statistical tests : one way ANOVA with Tukey 's post-test using SPSS software , version 20.0 ( IBM Corp , NY , USA ) , considering a significance level of 5 % .


Phenylalanine levels in the first and second analysis were , respectively , in Group I : 11.9 1.22 and 29.72 0.73 ; in Group II : 11.72 1.04 and 13.44 0.61 ; and in Group III : 11.3 1.18 and 15.42 0.83 mol/L .


The observed results demonstrated that human milk with fortifiers derived from human milk acted as a good substratum for preterm infant feeding both in the evaporated or the lyophilized form , without significant increases in plasma phenylalanine levels in comparison to human milk with commercial fortifier .


Physical inactivity , inadequate dietary protein , and low-grade systemic inflammation contribute to age-related muscle loss , impaired function , and disability .


We assessed the effects of progressive resistance training ( PRT ) combined with a protein-enriched diet facilitated through lean red meat on lean tissue mass ( LTM ) , muscle size , strength and function , circulating inflammatory markers , blood pressure , and lipids in elderly women .


In a 4-mo cluster randomized controlled trial , 100 women aged 60-90 y who were residing in 15 retirement villages were allocated to receive PRT with lean red meat ( 160 g cooked ) to be consumed 6 d/wk [ resistance training plus lean red meat ( RT+M eat ) group ; n = 53 ] or control PRT [ 1 serving pasta or rice/d ; control resistance training ( CRT ) group ; n = 47 ) ] .


All women undertook PRT 2 times/wk and received 1000 IU vitamin D3/d .


The mean ( SD ) protein intake was greater in the RT+M eat group than in the CRT group throughout the study ( 1.3 0.3 compared with 1.1 0.3 g kg d , respectively ; P < 0.05 ) .


The RT+M eat group experienced greater gains in total body LTM ( 0.45 kg ; 95 % CI : 0.07 , 0.84 kg ) , leg LTM ( 0.22 kg ; 95 % CI : 0.02 , 0.42 kg ) , and muscle strength ( 18 % ; 95 % CI : 0.03 , 0.34 ) than did the CRT group ( all P < 0.05 ) .


The RT+M eat group also experienced a 10 % greater increase in serum insulin-like growth factor I ( P < 0.05 ) and a 16 % greater reduction in the proinflammatory marker interleukin-6 ( IL-6 ) ( P < 0.05 ) after 4 mo. .


There were no between-group differences for the change in blood lipids or blood pressure .


A protein-enriched diet equivalent to 1.3 g kg d achieved through lean red meat is safe and effective for enhancing the effects of PRT on LTM and muscle strength and reducing circulating IL-6 concentrations in elderly women .


This trial was registered at the Australian Clinical Trials Registry as ACTRN12609000223235 .


Actinic keratoses ( AKs ) are a common premalignant skin condition .


Many treatments are available for AKs .


Photodynamic therapy ( PDT ) is one of the most effective treatments .


However , major concerns exist on the possibility of PDT-induced DNA-mutagenesis/immunosuppression , leading to AKs recurrence/treatment failure .


An extract ( PLE ) from the fern polypodium leucotomos reduces UV-induced immunosuppression and mutagenesis .


To assess the ability of PLE to enhance the efficacy of PDT treatment , reducing AKs recurrence on the scalp .


Thirty-four bald patients presenting at least two AKs on the scalp were alternatively assigned to two groups .


Both groups underwent two PDT-sessions one-week apart .


The first group began oral PLE supplementation one week after the last PDT session .


Evaluation of the effect of PLE supplementation was performed by direct inspection of the bald areas , lesions count , and photodynamic diagnosis assessment at 2 and 6 months .


Both groups were homogeneous in terms of skin phototype and previous UV exposure .


Mean age was 75.7 7.8 years and 76.5 5.5 years , respectively .


Both treatment modalities were successful in reducing AKs number ( p < .001 ) .


However , PLE supplementation increased clearance rate compared with PDT alone ( p = .040 ) .


