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[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "BACKGROUND" ]

[ "age-related cognitive decline is common and may lead to substantial difficulties and disabilities in everyday life .", "we hypothesized that @ hours of visual speed of processing training would prevent age-related declines and potentially improve cognitive processing speed .", "within two age bands ( @-@ and @ ) @ patients were randomized to ( a ) three computerized visual speed of processing training arms ( @ hours on-site , @ hours on-site , or @ hours at-home ) or ( b ) an on-site attention control group using computerized crossword puzzles for @ hours .", "the primary outcome was the useful field of view ( ufov ) test , and the secondary outcomes were the trail making ( trails ) a and b tests , symbol digit modalities test ( sdmt ) , stroop color and word tests , controlled oral word association test ( cowat ) , and the digit vigilance test ( dvt ) , which were assessed at baseline and at one year .", "@ participants ( @ % ) completed the study and were included in the analyses .", "linear mixed models were used with blom rank transformations within age bands .", "all intervention groups had ( p < @ ) small to medium standardized effect size improvements on ufov ( cohen 's d = -@ to -@ , depending on intervention arm ) , trails a ( d = -@ to -@ ) , trails b ( d = -@ to -@ ) , sdmt ( d = @ to @ ) , and stroop word ( d = @ to @ ) .", "converted to years of protection against age-related cognitive declines , these effects reflect @ to @ years on ufov , @ to @ years on trails a , @ to @ years on trails b , @ to @ years on sdmt , and @ to @ years on stroop word .", "visual speed of processing training delivered on-site or at-home to middle-aged or older adults using standard home computers resulted in stabilization or improvement in several cognitive function tests .", "widespread implementation of this intervention is feasible .", "clinicaltrials.gov nct-@ ." ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "patients ' race or ethnic background may affect their ability to access health care due to their socioeconomic status , hereditary predispositions to illnesses , or discrimination either perceived or actual by those providing health care .", "for patients with mental health disorders , additional barriers are created due to poor experiences with the health care system .", "this was a mixed methods randomized control study examining the effectiveness of care managers linking patients to primary care after psychiatric crisis .", "the aim reported in this paper was to analyze differences by minority status in patients ' quantitative and qualitative responses before and after facilitation to primary care ( n = @ ) .", "patients responded to a `` patient enablement '' and primary care index assessing their feelings of empowerment after a primary care visit ; and to qualitative questions about their experiences and perceptions of care .", "following a primary care visit , responses by minority and non-minority individuals did not differ significantly on either the patient enablement or primary care index score .", "on qualitative inquiry , both non-minorities and minorities reported positive and negative views of their health , with corresponding positive and negative health experiences .", "in sum , there were no differences in patient enablement between the minority and non-minority subgroups over the course of the study , nor were there any changes in patient 's perception of their relationship with healthcare providers .", "however , this cohort found primary care services less satisfactory than a general population without mental illness .", "patients with psychiatric disorders experience stigmatization in their attempts to access health care .", "this stigma may have a greater impact than race and ethnicity , thereby leading to a similarity in perception of health care between minorities and non-minorities with mental illness ." ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "human immunodeficiency virus type @ ( hiv-@ ) - specific cellular immunity contributes to the control of hiv-@ replication .", "hiv-@-infected volunteers who were receiving antiretroviral therapy were given a replication-defective adenovirus type @ hiv-@ gag vaccine in a randomized , blinded therapeutic vaccination study .", "hiv-@-infected vaccine or placebo recipients underwent analytical treatment interruption ( ati ) for @ weeks .", "the log ( @ ) hiv-@ rna load at the ati set point and the time-averaged area under the curve served as co-primary end points .", "immune responses were measured by intracellular cytokine staining and carboxyfluorescein succinimidyl ester dye dilution .", "vaccine benefit trends were seen for both primary end points , but they did not reach a prespecified significance level of p < or = @ .", "the estimated shifts in the time-averaged area under the curve and the ati set point were @ ( p = @ , unadjusted ) and @ ( p = @ , unadjusted ) log ( @ ) copies lower , respectively , in the vaccine arm than in the placebo arm .", "hiv-@ gag-specific cd@ ( + ) cells producing interferon-gamma were an immunologic correlate of viral control .", "the vaccine was generally safe and well tolerated .", "despite a trend favoring viral suppression among vaccine recipients , differences in hiv-@ rna levels did not meet the prespecified level of significance .", "induction of hiv-@ gag-specific cd@ cells correlated with control of viral replication in vivo .", "future immunogenicity studies should require a substantially higher immunogenicity threshold before an ati is contemplated ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "although epinephrine commonly is added to local anesthetics for regional anesthesia , rarely it may cause undesirable hemodynamic side effects .", "this study compared the hemodynamic and blockade effects of @ and @ microg epinephrine during axillary brachial plexus blockade with lidocaine @ % .", "sixty american society of anesthesiologist classification i or ii patients were divided randomly into @ groups .", "patients in group @ received @ ml of saline containing @ microg epinephrine and then @ ml of @ % lidocaine ; patients in group @ received @ ml of saline alone and then @ microg of epinephrine mixed with @ ml of @ % lidocaine ; patients in group @ received @ ml of saline alone and then @ ml of @ % lidocaine .", "hemodynamic data were measured for @ to @ minutes at @-minute intervals after axillary injection .", "the duration time of motor and sensory block was recorded .", "complete anesthesia was achieved in @ % of patients in groups @ and @ and @ % in group @ .", "motor block duration was significantly longer in group @ than in groups @ and @ ( p < @ ) .", "there were no significant differences in analgesia between groups @ and @ .", "analgesia duration was significantly longer in groups @ and @ than in group @ ( p < @ ) .", "heart rate from the @rd to @th minute was higher in group @ than in groups @ and @ ( p < @ ) .", "systolic arterial pressure from the @rd to @th minute and diastolic arterial pressure from @nd to @th minute were higher in group @ than in groups @ and @ ( p < @ ) .", "low-dose epinephrine offers more stable hemodynamics and similar blockade , and thus may be beneficial for patients undergoing forearm and hand surgery who are at risk for tachycardia and/or hypertension ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "to assess the effect of different doses of tramadol when added to lignocaine during intravenous regional anesthesia ( ivra ) .", "sixty patients , scheduled for hand surgery under ivra in king fahd university hospital , al-khobar , saudi arabia from january @ to january @ were randomly allocated into @ groups ( @ patients each ) in a double blind controlled study .", "all patients received @ % lignocaine , @ml plus @ml of a study solution containing either isotonic saline control group , or tramadol @mg ( group t@ ) or tramadol @ mg ( group t@ ) .", "hemodynamic changes , sensory and motor block onset and recovery times , tourniquet tolerance time , the quality of intraoperative anesthesia and the duration of postoperative analgesia were assessed .", "all patients , @ in each group completed the study period .", "patients who received tramadol had earlier onset of sensory block ( @ + / = @ ; @ + / = @ min in the t@ ; and t@ groups ) compared with the control group ( @ + / = @ min ) .", "patients who received @mg of tramadol had better tolerance of tourniquet ( p = @ ) , and less intraoperative fentanyl supplementation ( p = @ ) .", "they had also a longer time to the first postoperative analgesic request ( p = @ ) compared with the control group .", "tramadol @ mg is a beneficial additive to lignocaine for ivra since it shortened the onset of sensory block , enhanced the tourniquet tolerance and improved the perioperative analgesia ." ]

[ "BACKGROUND", "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "medication use is a potentially modifiable risk factor for falling ; psychotropic and cardiovascular drugs have been indicated as main drug groups that increase fall risk .", "however , evidence is mainly based on studies that recorded falls retrospectively and/or did not determine medication use at the time of the fall .", "therefore , we investigated the associations indicated in the literature between medication use and falls , using prospectively recorded falls and medication use determined at the time of the fall .", "data from the b-proof ( b-vitamins for the prevention of osteoporotic fractures ) study were used , concerning community-dwelling elderly aged @ years .", "we included @,@ participants with pharmacy dispensing records .", "during the @ - to @-year follow-up , participants recorded falls using a fall calendar .", "cox proportional hazard models were applied , adjusting for potential confounders including age , sex , health status variables and concomitant medication use .", "during follow-up , @,@ participants experienced at least one fall .", "users of anti-arrhythmic medication had an increased fall risk ( hazard ratio [ hr ] @ ; @ % confidence interval [ ci ] @-@ @ ) compared with non-users .", "similarly , non-selective beta-blocker use was associated with an increased fall risk ( hr @ [ @ % ci @-@ @ ] ) , while statin use was associated with a lower risk ( hr @ [ @ % ci @-@ @ ] ) .", "benzodiazepine use ( hr @ [ @ % ci @-@ @ ] ) , and antidepressant use ( hr @ [ @ % ci @-@ @ ] ) were associated with an increased fall risk .", "use of other cardiovascular and psychotropic medication was not associated with fall risk .", "our results strengthen the evidence for an increased fall risk in community-dwelling elderly during the use of anti-arrhythmics , non-selective beta-blockers , benzodiazepines , and antidepressant medication .", "clinicians should prescribe these drugs cautiously and if possible choose safer alternatives for older patients ." ]

[ "BACKGROUND", "BACKGROUND", "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "chronic alcohol abuse is associated with deficits in cognitive control functions .", "cognitive control is likely to be mediated through the interaction between intrinsic large-scale brain networks involved in externally oriented executive functioning and internally focused thought processing .", "improving the interaction between these functional brain networks could be an important target for treatment .", "therefore , the current study aimed to investigate the effects of the cognitive enhancer modafinil on within-network and between-network resting-state functional connectivity and cognitive control functions in alcohol-dependent patients .", "in a double-blind , placebo-controlled cross-over design , resting-state functional magnetic resonance imaging and a stroop task were employed in alcohol-dependent patients ( n = @ ) and healthy control subjects ( n = @ ) .", "within-network and between-network functional connectivity was calculated using a combination of independent component analysis and functional network connectivity analysis .", "modafinil significantly increased the negative coupling between executive networks and the default mode network , which was associated with modafinil-induced improvement in cognitive control in alcohol-dependent patients .", "these findings demonstrate that modafinil at least partly exerts its effects by targeting intrinsic functional relationships between large-scale brain systems underlying cognitive control .", "the current study therefore provides a neurobiological rationale for implementing modafinil as an adjunct in the treatment of alcohol dependence , although clinical studies are needed to substantiate this promise ." ]

[ "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "the present study aimed at determining if the addition of spaced education to traditional face-to-face lectures increased the time students kept busy with the learning content of a theoretical radiological science course .", "the study comprised two groups of @ third-year dental students .", "the students were randomly assigned to a `` traditional group '' and a `` spaced education group '' .", "both groups followed a traditional face-to-face course .", "the intervention in the spaced education group was performed in way that these students received e-mails with a delay of @days to each face-to-face lecture .", "these e-mails contained multiple choice questions on the learning content of the lectures .", "the students returned their answers to the questions also by e-mail .", "on return they received an additional e-mail that included the correct answers and additional explanatory material.all students of both groups documented the time they worked on the learning content of the different lectures before a multiple choice exam was held after the completion of the course .", "all students of both groups completed the tril questionnaire ( trierer inventar zur lehrevaluation ) for the evaluation of courses at university after the completion of the course .", "the results for the time invested in the learning content and the results of the questionnaire for the two groups were compared using the mann-whitney-u test .", "the spaced education group spent significantly more time ( @ min ) on keeping busy with the learning content compared to the traditional group ( @ min , p < @ ) .", "the spaced education group rated the didactics of the course significantly better than the traditional group ( p = @ ) .", "the students of the spaced education group also felt that their needs were fulfilled significantly better compared to the traditional group as far as communication with the teacher was concerned ( p = @ ) .", "adding spaced education to a face-to-face theoretical radiological science course activates students in a way that they spend significantly more time on keeping busy with the learning content ." ]

[ "BACKGROUND", "BACKGROUND", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "METHODS", "METHODS" ]

[ "studies with a follow-up of < @ weeks have indicated immune-preserving effects of yogurt probiotic supplementation among hiv patients .", "to evaluate the impact of @ weeks use of probiotics , a randomized , double blind , controlled study was undertaken on @ women who were nave to anti-retroviral treatment .", "ten participants were excluded post-randomization due to non-eligibility .", "thirty participants were assigned placebo , of whom @ completed the study versus @ of @ completing the study in the probiotics group ( p = @ ) .", "from baseline to @ weeks follow-up , the cd@ count declined on average @ cd@ cells/l ( @ % confidence interval : -@ ; @ ) with placebo versus an increase of @ cells/l ( @ % ci : -@ ; @ ) with probiotics ( p = @ ) .", "from baseline to @ weeks , the cd@ count increased with @ cells/l ( @ % ci : -@ ; @ ) in the placebo group versus @ cells/l ( @ % ci : -@ ; @ ) with probiotics ( p = @ ) .", "no differences in immune markers , diarrhea incidence or adverse events were observed .", "lactobacillus gr-@ and rc-@ may be safely consumed at @ x @ ( @ ) cfu/day by moderately immune compromised hiv patients but this did not universally preserve immune-function .", "women were randomized to receive oral capsules containing lactobacillus rhamnosus gr-@ and lactobacillus reuteri rc-@ ( @ x @ ( @ ) colony forming units ) or placebo twice daily for @ weeks .", "the cd@ count and immune markers ( igg , ige , ifn and il-@ ) were measured at baseline and during follow-up , the occurrence of diarrhea was reported daily ." ]

