Datasets:

nanyy1025

/

pubmed_rct_200k

like 0

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

[ "to estimate whether doxycycline , a matrix metalloproteinase inhibitor , would decrease unscheduled bleeding associated with initiation of a continuous oral contraceptive pill .", "participants initiating a continuous oral contraceptive pill ( @ micrograms of ethinyl estradiol/@ micrograms of levonorgestrel ) were randomly assigned to receive either doxycycline ( @ mg orally twice daily ) or placebo taken for @ days at the onset of each bleeding or spotting episode during the first @ days of the study period .", "for the final @ days of the study , participants were observed on the oral contraceptive pill alone .", "the primary outcome was the number of bleeding and spotting days .", "a sample size of @ ( @ in each arm ) was calculated to detect a @ % reduction in bleeding ( beta = @ , alpha = @ ) and accounted for a @ % dropout rate .", "sixty-six women were randomly assinged ( @ in each study group ) .", "there were no significant differences during the @-day treatment in bleeding or spotting days ( doxycycline [ mean { standard error } , placebo , p = @ ) or the length of the longest bleeding or spotting episode ( doxycycline , placebo , p = @ ) between study groups .", "similarly , no significant differences in bleeding patterns existed between groups during the final @ days .", "doxycycline , administered once bleeding has started , does not decrease unscheduled bleeding or shorten episodes of unscheduled bleeding in continuous oral contraceptive pill users .", "i." ]

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

[ "the purpose of this study was to evaluate the effect of metronidazole treatment on the incidence of postoperative pelvic inflammatory disease after first-trimester abortion in women with bacterial vaginosis .", "a double-blind , randomized , multicenter study was conducted on @ women undergoing first-trimester legal abortion and fulfilling the criteria for bacterial vaginosis .", "the women were randomized to either metronidazole @ mg three times daily for @ days or placebo .", "treatment was started at the outpatient visit the week before the operation .", "among the @ women who could be evaluated , pelvic inflammatory disease developed in @ after the abortion .", "in the treatment group there were three infections ( @ % ) compared with @ ( @ % ) in the placebo group ( p less than @ ) .", "these data suggest that patients with bacterial vaginosis should be treated in conjunction with first-trimester abortion because treatment with metronidazole reduces the postoperative infection rate more than three times ." ]

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

[ "prospective studies have shown that c-reactive protein ( crp ) can be used to predict risk of future cardiovascular events .", "high-sensitivity methods for crp ( hs-crp ) measurement are needed for this purpose .", "we compared the clinical efficacy of an automated and commercially available latex-enhanced assay ( latex ) for hs-crp ( dade behring ) to a validated in-house elisa , previously shown to predict future peripheral arterial disease ( pad ) in asymptomatic populations .", "using a prospective , nested , case-control design , we measured baseline hs-crp concentrations in @ apparently healthy men who subsequently developed symptomatic pad and @ age - and smoking habit-matched controls who remained free of vascular disease over the follow-up period of @ months .", "the two hs-crp assays correlated highly ( r = @ ; p < @ ) , and all but two participants were classified into concordant quartiles or varied by only one quartile .", "the median hs-crp of the case group was significantly higher than that of controls when measured by either the elisa ( @ vs @ mg/l ; p = @ ) or the latex method ( @ vs @ mg/l ; p = @ ) .", "furthermore , for both elisa and the latex method , the calculated relative risks of developing pad increased significantly with each increasing quartile of hs-crp .", "the calculated interquartile increase in relative risk of pad was @ % ( @ % confidence interval , @-@ @ % ; p = @ ) for elisa and @ % ( @ % confidence interval , @-@ @ % ; p = @ ) for the latex method .", "our findings indicate that the latex method is equally as efficacious as the validated elisa in classifying patients into cutoff points established by prospective studies for risk stratification for coronary and cerebrovascular disease ." ]

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

[ "to investigate the efficacy of letrozole for delaying bone maturation and increasing predicted adult height in boys with idiopathic central precocious puberty ( icpp ) who have a bone age above @ years and a short stature , and its adverse effects .", "twenty icpp boys with a bone age above @ years and a short stature were randomly divided into letrozole treatment ( n = @ ) and control groups ( n = @ ) .", "the letrozole treatment group received oral letrozole [ @ mg / ( m ( @ ) d ) , qd ] for @ months , while the control group received no treatment and was observed periodically .", "bone age , growth rate , height standard deviation ( sd ) score , predicted adult height sd score , sexual maturity , and levels of follicle-stimulating hormone ( fsh ) , luteinizing hormone ( lh ) , dehydroepiandrosterone , testosterone ( t ) , estradiol ( e@ ) , progesterone ( p ) , and androstenedione ( asd ) were measured .", "the letrozole-related adverse reactions were evaluated .", "after @ months of treatment , both groups had a significantly increased bone age , but the letrozole group had a significantly slowed increase in bone age compared with the control group ( @ @ years vs @ @ years ; p < @ ) ; compared with the control group , the letrozole group had a significantly increased predicted adult height sd score ( -@ @ vs -@ @ ; p < @ ) and a significantly increased t level ( @ @ nmol/l vs @ @ nmol/l ; p < @ ) .", "there was no significant difference in testicular volume between the two groups .", "the treatment led to no significant changes in growth rate , tanner stage , and levels of fsh , lh , p , e@ and asd in the two groups , and there was no significant difference in these indices between the two groups .", "no adverse reactions were observed during letrozole treatment .", "letrozole delays bone maturation and increases predicted adult height in icpp boys with a bone age above @ years and a short stature , and it causes no obvious adverse reactions ." ]