Polypodium leucotomos improves PDT clearance and decreases AK recurrence rate at 6 months , suggesting its use as a complementary agent in the treatment of field cancerization .


Type 2 diabetes mellitus is a chronic condition that requires ongoing , life-long care in order to be controlled .


The aims of the study were to assess the effect of nursing case management on glycated hemoglobin ( HbA1c ) levels compared to usual care in people with type 2 diabetes mellitus and to determine if effects of nursing case management varied by gender , age , duration of disease , education , and income .


This is a pragmatic clinical trial , conducted in the municipality of Bandeirantes , Paran , Brazil , in 2011 and 2012 .


Eighty individuals were recruited and randomized equally to receive nursing case management or usual care .


Covariates were sociodemographic and clinical factors .


The outcome was HbA1c measured at baseline , 6 months , and 12 months .


The sample consisted predominately of women ; most had been diagnosed with type 2 diabetes mellitus within the previous 5 years .


Mean age was 50.14 ( SD = 7.00 ) , with 5.27 ( SD = 4.39 ) years of schooling and an average HbA1c of 9.90 % ( SD = 2.49 ) .


Hemoglobin A1c was reduced from an average of 10.33 % to 9.0 % ( p < .01 ) in the nursing case management group and from 9.57 % to 8.93 % ( p = .05 ) in the usual care group ; the group by time effect was not significant .


Case management effects varied by younger age ( p = .05 ) , duration of type 2 diabetes less than 5 years ( p = .03 ) , up to 4 years of schooling ( p = .04 ) , and being in the lowest-income stratum ( p = .02 ) .


Both groups showed a statistically significant reduction of HbA1c at 6 and 12 months following baseline .


The difference in proportional reduction of HbA1c between groups was not statistically significant .


To establish and evaluate a systematic training programme to be included into the ophthalmologic resident curriculum .


Medical students ( n = 20 ) within a year from graduation and with no previous ophthalmic experience were included in this prospective study and randomized into two groups .


Group A ( n = 10 ) completed the Eyesi cataract simulator training programme once a week for 4 weeks , while Group B ( n = 10 ) completed it once a week at the first and the last week .


Two cataract surgeons were used to determine two different levels of reference scores .


Score per analysed module [ two different levels of Capsulorhexis ( A and B ) , Hydromaneuver , Phaco divide and conquer ] , Overall score , Total time , Cornea injury , Capsule rupture and Capsule damage by ultrasound were recorded .


Group A outperformed Group B in several modules , reached a significant higher number of reference scores ( p < 0.01 ) and caused fewer complications with regard to Capsule rupture ( p = 0.01 ) and Capsule damage by ultrasound ( p < 0.05 ) .


Both Groups A and B improved their performance and also became more time efficient ( p < 0.01 for both groups ) .


Group A showed positive learning curves for Overall score ( p < 0.01 ) , Capsulorhexis A ( p < 0.01 ) , Capsulorhexis B ( p < 0.01 ) and Hydromaneuver ( p = 0.01 ) .


Group B showed a significant improvement for Overall score ( p < 0.01 ) , Hydromaneuver ( p = 0.02 ) and Phaco divide and conquer ( p < 0.01 ) .


Repetitive training with a systematic training programme , based on validated modules in the Eyesi simulator , was shown to improve simulated cataract surgery skills .


Higher level of skills and more reference scores were reached with more training .


Furthermore , the programme was optimized to be applied into the standard ophthalmological curriculum for cataract surgery training .


Late recurrence of atrial fibrillation ( AF ) after radiofrequency ablation remains significant .


Asymptomatic recurrence poses a difficult clinical problem as it is associated with an equally increased risk of stroke and death compared with symptomatic AF events .


Meta-analyses reveal that no single preablation patient characteristic efficiently predicts these AF recurrences .


This study aimed to evaluate the prognostic value of premature atrial complex ( PAC ) occurrence with regard to the risk of late AF recurrence after radiofrequency ablation .


The study cohort consisted of 124 patients with 7-day Holter recordings at 6 months post radiofrequency ablation for AF .