[ "BACKGROUND", "BACKGROUND", "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "booster sessions as a means of maintaining the benefits of psycho-educational programs have received little attention in caregiving research .", "caregivers were offered a booster session following participation in a program entitled learning to become a family caregiver ( lbfc ) intended to facilitate transition to the caregiver role after diagnostic disclosure of dementia in a relative .", "the @-minute booster session served to review program content and afforded the opportunity to discuss and practice learned skills .", "this study sought to test the efficacy of the booster session in maintaining or recovering program effects at six months post-program .", "participants in the program were randomly assigned to a group that received the booster session ( n = @ ) or a group that did not ( n = @ ) .", "a third control group was also formed , which continued to receive only the usual care provided in memory clinics .", "eligible participants - french-speaking primary caregivers of a relative diagnosed with alzheimer 's in the past nine months - were recruited in memory clinics in quebec ( canada ) .", "participants were blindly assessed before randomization and six months after the booster session on outcomes associated with a healthy role transition .", "prediction analyses revealed one significant positive effect of the booster session : emergence of preparedness to provide care .", "moreover , with or without the booster session , the program continued to have a positive effect on psychological distress and contributed to the emergence of self-efficacy in dealing with caregiving situations .", "the booster session had no significant effect on knowledge of services , planning for future care needs , use of reframing as a coping strategy , perceived informal support , and family conflicts .", "the limited effect observed is discussed in terms of the booster session 's content and intensity .", "recommendations are made for designing future research on the effect of booster sessions , including the importance of including a placebo booster group ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "postoperative atrial fibrillation ( af ) is a common complication of cardiac surgery that is associated with an increased incidence of other complications .", "the goal of this prospective randomized study was to evaluate the effect of ultra-low dose landiolol hydrochloride for prevention of af after off-pump coronary artery bypass grafting ( cabg ) .", "the subjects were @ patients who underwent isolated cabg and were randomly divided into those who received landiolol from icu admission until the beginning of oral drug intake ( group l ) and those administered diltiazem hydrochloride over the same period ( group d ) .", "the incidence of af within one week after surgery was examined as the primary endpoint .", "heart rate , blood pressure , cardiac output , and other hemodynamic parameters were used as secondary endpoints .", "the rates of adverse events were also recorded .", "the incidences of af in the first postoperative week were @ % and @ % in groups l and d , respectively ( p = @ ) .", "there were no differences in hemodynamic parameters between the groups .", "in multivariate analysis , no factor emerged as a significant risk factor for postoperative af .", "two patients had adverse events of asthma and hypotension , respectively , in group l.", "ultra-low dose landiolol is effective for preventing af after cabg without worsening hemodynamics ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "an attempt has been made to prospectively compare the results of two laparoscopic pyeloplasties : dismembered anderson-hynes ( a-h ) plasty and nondismembered y-v plasty .", "complications following the procedures have been studied as well .", "fifty patients with primary ureteropelvic junction obstruction ( upjo ) were prospectively selected at random to undergo dismembered a-h ( @ patients-even numbers ) and nondismembered y-v ( @ patients-odd numbers ) laparoscopic pyeloplasty .", "upjo was diagnosed on the basis of ultrasonography , excretory urography , and diuretic renography ( dr ) .", "the intensity of pain was assessed according to a visual analog pain scale ( vas ) .", "success was defined by three factors taken collectively : @ % or greater pain relief in comparison with the preoperative vas score , no obstruction on dr ( decreasing renographic excretion curve , t ( @/@ ) < @ min ) , and improved or stable differential renal function .", "the mean follow-up was @ months for the a-h group and @ months for y-v group ( p = @ ) .", "both groups were comparable in terms of preoperative data , except for the presence of the crossing vessel , which was more often observed in the y-v group .", "no statistically significant differences between the studied groups were found in operative times , morbidity , and hospitalization length .", "the success rate in the a-h group was @ % and @ % in the y-v group , the difference being not statistically significant .", "laparoscopic a-h pyeloplasty achieved a higher success rate then y-v pyeloplasty ; however , the difference was not statistically significant ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to study the pharmacokinetics and accumulation of deramciclane and its metabolite n-desmethylderamciclane after @ mg twice daily doses for @ weeks .", "sixteen healthy male subjects , age range of @-@ years , participated in this randomized , double-blind , parallel-group , placebo-controlled study .", "ten subjects first received a single @ mg dose of deramciclane followed by @ mg deramciclane b.i.d. between days @ and @ .", "six subjects received matching placebo in a similar manner .", "pharmacokinetics of deramciclane and n-desmethylderamciclane were determined on days @ , @ , @ , @ and @ .", "plasma prolactin concentrations were measured before drug administration and @ hours after on the same days .", "safety was monitored using repeat laboratory determinations and ecg recordings .", "the mean ( sd ) auc ( @-infinity ) of deramciclane was @,@ ( @ ) ng x h/ml after the first dose .", "the auc ( tau ) calculated for the dosing interval was significantly higher at week @ ( p = @ ) than the auc ( @-infinity ) after the first dose but thereafter there was no further accumulation of deramciclane .", "the mean accumulation indices at weeks @ , @ , @ and @ varied between @ and @ with no tendency to increase over time .", "the mean apparent elimination half-life of deramciclane was @ ( @ ) hours after the first dose and @ ( @ ) hours after @-week repeated dosing ; this difference was not statistically significant .", "the accumulation index of n-desmethylderamciclane increased from week @ to week @ but remained stable thereafter .", "the treatment was well tolerated .", "plasma prolactin levels were not influenced by deramciclane administration .", "deramciclane administration , @ mg twice daily for @ weeks to healthy male volunteers , is well tolerated , and there is no evidence of continuous accumulation of the drug during maintenance treatment .", "deramciclane at a dose of @ mg b.i.d. does not antagonize dopamine receptors to a significant degree ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to evaluate the clinical and radiographic results of dental implant placed using osteotome sinus floor elevation ( osfe ) with and without simultaneous grafting .", "forty-five patients were randomly assigned into two groups : group@ : osfe with deproteinized bovine bone mineral ( dbbm ) mixed with autogenous bone chips , and group@ : osfe without grafting .", "the endo-sinus bone gain ( esbg ) was assessed on radiographs at @ , @ , @ , @months following surgery as primary outcome measurement .", "implant survivals and marginal bone loss ( mbl ) were assessed as secondary outcome measurements .", "twenty-one implants in group@ and @ implants in group@ were analysed .", "the residual bone height ( rbh ) was @ mm in average ( @ mm for group@ and @ mm for group@ ) .", "the @-year cumulative survival rates of implants were @ % for group@ and @ % for group@ .", "the esbg in group@ reduced from @ mm at @months to @ mm at @months , whereas the esbg in group@ increased from @ mm at @months to @ mm at @months .", "the mbl after @years was @ mm in group@ and @ mm in group@ .", "osfe and simultaneous implant installation with and without grafting both resulted in predictable results .", "the application of grafting materials has no significant advantage in terms of clinical success ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "botulinum toxin a ( btx-a ) is an inhibitor of muscular contractions in both striated and smooth muscle .", "the purpose of this study was to observe the safety and efficacy of endoscopic injections of btx-a into the gastric wall in obese patients .", "twenty obese patients ( bmi > @ kg/m@ ) were randomized into two groups : group @ ( @ u btx-a ) and group @ ( @ u btx-a ) .", "for each patient , @ puncture sites were selected into the gastric wall .", "body weights and bmis were recorded and gastric emptying times were determined before treatment and @ , @ and @ weeks after treatment .", "blood samples for cholesterol , triglycerides , insulin , leptin , motilin , peptide tyrosine ( pyy ) and ghrelin levels were obtained before treatment and @ , @ and @ weeks after treatment .", "nineteen patients completed the follow-up .", "both groups showed significant body weight and bmi decrease ( p < @ ) with decreased tg levels .", "the gastric emptying times were longer than those before treatment in both groups , especially at the @-week point ( p < @ ) .", "a significant decrease in fasting ghrelin levels in all @ obese patients was found after btx-a administration @ weeks later , and pyy levels in all @ patients decreased , especially at the @-week point .", "no severe complications were observed .", "endoscopic multi-punctures of btx-a including fundic injections may decrease body weight and bmi by delaying the gastric emptying time .", "the effect of btx-a on ghrelin levels may also be involved in the reduction of appetite ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "infliximab is effective in improving signs and symptoms of joint/skin involvement , functional status , and quality of life in patients with psoriatic arthritis ( psa ) .", "using impact trial data , we assessed the effect of infliximab ( ifx ) on structural damage in psa .", "patients with active psa were randomly assigned to receive placebo ( pbo/ifx ) or infliximab @ mg/kg ( ifx/ifx ) at weeks @ , @ , @ , and @ , with the primary endpoint at week @ .", "the pbo group received infliximab loading doses at weeks @ , @ , and @ .", "thereafter , all patients received infliximab @ mg/kg every @ weeks through week @ .", "hand/feet radiographs were obtained at weeks @ and @ .", "total radiographic scores were determined using the psa modified van der heijde-sharp ( vdh-s ) score .", "projected annual rate of progression was calculated by dividing x ray score by disease duration ( years ) .", "as reported previously , @ % of infliximab treated patients versus @ % of pbo treated patients achieved an acr@ response at week @ ( p < @ ) .", "at week @ , @ % of patients achieved an acr@ response .", "radiographs ( baseline and week @ ) were available for @/@ patients .", "at baseline , estimated mean annual rate of progression was @ modified vdh-s points/year .", "mean ( median ) changes from baseline to week @ in the total modified vdh-s score were -@ ( -@ ) for pbo/ifx and -@ ( -@ ) for ifx/ifx patients ( p = ns ) .", "at week @ , @ % and @ % of patients in the pbo/ifx and ifx/ifx groups had no worsening in the total modified vdh-s score .", "infliximab inhibits radiographic progression in patients with psa through week @ ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "this longitudinal study was designed to assess the effect of an educational training package for primary health care teams in accident prevention for older people , with reference to the incidence of accidents and their associated economic consequence .", "nineteen general practices in the west midlands serving a population of @ @ were allocated randomly at the practice level either to receive training or continue normal practice .", "study data was collated from the initial telephone call , reporting an accident , to the surgery , advice/treatment given at the practice and/or the community , casualty , inpatient care , written correspondence to the patient 's gp and any subsequent follow-up visits for accidents to people aged @ years or older .", "one thousand , six hundred and sixty-six ( @ % ) patients aged @ years or older registered with the participating practices experienced one accident or more , costing the nhs pound @ million .", "extrapolated nationally , annual costs to the nhs for accidents to older people amount to pound @ million .", "the educational package had no significant impact on the incidence of accidents .", "a paucity of general safety advice was given [ @ ( @ % ) occasions ] .", "budgets are being eroded and patients are suffering unnecessarily due to lack of accident prevention advice .", "this should be considered a priority within the primary health care team .", "educational packages alone do not appear to be a cost-effective approach to accident prevention in primary care ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to evaluate the effect of intraperitoneal installation and periportal infiltration of bupivacaine on postoperative pain and return of bowel function .", "a prospective , double-blind , randomized trial ( canadian task force classification i ) .", "gata school of medicine , department of obstetrics and gynecology , reproductive endocrinology unit .", "eighty patients undergoing operative gynecologic laparoscopy .", "periportal infiltration of local anesthesia with @ ml @ % bupivacaine before incision and another @ ml @ % bupivacaine diluted with @ ml of saline or equal amount of physiologic saline injected into the peritoneal cavity at the end of the procedure .", "each patient recorded the severity of her pain on a visual analog scale ( vas ) at @ , @ , @ , and @ hours and the time of first bowel movement and first flatus after surgery .", "seventy-seven patients completed the study ( @ in the bupivacaine group ; @ in the control group ) .", "the severity of postoperative pain , as recorded on the vas , was significantly less at @ , @ , @ , and @ hours after surgery in the group receiving bupivacaine compared with those in the control group .", "the first bowel movement in the bupivacaine group occurred earlier than in the control group ( @ + / - @ min vs @ + / - @ min , p < @ ) ; similarly , the first flatus occurred earlier in the bupivacaine group than in the control group ( @ + / - @ min vs @ + / - @ min p < @ ) .", "intraperitoneal installation and periportal infiltration of bupivacaine decrease postoperative pain and hasten the return of bowel function .", "both decreased postoperative pain and shortened duration for the return of bowel function are crucial for comfort and discharge of the patient ." ]

[ "BACKGROUND", "BACKGROUND", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "the platelet glycoprotein iib/iiia receptor inhibitor abciximab , a monoclonal antibody , has been shown to improve early and late outcomes among diabetic patients undergoing percutaneous coronary intervention ( pci ) .", "it is unknown whether small-molecule agents confer similar benefits .", "in @ countries , @ patients undergoing pci with stent implantation were randomized to tirofiban or abciximab .", "at the time of enrollment , patients were stratified according to diabetes status .", "as compared with non-diabetic patients , patients with diabetes ( n = @ ) showed similar @-day ischemic outcomes , an increased incidence of any target vessel revascularization ( tvr ) at @ months ( @ % versus @ % ; p = @ ) , and a trend toward higher @-year mortality ( @ % versus @ % ; p = @ ) .", "among diabetic patients randomized to tirofiban ( n = @ ) , the incidence of death , myocardial infarction ( mi ) , or urgent tvr at @ days was @ % , and among those randomized to abciximab ( n = @ ) it was @ % ( hazard ratio [ hr ] @ ; p = @ ) .", "at @ months , the composite of death , mi , or any tvr occurred in @ % and in @ % of tirofiban and abciximab patients , respectively ( hr @ ; p = @ ) .", "any tvr occurred in @ % and @ % , respectively ( hr @ ; p = @ ) .", "the @-year mortality was @ % in the tirofiban group and @ % in the abciximab group ( hr @ ; p = @ ) .", "among diabetic patients undergoing pci , tirofiban and abciximab were associated with comparable event rates , including similar rates of @-month tvr and @-year mortality .", "these findings suggest that the non-glycoprotein iib/iiia properties of abciximab do not translate into a discernible long-term clinical benefit among diabetic patients ." ]

[ "BACKGROUND", "BACKGROUND", "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "CONCLUSIONS", "CONCLUSIONS", "BACKGROUND" ]

[ "the physical activity ( pa ) levels of many children and adolescents in australia are currently insufficient to promote health benefits .", "physical education ( pe ) programs aim to promote pa and reach nearly all school-aged children , but pa levels within pe lessons are often low .", "pe teachers may influence children 's motivation to be physically active in pe lessons , but little is known about teacher strategies that effectively motivate children to participate in pa , and few intervention studies have examined motivational strategies in pe .", "the purpose of this study was to compare the effect of three motivational strategies , each based on self-determination theory ( sdt ) , on pa levels , and their hypothesized antecedents , during year @ pe lessons .", "this study employed a cluster-randomized controlled trial design .", "following a familiarization session , pa levels and hypothesized pa antecedents were measured during a baseline lesson and a post-intervention or control lesson .", "teachers ( n = @ ) and their classes from five secondary schools in sydney , australia were randomly assigned into four blocks and instructed to provide one of four @-min lesson teaching strategy conditions : ( @ ) explaining the relevance of activities ; ( @ ) providing choice from pa options selected by the teacher ; ( @ ) providing equipment and free choice of activities ; or ( @ ) usual practice .", "the primary outcomes were lesson time spent in moderate-to-vigorous pa , and motivation towards the lesson .", "secondary outcomes were perceptions of teacher behavior , psychological needs satisfaction , and lesson time spent in sedentary behavior .", "pa and sedentary behavior were measured during baseline and post-intervention lessons with waist-mounted actigraph gt@x accelerometers .", "teacher behavior , psychological needs satisfaction , and motivation were assessed via questionnaires at the end of each lesson .", "linear mixed-model analyses will be run on all outcomes , with students nested within teachers as a random effect .", "study findings will inform the development of effective sdt-based teaching strategy interventions to enhance students ' psychological needs satisfaction , motivation , and pa levels .", "more effective teaching strategies may be identified that are capable of improving adolescents ' pa levels , and thereby provide beneficial population health outcomes .", "this trial is registered with current controlled trials and is traceable as isrctn@ ." ]

[ "OBJECTIVE", "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "@ .", "to verify the sensibility of panic patients to a mixture of @ % co@ and @ % o@ @ .", "to determine if a ten days treatment with clonazepam attenuates the panic attacks induced by the inhalation of @ % carbon dioxide in panic disorder .", "we randomly selected six panic disorder subjects , using the structured clinical interview for dsm-iv .", "all subjects went double-blindly through an inhalation of @ % co@ and compressed gas ( atmospheric air ) on two occasions .", "first , at baseline , when they were drug free .", "second , after a @ days clonazepam treatment .", "neither at baseline nor after treatment any patient had a panic attack during compressed gas inhalation .", "at the first test five patients ( @ % ) had a severe panic attack with high levels of subjective anxiety during carbon dioxide inhalation .", "after @ ( + / - @ ) days of clonazepam treatment , only two ( @ % ) patients experienced a mild panic attack .", "this pilot study suggests the efficacy of the short term clonazepam therapy in attenuating panic attacks and supports the usefulness of the @ % carbon dioxide challenge test as an analogue method for study the efficacy of anti-panic drugs .", "further placebo-controlled studies to pharmacological treatment are warranted ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to evaluate possible seasonal variations in myopia progression and ocular elongation in school children .", "seventy-one children who were enrolled in a clinical trial of bifocals were examined every @ months for @ months .", "three @-month intervals ( `` winters '' ) included none of the summer vacation from school , and two intervals ( `` summers '' ) included all of the summer vacation .", "myopia was evaluated , after cycloplegia with @ drops of @ % tropicamide , by automated refractor , and changes in axial length and in vitreous chamber depth were measured by a-scan ultrasonography .", "data from left and right eyes were averaged because there was no evidence of a significant eye-visit interaction .", "analysis of variance with a planned contrast was used to evaluate differences between the observed rates of change over the two summers compared with expected rates assuming no seasonal effect .", "for @ children in single-vision lenses , myopia progression rates over the two summers averaged @ d compared with @ d over the three winters .", "for @ children in bifocal glasses , summer rates averaged @ d compared with @ d for winters .", "analysis of variance showed that seasonal effects on myopia progression were significant ( p < @ ) for both groups for the first summer and approached significance for the second summer .", "increases in vitreous chamber depth were also slower during the summer , significantly so ( p < @ ) for both summers in the single-vision group and for the second summer only in the bifocal group .", "changes in axial length were somewhat slower in the summer , but the effect of season reached statistical significance in that variable only for the second summer in the bifocal group ( p = @ ) .", "myopia progression rates were slower during the @-month periods that included all of the summer vacation than would be expected assuming no seasonal effect .", "ocular growth was also slower in the summer ; but that trend , in most cases , was statistically significant only for changes in vitreous chamber depth and not for axial length ." ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "anthracyclines are the most active cytostatic agents in patients with metastatic breast cancer .", "drug resistance and dose intensity are relevant issues in the treatment of cancer .", "a randomized phase ii study in @ patients with advanced progressive metastatic breast cancer was performed .", "twenty-six were treated with epirubicin ( epi ) @ mg/m@ i.v. bolus injection divided over three days combined with a daily dose of @ mg verapamil ( vpl ) orally administered one day before and during epi .", "twenty-five patients received the same dose and schedule of epi without vpl .", "evaluation of response was carried out after three @-day cycles .", "study endpoints were objective response rate and overall survival .", "among the @ evaluable patients treated with epi+vpl @ cr ( @ % ) , @ pr ( @ % ) , @ nc ( @ % ) and @ pd ( @ % ) were observed .", "two patients were excluded because of toxicity .", "among the @ evaluable patients treated with epi alone @ pr ( @ % ) , @ nc ( @ % ) and @ pd ( @ % ) were observed , and one patient was excluded because of toxicity .", "myelotoxicity was the major side effect followed by alopecia , stomatitis/mucositis and nausea .", "the patient group treated with vpl had lower blood pressure levels during therapy , with complete normalization after discontinuation of vpl .", "the median overall survival times were similar : @ month in the epi group and @ month in the epi+vpl group .", "in both treatment groups the objective response rate was about @ % and the overall survival rates were also the same .", "no clinical relevance could be demonstrated for the hypothesized resistance modifying action of vpl .", "furthermore , vpl did not increase the toxicity of epi ." ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "all astronauts experience some degree of orthostatic intolerance following spaceflight , ranging from tachycardia to orthostatic hypotension and syncope .", "the purpose of this study was to evaluate the ability of two compression garments , the national aeronautics and space administration 's inflatable antigravity suit ( ags ) and the russian federal space agency 's non-inflatable compression garment ( kentavr ) , to prevent hypovolemia-related orthostatic intolerance .", "to mimic the plasma volume loss experienced by astronauts during spaceflight @ healthy subjects received an intravenous dose of a diuretic , furosemide ( @ mg x kg ( -@ ) ) , and then consumed a low-salt diet for @ h. thereafter , subjects participated in a @-min @ degrees head-up tilt test wearing either the ags ( n = @ ) or kentavr ( n = @ ) .", "compression garments were used in the fashion recommended by the respective agencies , delivering approximately @ mmhg and approximately @ mmhg of compression in the ags and kentavr , respectively .", "incidence of presyncope and hemodynamic responses during upright tilt were compared to a separate group of hypovolemic control subjects ( n = @ ) .", "subjects wearing the ags or kentavr completed the full @ min of upright tilt without incidence of orthostatic hypotension or presyncope .", "in contrast , only @ control subjects ( @ % ) were able to complete the tilt test .", "in addition , both types of compression garments maintained systolic blood pressure and significantly reduced tilt-induced tachycardia and reductions in stroke volume .", "although both garments successfully countered hypovolemia-induced orthostatic intolerance , the kentavr provided protection by using lower levels of compression .", "determining the optimal compression level required for protection of intolerance may improve crewmember comfort and decrease restrictions on physical activities after spaceflight ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "this article evaluates a demonstration program that extended coverage for disease prevention/health promotion services to medicare beneficiaries .", "community-dwelling medicare beneficiaries who lived in five rural counties in northwest pennsylvania were recruited between may and december @ .", "the demonstration lasted @ months and beneficiaries were followed for an additional @ months .", "data for the evaluation came from an initial health risk assessment , medicare administrative records , follow-up surveys , and redeemed vouchers for the waivered services .", "the waivered services included health screenings , influenza immunization , nutritional counseling , smoking and alcohol cessation , and depression/dementia evaluations .", "medicare beneficiaries were randomized to one of two experimental groups and a control group .", "one experimental group received the newly waived services from hospitals that received a capitated fee ; the other received services from providers who were paid fee-for-service .", "eligibility for most waivered services was based on risk .", "chi-square tests of association were used to determine if use of health promotion services and use of medical care services varied across groups .", "logistic regressions were used to assess the factors associated with participation .", "product-limit survival analysis was used to assess whether mortality rates varied across groups .", "participation rates in the new programs varied by program and by experimental group , and ranged from @ percent for smoking cessation programs to @ percent for influenza immunization .", "the demonstration led to an increase in influenza immunization rates relative to the control group .", "there were no differences in the use of medical care services or health outcomes between the experimental and control groups .", "older rural americans will modestly increase their use of disease prevention / health promotion services if they are covered by medicare .", "use will be higher among those with more education .", "further research is needed to assess long-term benefits of such programs ." ]