No patients had AF recurrence before this time .


Patients were followed-up every 6 months .


Holter-detected PACs were defined as any supraventricular complexes occurring > 30 % earlier than expected .


During a median follow-up of 4.2 years ( first quartile to third quartile [ Q1-Q3 ] = 1.6-4 .5 ) , 32 patients ( 26 % ) had late recurrences of AF at a median of 462 days ( Q1-Q3 = 319-1026 ) post radiofrequency ablation .


The number of PACs per 24 hours was 248 ( Q1-Q3 = 62-1026 ) in patients with and 77 ( Q1-Q3 = 24-448 ) in patients without recurrence of AF ( P = 0.02 ) .


Multivariate analysis of the risk of late AF recurrence found 142 PACs per 24 hours to have a hazard ratio 2.84 ( confidence interval , 1.26-6 .43 ) , P = 0.01 .


This study showed that occurrence of 142 PACs per day at 6 months after PVI was independently associated with a significantly increased risk of late AF recurrence .


These results could have important clinical implications for the design of post-PVI follow-up .


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


Unique identifier : ACRTN12606000467538 .


Distal radius fracture ( DRF ) in postmenopausal women is often the first clinical sign of osteoporosis ( OP ) .


Despite the availability of effective treatments , only a minority of patients who sustain a fragility fracture are tested for OP .


The purpose of this study was to examine whether a simple intervention by the hospital staff increases rates of OP workup .


We conducted a prospective randomized clinical trial .


Ninety nine patients after DRF were randomized to two groups .


Both groups were contacted after their fracture and were asked to answer a questionnaire and were informed about the possible relationship between DRF and OP .


In the intervention group , patients were sent an explanatory pamphlet and a letter to their primary care physician .


An additional survey was conducted to establish whether the intervention improved the number of patients who undergo OP workup .


The intervention increased the proportion of patients who turned to their primary care physician from 22.9 % to 68.6 % , and increased the proportion of patients undergoing OP workup from 14.3 % to 40 % ( p < 0.001 ) .


Women with DRF who receive an explanation about possible OP implications and are sent explanatory materials are more likely to undergo OP workup .


The aims of the study were to clarify the occurrence of disturbance in surgical wound healing ( DSWH ) after surgery of zygomatic complex ( ZC ) fractures and to determine whether perioperatively applied dexamethasone increases the risk for DSWH .


Of 64 patients who were included in a single-blind prospective trial , 33 perioperatively received a total dose of 10 mg or 30 mg of dexamethasone .


The remaining 31 patients served as controls .


DSWH occurred in 9 patients ( 14.1 % ) .


Occurrence of DSWH was 24.4 % in patients who received dexamethasone and 3.2 % in controls .


The association between DSWH and dexamethasone was significant ( P = .016 ) .


Intraoral approach also was associated with DSWH significantly ( P = .042 ) .


No association emerged between DSWH and age , gender , time span from accident to surgery , or duration of surgery .


DSWH occurred significantly more frequently in patients who received perioperative dexamethasone .


Because of increased risk of DSWH , perioperative dexamethasone can not be recommended in open reduction and fixation of ZC fractures .


To assess the explanatory power of disease severity and health-related quality of life ( HRQOL ) on absenteeism and presenteeism in a working population suffering from depression and/or anxiety disorders .


We used data of a large , multicenter , randomized trial ( n = 644 ) .


Pearson chi-squared tests , analysis of variance , and multinomial logistic regression analyses were performed to explore associations of the type of the disorder and HRQOL with different types of productivity losses .


Multivariate regression analyses were performed to assess associations with the duration of absenteeism .


The type of the disorder , disease severity , and HRQOL were associated with different types of productivity losses .


Health-related quality of life and age were significantly associated with the duration of absenteeism .


Our findings indicate that HRQOL may significantly explain the type of productivity loss as well as the duration of absenteeism .


In resource-limited settings without safe alternatives to breastfeeding , the WHO recommends exclusive breastfeeding and antiretroviral ( ARV ) prophylaxis .