[ "OBJECTIVE", "OBJECTIVE", "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "epidural anesthesia is a technically challenging regional anesthetic technique that can be difficult to teach to novices .", "epidural simulators are now available to allow realistic training within a safe and controlled environment before attempting the procedure on patients .", "potentially , this may improve skill acquisition by novice residents .", "the purpose of this study was to examine the effect of a high-fidelity epidural anesthesia simulator on residents ' ability to perform their first labor epidurals and on their learning curve compared with a group having training with a low-fidelity model .", "second-year anesthesia residents were recruited .", "subjects were randomized into @ groups and practiced epidural needle insertion on a high-fidelity epidural simulator or on a low-fidelity model .", "subjects were then repeatedly videotaped performing epidural anesthesia over a @-month period .", "two blinded examiners graded each session , using a previously validated global rating scale and manual skill checklist to judge the skill level .", "seventy-two sessions performed by @ residents were recorded .", "manual skill checklist and global rating scale total scores were compared across the @ study groups at baseline ( first epidural ) , middle ( @-@ epidurals ) and late ( > @ epidurals ) time points using independent-samples t tests .", "no significant differences in scores were detected at either one of these time points .", "our study shows that a simple model can be as useful for learning how to place an epidural catheter as an expensive anatomically correct simulator .", "new and more technologically advanced simulators should be compared against lower fidelity models to establish their utility and cost-effectiveness ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to assess the effects of long-term mometasone furoate delivered via a dry powder inhaler ( mf-dpi ) on growth velocity and hypothalamic-pituitary-adrenal axis function in children with asthma .", "children aged @-@ years with asthma ( n = @ ) were randomized to mf-dpi @ g ( delivered dose ; actuated dose is @ g ) once daily in the morning ( qd am ) , @ g twice daily ( bid ) , @ g qd am , or placebo for @ weeks followed by a @-month follow-up period .", "the primary outcome was growth velocity calculated from stadiometric heights recorded at each visit .", "secondary outcomes included serum and @-h urinary cortisol , serum osteocalcin , and urinary n-telopeptide .", "mf-dpi @ g qd am treatment did not significantly affect growth velocity compared with placebo ( -@ @ cm/y , p = @ ) .", "when the effect of a total daily dose of @ g mf-dpi on growth velocity was examined , no significant effect was demonstrated for mf-dpi @ g bid compared with placebo ( -@ @ cm/y , p = @ ) , although the change in mean growth velocity with mf-dpi @ g qd am reached statistical significance ( -@ @ cm/y , p = @ ) .", "the effects of all examined doses of mf-dpi on mean plasma cortisol levels were similar to cortisol changes seen in the placebo group , suggesting an absence of drug-related effects .", "no differences in @-h urinary cortisol or other outcomes were observed between groups .", "one year of treatment with a total daily dose of @ g of mf-dpi in the morning resulted in no significant difference , whereas a total daily dose of @ g of mf-dpi was associated with some changes in growth velocity when compared with placebo .", "the differences in growth velocity , and the absence of drug-related cortisol effects , support the use of a total daily dose of @ g of mf-dpi in children aged @-@ years with mild persistent asthma ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "to determine the effects of hormone therapy ( ht ) on ischemia modified albumin ( ima ) and soluble ( s ) cd@ ligand in obese surgical menopausal women .", "a total of @ obese surgical menopausal women with a body mass index ( bmi ) > @ kg/m@ were admitted to the study .", "twenty-seven women received estradiol hemihydrate two mg and @ did not receive any menopausal therapy .", "at baseline and after three and six months of treatment , ima and scd@ ligand levels were measured .", "there were no significant differences among the groups for any variables at baseline .", "no difference in change in the serum scd@l levels was found in obese surgical menopausal women after three and six months of ht .", "serum ima levels were statistically lowered in obese women with ht after six months of treatment .", "ht may have a beneficial reduction in ima levels in obese surgical menopausal women ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "the purpose of this randomized trial was to compare the efficacy of a low-intensity exercise rehabilitation program vs a high-intensity program in changing physical function , peripheral circulation , and health-related quality of life in peripheral arterial disease ( pad ) patients limited by intermittent claudication .", "thirty-one patients randomized to low-intensity exercise rehabilitation and @ patients randomized to high-intensity exercise rehabilitation completed the study .", "the @-month exercise rehabilitation programs consisted of intermittent treadmill walking to near maximal claudication pain @ days per week at either @ % ( low-intensity group ) or @ % ( high-intensity group ) of maximal exercise capacity .", "total work performed in the two training regimens was similar by having the patients in the low-intensity group exercise for a longer duration than patients in the high-intensity group .", "measurements of physical function , peripheral circulation , and health-related quality of life were obtained on each patient before and after the rehabilitation programs .", "after the exercise rehabilitation programs , patients in the two groups had similar improvements in these measures .", "initial claudication distance increased by @ % in the low-intensity group ( p < @ ) and by @ % in the high-intensity group ( p < @ ) , and absolute claudication distance increased by @ % ( p < @ ) and @ % ( p < @ ) in the low-intensity and high-intensity groups , respectively .", "furthermore , both exercise programs elicited improvements ( p < @ ) in peak oxygen uptake , ischemic window , and health-related quality of life .", "the efficacy of low-intensity exercise rehabilitation is similar to high-intensity rehabilitation in improving markers of functional independence in pad patients limited by intermittent claudication , provided that a few additional minutes of walking is accomplished to elicit a similar volume of exercise ." ]

[ "BACKGROUND", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "topical steroids are first-line medication to control nasal polyposis ( np ) , a disease with long-term clinical course .", "the aim of this study was to evaluate the efficacy and safety of fluticasone propionate aqueous nasal spray ( fpans ) @ microg twice a day ( bd ) after @ month of treatment , and to compare fpans @ microg bd and fpans @ microg once a day ( od ) in maintenance and long-term treatment .", "double-blind , placebo-controlled , @-month study with three treatment periods ( @-month acute period followed with @-month maintenance period and @-month follow-up period ) was carried out .", "group @ received fpans @ microg bd , during acute , maintenance and follow-up periods , group @ received fpans @ microg bd during acute period and fpans @ microg od during maintenance and follow-up periods , and group @ received placebo during acute and maintenance periods and fpans @ microg bd during follow-up period .", "endpoints were change from baseline in clinic peak nasal inspiratory flow ( pnif ) , domiciliary evening pnif , intensity of symptoms and polyposis grade .", "after acute period and maintenance periods , fpans @ microg bd was significantly more effective than placebo on all endpoints and more effective than fpans @ microg od after @-month maintenance period on clinic pnif , evening pnif , obstruction , percentage of days with no sense of smell and percentage of nights with no disturbances .", "the two doses were similar on other endpoints .", "after the @-month follow-up period , there was no difference between the two doses of fpans at all efficacy endpoints .", "the safety profile of fpans did not highlight any new or unanticipated adverse events .", "the study demonstrated the efficacy of fpans @ microg bd in acute treatment and fpans @ microg od as a sufficient dose to maintain a long-term efficacy in the treatment for np ." ]

[ "BACKGROUND", "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "chronic viral hepatitis averages @ % to @ % in heart transplant patients .", "several studies have shown that ursodiol may improve liver biochemistry in patients with chronic hepatitis .", "we used a double-blind randomized controlled trial to evaluate the effect of ursodiol in heart transplant patients with chronic viral hepatitis .", "thirty heart patients with chronic viral hepatitis b , c , or non-a-g received ursodiol , @ mg per day ( group @ ) , and @ received placebo ( group @ ) for @ months .", "endpoints were improvement in liver biochemical tests and in total knodell score .", "intent-to-treat and per-protocol analyses were performed .", "at entry , both groups were comparable for all of the studied parameters .", "during the study period , serum alanine aminotransferase , aspartate aminotransferase , and gamma-glutamyl transpeptidase variations were not different between group @ and group @ patients .", "knodell score improved in @ % of group @ patients and in @ % of group @ patients ( ns ) .", "adverse events or mortality were not different in the two groups during the study period .", "similar results were observed by intent-to-treat and per-protocol analyses .", "a @-month course of ursodiol therapy had no effect on liver enzymes or liver histology in heart transplant patients with chronic hepatitis ." ]

[ "OBJECTIVE", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to evaluate the safety in terms of hypotensive action of nitroglycerin and lisinopril started early after myocardial infarction .", "one thousand five hundred twenty-six patients with suspected myocardial infarction were randomized by @ centers within @ hours from the onset of symptoms to receive oral lisinopril ( @ then @ mg/day ) , nitroglycerin ( intravenous infusion during the first @ hours , then @ mg/day transdermal ) , or neither .", "systolic blood pressure , intensively monitored during the first @ hours , decreased sharply by @ mm hg during the first @ hours , then more slowly to an average value of @ mm hg .", "nitroglycerin lowered systolic blood pressure during the first @ hours by @ mm hg versus control subjects , and it was similar to control subjects from @ hours .", "lisinopril reduced systolic blood pressure by @ mm hg over @ hours compared with control subjects .", "persistent hypotension was significantly more frequent in the lisinopril group ( @ % ) than in the nitroglycerin group ( @ % ) or control group ( @ % ) , but absolute numbers of deaths in patients with persistent hypotension were almost identical .", "lisinopril and nitroglycerin are both safe and effective in reducing blood pressure in the first day after myocardial infarction .", "however , the effect is lost thereafter with transdermal nitroglycerin , but persists with lisinopril ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "s-@ is a novel oral fluoropyrimidine comprised of ft and two modulators , gimeracil ( cdhp ) and oteracil potassium ( oxo ) .", "this study investigated the food effects on the pharmacokinetics ( pk ) of oxo , other components of s-@ , and their metabolites at different gastric ph adjusted by proton pump inhibitor ( ppi ) .", "patients with and without ppi were treated with s-@ at @ mg/m ( @ ) twice daily orally on days @-@ under either fed or fasting condition , and then were crossed over to fasting/fed conditions on days @-@ with washout on days @-@ and @-@ .", "the study enrolled @ patients including @ pk-evaluable patients .", "for the single-dose and multiple-dose pharmacokinetics , the administration of s-@ under fed conditions resulted in decreased exposure to oxo relative to fasting administration .", "there was a marginal decrease in exposure to cdhp and @-fu under fed versus fasting conditions , although ft exposure was not altered by food , which demonstrated lack of food effect .", "ppi administration together with s-@ did not significantly change its bioavailability .", "oxo exposure was reduced under fed compared to fasting condition .", "to increase the bioavailability of s-@ , the administration of s-@ under fasting condition was more effective in the western countries ." ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "postoperative nausea and vomiting are observed in increased frequency after laparoscopic surgery .", "this study was performed in order to compare the efficacy of two @-hydroxytryptamine-@ ( @-ht@ ) receptor antagonists , ondansetron and tropisetron , in preventing postoperative nausea and vomiting ( ponv ) after laparoscopic cholecystectomy .", "using a randomized , double-blind study design , @ asa i and ii patients scheduled for laparoscopic cholecystectomy were randomly assigned to receive @ mg ondansetron ( group a , n = @ ) , @ mg tropisetron ( group b , n = @ ) , or placebo ( group c , n = @ ) intravenously ( iv ) before induction of anesthesia .", "the end points evaluated were frequency of nausea , nausea intensity rated on a scale from @ ( mild ) to @ ( most severe ) , frequency of vomiting , and need for rescue antiemetics .", "these parameters were measured immediately after surgery ( @ h ) , at @ h , @ h , and @ h postoperatively .", "the frequency of nausea was significantly higher in group a ( @ % ) compared to group b ( @ % ) at @ h postoperatively ( p < @ ) .", "however , patients of group a had significantly lower nausea scores at @ h postoperatively compared to group b. postoperative vomiting occurred in @ % of patients in group a and @ % of patients in group b throughout the whole study period ( p = n.s. ) .", "the need for rescue antiemetics was similar between groups a and b. both groups were superior to placebo concerning all studied parameters .", "our results show that ondansetron may be more effective in controlling nausea intensity during the first @ h after laparoscopic cholecystectomy , while tropisetron has a longer-acting activity , with a major impact on nausea frequency at @ h postoperatively ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "to evaluate the safety and efficacy of two different regimens of mitomycin-c ( mmc ) application as adjunctive chemotherapy in the treatment of pterygia .", "one hundred fifty-six patients underwent pterygium excision using the bare sclera technique .", "they were randomly assigned to have either @ mg/ml of mmc applied to the bare sclera for @ minutes intraoperatively , or @-mg / ml drops applied topically for @ weeks postoperatively .", "the mean follow-up period was @ months ( range @ to @ ) .", "complications with the intraoperative mmc included @ cases of recurrence ( @ % ) , @ cases of superficial punctate keratitis ( spk ) , and @ cases of delayed conjunctival wound healing .", "topical mmc led to @ cases of recurrence ( @ % ) , @ cases of spk , @ cases of delayed conjunctival wound healing , and @ cases of mild iritis .", "a single , intraoperative application of mmc is a simple , effective alternative adjunctive treatment for pterygium ." ]

[ "OBJECTIVE", "OBJECTIVE", "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to examine the changes in slow ( @-@hz ) and fast ( @-@hz ) alpha bands of eeg in three groups of subjects submitted to different amounts of functional electrostimulation ( fes ) .", "our hypothesis is that different amounts of electrostimulation may cause different patterns of activation in the sensorimotor cortex .", "in particular , we expect to see an increase in alpha power due to habituation effects .", "we examine the two bands comprised by alpha rhythm ( i.e. , slow and fast alpha ) , since these two sub-rhythms are related to distinct aspects : general energy demands and specific motor aspects , respectively .", "the sample was composed of @ students , both sexes , aging between @ and @ years old .", "the subjects were randomly distributed in three groups : control ( n = @ ) , g@ ( n = @ ) and g@ ( n = @ ) .", "a fes equipment ( neuro compact-@ ) was used to stimulate the right index finger extension .", "simultaneously , the electroencephalographic signal was acquired .", "we investigated the absolute power in slow and fast alpha bands in the sensorimotor cortex .", "the g@ indicated a significant increasing in absolute power values in lower and higher alpha components , respectively , when compared with the control group .", "particularly , in the following regions : pre-motor cortex and primary motor cortex .", "fes seems to promote cortical adaptations that are similar to those observed when someone learns a procedural task .", "fes application in the g@ was more effective in promoting such neural changes .", "the lower and higher components of alpha rhythms behave differently in their topographical distribution during fes application .", "these results suggest a somatotopic organization in primary motor cortex which can be represented by the fast alpha component ." ]

[ "BACKGROUND", "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "even mild perioperative hypothermia is associated with several severe adverse effects .", "resistive heating has possible advantages compared with other active warming systems because it can heat several fields independently .", "to assess this new warming system , we measured core temperature in patients during surgery who were warmed with circulating water mattresses , forced air covers or resistive heating covers .", "twenty-four patients undergoing laparoscopic cholecystectomy were randomly assigned to ( i ) circulating water mattress ( @ degrees c ) , ( ii ) forced air warming ( set to ` medium ' ) or ( iii ) carbon-fibre resistive warming ( @ degrees c ) .", "warming was applied throughout anaesthesia and surgery .", "the groups were compared using one-way anova and student-newman-keuls tests .", "confounding factors were similar among the groups .", "core temperatures in each group decreased for @ min , but subsequently increased in the forced air and resistive heating groups .", "there was no significant difference between the forced air and resistive heating groups at any time .", "in contrast , core temperature in the circulating water group continued to decrease .", "consequently , core temperature in the circulating water group was significantly lower than in the other groups @ min after anaesthetic induction and at later times .", "resistive heating maintains core body temperature as well as forced air heating and both are better than circulating water .", "resistive heating offers the advantage of adjustable heating pods ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "CONCLUSIONS" ]

[ "to select the best solution of immediate analgesia of migraine treated with acupuncture .", "taken @ cases of migraine in attack stage as research objects , by means of orthogonal experimental design , applying the l@ ( @ ( @ ) ) orthogonal table , the therapeutic effect of immediate analgesia of acupuncture for migraine in attack stage was analyzed in four factors , which were effective acupoints combination , electroacupuncture therapy , auricular therapy and bloodletting therapy , and three levels of each factors .", "in the test procession , random approaches ( stratified random and central random ) and blinding experiment ( the appraiser blind ) were used .", "the time points of observation were before treatment , and @ , @ minutes after treatment .", "visual analogue scale ( vas ) was used to evaluate therapeutic effect .", "comparing with the headache before treatment , at the time points of @ and @ minutes after treatment , the best solution for headache relief was needling therapy ( local and distal points and points selection according to the differentiation ) , auricular electroacupuncture therapy and bloodletting at taiyang zimai ( extra ) or taiyang ( ex-hn @ ) and ashi points .", "in the attack stage of migraine , by the therapy combined with puncture on local and distal points and the points according to the differentiation , auricular electroacupuncture and bloodletting at taiyang zimai or taiyang ( ex-hn @ ) and ashi points , the favorable effects of immediate analgesia are received ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "compared to the well-established stimulating catheter technique , the use of ultrasound guidance alone for interscalene perineural catheter insertion is a recent development and has not yet been examined in a randomized fashion .", "we hypothesized that an ultrasound-guided technique would require less time and produce equivalent results compared to electrical stimulation ( es ) when trainees attempt interscalene perineural catheter placement .", "preoperatively , patients receiving an interscalene perineural catheter for shoulder surgery were randomly assigned to an insertion protocol using either ultrasound guidance with a nonstimulating catheter or es with a stimulating catheter .", "the primary outcome was the procedural duration ( in minutes ) , starting when the ultrasound probe ( ultrasound group ) or catheter insertion needle ( es group ) first touched the patient and ending when the catheter insertion needle was removed after catheter insertion .", "all ultrasound-guided catheters ( n = @ ) were placed successfully and resulted in surgical anesthesia versus @ % of es-guided catheters ( n = @ ; p = @ ) .", "perineural catheters placed by ultrasound ( n = @ ) took a median ( @th-@th percentiles ) of @ ( @-@ @ ) minutes compared to @ ( @-@ @ ) minutes for es ( n = @ ; p = @ ) .", "all catheters placed according to the protocol in both treatment groups resulted in a successful nerve block ; however , @ patient in the es group had local anesthetic spread to the epidural space .", "there was @ vascular puncture using ultrasound guidance compared to @ in the es-guided catheter group ( p = @ ) .", "trainees using a new ultrasound-guided technique can place inter-scalene perineural catheters in less time compared to a well-documented technique using es with a stimulating catheter and can produce equivalent results ." ]

[ "BACKGROUND", "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "in some patients with chronic stable angina the beneficial effects of nitrates may result not only from a reduction in venous return , but also from their action on coronary circulation .", "in these patients , rate-pressure product at ischemia ( rppi ) increases to > @ bpm x mmhg after sublingual nitrates ( sln ) .", "the relative susceptibility of the venous system and the coronary circulation to the development of nitrate tolerance and the effects of two different drug schedules on the development of tolerance were investigated in patients with these characteristics .", "five patients were treated with isosorbide-@-mononitrate ( is@mn ) @ bid ( @ am and @ pm ) for @ week ( group @ ) and @ patients with is@mn @ bid ( @ am and @ pm ) for @ week ( group @ ) .", "tolerance was identified as the decreased effect of sln ; the effects of nitrates were evaluated in relation to : reduction in left ventricle area ( delta lva ) , which had been measured using equilibrium radionuclide ventriculograms in lao @ degrees ; this area was considered as an index of the venous return effects ; increase in rppi ( delta rppi ) , which had been assessed by ergometric test ; rppi was considered an index of coronary flow reserve .", "measurements of lva and rppi were made in wash-out at the start of the study ( delta lva @ and delta rppi @ ) and after @ week of treatment ( delta lva @ and delta rppi @ ) .", "the mean values of the differences were then evaluated and compared using student 's `` t '' test .", "in group @ patients delta lva @ and delta rppi @ showed values which were similar to delta lva @ and delta rppi @ ( mean value delta lva @ @ vs mean delta lva @ @ pixels , p = ns ; mean value delta rppi @ @ vs mean delta rppi @ @ bpm x mmhg , p = ns ) .", "these results suggest that group @ patients did not develop tolerance either at the coronary or at the venous level .", "in group @ patients , delta lva @ was significantly lower than delta lva @ ( mean delta lva @ @ vs mean delta lva @ @ pixels , p < @ ) .", "this finding indicated tolerance to nitrates at the venous level .", "on the other hand , in all group @ patients , values of delta rppi @ , though lower than delta rppi @ ( mean delta rppi @ @ vs mean delta rppi @ @ bpm x mmhg , p < @ ) were still higher than @ bpm x mmhg , indicating that the effect of nitrates at the coronary level was preserved .", "these data suggest that in patients treated with high doses of nitrates , the effect of these drugs at the coronary level is still present when tolerance has already developed at the venous level ." ]

[ "OBJECTIVE", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to investigate whether red cell folate ( rcf ) levels relate to side effects , withdrawals , or disease activity during treatment with the folic acid antagonist methotrexate ( mtx ) for rheumatoid arthritis ( ra ) .", "side effects were recorded monthly , rcf levels were measured by lactoglobulin binding radioassays , and @ variables for disease activity were measured in a placebo controlled double blind trial of @ weeks ' duration comparing efficacy of mtx ( n = @ ) and d-penicillamine ( n = @ ) .", "from week @ rcf levels decreased only in the mtx group ( p < @ ) , and @ mtx treated patients withdrew due to side effects .", "withdrawals had lower rcf values at weeks @ and @ compared to the remaining patients ( p < @ ) .", "folate deficiency evolved in @ patients ; @ of these developed cytopenia .", "aberrations in the scheduled dosage increase were related to lower pretreatment values of rcf ( p = @ ) .", "side effect scores were inversely correlated to rcf values at weeks @ , @ , and @ ( p < @ ) .", "rcf levels measured concomitantly with liver enzyme elevation were lower than the remaining values ( p < @ ) .", "when side effects were reported , @ % of concomitantly measured rcf values were below @ nmol/l .", "rcf values at entry did not correlate to improvement in any variable for disease activity , or a graded overall improvement .", "rcf levels decrease during mtx treatment and relate to side effects , withdrawals , liver enzyme elevations and aberrant mtx dosage increase , but not to the therapeutic effect .", "rcf above @ nmol/l protects against side effects ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "to examine whether frequent written feedback to faculty would improve their teaching in clinical settings .", "forty-four pediatrics faculty at the medical college of wisconsin participated in @ and @ in a prospective randomized trial of feedback about clinical teaching .", "during a six-month baseline period all the faculty were rated on ten teaching traits by residents and students using a seven-point likert scale ; evaluation summaries were placed in the teaching folders of the faculty .", "during a @-month treatment period , @ faculty were randomly selected to be given directed feedback every two months in the form of mailed computer-generated summaries that contained the most recent and cumulative mean ratings for the individual faculty member and the department , as well as written comments .", "mean ratings were compared within the feedback and control groups and between the two groups by using two-tailed paired t-tests and student 's t-tests , respectively .", "the faculty receiving feedback showed significantly increased ratings over time for the traits of knowledge ( p = @ ) , demonstrates skill ( s ) ( p = @ ) , provides feedback to trainee ( p = @ ) , and sets reasonable expectations ( p = @ ) .", "the faculty receiving feedback had an average increase in ratings across all ten traits that was significantly greater than the average increase of their control-group peers ( p < @ ) .", "those in the feedback group who had received mean ratings for overall teaching effectiveness that were below the department mean at baseline showed the greatest improvement by the end of the treatment period ( p < @ ) .", "the provision of written feedback improved the ratings of teaching effectiveness , especially among the faculty who had been rated below average ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "this randomized , single-dose , double-blind , phase iii study was designed to compare the level of procedural pain after use of premixed equimolar mixture of @ % oxygen and nitrous oxide ( emono ) or placebo ( premixed @ % nitrogen and oxygen ) .", "patients aged @ to @ years were randomly assigned to receive emono ( n = @ ) or placebo ( n = @ ) delivered by inhalation through a facial mask @ minutes before cutaneous , muscle , or bone/joint procedures .", "pain was evaluated ( on a scale from @-@ ) using a self-reported faces pain scale-revised ( fps-r ) or a spanish observational pain scale ( llanto ) .", "rescue analgesia ( with propofol or sevoflurane ) was administered if pain scores were greater than or equal to @ .", "collaboration , acceptance , ease of use and safety were evaluated by the attending nurse .", "there were significant differences between the @ groups ( emono versus placebo ) for both scales ( mean values ) : llanto : @ vs @ , respectively ( p = @ ) and fps-r : @ vs @ , respectively ( p = @ ) .", "patients not receiving emono ( p = @ ) - in particular those aged younger than @ years ( p < @ ) - required more rescue analgesia .", "there were also significant differences between the @ groups ( emono versus placebo ) for adequate collaboration ( @ % vs @ % ; p < @ ) and acceptance ( @ % vs @ % ; p < @ ) .", "ease of use was not significantly different between groups ( @ % vs @ % ; p > @ ) .", "only @ patients ( in the emono group ) presented with mild adverse events .", "emono inhalation was well tolerated and had an estimated analgesic potency of @ % , and it is therefore suitable for minor pediatric procedures ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "the authors conducted a prospective , comparative clinical trial for the purpose of additional effect of lipoprostaglandin e @ ( lipo-pge @ ) on sudden hearing loss .", "with the approval of the institute ethics committee , a total of @ consecutive patients with diagnoses of sudden hearing loss were included in the study .", "the patients in the lipo-pge @ group received continuous infusion of @ microl lipo-pge @ and @ mg methylprednisolone for @ days , and the patient in the control group were treated with only @ mg methylprednisolone .", "the total recovery rate after the treatment was @ % .", "there were @ % recovery rate in lipo-pge @ group and @ % recovery rate in control group .", "however , no significant differences were observed in the improvements of pure tone average and subjective symptoms between the lipo-pge @ and control groups .", "the results failed to prove a beneficial effect of lipo-pge @ in the treatment of sudden hearing loss in spite of its higher cure rate ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "BACKGROUND" ]

[ "this study was designed to assess efficacy and safety of paliperidone extended-release ( er ) in patients with schizoaffective disorder .", "a randomized , @-week , double-blind , placebo-controlled study was conducted .", "subjects with a structured clinical interview for dsm-iv diagnosis of schizoaffective disorder , positive and negative syndrome scale ( panss ) total score > or = @ , score > or = @ on > or = @ panss items ( hostility , excitement , tension , uncooperativeness , poor impulse control ) , and young mania rating scale and/or hamilton depression rating scale , @-item version scores > or = @ were eligible .", "subjects received higher-dose ( @ mg/d ) or lower-dose ( @ mg/d ) paliperidone er .", "dose adjustments by @-mg increments were allowed until day @ .", "the study was conducted from october @ through february @ .", "a total of @ subjects were randomly assigned to paliperidone er lower dose ( n = @ ) , higher dose ( n = @ ) , or placebo ( n = @ ) .", "mean + / - sd modal dose in lower - and higher-dose groups : @ + / - @ and @ + / - @ mg/d , respectively .", "mean + / - se panss total score ( primary outcome ) improved significantly with higher-dose paliperidone er versus placebo ( -@ + / - @ versus -@ + / - @ ; p = @ ) .", "change with lower-dose paliperidone er ( -@ + / - @ ) was not significantly different from placebo ( p = @ ) .", "no new safety issues were identified ; common adverse events were headache ( placebo : @ % ; paliperidone er : lower dose , @ % , higher dose , @ % ) and tremor ( @ % , @ % , @ % , respectively ) .", "mean prolactin and weight changes were greater with active treatment than placebo .", "higher-dose paliperidone er was effective and well tolerated in patients with acute schizoaffective disorder .", "these findings and those from a companion study constitute the first registration program for antipsychotic treatment in schizoaffective disorder .", "clincaltrials.gov identifier : nct@ ." ]

[ "BACKGROUND", "BACKGROUND", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "in the @-year uplift trial , tiotropium improved lung function and health-related quality of life and decreased exacerbations compared with usual respiratory medications except inhaled anticholinergics in patients with chronic obstructive pulmonary disease ( copd ) .", "mortality and its causes was a secondary endpoint in uplift .", "we describe the effect of tiotropium on survival and analyze differences between mortality during treatment and during follow-up of discontinued patients .", "this study involved a randomized , double-blind trial comparing tiotropium with placebo in patients with copd ( > or = @ yr of age ; postbronchodilator fev ( @ ) < or = @ % ; fev ( @ ) / fvc < or = @ % ) .", "mortality was evaluated during treatment and with follow-up of discontinued patients .", "cause of death was adjudicated by an endpoint committee .", "a total of @,@ patients were randomized , @,@ to placebo and @,@ to tiotropium .", "while patients were receiving treatment , there were @ deaths , with a lower risk in the tiotropium group ( hazard ratio , @ ; @ % confidence interval [ ci ] , @-@ @ ) .", "statistical significance was observed at the end of the protocol-defined treatment period ( p = @ ) but not @ days thereafter ( p = @ ) .", "adjustment by gold stage , sex , age , baseline smoking behavior , and baseline respiratory medications subgroups did not alter the results of the analysis .", "the most common causes of death adjudicated by an independent end-point committee were lower respiratory , cancer , general disorders , and cardiac disorders .", "the hazard ratios for lower respiratory and cardiac mortality during treatment were @ ( @ % ci , @-@ @ ) and @ ( @ % ci , @-@ @ ) , respectively .", "treatment with tiotropium over @ years is associated with decreased mortality , with the effect being most prominent in the cardiac and respiratory systems ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "to evaluate the effect of early exercise therapy on the natural killer cell cytotoxic activity ( nkca ) of patients who had undergone curative resection of stomach cancer .", "prospective study .", "thirty-five stomach cancer patients who had undergone curative surgery were randomly divided into an exercise group ( n = @ ) and a control group ( n = @ ) .", "from postoperative day @ , moderated exercise using arm and bicycle ergometers performed twice a day , @ times a week , for @ days .", "the intensity of exercise was @ % of maximal heart rate .", "venous blood samples were obtained on postoperative days @ , @ , and @ .", "mean sequential change of nkca .", "the mean sequential change of nkca decreased until postoperative day @ and then increased .", "mean nkca of day @ decreased in both groups , compared with that at postoperative day @ .", "at day @ , the mean nkca of the exercise group demonstrated a significant increase compared with that of the control group ( p < @ ) .", "this study suggests that early moderate exercise has a beneficial effect on the function of in vitro nk cells in stomach cancer patients after curative surgery ." ]

[ "BACKGROUND", "METHODS", "METHODS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "this study was undertaken to compare the sleep profiles of healthy infants in swaddling and sleeping bag conditions .", "polysomnographs of @ healthy infants ( @ in the study group , @ in the control group ) with a mean age of @ weeks were recorded in the sleeping laboratory .", "a positive decision from the local ethics committee and the written consent of the parents were obtained for the study .", "swaddling significantly reduces the rate of spontaneous waking ( events/h : @ [ @-@ @ ] vs. @ [ @-@ @ ] , p = @ ) and the number of sleep stage changes ( events/h : @ [ @-@ @ ] vs. @ [ @-@ @ ] , p = @ ) .", "swaddling promotes quiet sleep ( @ % [ @ % -@ % ] vs. @ % [ @ % -@ % ] , p = @ ) , the time spent awake was decreased ( @ % [ @ % -@ % ] vs. @ % [ @ % -@ % ] , p = @ ) and sleep efficiency was increased ( @ % [ @ % -@ % ] vs. @ % [ @ % -@ % ] , p = @ ) .", "swaddling promotes a more quiet sleep in infants ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to investigate the influence of coping style on interference caused by a variety of common post-treatment symptoms after hematopoietic stem cell transplantation .", "longitudinal ; secondary analysis of data from the original study that examined health-related quality-of-life variables ( e.g. , depression , well-being ) in adult patients treated with conventional bone marrow transplantation or depleted t-cell bone marrow transplantation .", "fifteen university medical centers in the united states .", "@ adult recipients of hematopoietic stem cell transplantation .", "patients were assessed via telephone-based interviews for coping style at baseline and for symptom interference in daily living six months post-treatment .", "coping style and symptom interference .", "neither age nor gender predicted symptom interference , with the exception of chronic graft-versus-host disease , where older patients experienced more interference at six months , and breathing symptoms , for which women experienced more interference than men at six months .", "avoidant coping style at baseline predicted increased interference from symptoms , but emotion-focused and instrumental coping styles did not predict decreased interference .", "a generalized avoidant coping style before treatment increased interference from common cancer symptoms six months after hematopoietic stem cell transplantation .", "an intervention to teach alternate coping strategies should be implemented prior to treatment and tested for prevention of symptom-related life interference ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "there is evidence that high-protein foods increase satiety and may aid weight loss , yet little is known of differential effects of protein composition .", "the aim of the study was to compare the acute effects of @ whey proteins on satiety and food intake and to evaluate possible relationships with postprandial serum amino acid concentrations .", "isoenergetic high-protein shakes ( @ mj ) containing @ g whey protein were given to @ lean male participants using a crossover design .", "three protein fractions identified as satiating in a rat model , glycomacropeptide ( gmp ) , beta-lactoglobulin ( - lac ) , and colostrum whey protein concentrate ( wpc ) , were compared with a wpc control .", "a standardized @ mj breakfast was given at @ hours , followed by the preload beverages at @ hours .", "participants rated appetite sensations using visual analogue scales ( vas ) prior to the beverage ( baseline , @ minutes ) and then at @ , @ , @ , @ , @ , @ , and @ minutes .", "energy and macronutrient intake was measured by covert weighing of an ad libitum lunch meal at @ minutes .", "repeat blood samples were collected via venous cannulation .", "serum amino acid ( a.a. ) concentrations differed between whey fractions ( p = @ ) and were higher following gmp compared to - lac ( p = @ ) and colostrum wpc ( p = @ ) but not the wpc control ( p = @ ) .", "there was no difference in vas-rated hunger , satisfaction , or thoughts of food between whey fractions , but fullness did differ ( p = @ ) and was highest following the - lac beverage .", "energy intake was not suppressed relative to control by any of the @ whey fractions .", "we conclude that total serum a.a. concentration was a poor indicator of satiety , with little evidence of differential satiety between these whey proteins other than a modest enhancement of fullness by - lac ." ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "our objective was to assess for the relationship between timing of clinical improvement and resolution of depressive symptoms during the treatment of major depressive disorder ( mdd ) .", "thirty-nine mdd outpatients who responded following a @-week , double-blind study comparing hypericum perforatum , fluoxetine or placebo were included in the analysis .", "onset of clinical improvement was defined as a @ % decrease in @-item hamilton depression scale ( hdrs-@ ) scores that was not followed by a subsequent worsening of symptoms .", "controlling for baseline symptom severity , we then assessed for the relationship between timing of clinical improvement and depressive symptom severity at endpoint .", "among responders , earlier clinical improvement predicted lower hdrs-@ scores at week @ ( p = @ ) .", "this was also true of responders who received active treatment ( n = @ , p = @ ) but not placebo responders ( n = @ ; p > @ ) .", "finally , patients with an early onset of clinical improvement ( occurring during the first @ weeks ) had lower week @ hdrs-@ scores than patients with a late onset of clinical improvement ( p = @ ) .", "in the present work , earlier as well as early clinical improvement during treatment is predictive of greater symptom resolution at endpoint among responders .", "this was replicated among patients who received active treatment ( either hypericum or fluoxetine ) but not placebo ." ]

[ "BACKGROUND", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "rapid response to antidepressant therapy is desirable and may be particularly critical in elderly patients with major depressive disorder ( mdd ) .", "findings are based on post-hoc analyses from a double-blind trial of elderly patients with mdd > or = @ years , randomly assigned @:@ to duloxetine @ mg qd ( n = @ ) or placebo ( n = @ ) for @ weeks .", "depression and pain measures included the geriatric depression scale ( gds ) , @-item hamilton depression scale ( hamd@ ) , cgi-severity , and visual analog scale ( vas ) for overall pain .", "the time to response and remission for duloxetine compared with placebo was evaluated using cox proportional hazards ( ph ) modeling , kaplan-meier estimation , and categorical repeated measures analysis .", "significant improvements of estimated hamd@ response and remission rates for duloxetine started at week @ ( p = @ and p = @ , respectively ) .", "time to hamd@ response and remission were significantly shorter for duloxetine versus placebo ( p @ for all ph treatment-by-age interactions ) .", "the placebo-referenced duloxetine hr for time to @ % reduction in overall pain was @ ( p = @ ) for patients with moderate to severe pain .", "duloxetine demonstrated a faster time to antidepressant response and improvement in self-reported pain as compared with placebo .", "clinical trial registry number for this study : nct@ , at www.clinicaltrials.gov ." ]

[ "BACKGROUND", "BACKGROUND", "OBJECTIVE", "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "several probiotic strains have been shown to enhance human resistance to infectious disease .", "it is speculated that these strains may impose this effect by excretion of anti-microbial components , by competing with pathogens for intestinal nutrients and/or mucosal adhesion sites or modulating the immune system .", "a parallel , double-blind , placebo-controlled @-week intervention was performed in healthy males , to study the effect of a blend of probiotic bacteria ( lactobacillus helveticus rosell-@ , lactobacillus rhamnosus rosell-@ , bifidobacterium longum ssp .", "longum rosell-@ ) and a probiotic yeast ( saccharomyces cerevisiae var boulardii cncm i-@ ) on enterotoxigenic escherichia coli ( etec ) challenge .", "primary outcomes studied were fecal etec excretion and total fecal output per day .", "subjects were randomized to the probiotic ( @ @ ( @ ) colony-forming units ( cfus ) ; twice daily ; n = @ ) or placebo group ( twice daily ; n = @ ) .", "after @ weeks , subjects were orally challenged with a live attenuated etec ( @ @ ( @ ) cfu ) , previously demonstrated to induce mild , short-lived symptoms of a foodborne infection .", "before and after etec challenge , subjects collected @h fecal samples .", "compliance to study guidelines , stool consistency ( bristol stool score ) , stool frequency , and frequency and severity of gastrointestinal ( gi ) complaints were recorded by the subjects on a daily record questionnaire .", "etec challenge induced a significant increase in fecal etec excretion in both groups .", "however , a statistically significant increase in fecal output was only observed in the probiotic group .", "etec challenge resulted in a decrease in the percentage of fecal dry weight , and an increase in reported bristol stool score , stool frequency and gi complaints .", "dietary probiotics significantly decreased the percentage of fecal dry weight .", "in addition , etec increased c-reactive protein , total secretory immunoglobulin a ( iga ) and immunoglobulin g colonization factor antigen ii .", "dietary probiotics did not increase resistance to oral attenuated etec challenge in human subjects ." ]