Given the high prevalence of anemia among HIV-infected women , mothers and their infants ( through fetal iron accretion ) may be at risk of iron deficiency .


We assessed the effects of maternal micronutrient-fortified lipid-based nutrient supplements ( LNS ) and maternal ARV treatment or infant ARV prophylaxis on maternal and infant iron status during exclusive breastfeeding from birth to 24 weeks .


The Breastfeeding , Antiretrovirals , and Nutrition study was a randomized controlled trial conducted in Lilongwe , Malawi , from 2004 to 2010 .


HIV-infected mothers ( CD4 > 200 cells/L ) and their infants were randomly assigned to 28-week interventions : maternal LNS/maternal ARV ( n = 424 ) , maternal LNS/infant ARV ( n = 426 ) , maternal LNS ( n = 334 ) , maternal ARV ( n = 425 ) , infant ARV ( n = 426 ) , or control ( n = 334 ) .


Longitudinal models tested intervention effects on hemoglobin ( Hb ) .


In a subsample ( n = 537 ) with multiple iron indicators , intervention effects on Hb , transferrin receptors ( TfR ) , and ferritin were tested with linear and Poisson regression .


In longitudinal models , LNS effects on maternal and infant Hb were minimal .


In subsample mothers , maternal ARVs were associated with tissue iron depletion ( TfR > 8.3 mg/L ) ( risk ratio : 3.1 , P < 0.01 ) , but not in ARV-treated mothers receiving LNS ( P = 0.17 ) .


LNS without ARVs was not associated with iron deficiency or anemia ( P > 0.1 ) .


In subsample infants , interventions were not associated with impaired iron status ( all P > 0.1 ) .


Maternal ARV treatment with protease inhibitors is associated with maternal tissue iron depletion ; but LNS mitigates adverse effects .


ARVs do not seem to influence infant iron status ; however , extended use needs to be evaluated .


This study examined the sparing effect of sufentanil on the median effective concentration ( EC ) of epidural ropivacaine in elderly patients undergoing elective transurethral resection of prostate ( TURP ) .


This was a prospective randomized double-blind dose-response study .


Fifty eight elderly patients with American Society of Anesthesiologists physical status I-II who were scheduled for TURP surgery under epidural anesthesia were randomly allocated to a group receiving 15 mL of ropivacaine ( group R ) or a group receiving ropivacaine plus 5 g of sufentanil ( group RS ) .


The concentration of ropivacaine was determined by a Dixon 's up-and-down sequential allocation .


The first participant received 0.3 % of ropivacaine in both groups and subsequent concentrations were determined by the response of the previous patient in the same group .


The EC of epidural ropivacaine was analyzed using the Dixon and Massey method .


The EC of ropivacaine during TURP surgery was 0.186 % ( 95 % confidence interval , 0.173-0 .200 % ) in group R , and 0.136 % ( 95 % confidence interval , 0.127-0 .144 % ) in group RS ( p < 0.01 ) .


No differences in Bromage scale of motor block examination and the onset time of sensory block were observed .


Administration of 5 g of epidural sufentanil caused a 37 % reduction in the EC of epidural ropivacaine in elderly patients who underwent TURP surgery .


Thus , sufentanil addition during surgery of TURP can decrease the dose of ropivacaine anesthesia required .


The National Institute for Health and Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials .


Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the feasibility and impact of a Self Determination Theory-based ( SDT ) exercise referral consultation .


An exploratory cluster randomised controlled trial comparing standard provision exercise referral with an exercise referral intervention grounded in Self Determination Theory .


Individuals ( N = 347 ) referred to an exercise referral scheme were recruited into the trial from 13 centres.Outcomes and processes of change measured at baseline , 3 and 6-months : Minutes of self-reported moderate or vigorous physical activity ( PA ) per week ( primary outcome ) , health status , positive and negative indicators of emotional well-being , anxiety , depression , quality of life ( QOL ) , vitality , and perceptions of autonomy support from the advisor , need satisfaction ( 3 and 6 months only ) , intentions to be active , and motivational regulations for exercise.Blood pressure and weight were assessed at baseline and 6 months .