[ "BACKGROUND", "BACKGROUND", "BACKGROUND", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "seborrheic dermatitis ( sd ) is a chronic mild skin disorder with high prevalence .", "various treatment options are available , including topical antifungals and anti-inflammatories .", "antifungal and anti-inflammatory properties of quassia amara have been reported .", "to check the efficacy and safety of a topical gel with @ % quassia amara extract and compare it with topical @ % ketoconazole and @ % topical ciclopiroxolamine in the treatment of facial sd .", "a group of @ patients displaying facial sd were randomly distributed in @ groups and given either a topical gel with @ % quassia amara extract , a topical gel with @ % ketoconazole , or a topical gel with @ % ciclopirox olamine for @ weeks .", "disease severity was assessed at the start and weekly along treatment , as well as @ weeks after the end of treatment .", "in each selected area , severity of erythema , scaling , pruritus , and papules were scored from @ to @ , the sum of these values representing the score of sd on the face .", "this evaluation was conducted at each visit .", "the decrease in sd score with all @ products was compared at each visit .", "at each stage , overall improvement , safety , and tolerability were also assessed .", "of the @ patients , @ ( @ % ) completed the study .", "the @ therapeutic options resulted to be very effective , with a significant advantage in efficacy for @ % quassia extract .", "for the other @ drugs , the results were in line with those previously published in the literature .", "topical gel with @ % quassia extract represents a new , safe , and effective treatment for facial sd ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "the authors used data from a larger study to evaluate the long-term effects of a peer advocate intervention on condom and contraceptive use among hiv-infected women and women at high risk for hiv infection .", "hiv-infected women in one study and women at high risk for hiv infection in a second study were selected from the women and infants demonstration project and assigned to a standard or an enhanced hiv prevention treatment group .", "the enhanced intervention included support groups and one-on-one contacts with peer advocates tailored to clients ' needs .", "the authors interviewed women at baseline and at @ - , @ - and @-months , and measured changes in consistency of condom and contraceptive use and in self-efficacy and perceived advantages and disadvantages of condom and contraceptive use .", "of hiv-infected women , the enhanced group had improved consistency in condom use , increased perceived advantages of condom use , and increased level of self-efficacy compared with the standard group .", "of women at risk , the enhanced intervention group at six months maintained consistent condom use with a main partner and perceived more benefit of condom use compared with the standard group .", "these differences diminished at @ months .", "the enhanced intervention was generally effective in the hiv + study .", "in the at-risk study , however , intervention effects were minimal and short-lived .", "factors related to the theory , intervention design , and sample characteristics help explain these differences ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "our objective was to compare four management strategies for heartburn : therapy with an h@-receptor antagonist ( ranitidine ) , therapy with a proton pump inhibitor ( lansoprazole ) , crossover from ranitidine to lansoprazole ( `` step-up '' therapy ) , and crossover from lansoprazole to ranitidine ( `` step-down '' therapy ) .", "this was a controlled , double-blind , multicenter trial comprising @ adults with heartburn , randomized to one of four groups for @ wk .", "subjects received either ranitidine @ mg b.i.d. for @ wk , or lansoprazole @ mg once daily for @ wk , or ranitidine @ mg b.i.d. for @ wk [ corrected ] followed by lansoprazole @ mg once daily for @ wk ( `` step-up '' ) , or lansoprazole @ mg once daily for @ wk followed by ranitidine @ mg b.i.d. for @ wk ( `` step-down '' ) .", "outcome measures were based on self-reports in daily diaries of @-h heartburn severity , measured by maximum daytime and nighttime severity , and percentage of @-h heartburn-free days measured by absence of both daytime and nighttime heartburn .", "median heartburn severity was significantly lower ( p < @ ) for lansoprazole ( @ ) than the other groups ( @ ranitidine , @ `` step-up , '' @ `` step-down '' ) .", "the lansoprazole group had a significantly higher percentage of @-h heartburn-free days ( median @ % , p < @ ) than other groups ( @ , @ , and @ % , respectively ) .", "in the `` step-up '' and `` step-down '' groups , heartburn was less severe , and percentages of @-h heartburn-free days were higher during lansoprazole treatment regardless of treatment sequence .", "proton pump inhibitor treatment provides more consistent heartburn relief than an h@-receptor antagonist , or `` step-up '' or `` step-down '' therapy ." ]

[ "BACKGROUND", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "this study evaluated the benefits and safety of a multimodal pain control protocol , which included a periarticular injection of local anesthetics , in patients undergoing total hip arthroplasty .", "between march @ and march @ , @ patients undergoing unilateral total hip arthroplasty were randomized to undergo either a multimodal pain control protocol or a conventional pain control protocol .", "the following parameters were compared : the preoperative and postoperative visual analogue scales ( vas ) , hospital stay , operative time , postoperative rehabilitation , additional painkiller consumption , and complication rates .", "there was no difference between the groups in terms of diagnosis , age , gender , and bmi .", "although both groups had similar vas scores in the preoperative period and on the fifth postoperative day , there was a significant difference between the groups over the four-day period after surgery .", "there were no differences in the hospital stay , operative time , additional painkiller consumption , or complication rate between the groups .", "the average time for comfortable crutch ambulation was @ days in the multimodal pain control protocol group and @ days in the control group .", "the multimodal pain control protocol can significantly reduce the level of postoperative pain and improve patients ' satisfaction , with no apparent risks , after total hip arthroplasty ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to compare cardiorespiratory and anesthesia effects of iv administered propofol and thiopental in dogs .", "@ healthy mixed-breed dogs .", "each dog was anesthetized with isoflurane , then a thermistor catheter was inserted in the pulmonary artery .", "after a minimum of @ hours of recovery , a catheter was placed in a cephalic vein for administration of lactated ringer 's solution and drugs .", "propofol ( @ mg/kg of body weight ) or thiopental ( @ mg/kg ) was administered to each dog in a randomized crossover design study .", "all dogs were intubated and allowed to breathe @ % oxygen spontaneously .", "heart rate and rhythm ; systolic , diastolic , and mean arterial blood pressures ; respiratory rate ; end-tidal carbon dioxide concentration ; tidal volume ; and reflexes ( toe web pinch , palpebral response , and jaw tone ) were measured before and every @ minutes for the first @ minutes , then at @ , @ , and @ minutes after drug administration .", "cardiac output was determined at @ , @ , @ , @ , @ , @ , and @ minutes , and blood samples were collected at @ , @ , @ , and @ minutes .", "time to endotracheal extubation , head lift , and ability to sit sternally and walk unaided were recorded .", "@ of @ dogs in each group were apneic after drug administration .", "reflexes were decreased similarly for both anesthetic agents , but were not completely lost .", "time to sternal position and walking unaided were significantly shorter in response to propofol .", "anesthesia was rapid ; however , respiratory depression and apnea were major adverse effects associated with propofol and thiopental .", "propofol has the advantage of inducing rapid , coordinated anesthesia recovery ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to evaluate the influence of the methylxanthine derivative , pentoxifylline , on plasma levels of tumor necrosis factor ( tnf ) - alpha , interleukin ( il ) -@ , and il-@ in prematurely delivered infants with generalized bacterial infections and to assess the effect of this immunomodulating drug on the clinical outcome in newborns with sepsis .", "a prospective , randomized , double-blind trial .", "the neonatal intensive therapy units in university teaching hospitals .", "one hundred patients with sepsis admitted during a @-yr period .", "patients were randomly assigned to receive pentoxifylline ( pentoxifylline group ) in a dose of @ mg/kg/hr for @ hrs on @ successive days or an identically presented placebo ( placebo group ) .", "only infants with sepsis confirmed by positive blood culture were recruited into the study .", "there were no significant differences at randomization between the pentoxifylline and placebo groups with regard to the birth weight , gestational age , gender , apgar score , hypotension , neutropenia , thrombocytopenia , metabolic acidosis , plasma levels of cytokines , and occurrence of shock .", "plasma levels of tnf , il-@ , and il-@ were evaluated before and after the drug or placebo administration on the first , third , and sixth days of therapy .", "cytokines were determined by immunoenzymetric test easia ( tnf ) and endogen interleukin-elisa ( il-@ , il-@ ) .", "the frequency of gram-negative sepsis was similar in both groups ( @ % and @ % ) .", "pentoxifylline significantly diminished plasma tnf levels ( p = @ ) but had no effect on plasma il-@ levels .", "mean plasma il-@ levels , which were measured in the pentoxifylline group on the @th day of the study , were significantly lower compared with respective data obtained in the placebo group .", "only @ of @ infants with sepsis in the pentoxifylline group died , whereas @ of @ infants in the placebo group did not survive ( p = @ ) .", "an increased incidence of disordered peripheral circulation and metabolic acidosis ( p = @ ) , anuria or oliguria ( p = @ ) , disseminated intravascular coagulation ( p = @ ) , and the occurrence of clinical symptoms of necrotizing enterocolitis ( p = @ ) was observed in the course of sepsis in infants in the placebo group .", "pentoxifylline significantly affects the synthesis of tnf and il-@ as well as reduces the mortality rate in premature infants with sepsis .", "the dosage and schedule of drug administration in this study attenuated the severity of the clinical course of sepsis in this group of patients ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "development of scoring systems of diagnostics of gallbladder cholesterolosis ( gbc ) on the grounds of clinical and laboratory-instrumental parameters determined in the general clinical practice .", "for development of the scoring systems , the methods of the logistic regression ( lr ) and artificial neuron networks ( ann ) were used .", "the results of specially carried clinical observations of @ patients , who had cholelithiasis with morphological confirmation of presence of gbc or chronic cholecystitis after planned cholecystectomy , were analysed .", "the scoring systems of diagnostics of gbc have been created : the detailed scring system , subjected to @ parameters ( @ quantitative ones ; @ qualitative ones ) and the diminished scring system subjected to @ the most informative parameters ( @ clinical ones , @ ultrasonic signs ) .", "using the detailed scoring system of diagnostics of gbc allowed to set a correct diagnosis in @,@ % cases , specificity of the method was @ % , sensitiveness -- @ % .", "diminished scoring system provides the correct diagnostics of gbc in @ % cases , the model specificity -- @ % , sensitiveness -- @ % .", "using lr and ann allowed to evaluate the influence of individual clinical and laboratory-instrumental parameters on probability of the gbc diagnosis .", "developed scoring systems open new possibilities of the early diagnosing of this disease that enables to conduct the identical medication treatment in proper time , cut off clinical presentations and prevent the development of cholelithiasis ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "the aim of the antihypertensive treatment and lipid profile in a north of sweden efficacy evaluation study was to compare the long-term effect of the commonly used inexpensive medication with a low-dose diuretic ( hydrochlorothiazide ) , alone or in combination with a beta-adrenoceptor ( atenolol ) , with that of more modern but also more expensive antihypertensive treatment with an angiotensin-ii-receptor blocker ( candesartan ) , alone or in combination with a calcium antagonist ( felodipine ) , and to do so in newly diagnosed patients with primary hypertension .", "the objectives included comparisons of the effects on the glucose metabolism , lipoprotein metabolism , electrolytes , blood pressure , and subjective symptoms .", "a @-year , prospective randomized , double-blind , controlled trial .", "in an investigator-initiated study , we included @ patients ( mean age @ years , @ % men ) ; @ patients ( @ % ) had never been treated with antihypertensive drugs before the study .", "no patient was lost to follow-up .", "both treatment regimens lowered blood pressure well ( @/@ mmhg in the hydrochlorothiazide group and @/@ mmhg in the candesartan group ) , with a majority of patients needing two drugs .", "fasting levels of both serum insulin and plasma glucose increased in the hydrochlorothiazide group in contrast to unaffected levels in the candesartan group .", "diabetes mellitus was diagnosed in nine patients during follow-up , in eight patients in the hydrochlorothiazide group ( @ % ) and in one patient ( @ % ) in the candesartan group ( p = @ ) .", "triglycerides increased and high-density lipoprotein-cholesterol decreased more in the hydrochlorothiazide group than in the candesartan group .", "both the low-density lipoprotein/high-density lipoprotein and the apolipoprotein b/apolipoprotein a-i ratios increased in the hydrochlorothiazide group .", "at @ months , @ patients in the hydrochlorothiazide group versus five in the candesartan group had a ` metabolic syndrome ' , as defined by the world health organization ( p = @ ) despite @ year of active blood pressure-lowering therapy .", "there were less ( p = @ ) adverse events in the candesartan group , but no major differences in the subjective symptoms assessment profile .", "one subject in each group had a myocardial infarction .", "antihypertensive treatment with a diuretic , if needed combined with a beta-adrenoceptor blocker , was associated with an aggravated metabolic profile ; this was not so for patients treated with an angiotensin-ii-receptor blocker , if needed combined with a calcium antagonist .", "an antihypertensive treatment strategy that costs more in the short run but has no metabolic adverse effects may have a health economic impact in the long term ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to investigate prospectively the feasibility and efficacy of dose escalation using three-dimensional conformal radiotherapy ( @d-crt ) boost technique for locally recurrent nasopharyngeal carcinoma ( npc ) in a randomised study .", "thirty-six patients with locally recurrent npc ( > @ months interval from previous radical radiotherapy , no cervical lymph-node involvement and no distant metastasis ) were enrolled .", "treatment included conventional external-beam radiotherapy to @ gy , followed by a @d-crt boost to the gross tumour region .", "patients were randomised to three boost dose levels : @ gy , @ gy and @ gy for groups i , ii and iii , respectively , with @ patients in each group .", "all boost doses were delivered in @-gy fractions and @ fractions per week .", "median follow-up was @ months ( range @-@ months ) .", "three-year , local-recurrence-free survival rate was significantly higher ( @ % ) for the high-dose group iii than for groups i and ii ( @ % and @ % , respectively , p = @ ) .", "no significant difference was found in the @-year overall survival rate among the three groups ( @ % , @ % and @ % for groups i , ii and iii , respectively ) .", "three-year distant metastases rates were @ % , @ % and @ % , respectively .", "skull-base invasion ( p = @ ) and pathology ( p = @ ) correlated with overall survival .", "treatment was well tolerated and no significant difference was observed among the three groups in acute and late toxicities ( grade iii toxicity is minimal : @ % , @ % , @ % of oral mucositis and @ % , @ % , @ % of nasopharyngeal mucositis in groups i , ii , iii , respectively , and @ % leukocytopenia only in group ii ; no grade iv toxicity occurred in any of the groups except for a fatal bleeding in group iii ) .", "re-irradiation with high-dose @d-crt boost technique results in high local control rate and acceptable toxicity in patients with recurrent npc .", "dose escalation to the boost volume to @ gy ( @ gy + @ gy boost ) results in improved recurrence-free survival compared with lower doses ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to compare the efficacy and side effects of sublingual misoprostol and intravenous methylergometrine for active management of third stage of labor .", "one hundred twenty low risk pregnant women at term with spontaneous onset of labor were included in the study .", "the women were randomized to receive either two tablets of misoprostol ( @ microg/tablet ) sublingually or @ ml of methylergometrine ( @ microg ) intravenous injection , after the delivery of the anterior shoulder of the baby .", "the main outcome measures were : need for additional oxytocic drugs , blood loss > or = @ ml , change in hemoglobin levels and side effects .", "postpartum hemorrhage as defined by hemorrhage > or = @ ml occurred in @ % of the women in the sublingual misoprostol group but none of the women in the methylergometrine group ( p > @ ) .", "there was a need for additional oxytocic drugs in @ % and @ % after methylergometrine and misoprostol , respectively ( p > @ ) .", "the change in hemoglobin levels at @ h postpartum were @ and @ gm % in methylergometrine and misoprostol group , respectively ( p > @ ) .", "in the misoprostol group , @ % women developed fever > or = @ degrees c and @ % had shivering while in methylergometrine group none experienced these side effects .", "however , the incidence of other side effects like nausea , vomiting , headache and giddiness were similar in both groups .", "sublingual misoprostol appears to be as effective as intravenous methylergometrine in the prevention of postpartum hemorrhage .", "however , larger randomized studies are needed to advocate its routine use ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "to compare dexmedetomidine vs. placebo with respect to the amount of additional propofol and morphine used for bispectral index-guided sedation and analgesia in mechanically ventilated , intensive care patients after surgery .", "prospective , randomized , double blind , placebo-controlled , phase ii clinical trial .", "general surgical and cardiac surgical intensive care units .", "thirty patients scheduled for major surgery requiring mechanical ventilation for a minimum of @ hrs were included in the study .", "patients were assigned randomly to receive either dexmedetomidine ( loading infusion , @ microg x kg ( -@ ) x hr ( -@ ) for @ mins ; maintenance infusion , @-@ @ microg x kg ( -@ ) x hr ( -@ ) ) or placebo after intensive care unit admission .", "sedation was guided by using the electroencephalographic parameter bispectral index , a new noninvasive method to estimate the level of sedation .", "we aimed at maintaining bispectral index ranges between @ and @ during mechanical ventilation before starting weaning , @ and @ during weaning , and @ to @ postextubation .", "additional sedative and analgesic medication was given ( propofol and morphine ) as clinically indicated and within the previously mentioned bispectral index ranges .", "patients receiving dexmedetomidine required significantly less propofol during mechanical ventilation ( @ + / - @ vs. @ + / - @ mg x kg ( -@ ) x hr ( -@ ) ; p < @ ) and weaning ( @ + / - @ vs. @ + / - @ mg x kg ( -@ ) x hr ( -@ ) ; p < @ ) to maintain the target bispectral index range .", "during study drug administration , morphine requirements for dexmedetomidine-treated patients were reduced by @ % ( p = @ ) .", "hemodynamic stability during weaning and after extubation was better maintained in patients receiving dexmedetomidine .", "dexmedetomidine reduced propofol requirements and improved hemodynamic stability during bispectral index-guided intensive care unit sedation ." ]

[ "BACKGROUND", "OBJECTIVE", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "the development of competency frameworks , such as canmeds , has helped define professional behavior , but programs that translate their theoretical aspects into practical learning are lacking .", "to improve instruction of the canmeds framework , the university of alberta implemented a program in which @ first-year medical students shadowed a first-year resident for eight months .", "a randomized trial compared participants ' attitudes and knowledge regarding canmeds to controls .", "a concurrent-triangulation mixed methods design with questionnaires and interviews provided a comprehensive understanding of program experiences .", "students reported increasing their understanding of canmeds and increased their acceptance of the framework 's importance and knowledge of its contents when compared to controls .", "residents also reported that their knowledge of canmeds had increased .", "participants considered the program to be effective for learning canmeds and developing professionalism , especially when paired with clinical encounters relevant to given professional roles .", "this simple , low cost , near-peer shadowing program can be useful for teaching professional behavior ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to determine whether aminophylline reduced the duration of respiratory support in children admitted to intensive care with bronchiolitis .", "a multicentre , randomised , double-blind , placebo controlled trial .", "paediatric intensive care units in teaching hospitals .", "forty-five children with severe bronchiolitis .", "patients were randomly assigned to receive an infusion of aminophylline ( @ ) or placebo ( @ ) .", "the primary outcome measure was the number of hours of respiratory support required in the @ hours after randomisation ; respiratory support was defined as either nasal continuous positive airways pressure or mechanical ventilation .", "the trial was stopped early due to poor recruitment .", "respiratory support was required for a median of only @ days ( interquartile range [ iqr ] , @-@ @ days ) in the aminophylline group compared with @ days ( iqr , @-@ @ ) days in the placebo group .", "however , more patients in the placebo group were receiving respiratory support at the time of randomisation and , after adjustment for this , there was no suggestion of a beneficial effect of aminophylline among the small number of patients studied ( p = @ , exact log-rank test stratified by respiratory support at the time of randomisation and censored at the time of death in one child in the aminophylline group ) .", "not enough children were recruited for the study to test the hypothesis that aminophylline reduces the need for respiratory support in severe bronchiolitis .", "consequently , the role of aminophylline in the management of severe bronchiolitis remains unknown ." ]

[ "OBJECTIVE", "OBJECTIVE", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "in patients with acute myocardial infarction and st-segment elevation ( stemi ) , primary angioplasty is frequently not available or performed beyond the recommended time limit .", "we designed a non-inferiority , randomized , controlled study to evaluate whether lytic-based early routine angioplasty represents a reasonable reperfusion option for victims of stemi irrespective of geographic or logistical barriers .", "a total of @ stemi patients were randomized to full tenecteplase followed by stenting within @-@ h of randomization ( early routine post-fibrinolysis angioplasty ; @ patients ) , or to undergo primary stenting with abciximab within @ h of randomization ( primary angioplasty ; @ patients ) .", "the primary endpoints were epicardial and myocardial reperfusion , and the extent of left ventricular myocardial damage , determined by means of the infarct size and @-week left ventricular function .", "the secondary endpoints were the acute incidence of bleeding and the @-month composite incidence of death , reinfarction , stroke , or revascularization .", "early routine post-fibrinolysis angioplasty resulted in higher frequency ( @ vs. @ % , p = @ ) of complete epicardial and myocardial reperfusion ( timi @ epicardial flow and timi @ myocardial perfusion and resolution of the initial sum of st-segment elevation > or = @ % ) following angioplasty .", "both groups were similar regarding infarct size ( area under the curve of ck-mb : @ + / - @ vs. @ + / - @ microg/l/h , p = @ ) ; @-week left ventricular function ( ejection fraction : @ + / - @ vs. @ + / - @ % , p = @ ; endsystolic volume index : @ + / - @ vs. @ + / - @ , p = @ ) ; major bleeding ( @ vs. @ % , p = @ ) and @-month cumulative incidence of the clinical endpoint ( @ vs. @ % , p = @ ; relative risk : @ ; @ % confidence interval : @-@ @ ) .", "early routine post-fibrinolysis angioplasty safely results in better myocardial perfusion than primary angioplasty .", "despite its later application , this approach seems to be equivalent to primary angioplasty in limiting infarct size and preserving left ventricular function ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to compare the effect of budesonide turbuhaler @ microg/day with budesonide aqua @ microg/day in the treatment of seasonal allergic rhinitis ( sar ) .", "secondarily to ascertain patients ' preferences for the two nasal devices and to assess quality of life .", "randomized , multicentre , double-blind , double - dummy , parallel groups study .", "private practices and hospital clinics in ontario , quebec and manitoba .", "two hundred and eighty-four out-patients with sar , who were symptomatic during the ragweed season , volunteered for enrolment ( @ randomized ) .", "mean daily nasal symptom scores were significantly reduced with treatment .", "there were no statistically significant changes from baseline for eye symptoms .", "most patients ( more than @ % ) achieved substantial control of their symptoms with budesonide .", "the most common nasal and non-nasal adverse events for both groups were epistaxis and headache .", "turbuhaler was easier to use and more convenient to carry , had less of an unpleasant taste , and caused less nasal irritation than the aqua spray .", "more than twice as many patients preferred turbuhaler to the aqua spray ( @ % versus @ % ) .", "improvement in quality of life from baseline to clinic visits was statistically significant in both groups .", "once daily use of @ mg of budesonide aqua and @ mg of budesonide turbuhaler are equally safe and efficacious in the treatment of sar .", "patients preferred the budesonide powder formulation delivered via turbuhaler two to one over the aqua formulation ." ]

[ "BACKGROUND", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "physicians have difficulty keeping up with new evidence from medical research .", "we developed the mcmaster premium literature service ( plus ) , an internet-based addition to an existing digital library , which delivered quality - and relevance-rated medical literature to physicians , matched to their clinical disciplines .", "we evaluated plus in a cluster-randomized trial of @ participating physicians in northern ontario , comparing a full-serve version ( that included alerts to new articles and a cumulative database of alerts ) with a self-serve version ( that included a passive guide to evidence-based literature ) .", "utilization of the service was the primary trial end-point .", "mean logins to the library rose by @ logins/month/user ( @ % ci @ , @ ) in the full-serve group compared with the self-serve group .", "the proportion of full-serve participants who utilized the service during each month of the study period showed a sustained increase during the intervention period , with a relative increase of @ % ( @ % ci @ , @ ) compared with the self-serve group .", "there were no differences in these proportions during the baseline period , and following the crossover of the self-serve group to full-serve , the self-serve group 's usage became indistinguishable from that of the full-serve group ( relative difference @ ( @ % ci -@ , @ ) .", "also during the intervention and crossover periods , measures of self-reported usefulness did not show a difference between the @ groups .", "a quality - and relevance-rated online literature service increased the utilization of evidence-based information from a digital library by practicing physicians ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "antiviral hyper-activation-limiting therapeutic agents ( av-halts ) are a novel experimental drug class designed to both decrease viral replication and down-regulate excessive immune system activation for the treatment of chronic infections , including human immunodeficiency virus ( hiv ) / acquired immunodeficiency syndrome .", "vs@ , a first-in-class av-halt , is a single-dosage form combining didanosine ( ddi , @ mg ) , an antiviral ( av ) , and hydroxyurea ( hu , @ mg ) , a cytostatic agent , designed to provide a slow release of ddi to reduce its maximal plasma concentration ( c ( max ) ) to potentially reduce toxicity while maintaining total daily exposure ( auc ) and the av activity .", "this was a pilot phase i , open-label , randomized , single-dose , four-way crossover trial to investigate the fasted and non-fasted residual variance of auc , c ( max ) and the oral bioavailability of ddi and hu , co-formulated as vs@ , and administered as two different fixed-dose combination formulations compared to commercially available ddi ( videx ec ) and hu ( hydrea ) when given simultaneously .", "formulation vs@-@ had a favourable safety profile , displayed a clear trend for lower ddi c ( max ) ( p = @ ) compared to videx ec , and the @ % confidence intervals around the least square means ratio of c ( max ) did not include @ % .", "ddi auc ( ) was not significantly decreased compared to videx ec .", "hu pharmacokinetic parameters were essentially identical to hydrea , although there was a decrease in hu exposure under fed versus fasted conditions .", "a phase iia trial utilizing vs@-@ formulation has been fielded to identify the optimal doses of hu plus ddi as an av-halt for the treatment of hiv disease ." ]

[ "BACKGROUND", "BACKGROUND", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "some patients with type @ diabetes mellitus ( t@dm ) receiving monotherapy with a sulfonylurea ( su ) are unable to meet recommended glycemic targets over the long term and require additional pharmacologic agents to maintain glycemic control .", "this study was designed to assess the utility of adjunctive therapy with the dipeptidyl peptidase ( dpp ) -@ inhibitor linagliptin in patients with t@dm inadequately controlled with su monotherapy .", "to assess the efficacy and tolerability of linagliptin as add-on therapy in patients with inadequately controlled t@dm despite background therapy with an su .", "in this phase iii , multicenter , randomized , double-blind , placebo-controlled trial , patients with inadequately controlled t@dm on su monotherapy were randomly assigned to receive treatment with linagliptin @ mg once daily ( n = @ ) or placebo ( n = @ ) for @ weeks .", "the primary end point was the mean change in hemoglobin ( hb ) a ( @c ) from baseline to week @ , evaluated using ancova .", "tolerability was assessed using laboratory analysis , spontaneous reporting , and physical examination and interview .", "mean baseline characteristics were similar in the linagliptin and placebo groups .", "linagliptin treatment was associated with a placebo-corrected mean ( @ % ci ) change in hba ( @c ) from baseline ( @ % ) to @ weeks of -@ % ( -@ to -@ ; p < @ ) .", "patients in the linagliptin group were more likely compared with placebo to achieve the hba ( @c ) target level of < @ % after @ weeks of treatment ( @ % vs @ % , respectively ; odds ratio [ or ] = @ ; @ % ci , @-@ @ ; p = @ ) .", "similarly , patients in the linagliptin group were more likely to achieve an hba ( @c ) reduction of @ % compared with those in the placebo group ( @ % vs @ % ; or = @ , @ % ci @-@ @ ; p < @ ) .", "the overall frequency of adverse events was similar between the linagliptin and placebo groups ( @ % vs @ % ) .", "the incidences of hypoglycemic events were not significantly different between the @ groups ( @ % vs @ % ) , and none of the hypoglycemic episodes were assessed as severe by the investigator .", "the difference in the changes in mean body weight was not significant ( +@ vs -@ kg ; p = @ ) .", "the addition of linagliptin to su therapy for @ weeks in these patients with t@dm was associated with statistically significant and clinically meaningful reductions in hba ( @c ) compared with placebo .", "the overall tolerability of linagliptin was similar to that of placebo , with a low risk for hypoglycemia and no significant weight gain .", "these findings support the use of linagliptin as adjunctive therapy in patients with t@dm inadequately controlled on su monotherapy .", "clinicaltrials.gov identifier : nct@ ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "a double-blind , noninferiority trial was conducted to establish the safety and efficacy of a once-daily , @-day course of levofloxacin @ mg compared to a twice-daily , @-day course of ciprofloxacin in complicated urinary tract infections ( cuti ) and acute pyelonephritis ( ap ) .", "this report focuses on subjects with ap .", "adult male and female subjects with clinical signs and symptoms of ap and laboratory confirmation of their diagnosis were randomized to receive one dose of levofloxacin @ mg once daily intravenously ( i.v. ) or orally and one dose of placebo for @ days , followed by placebo ; or ciprofloxacin @ mg i.v. and/or @ mg orally twice daily for @ days .", "the primary , prospectively defined end point was microbiologic eradication at post-therapy ( study days @-@ ) .", "secondary outcomes included clinical response and safety and tolerability .", "in the modified intent-to-treat ( mitt ) population ( levofloxacin @ , ciprofloxacin @ ) , @ % of levofloxacin-treated and @ % of ciprofloxacin-treated subjects achieved microbiological eradication ( difference -@ , @ % ci -@ % , @ % ) .", "in the microbiologically evaluable ( me ) population ( levofloxacin @ , ciprofloxacin @ ) , @ % of levofloxacin-treated vs. @ % of ciprofloxacin-treated subjects ( difference -@ , @ % ci -@ % , @ % ) achieved microbiologic eradication .", "clinical success was achieved in @ % vs. @ % ( mitt ) and in @ % vs. @ % ( me ) of levofloxacin-treated and ciprofloxacin-treated subjects , respectively .", "escherichia coli was the most commonly isolated uropathogen .", "few ( @ % ) of the pathogens were fluoroquinolone-resistant .", "adverse events ( aes ) were similar to those seen previously with both agents .", "potential limitations are that this analysis is based on a subset of subjects from a larger study and , because of different durations of therapy , the results may be biased against levofloxacin .", "high-dose , short-course therapy with levofloxacin in subjects with ap is at least as effective as standard @-day therapy with ciprofloxacin ." ]

[ "BACKGROUND", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "it is unknown whether inhaled corticosteroids can modify the subsequent development of asthma in preschool children at high risk for asthma .", "we randomly assigned @ participants two or three years of age with a positive asthma predictive index to treatment with fluticasone propionate ( at a dose of @ mug twice daily ) or masked placebo for two years , followed by a one-year period without study medication .", "the primary outcome was the proportion of episode-free days during the observation year .", "during the observation year , no significant differences were seen between the two groups in the proportion of episode-free days , the number of exacerbations , or lung function .", "during the treatment period , as compared with placebo use , use of the inhaled corticosteroid was associated with a greater proportion of episode-free days ( p = @ ) and a lower rate of exacerbations ( p < @ ) and of supplementary use of controller medication ( p < @ ) .", "in the inhaled-corticosteroid group , as compared with the placebo group , the mean increase in height was @ cm less at @ months ( p < @ ) , but by the end of the trial , the height increase was @ cm less ( p = @ ) .", "during treatment , the inhaled corticosteroid reduced symptoms and exacerbations but slowed growth , albeit temporarily and not progressively .", "in preschool children at high risk for asthma , two years of inhaled-corticosteroid therapy did not change the development of asthma symptoms or lung function during a third , treatment-free year .", "these findings do not provide support for a subsequent disease-modifying effect of inhaled corticosteroids after the treatment is discontinued .", "( clinicaltrials.gov number , nct@ . )" ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "patients with asthma are interested in the use of breathing exercises but their role is uncertain .", "the effects of the buteyko breathing technique , a device which mimics pranayama ( a yoga breathing technique ) , and a dummy pranayama device on bronchial responsiveness and symptoms were compared over @ months in a parallel group study .", "ninety patients with asthma taking an inhaled corticosteroid were randomised after a @ week run in period to eucapnic buteyko breathing , use of a pink city lung exerciser ( pcle ) to mimic pranayama , or a pcle placebo device .", "subjects practised the techniques at home twice daily for @ months followed by an optional steroid reduction phase .", "primary outcome measures were symptom scores and change in the dose of methacholine provoking a @ % fall in fev ( @ ) ( pd ( @ ) ) during the first @ months .", "sixty nine patients ( @ % ) completed the study .", "there was no significant difference in pd ( @ ) between the three groups at @ or @ months .", "symptoms remained relatively stable in the pcle and placebo groups but were reduced in the buteyko group .", "median change in symptom scores at @ months was @ ( interquartile range -@ to @ ) in the placebo group , -@ ( -@ to @ ) in the pcle group , and -@ ( -@ to @ ) in the buteyko group ( p = @ for difference between groups ) .", "bronchodilator use was reduced in the buteyko group by two puffs/day at @ months ; there was no change in the other two groups ( p = @ ) .", "no difference was seen between the groups in fev ( @ ) , exacerbations , or ability to reduce inhaled corticosteroids .", "the buteyko breathing technique can improve symptoms and reduce bronchodilator use but does not appear to change bronchial responsiveness or lung function in patients with asthma .", "no benefit was shown for the pink city lung exerciser ." ]

[ "BACKGROUND", "BACKGROUND", "BACKGROUND", "BACKGROUND", "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "BACKGROUND" ]