Perceptions of the autonomy support provided by the health and fitness advisor ( HFA ) did not differ by arm .


Between group changes over the 6-months revealed significant differences for reported anxiety only .


Within arm contrasts revealed significant improvements in anxiety and most of the Dartmouth CO-OP domains in the SDT arm at 6 months , which were not seen in the standard exercise referral group .


A process model depicting hypothesized relationships between advisor autonomy support , need satisfaction and more autonomous motivation , enhanced well being and PA engagement at follow up was supported .


Significant gains in physical activity and improvements in quality of life and well-being outcomes emerged in both the standard provision exercise referral and the SDT-based intervention at programme end .


At 6-months , observed between arm and within intervention arm differences for indicators of emotional health , and the results of the process model , were in line with SDT .


The challenges in optimising recruitment and implementation of SDT-based training in the context of health and leisure services are discussed .


The trial is registered as Current Controlled trials ISRCTN07682833 .


Drug-eluting stents ( DES ) with durable polymer have significantly reduced restenosis and target vessel revascularization compared with bare metal stents .


Durable polymer has been linked with persistent inflammation of vessel wall and delayed endothelial healing that may increase the risk of late and very late stent thrombosis .


This study sought to evaluate the efficacy and safety of HELIOS completed biodegradable polymer sirolimus-eluting stent ( SES ) in de novo coronary lesions .


Totally , 287 patients with one or two de novo coronary lesions ( lesion length 38 mm and reference vessel diameter 2.5-4 .0 mm ) were enrolled in the HOPE study , a prospective , multicenter , randomized , non-inferiority trial .


Patients were randomized to treatment either with HELIOS completed biodegradable polymer SES ( n = 142 ) or PARTNER durable polymer SES ( n = 145 ) .


The primary endpoint was angiographic in-stent late lumen loss ( LLL ) at 9-month follow-up .


The secondary endpoint included stent thrombosis and major adverse cardiac events including cardiac death , myocardial infarction ( MI ) and target lesion revascularization ( TLR ) .


The 9-month in-stent LLL in the HELIOS group was similar to the PARTNER group , ( 0.16 0.22 ) mm vs. ( 0.19 0.30 ) mm ( P = 0.28 ) .


The difference and 95 % confidence interval were -0.03 ( -0.09 , 0.04 ) , and the P value for non-inferiority < 0.01 .


Major adverse cardiovascular event ( MACE ) occurred in 7.9 % vs. 8.2 % , MI in 2.4 % vs. 3.0 % , TLR in 5.5 % vs. 3.0 % , and stent thrombosis in 0 vs. 1.5 % ; and events were comparable between the HELIOS group and PARTNER group at three-year follow-up ( all P > 0.05 ) .


The three-year cardiac death was lower in the HELIOS group , but with no significant difference , 0 vs. 3.0 % ( P = 0.12 ) .


In the HOPE trial , the novel completed biodegradable polymer SES HELIOS was non-inferior to the durable polymer SES PARTNER with respect to nine-month in-stent LLL in de novo coronary lesions .


The incidence of other clinical endpoints was low for both of the stents in three-year follow-up .


Postoperative atrial fibrillation ( POAF ) is the most frequent complication arising after cardiac surgery , occurring in 30 % of cases .


Amiodarone is the most effective drug for prophylaxis and treatment .


However , because of significant extracardiac side effects , only high-risk patients are eligible for prophylactic amiodarone therapy .


We performed a randomized prospective study of 100 patients undergoing cardiac surgery with epicardial application of amiodarone-releasing hydrogel to determine the effectiveness of preventing POAF .


After institutional review board approval , 100 patients , from January 2012 to July 2013 , who had undergone cardiac surgery , were randomized to 2 equal groups .


The study group received poly-based hydrogel with amiodarone sprayed diffusely over the epicardium .


The control group underwent the procedure without the spray .


Continuous telemetry monitored for POAF , and amiodarone levels in the atria , plasma , and tissue were measured postoperatively .