[ "this trial aims to evaluate effective delivery and cost effectiveness of an innovative structured psycho-educational programme ( cascade ) for young people and their families living with diabetes .", "the increase in numbers of people being diagnosed with diabetes is posing a challenge for both the uk and the rest of the world .", "the peak age for diagnosis is between @ and @ years of age .", "there is clear evidence that improved diabetes control from diagnosis in childhood can reduce the incidence and progression of long-term complications .", "however , despite the development of improved insulin regimens and delivery methods , the overall metabolic control in children and adolescents has improved little in the uk in the past decade .", "therefore there is a need for novel interventions and health delivery mechanisms aimed at young people and their families to help improve control and reduce complications , illness burden and costs to the nhs .", "the cascade trial is a multi-centre randomised control trial with @ clinics randomised to control or intervention groups , with @ children and young people involved in the study .", "the intervention will be delivered in @ group sessions , over a @ month period .", "a developmentally appropriate curriculum will be delivered to groups of @ - @ families , focusing on achievement of increasing competency in self-management of diabetes .", "the control group will receive standard care from their clinical team , usually consisting of regular @-monthly clinic visits and telephone contact as required with the clinical nurse specialist and consultant .", "the primary outcomes of the trial will be change in hba@c between baseline and @ months and @ months post recruitment .", "secondary outcomes will include measures related to the economic evaluation , psychosocial outcomes , outcomes related to management of diabetes outcomes , and adherence to the intervention .", "the trial will be run by independent research and service delivery teams and supervised by a trial steering committee .", "a data monitoring and ethics committee has been put in place to monitor the trial and recommend stopping/continuation according to a peto-haybittle rule .", "the trial will be conducted according to the principles of mrc good clinical practice ( gcp ) guidelines and ctru phase iii trial standard operating procedures .", "current controlled trials isrctn@ ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "a prospective randomized study was performed to test the hypothesis that tamoxifen might improve the survival of patients with advanced hepatocellular carcinoma ( hcc ) and to correlate the response of treatment with the expression of hormone receptors .", "one hundred nineteen patients with advanced and otherwise untreatable hcc were included in a placebo-controlled , single-blind trial .", "the patients were randomized to tamoxifen group ( @ patients ) and control group ( @ patients ) and were prescribed with a daily dose of @ mg of tamoxifen and placebo , respectively .", "immunohistochemical tests for estrogen and progesterone receptors were performed on the tumor tissues obtained from @ patients .", "all patients were closely monitored and the survival outcome of the two groups of patients was compared and stratified according to the hormonal receptor status .", "there was no difference in the @-month mortality rates ( @ % vs. @ % , p = @ ) and the median survival ( @ days vs. @ days , p = @ ) between the tamoxifen group and the control group .", "furthermore , the expression of hormone receptors in the tumors did not affect the survival outcome of the patients treated with tamoxifen .", "none of the patients who survived longer than @ months had tumor that had partial response to tamoxifen treatment on follow-up imaging study .", "tamoxifen has no efficacy in the treatment of patients with advanced hcc and response to treatment was not affected by the expression of hormone receptors ." ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "working memory ( wm ) problems influence most activities of daily living .", "the aim was to evaluate if computerized working memory training after brain injury has a significant effect on functioning in daily life .", "outpatients with wm deficits , aged @-@ years , were randomized to either intervention group ( ig , n = @ ) or control group ( cg , n = @ ) and received @ weeks standard rehabilitation .", "the ig also received wm training with the cogmed qm training program .", "assessments were made before ( a@ ) , immediately ( a@ ) and @ months ( a@ ) after intervention .", "after follow-up , the cg was offered the computerized training and assessed after this ( a@ ; n = @ ) .", "assessments included the wais-iii digit span reversed , fatigue impact scale ( fis ) , assessment of motor and process skills ( amps ) , rivermead behavioural memory test-ii ( rbmt-ii ) and a wm questionnaire .", "the ig improved on digit span and fis , a@-a@ , and significantly more than the cg on the wm questionnaire , a@-a@ .", "both groups improved in amps motor skill and the amps process skill score tended towards significant improvement in the ig , from a@-a@ .", "after training ( a@-a@ ) , the cg improved in digit span and rbmt-ii .", "the wm training seems to have a generalized effect on functional activity and lessens fatigue ." ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "ovarian hyperstimulation syndrome ( ohss ) seems to be induced by the ovarian release of vascular endothelial growth factor ( vegf ) , which increases vascular permeability .", "dopamine agonists inhibit vegf receptor phosphorylation and thereby decrease vascular permeability .", "a randomized , double-blind , placebo-controlled , multicentre study assessing three oral doses ( @ , @ , @ microg/day ) of the non-ergot derived dopamine agonist quinagolide started on the day of human chorionic gonadotrophin ( hcg ) and continued for @-@ days without dose-titration in comparison to placebo in preventing moderate/severe early ohss ( onset < or = @ days after hcg administration ) in @ ivf patients with > or = @ but less than @ follicles > or = @ mm .", "the incidence of moderate/severe early ohss was @ % ( @/@ ) in the placebo group and @ % ( @/@ ) , @ % ( @/@ ) and @ % ( @/@ ) in the quinagolide @ , @ and @ microg/day groups , respectively .", "the moderate/severe early ohss rate was significantly lower with all quinagolide groups combined compared with placebo [ p = @ ; or = @ ( @-@ @ ) ] .", "the incidence of ultrasound evidence of ascites among patients with no clinical pregnancy was significantly reduced from @ % ( @/@ ) with placebo to @ % ( @/@ ) with all quinagolide groups combined [ p = @ ; or = @ ( @-@ @ ) ] , although there was no difference for those with clinical pregnancy .", "quinagolide did not have a detrimental effect on pregnancy or live birth rates .", "the incidence of gastrointestinal and central nervous system adverse events increased with increasing doses of quinagolide .", "quinagolide appears to prevent moderate/severe early ohss while not affecting treatment outcome .", "the effect is more marked in patients who did not achieve a clinical pregnancy .", "quinagolide administered in high doses without dose-titration is associated with poor tolerability .", "clinicaltrials.gov identifier : nct@ ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "to explore the optimal approach to the prevention of hypotension during cesarean section for the benefits of both the parturients and the newborns .", "forty singleton full-term pregnant women undergoing elective cesarean delivery were randomly allocated into two equal groups .", "for prevention of hypotension during spinal anesthesia , ephedrine or pre-anesthetic volume with voluven was administered .", "the changes of blood pressure , heart rate , and apgar scores of the newborns were monitored and recorded , and the umbilical arterial blood gas variables were compared between the two groups .", "the placental samples were collected and immunohistochemistry for cd@ was performed for stereological study of the placental villous capillaries .", "the umbilical arterial paco ( @ ) , pao ( @ ) and apgar scores showed no significant differences between the two groups ( p < @ ) .", "the heart rate , incidence of hypotension and the lactic acid value were significantly higher , and the umbilical arterial ph significantly lower in ephedrine group than in the voluven group ( p > @ ) .", "while the length density of the villous capillaries was comparable between the two groups ( p > @ ) , the volume density of the villous capillaries was significantly decreased in ephedrine group ( p < @ ) .", "pre-anesthetic volume expansion with voluven can maintain stable hemodynamics during spinal anesthesia and also efficiently improve the tissue perfusion , microcirculation and uteroplacental blood flow , thus increasing the oxygen supply to the fetus ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "exposure to trauma reminders has been considered imperative in psychotherapy for posttraumatic stress disorder ( ptsd ) .", "the authors tested interpersonal psychotherapy ( ipt ) , which has demonstrated antidepressant efficacy and shown promise in pilot ptsd research as a non-exposure-based non-cognitive-behavioral ptsd treatment .", "the authors conducted a randomized @-week trial comparing ipt , prolonged exposure ( an exposure-based exemplar ) , and relaxation therapy ( an active control psychotherapy ) in @ unmedicated patients who had chronic ptsd and a score > @ on the clinician-administered ptsd scale ( caps ) .", "randomization stratified for comorbid major depression .", "the authors hypothesized that ipt would be no more than minimally inferior ( a difference < @ points in caps score ) to prolonged exposure .", "all therapies had large within-group effect sizes ( d values , @-@ @ ) .", "rates of response , defined as an improvement of > @ % in caps score , were @ % for ipt , @ % for prolonged exposure , and @ % for relaxation therapy ( not significantly different between groups ) .", "caps outcomes for ipt and prolonged exposure differed by @ points ( not significant ) , and the null hypothesis of more than minimal ipt inferiority was rejected ( p = @ ) .", "patients with comorbid major depression were nine times more likely than nondepressed patients to drop out of prolonged exposure therapy .", "ipt and prolonged exposure improved quality of life and social functioning more than relaxation therapy .", "this study demonstrated noninferiority of individual ipt for ptsd compared with the gold-standard treatment .", "ipt had ( nonsignificantly ) lower attrition and higher response rates than prolonged exposure .", "contrary to widespread clinical belief , ptsd treatment may not require cognitive-behavioral exposure to trauma reminders .", "moreover , patients with comorbid major depression may fare better with ipt than with prolonged exposure ." ]

[ "OBJECTIVE", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "the authors ' goal was to compare the efficacy and tolerability of @ months ' treatment with flexible-dose ziprasidone and olanzapine in patients with schizophrenia or schizoaffective disorder .", "brief psychiatric rating scale ( bprs ) scores and clinical global impression ( cgi ) severity scores were obtained for @ responders to a @-week acute study of olanzapine and ziprasidone during a blinded @-month continuation study and optional extension study .", "comparable improvements in bprs and cgi severity scores were seen with both drugs .", "olanzapine produced significant increases from acute-study baseline values in weight and body mass index and within-group increases in total cholesterol , low-density lipoprotein cholesterol , and fasting insulin .", "between-group differences were not significant for lipids and insulin .", "mean qtc values at endpoint were @ msec ( baseline mean = @ msec ) and @ msec ( baseline mean = @ msec ) for ziprasidone and olanzapine , respectively .", "no patient had a qtc interval > or = @ msec .", "ziprasidone and olanzapine had comparable long-term efficacy ; olanzapine was associated with significant weight gain and metabolic alterations ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "to compare magnesium sulphate concentrations achieved by intramuscular and intravenous regimens used for the prevention of eclampsia .", "low-resource obstetric hospitals in nagpur and vellore , india .", "pregnant women at risk for eclampsia due to hypertensive disease .", "a pharmacokinetic study was performed as part of a randomised trial that enrolled @ women comparing intramuscular and intravenous maintenance regimens of magnesium dosing .", "data from @ enrolled women were analysed in the pharmacokinetic study .", "a single sample was drawn per woman with the expectation of using samples in a pooled data analysis .", "pharmacokinetic parameters of magnesium distribution and clearance .", "magnesium clearance was estimated to be @ dl/hour , volume of distribution to be @ dl and intramuscular bioavailability to be @ % .", "the intramuscular regimen produced higher initial serum concentrations , consistent with a substantially larger loading dose .", "at steady state , magnesium concentrations in the intramuscular and intravenous groups were comparable .", "with either regimen , a substantial number of women would be expected to have serum concentrations lower than those generally held to be therapeutic .", "clinical implications were that a larger loading dose for the intravenous regimen should be considered ; where feasible , individualised dosing of magnesium sulphate would reduce the variability in serum concentrations and might result in more women with clinically effective magnesium concentrations ; and lower dose magnesium sulphate regimens should be considered with caution ." ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "chronic kidney disease ( ckd ) and diabetes mellitus ( dm ) are common comorbidities in heart failure ( hf ) and each is associated with poor outcomes .", "however , the effects of multimorbidity related to having both ckd and dm compared to ckd alone have not been well studied in a propensity-matched population of chronic hf patients .", "of the @ ambulatory chronic hf patients in the digitalis investigation group trial , @ had ckd , of whom @ had dm .", "based on the absence or presence of dm , patients were categorized ckd-only and ckd-dm , respectively .", "propensity scores for ckd-dm were calculated for each patient and were used to match @ pairs of ckd-only and ckd-dm patients .", "hazard ratios ( hr ) and @ % confidence intervals ( ci ) comparing ckd-dm patients with ckd-only patients were estimated using matched cox regression models .", "all-cause mortality occurred in @ % ( rate , @/@ ,@ person-years of follow-up ) of ckd-dm patients and @ % ( rate , @/@ ,@ person-years ) of ckd-only patients ( hr when ckd-dm is compared with ckd-only , @ ; @ % - ci , @-@ @ ; p = @ ) .", "all-cause hospitalization occurred in @ % ( rate , @/@ ,@ person-years ) and @ % ( rate , @/@ ,@ person-years ) of ckd-dm and ckd-only patients respectively ( hr , @ ; @ % - ci , @-@ @ ; p < @ ) .", "respective hr and @ % - ci for other outcomes were : cardiovascular mortality ( @ ; @-@ @ ; p = @ ) , hf mortality ( @ ; @-@ @ ; p = @ ) ; cardiovascular hospitalization ( @ ; @-@ @ ; p = @ ) and hf hospitalization ( @ ; @-@ @ ; p < @ ) .", "compared with comorbidity due to ckd alone , multimorbidity with ckd and dm was associated with poor outcomes in chronic hf patients ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "to examine the pharmacokinetics and the relation between plasma concentrations of the new potassium channel blocker dofetilide and qtc prolongation on the surface electrocardiogram after oral and intravenous administration .", "ten healthy volunteers received a single dose of @ mg dofetilide orally and intravenously ( over @ minutes ) in a randomized crossover study .", "the qtc interval versus dofetilide plasma concentration was analyzed by use of pharmacokinetic and pharmacodynamic modeling techniques .", "dofetilide absolute bioavailability and systemic clearance were @ % + / - @ % and @ + / - @ l/hr/kg , respectively .", "mean maximum increase in qtc interval duration was @ msec ( @ % ) and @ msec ( @ % ) after intravenous and oral administration , respectively .", "a counterclockwise hysteresis loop between dofetilide plasma concentrations and qtc interval duration was observed after intravenous infusions in all subjects , whereas direct linear relationships were observed after oral administrations in eight of @ subjects .", "pharmacokinetic-pharmacodynamic modeling showed the consistency of the effect versus concentration relationships obtained with the two routes of administration .", "with use of a maximum effect ( emax ) model and data obtained after intravenous infusion , mean maximum qtc prolongation ( emax ) was @ + / - @ msec and mean dofetilide plasma concentration associated with half the maximum effect ( ec@ ) was @ + / - @ ng/ml .", "pharmacokinetic-pharmacodynamic modeling was useful in detecting the maximum effect and in describing the plasma concentration versus effect relationship during intravenous infusion of dofetilide but was otherwise not superior to analyses performed with postdistribution data .", "we conclude that dofetilide prolongs qtc interval duration in a concentration-dependent manner in normal volunteers during sinus rhythm and that pharmacokinetic-pharmacodynamic modeling is useful for examination of maximum qtc prolongation induced by dofetilide ." ]

[ "BACKGROUND", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "carperitide is used to treat acute decompensated heart failure ( adhf ) , but its effects on long-term prognosis have not been studied .", "a multicenter randomized controlled study of @ patients with adhf was performed to clarify the drug 's effects on long-term prognosis .", "low-dose carperitide ( @-@ @ microg x kg ( -@ ) x min ( -@ ) ) was infused for @ h as the initial treatment ( n = @ ) , whereas in the control group ( n = @ ) , standard medical treatment other than carperitide was given without limitation .", "anti-aldosterone drugs were prohibited in both groups .", "during carperitide infusion , significant increases of the atrial natriuretic peptide and cyclic gmp levels and a significant decrease in the heart-type fatty acid-binding protein/serum creatinine ratio were observed , suggesting inhibition of myocyte cell membrane damage .", "on the other hand , no significant differences in the plasma brain natriuretic peptide , troponin t , and creatinine levels were noted in either group .", "during @-month follow-up , significant reductions of death and rehospitalization occurred in the carperitide vs control group ( @ % vs @ % ; p = @ ) .", "cox regression analysis revealed that randomization to carperitide ( p = @ ) , pretreatment systolic blood pressure > or = @ mmhg ( p = @ ) , and beta-blocker therapy ( p = @ ) were independent predictors for freedom from cardiac events .", "acute-phase low-dose carperitide infusion improved the long-term prognosis of patients with adhf ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "to determine if intravenous hydroxyethylstarch ( hes ) affects the accuracy of hemoglobin ( hb ) measurements , as artificial colloids are known to increase red blood cell sedimentation rates .", "prospective , randomized study .", "tertiary-care academic medical institution .", "we randomized @ surgical american society of anesthesiologists ( asa ) physical status i and ii patients undergoing preoperative autologous blood donation before elective orthopedic surgery .", "patients were randomized to receive volume replacement with @ ml of @ % hes @,@ / @ or @ ml of electrolyte solution .", "measurements of hb concentration and leukocyte count were performed using an analyzer with a suction needle sampling from the bottom of the test tube .", "measurements were performed after mixing and repeated after a @-minute period of upright positioning of the tube ( at rest ) .", "in the study group that received hes , hb levels were increased above baseline after resting ( mean increase to @ % of baseline values , p < @ ) , whereas the leukocyte count was decreased ( mean decrease to @ % of baseline values , p < @ ) .", "no difference between baseline and resting measurements were observed in patients who received intravenous crystalloids .", "in addition , we repeatedly measured the hb concentration in an unstirred tube with and without the addition of hes .", "in blood samples containing hes , the hb concentration was increased above baseline after @ minutes of resting , compared with @ minutes without hes addition ( p < @ ) .", "mixing of test tube contents before sampling is critical for accurate measurement of the hb concentration in the blood of patients who received intravenous hes ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to examine significance of missing data and describe physical activity patterns using recall and accelerometer measures among youth in a nonlaboratory setting .", "fifty-four middle-school students wore tritrac-r@d monitors ( ttm ) and completed an interviewer-prompted @-h recall during two , @-d monitoring sessions .", "we coded @ @-min recall intervals to a standard met compendium .", "complete ttm data were gathered for @ students .", "ordinal multinomial models tested for bias in ttm estimates of activity levels due to : @ ) exclusion of subjects with incomplete ttm data , and @ ) exclusion of intervals within days due to missing ttm data .", "students with complete monitor data had an average @ + / - @ monitored hours per day over @ + / - @ d. compared with students with incomplete monitoring data , they reported similar proportions of recall @-min intervals at sedentary ( @ % vs @ % ) , light ( @ % vs @ % ) , moderate ( @ % vs @ % ) , and vigorous ( @ % vs @ % ) intensity levels ( p = @ ) .", "the proportion of recall intervals ( within days ) with and without simultaneous monitoring data did not differ by activity intensity ( p = @ ) across sedentary ( @ % vs @ % ) , light ( @ % vs @ % ) , moderate ( @ % vs @ % ) , and vigorous ( @ % vs @ % ) categories .", "recalls overestimated percent time per day in moderate and vigorous activity relative to ttm ( @ % vs @ % , p < @ ) .", "boys reported higher percent of time than girls in vigorous activity ( @ % vs @ % , p < @ ) .", "girls reported more time than boys ( @ % vs @ % , p < @ ) in light activities .", "no significant sex differences were observed using ttm .", "missing ttm data did not bias estimates of activity levels .", "self-reported activity measures overestimated moderate and vigorous activity relative to the ttm and varied by sex ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "the current study evaluated the efficacy and safety of risperidone and haloperidol as an adjunctive agent in combination with divalproate in patients with an episode of acute mania .", "this @-week randomized , single-blind study was conducted in psychiatric wards of a mental hospital .", "a total of @ patients were randomly assigned to the risperidone ( risperidone plus divalproate ) or haloperidol groups ( haloperidol plus divalproate ) .", "efficacy was assessed by changes in symptom rating scales [ young mania rating scale ( ymrs ) , brief psychiatric rating scale ( bprs ) , and clinical global impression ( cgi ) scores ] .", "safety and tolerability were assessed by monitoring the extrapyramidal symptom rating scale ( esrs ) and hamilton rating scale for depression .", "mean doses at baseline , and at weeks @ and @ were @ , @ and @ mg/day of risperidone and @ , @ and @ mg/day of haloperidol , respectively .", "risperidone was shown to have significant anti-manic effects which was observed as early as week @ , following start of treatment .", "the bprs scores were in favor of risperidone at week @ .", "patients receiving risperidone exhibited significant greater global improvement on the cgi , as early as week @ and over the entire treatment period , than haloperidol after @ weeks of treatment .", "the esrs at endpoint were significantly higher in the haloperidol patients .", "risperidone plus divalproate was more efficacious than haloperidol plus divalproate for treatment of acute mania , and was well tolerated due to its evidence showing rapid anti-manic action , effective and sustained control of manic and psychotic symptoms and a favorable safety and tolerability profile in acute mania ." ]