Daily electrocardiographic parameters were measured until postoperative day 14 .


The incidence of POAF was significantly less in the study group , with 4 of 50 patients ( 8 % ) incurring atrial fibrillation compared with 13 of 50 patients ( 26 % ) in the control group ( P < .01 ) .


The mean amiodarone concentrations in the atria ( 12.06 3.1 ) were significantly greater than those in the extracardiac tissues ( 1.32 0.9 ; P < .01 ) .


The plasma amiodarone levels remained below the detection limit ( < 8 g/mL ) during the 14 days of follow-up .


Bradycardia was observed less in the study group ( 76 29 ) than in the control group ( 93 18 ; P < .01 ) .


Epicardial application of amiodarone-releasing adhesive hydrogel is a less invasive , well-tolerated , quick , and effective therapeutic option for preventing POAF at minimal risk of extracardiac adverse side effects .


Many patients with cervical disc disease require leave from work , due to long-lasting , complex symptoms , including chronic pain and reduced levels of physical and psychological function .


Surgery on a few segmental levels might be expected to resolve disc-specific pain and reduce neurological deficits , but not the non-specific neck pain and the frequent illness .


No study has investigated whether post-surgery physiotherapy might improve the outcome of surgery .


The main purpose of this study was to evaluate whether a well-structured rehabilitation programme might add benefit to the customary post-surgical treatment for cervical disc disease , with respect to function , disability , work capability , and cost effectiveness .


This study was designed as a prospective , randomised , controlled , multi-centre study .


An independent , blinded investigator will compare two alternatives of rehabilitation .


We will include 200 patients of working age , with cervical disc disease confirmed by clinical findings and symptoms of cervical nerve root compression .


After providing informed consent , study participants will be randomised to one of two alternative physiotherapy regimes ; ( A ) customary treatment ( information and advice on a specialist clinic ) ; or ( B ) customary treatment plus active physiotherapy .


Physiotherapy will follow a standardised , structured programme of neck-specific exercises combined with a behavioural approach .


All patients will be evaluated both clinically and subjectively ( with questionnaires ) before surgery and at 6 weeks , 3 months , 6 months , 12 months , and 24 months after surgery .


The main outcome variable will be neck-specific disability .


Cost-effectiveness will also be calculated .


We anticipate that the results of this study will provide evidence to support physiotherapeutic rehabilitation applied after surgery for cervical radiculopathy due to cervical disc disease .


ClinicalTrials.gov identifier : NCT01547611 .


The influence of size on the effectiveness of nasobiliary catheters has not yet been studied .


We compared biliary drainage effectiveness and procedure-related discomfort and adverse events in 5 French ( Fr ) and 7 Fr nasobiliary catheters .


We prospectively studied 100 patients undergoing endoscopic biliary drainage for obstructive jaundice , who were randomly allocated to a 5 Fr or 7 Fr nasobiliary catheter group .


As the primary endpoint , the effectiveness was evaluated by the serum total bilirubin decreasing rate and the success rate of jaundice relief .


As the secondary endpoint , the degree of discomfort was investigated using a questionnaire survey after catheter removal .


The bilirubin decrease rate was significantly higher in the 7 Fr catheter group than in the 5 Fr group ( 53.0 21.4 % vs 40.5 29.9 % , respectively ; P = 0.019 ) .


The success rate of jaundice relief tended to be higher in the 7 Fr catheter group , although the difference was not statistically significant ( 98 % vs 88 % , respectively ; P = 0.056 ) .


The questionnaire survey demonstrated that total discomfort was significantly greater in the 7 Fr group ( 3.9 1.5 vs 3.2 1.4 , respectively ; P = 0.018 ) .


Larger-diameter catheters tended to increase difficulty in eating , although the difference between the groups was not statistically significant .


7 Fr nasobiliary catheters are recommended for patients requiring rapid and reliable relief of obstructive jaundice .


However , because they can cause greater discomfort , 5 Fr nasobiliary catheters are preferred in other settings .