[ "BACKGROUND", "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "shoulder impingement syndrome is a common musculoskeletal complaint leading to significant reduction of health and disability .", "physiotherapy is often the first choice of treatment although its effectiveness is still under debate .", "systematic reviews in this field highlight the need for more high quality trials to investigate the effectiveness of physiotherapy interventions in patients with subacromial impingement syndrome .", "this randomized controlled trial will investigate the effectiveness of individualized physiotherapy in patients presenting with clinical signs and symptoms of subacromial impingement , involving @ participants aged @-@ .", "participants are recruited from outpatient physiotherapy clinics , general practitioners , and orthopaedic surgeons in germany .", "eligible participants will be randomly allocated to either individualized physiotherapy or to a standard exercise protocol using central randomization .", "the control group will perform the standard exercise protocol aiming to restore muscular deficits in strength , mobility , and coordination of the rotator cuff and the shoulder girdle muscles to unload the subacromial space during active movements .", "participants of the intervention group will perform the standard exercise protocol as a home program , and will additionally be treated with individualized physiotherapy based on clinical examination results , and guided by a decision tree .", "after the intervention phase both groups will continue their home program for another @ weeks .", "outcome will be measured at @ weeks and at @ and @ months after inclusion using the shoulder pain and disability index and patients ' global impression of change , the generic patient-specific scale , the average weekly pain score , and patient satisfaction with treatment .", "additionally , the fear avoidance beliefs questionnaire , the pain catastrophizing scale , and patients ' expectancies of treatment effect are assessed .", "participants ' adherence to the protocol , use of additional treatments for the shoulder , direct and indirect costs , and sick leave due to shoulder complaints will be recorded in a shoulder log-book .", "to our knowledge this is the first trial comparing individualized physiotherapy based on a defined decision making process to a standardized exercise protocol .", "using high-quality methodologies , this trial will add evidence to the limited body of knowledge about the effect of physiotherapy in patients with sis ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "ropivacaine is a potent local anesthetic that , experimentally at low concentrations , produces an effective block of pain conducting nerve fibers .", "therefore , it was hypothesized that @ % and @ % ropivacaine would provide clinically adequate postoperative analgesia in continuous axillary plexus block .", "sixty patients ( asa i-ii ) scheduled for elective hand or forearm surgery received @ mg/kg of @ % ropivacaine for axillary block using nerve stimulator technique .", "one hour later , in random order , a continuous infusion of either @ % ropivacaine ( @ mg/kg/h ) , @ % ropivacaine ( @ mg/kg/h ) or saline @ to @ ml/h was started .", "the mean total ropivacaine dose for the surgical block was @ to @ mg/kg with the supplementation .", "all patients were pain free for the first @ to @ hours after the block .", "the need for postoperative analgesics during the infusion was similar in all groups .", "after the initial block , the maximum plasma concentrations ( mean @ microg/ml ) were measured at @ or @ minutes after injection .", "the highest individual plasma concentration was @ microg/ml .", "despite the high venous peak concentration , no toxic reactions were observed .", "the mean peak plasma concentration ( cmax ) was @ + / -@ microg/ml for saline , @ + / -@ microg/ml for @ % ropivacaine , and @ + / -@ microg/ml for @ % ropivacaine .", "during the continuous infusion of @ hours , the ropivacaine concentration declined steadily .", "ropivacaine is safe and effective for axillary brachial plexus block .", "the continuous infusion of @ % or @ % ropivacaine was no more beneficial than an infusion of saline in relieving postoperative pain in patients having elective hand surgery .", "none of the infusions were sufficient to adequately treat the patients ' pain without the addition of adjunct agents ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "patients from a randomized , double-blind , placebo-controlled study of progesterone suppository treatment for premenstrual syndrome ( pms ) were followed up to determine poststudy pms symptom levels and medication use .", "an average of @ year after the end of the treatment study , @ subjects were contacted for telephone interviews .", "all subjects met criteria for pms before the progesterone suppository treatment , and their symptoms were confirmed by daily symptom reports throughout the study .", "the outcome measure at follow-up was the patient 's global assessment of symptom severity , which was also rated by the subjects during the treatment study .", "the ratings at enrollment , end of study , and follow-up were compared .", "only @ % of the subjects ( n = @ ) were taking medications for pms at follow-up .", "symptom severity at follow-up was less than at enrollment but greater than at the end of the study .", "some of the improvement gained during treatment was maintained , but overall the subjects remained moderately symptomatic .", "validation of the pms condition , education , and support and caring may account for the symptom decreases during treatment , and the end of treatment and withdrawal of these conditions may account for the moderate return of symptoms ." ]

[ "OBJECTIVE", "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "staphylococcus aureus and mutans group streptococci can cause , among many other diseases , infective endocarditis and postoperative infections .", "the reduction of the number of these microorganisms in the oral cavity prior to surgical procedures has been related to a decreased incidence of such occurrences .", "the aim of this study was to evaluate the effect of a single preprocedural rinse with @ % chlorhexidine solution ( periogard ) on the salivary counts of s aureus and mutans group streptococci and determine maximal inhibitory dilutions ( mid ) of this and @ % cetylpyridinium chloride solution ( cepacol ) .", "saliva was collected from @ patients before and after @-second mouthrinses with chlorhexidine and cultured in appropriate media .", "the number of microorganisms was calculated based on the colony-forming units ( cfus ) .", "for the in vitro mid determination , @ strains of s aureus were seeded in the media containing one of the sequential dilutions of both antiseptics .", "s aureus , streptococcus mutans , and streptococcus sobrinus were initially isolated from @ % , @ % , and @ % of the patients , respectively .", "after rinsing with chlorhexidine , the reductions in the cfus were above @ % for all the studied microorganisms .", "in the mid determination , all isolates were inhibited with @/@ and @/@ dilutions of cetylpyridinium and chlorhexidine , respectively .", "dose-response curves were obtained for both antiseptics .", "single preprocedural chlorhexidine mouthrinse is effective in reducing salivary microorganisms to levels currently considered safe to perform invasive procedures , and it is still effective in a @:@ dilution ." ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "BACKGROUND" ]

[ "ischemia-reperfusion injuries , fluid overload , and cardiac insufficiency may all contribute to alveolar and interstitial lung edema .", "we hypothesized that aerosolized salbutamol would reduce extravascular lung water and improve oxygenation after lung resection by stimulating epithelial fluid clearance and cardiovascular function .", "blinded , randomized , cross-over trial .", "we selected @ patients with risk factors for lung edema .", "aerosolized drugs ( salbutamol , @ mg ; vs ipratropium , @ mg ) were administered on two consecutive trials , with a @-h washout period , on the day of surgery ( postoperative day [ pod ] -@ ) as well as on pod-@ .", "before and @ min after the end of drug administration , we determined the oxygenation index ( pao ( @ ) / fraction of inspired oxygen [ fio ( @ ) ] ratio ) , the extravascular lung water index ( evlwi ) , the pulmonary vascular permeability index ( pvpi ) , and the cardiac index ( ci ) using the single-indicator thermal dilution technique .", "complete data were obtained in @ patients .", "on pod-@ , the evlwi was increased compared with preoperative values ( @ + / - @ vs @ + / - @ , p < @ ) ; salbutamol treatment induced significant increases in pao ( @ ) / fio ( @ ) ratio ( + @ + / - @ % ) that were associated with decreases in evlwi ( - @ + / - @ % , p < @ ) and in pvpi ( - @ + / - @ % , p < @ ) along with increased ci ( + @ + / - @ % , p < @ ) .", "on pod-@ , repeated nebulization of salbutamol induced significant increases in pao ( @ ) / fio ( @ ) ratio and ci ( + @ + / - @ % and @ + / - @ % , respectively ) , whereas both evlwi and pvpi remained unchanged .", "nebulization of ipratropium bromide did not produce significant hemodynamic and respiratory changes on pod-@ and pod-@ .", "aerosolized salbutamol accelerates the resolution of lung edema , improves blood oxygenation , and stimulated cardiovascular function after lung resection in high-risk patients .", "this protocol trial ( cer@-@ ) has been registered at ( clinicaltrials.gov ) under nct@ ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "to compare the clinical efficacy and safety of anesthesia with intravenous propofol combined with fentanyl for ultrasound-guided transvaginal oocyte retrieval .", "totally @ unpremedicated infertile women ( asa i-ii ) scheduled for oocyte retrieval with ultrasound guidance were randomly divided into two groups to receive anesthesia with either intravenous propofol ( group a , n = @ ) or the combination of propofol and fentanyl ( group b , n = @ ) .", "the time when consciousness loss and recovery occurred , dosage of propofol for anesthesia maintenance , mean arterial blood pressure ( map ) , heart rate ( hr ) and oxygen saturation ( spo@ ) were recorded .", "there was no significant difference in the time of consciousness loss between groups a and b ( @ + / -@ s vs @ + / -@ s , p = @ ) , but consciousness recovery occurred earlier in group b ( @ + / -@ min vs @ + / -@ min , p < @ ) .", "the maintenance dosage of propofol in group b ( @ + / -@ mg/kg ) was significantly lower than that in group a ( @ + / -@ mg/kg , p < @ ) .", "at @ min after anesthesia induction , the map decreased from @ + / -@ kpa to @ + / -@ kpa in group a ( p < @ ) , and from ( @ + / -@ ) kpa to ( @ + / -@ ) kpa in group b ( p < @ ) , and returned to normal within @-@ min in both groups .", "the incidence of low spo@ ( < @ % ) was lower in group a than in group b ( ( @ % vs @ % , p < @ ) .", "anesthesia with propofol combined with fentanyl may reduce the maintenance dosage of propofol , shorten the time of consciousness recovery during oocyte retrieval with ultrasound guidance , and can be helpful for the patients ' early recovery and discharge from hospital ." ]

[ "OBJECTIVE", "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "in uncontrolled clinical trials , negative extrathoracic pressure has been shown to be an effective respiratory support .", "we aimed to assess its role in the context of current neonatal intensive care .", "a randomized controlled trial , with sequential analysis of matched pairs of infants .", "matching was undertaken by stratified randomization from @ groups divided according to gestational age , oxygen requirement , and whether patients were intubated at @ hours of age .", "two neonatal intensive care units .", "two hundred forty-four patients ( birth weight @ + / - @ kg ( mean + / - sd ) ; gestational age @ + / - @ weeks ) with respiratory failure .", "patients were randomized at @ hours of age to receive either standard neonatal intensive care , or standard care plus continuous negative extrathoracic pressure ( cnep , -@ to -@ cmh@o ) applied within a purpose-designed neonatal incubator .", "outcome scores : clinical scores were calculated for each infant at @ days of age , or death if earlier .", "scores included measures for mortality , respiratory outcome , the presence of cerebral ultrasound abnormalities , patent arterial duct , necrotizing enterocolitis , and retinopathy .", "the treatment given for the higher score for each pair was recorded and the cumulative net number of pairs favoring cnep plotted in the sequential analysis to provide an ethical early termination strategy .", "individual components of the outcome score and other secondary measurements were analyzed on completion of the trial .", "the sequential analysis reached a decision boundary after @ out of a possible maximum of @ pairs were completed .", "the overall outcome score showed an overall significant benefit for cnep .", "secondary analysis showed that the use of cnep was associated with an increase in mortality , cranial ultrasound abnormalities , and pneumothoraces , which were not statistically significant .", "however , @ % fewer patients were intubated ( @ % confidence interval [ ci ] , @-@ ) , and the total duration of oxygen therapy among surviving infants at @ days was lower ( @ days , compared with @ in controls ; difference @ days , @ % ci @ to @ ) .", "among all infants , the mean total duration of oxygen therapy was @ days among cnep-treated infants compared with @ days among the controls ( difference -@ days , @ % ci -@ to -@ ) .", "this reduction in mean levels is entirely attributable to substantially fewer patients requiring prolonged oxygen therapy , the median duration of treatment being very similar in the two groups .", "as a result , commensurately fewer surviving infants showed chronic lung disease of prematurity .", "the use of continuous negative pressure improves the respiratory outcome for neonates with respiratory failure ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "we compared ct fluoroscopy ( ctf ) for the initial puncture of bile ducts with conventional fluoroscopic guidance in patients with malignant jaundice in whom percutaneous transhepatic biliary drainage ( ptbd ) was planned .", "forty consecutive patients were randomized to two study groups : group a underwent ptbd under ctf and fluoroscopic guidance , group b underwent ptbd under fluoroscopic guidance alone .", "ctf-guided ptbd was performed using a combination of a helical ct scanner of the latest generation and a mobile c-arm ; conventional ptbd was performed under fluoroscopic guidance in the angiographic unit .", "end points of the study were the success ( a puncture that enabled safe placement of a guidewire in a suitable bile duct ) and the complication rate ( hemobilia , bile fistula , biliary peritonitis ) , the number of punctures required , the time needed for successful puncture of a suitable bile duct , and the patient 's radiation exposure .", "ctf-guided puncture of peripheral bile ducts suitable for ptbd was successful at the first attempt in @ cases , under conventional fluoroscopic guidance , in only two cases .", "we found a significantly different number of punctures ( @ in group a vs @ in group b ) , a significantly shorter time for puncture in group a ( mean @ sec ) , but also a significantly higher skin exposure dosage in group a ( mean @ msv surface dosage ) .", "there was no significant difference regarding the total procedure time .", "only one complication occurred in group b ( portobiliary fistula ) .", "ctf-guided initial puncture of bile ducts allowed a significantly reduced number of punctures and puncture times compared with puncture under conventional fluoroscopic guidance for placement of percutaneous transhepatic biliary drainage catheters ." ]

[ "BACKGROUND", "BACKGROUND", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "although current opinion favours the use of enteral over parenteral nutrition , the clinical benefits of early postoperative nutrition in patients undergoing elective surgery have never been clearly shown .", "we aimed to test the hypothesis that postoperative enteral nutrition is better ( fewer postoperative complications ) than parenteral nutrition containing similar energy and nitrogen amounts ( @ kj kg ( -@ ) day ( -@ ) and @ g aminoacid kg ( -@ ) day ( -@ ) ) .", "we did a randomised multicentre clinical trial in patients with gastrointestinal cancer who were malnourished and candidates for major elective surgery .", "@ patients were assigned to enteral nutrition and @ to parenteral nutrition .", "the primary endpoint was the occurrence of postoperative complications , and secondary endpoints were length of postoperative hospital stay , adverse effects , and treatment crossover .", "analysis was by intention to treat .", "postoperative complications occurred in @ ( @ % ) patients fed enterally versus @ ( @ % ) fed parenterally ( relative risk @ , @ % ci @-@ @ , p = @ ) .", "length of postoperative stay was @ days and @ days in the enteral nutrition and parenteral nutrition groups , respectively ( p = @ ) .", "adverse effects occurred in @ ( @ % ) patients fed enterally versus @ ( @ % ) patients fed parenterally ( @ , @-@ @ , p < @ ) .", "@ ( @ % ) patients on enteral nutrition had to switch to parenteral nutrition , whereas none of those fed parenterally crossed over to enteral feeding .", "we conclude that early enteral nutrition significantly reduces the complication rate and duration of postoperative stay compared with parenteral nutrition , although parenteral nutrition is better tolerated than enteral nutrition ." ]

[ "BACKGROUND", "BACKGROUND", "OBJECTIVE", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "health-related quality of life ( hrqol ) worsens with multiple sclerosis ( ms ) relapses and disease progression .", "common symptoms including depression and fatigue may contribute to poor hrqol .", "to report exploratory analyses assessing the impact of fingolimod ( fty@ ) on hrqol and depression in a phase ii study of relapsing ms.", "the hamburg quality of life questionnaire in ms ( haquams ) and beck depression inventory second edition ( bdi-ii ) scores were assessed during a @-month , placebo-controlled study and optional extension .", "haquams total score improved with fingolimod and worsened with placebo .", "mean score change from baseline to month @ was -@ with fingolimod @ mg ( p < @ versus placebo ) , -@ with fingolimod @ mg and +@ with placebo .", "categorical data supported a clinically important effect of fingolimod on hrqol .", "fingolimod @ mg was also beneficial over placebo in the fatigue/thinking haquams sub-domain ( p < @ versus placebo ) .", "change in mean bdi-ii scores from baseline to month @ and the proportion of patients with bdi-ii scores indicative of clinical depression favored fingolimod @ mg over placebo ( p < @ for both ) .", "at month @ , mean bdi-ii and haquams total scores appeared to be maintained in fingolimod-treated patients .", "fingolimod @ mg may improve hrqol and depression at @ months compared with placebo in patients with relapsing ms." ]

[ "OBJECTIVE", "METHODS", "METHODS", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS" ]

[ "the aim of this work was to determine the ergogenic effects of a nucleotide supplement on the metabolic and immune responses to short term high intensity exercise in volunteer , trained , male subjects .", "thirty moderately trained male subjects were randomly divided into @ equal sized groups , control ( c ) , placebo ( p ) or experimental ( e ) .", "each subject undertook a @ min maximal exercise test prior to , and after @ days , on either a nucleotide ( e ) or placebo supplement .", "prior to exercise testing unstimulated saliva samples and blood samples were taken .", "saliva was analysed for cortisol and iga , while blood was analysed for lactate , lactate dehydrogenase and creatine kinase .", "the postexercise c value was significantly higher than the pre-exercise concentration ( p < @ ; for c , p , and e ) .", "in the postsupplement c analysis , the e postexercise group was significantly lower than either the c ( p < @ ) or the p group ( p < @ ) .", "in the pre - and postsupplementation periods , the pre-exercise siga values were significantly higher than the postexercise values ( p < @ ) .", "however , in the postsupplementation period , the siga value in the e group was significantly higher than either the p ( p < @ ) or c ( p < @ ) groups .", "there were no significant changes in blood lactate , lactate dehydrogenase , or creatine kinase concentrations post supplementation .", "we concluded that a chronically ingested nucleotide supplement blunts the response of the hormones associated with physiological stress ." ]

[ "OBJECTIVE", "METHODS", "METHODS", "RESULTS", "RESULTS", "RESULTS", "RESULTS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS", "CONCLUSIONS" ]

[ "to improve understanding of barriers to participation in community-based arthritis self-management programmes and patient preferences for self-management education .", "individuals with hip or knee oa referred to orthopaedic surgeons or rheumatologists at six public and private hospitals in victoria , australia , were recruited for a randomized controlled trial ( rct ) of the stanford arthritis self-management programme ( asmp ) .", "as part of the study design , potential participants were asked during the screening and recruitment process about reasons for being unable to attend the course , reasons for not participating in the study and individual preferences for course scheduling .", "of @ individuals assessed , @ ( @ % ) were unable to attend six asmp sessions .", "this was commonly due to physical limitations , including illness , restricted mobility and pain ( @ % ) , difficulty getting to or from courses ( @ % ) , work commitments ( @ % ) , the time commitment required ( @ % ) and family roles ( @ % ) .", "among those who did not want to participate in the study ( n = @ ) , the overwhelming reason was disinterest ( @ % ) .", "specific preferences for course scheduling were frequent , confirming the practical challenges faced in organizing courses for the rct .", "incorporating patients from public and private settings , this study has elicited new insights into barriers to asmp participation .", "many people with hip or knee oa have limited capacity and motivation to attend community-based group programmes .", "future self-management programmes and research should include more accessible options for those who can not attend group-based programmes .", "trial registration .", "australian new zealand clinical trials registry , http://www.anzctr.org.au/ , actrn@ ." ]