On July 1 , 2012 ; UMIN000008288 ( Japan Primary Registries Network ) .


The recommended dose of erlotinib is 150mg daily either 1h before a meal ( complete fasting ) or 2h after a meal ( 2h post-meal ) , because of the food effect .


We conducted a cross-over pharmacokinetic study to compare the fed bioequivalence in the two conditions .


Twenty-three patients with non-small cell lung cancer were included in the analysis .


AUC0-24 and C max in the 2-h post-meal status were significantly higher than in the complete fasting status ( GMR = 1.33 , P < 0.001 ; GMR = 1.44 , P < 0.001 , respectively ) .


However , because the concentration of erlotinib did not reach the steady state within 7days in the complete fasting state , we conducted analyses only on day 14 , which showed no significant difference in AUC0-24 or C max between the two conditions .


The more rapid increase in AUC0-24 and C min did not produce any earlier and more severe toxic events .


The AUC0-24 increased significantly faster ( 48-53 % greater ) in the 2-h post-meal status than in complete fasting status , which suggested that the two gastric emptying states might differ in their absorption .


However , there was no clinically significant difference in bioavailability or toxicity between the two clinically used fed conditions at least in 14days .


Percutaneous tunneling ( hydrodissection ) in the neck and anterior chest in patients undergoing robotic thyroidectomy leads to significant hemodynamic responses such as increases in blood pressure and heart rate .


We evaluated whether a single preoperative dexmedetomidine injection attenuated hemodynamic responses to hydrodissection by reducing the half-maximal effective concentration ( EC50 ) of remifentanil needed to maintain hemodynamic stability during hydrodissection .


Forty-one patients undergoing robot-assisted endoscopic thyroidectomy were randomly allocated to one of the two groups-group D ( n = 22 ) and group C ( n = 19 ) patients received dexmedetomidine 1g/kg and normal saline for 10min before anesthetic induction , respectively .


The EC50 of remifentanil for hemodynamic stability during hydrodissection was determined using Dixon 's up-and-down method with initial dose ( 4and 5ng/mL in groups D and C , respectively ) .


The concentration of remifentanil for consecutive patients in each group was determined by the response of the previous patient , using increments or decrements of 0.5 ng/mL .


Hemodynamic stability during hydrodissection was defined as increased systolic blood pressure < 20 % of baseline .


The EC50 of remifentanil for maintaining hemodynamic stability during hydrodissection was 0.8 ng/mL in group D and 7.3 ng/mL in group C ( p = 0.002 ) .


A single preoperative dexmedetomidine injection attenuated hydrodissection-induced hemodynamic responses in patients undergoing robotic thyroidectomy .


Prenatal lipid-based nutrient supplements ( LNS ) have been shown to improve birth anthropometry .


However , little is known about the effects of such supplements on infant health .


We hypothesized that prenatal LNS compared with multiple micronutrient supplement for pregnant and lactating women would improve survival , growth , and morbidity during infancy .


Infants ' weight , length , head , chest , and mid-upper arm circumferences were measured during monthly home visits from birth to 12 months of age in the Micronutriments et Sant de la Mre et de l'Enfant -- 2 trial .


Differences in stunting and wasting episodes between study arms were assessed by Cox regression for recurrent event models .


Morbidity signs during the 2 weeks before the visits and death cases were also assessed by multilevel analysis accounting for repeated individual measurements .


Infant length-for-age growth ( -0.033 z score/month ; 95 % confidence interval : -0.601 to -0.006 ; P = .018 ) for the LNS group was inferior to that of the control group .


We did not find evidence of significant difference in mortality or morbidity between groups .


The previously reported positive effect of prenatal LNS on birth length was not sustained during the postnatal phase .


Prenatal LNS does not appear to make a long-lasting difference in child linear growth .


To assess the effect of pulsed electromagnetic fields ( PEMFs ) on balance ability of postmenopausal women with osteoporosis .


43 eligible patients were randomly divided into experimental ( n = 24 ) and control ( n = 19 ) groups .


Patients in both groups received conventional drug therapy .


Meanwhile , patients in the experimental group were given PEMFs once a day for 30 days .


The Berg Balance Scale ( BBS ) scores increased and the timed upand to test ( TUG ) scores , sway index ( forward-backward ) , rectangle area and sway path decreased in the patients in the experimental group ( P < 0.05 ) .


In the patients in the control group , only changes in BBS scores and sway path were statistically significant ( P < 0.05 ) .


The decrease of sway index ( forward-backward ) in the experimental group was greater than that of the control group ( P < 0 01 ) .


PEMFs can improve the balance ability of patients with post-menopausal osteoporosis .


The prognostic impact of improvement in health-related quality of life ( QoL ) and its relation to response in cardiac resynchronization therapy ( CRT ) recipients remains unknown .


To assess the correspondence between response to CRT and improvements in QoL and to verify if a change in QoL after pacing influences outcome in CRT patients .


Ninety-seven participants of the Triple-Site Versus Standard Cardiac Resynchronization Therapy Trial ( TRUST CRT ) randomized trial , in New York Heart Association class III-IV , QRS width 120 ms , left ventricular ejection fraction 35 % , and significant mechanical dyssynchrony were included .


Subjects filled out the Minnesota-QoL questionnaire prior to and 6 months after CRT with defibrillator ( CRT-D ) implantation .


Data on major adverse cardiac events ( MACEs : death , heart failure hospitalization , heart transplant ) collected within the next 2.5 years and adjudicated blindly constituted the censoring variables .


Within the first 6 months of resynchronization QoL improved in 81 % , while worsening in 19 % of patients .


Clinical response , but not the echocardiographic one , was associated with improved QoL .


During subsequent 2.5 years MACEs occurred in 37 % of patients ( 23 % died ) .


Subjects without QoL improvement were significantly ( both P < 0.05 ) more prone to experience MACE ( 61 % vs 32 % ) and die ( 44 % vs 18 % ) within the follow-up .


Unimproved QoL increased the probability of future MACE by 2.7 times ( 95 % confidence intervals [ CI ] : 1.26-5 .83 ; P = 0.01 ) and death by 3.2 times ( 95 % CI : 1.23-8 .32 ; P = 0.02 ) independently from clinical and echocardiographic response .


Clinical response , but not the echocardiographic one , was associated with improved QoL in CRT recipients .


These preliminary data suggest that lack of improvement in QoL after CRT was associated with a strongly unfavorable prognosis , regardless of functional or echocardiographic response .


Our results merit further studies with a larger number of patients .


To investigate the effect of resin-modified , glass-ionomer cement lining on the quality of posterior resin composite restorations , bonded with a two-step , total-etch or self-etching adhesive , at 1year .


Patients with 1-4 moderate-to-deep , primary occlusal caries in molars were informed and recruited .


A total of 110 composite restorations were placed in 75 participants , with one of four restorative procedures : ( a ) bonded with a total-etch adhesive ( Single Bond 2 ) ; ( b ) lined with glass-ionomer cement ( Fuji Lining LC ) , and then bonded with total-etch adhesive ; ( c ) bonded with a self-etching adhesive ( Clearfil SE Bond ) ; and ( d ) lined with glass-ionomer cement , and then bonded with self-etching adhesive .


At 1year , 57 patients ( 86 restorations ) attended the recall .


Each of the restorations was evaluated and scored from 1 ( clinically excellent ) to 5 ( clinically poor ) using the following criteria : ( a ) patient satisfaction ; ( b ) fracture and retention ; ( c ) marginal adaptation ; ( d ) recurrent caries ; and ( e ) post-operative sensitivity .


At 1year , the qualities of the restorations were not significantly affected by the placement of glass-ionomer cement lining , regardless of the adhesive used ( P > 0.05 ) .


Most of the restorations were scored 1 for all criteria .


The benefit of placing a glass-ionomer cement liner in resin composite restoration is questionable .


This was a prospective study of patients who underwent vertebroplasty ( VP ) at a single institute .