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

[ "to compare success rates , complications , and efficiency of suprapubic bladder aspiration with urethral catheterization in ill infants .", "prospective , randomized clinical study .", "the pediatric emergency department at the university of mississippi medical center in jackson .", "convenience sample of infants under @ months of age requiring an uncontaminated urine specimen for the evaluation of febrile illness , suspected urinary tract infection , or sepsis .", "infants with wet diapers were excluded .", "patients were randomized to undergo timed suprapubic bladder aspiration ( performed by a physician and a nurse ) or urethral catheterization ( performed by two nurses ) .", "if suprapubic bladder aspiration was unsuccessful , urethral catheterization was performed immediately and the bladder was drained ; emptying volume was recorded .", "all patients had a next-void `` bag '' urinalysis performed for post-procedure hematuria .", "fifty patients underwent primary suprapubic bladder aspiration .", "the success rate ( defined by obtaining at least @ ml of urine ) was @ % .", "mean + / - sd time per successful suprapubic bladder aspiration was @ + / - @ seconds .", "fifty patients underwent primary urethral catheterization .", "the success rate was @ % ; the mean time required was @ + / - @ seconds .", "after failed suprapubic bladder aspiration , urethral catheterization was @ % successful , with a mean draining volume of @ + / - @ ml .", "no immediate problems were identified among any instrumented patients ; later complications ( next-void hematuria after either procedure , other visceral injury with suprapubic bladder aspiration ) were not detected .", "both suprapubic bladder aspiration and urethral catheterization afford the emergency physician low-risk access to uncontaminated urine in ill infants .", "suprapubic bladder aspiration is less efficient in that it requires physician participation and failure rates are higher .", "these data suggest that successful suprapubic bladder aspiration is primarily dependent on the volume of urine in the bladder ; thus , in the ill or febrile ed infant who may be dehydrated , the likelihood of success decreases .", "the authors recommend that ed nursing and physician staff become comfortable with performing urethral catheterization on infants ." ]

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

[ "chronic obstructive pulmonary disease ( copd ) is a progressive , smoking-related , inflammatory lung disease in which tumor necrosis factor-alpha is overexpressed and has been suggested to play a pathogenic role .", "to determine if infliximab , an anti-tnf-alpha antibody , results in clinical benefit and has an acceptable safety profile in patients with moderate to severe copd .", "in a multicenter , randomized , double-blind , placebo-controlled , parallel-group , dose-finding study , subjects with moderate to severe copd received infliximab ( @ mg/kg [ n = @ ] or @ mg/kg [ n = @ ] ) or placebo ( n = @ ) at weeks @ , @ , @ , @ , @ , and @ .", "efficacy , health status , and safety were assessed through week @ .", "infliximab was generally well tolerated , but showed no treatment benefit as measured by the primary endpoint , chronic respiratory questionnaire total score .", "similarly , there was no change in secondary measures , including prebronchodilator fev ( @ ) , @-min walk distance , sf-@ physical score , transition dyspnea index , or moderate-to-severe copd exacerbations .", "post hoc analysis revealed that subjects who were younger or cachectic showed improvement in the @-min walk distance .", "malignancies were diagnosed during the study in @ of @ infliximab-treated subjects versus @ of @ placebo-treated subjects .", "no opportunistic infections were observed , and there were no differences in the occurrence of antibiotic-requiring infections , although the incidence of pneumonia was higher in infliximab-treated subjects .", "no infection-related mortality was observed .", "higher proportions of infliximab-treated subjects discontinued the study agent due to adverse events ( @-@ % ) than did placebo-treated subjects ( @ % ) .", "subjects with moderate to severe copd did not benefit from treatment with infliximab .", "although not statistically significant , more cases of cancer and pneumonia were observed in the infliximab-treated subjects .", "the impact of infliximab on malignancy risk in patients with copd needs to be further elucidated ." ]

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

[ "the purpose of the present study was to evaluate the effect of a relatively selective cyclooxygenase ( cox ) -@ inhibitor ( nimesulide ) and non-selective cox-@ / cox-@ inhibitor ( naproxen ) used as an adjunct to non-surgical ( scaling and root planing [ srp ] ) periodontal therapy in chronic periodontitis patients on the gingival tissue ( gt ) levels of prostaglandin ( pg ) e@ and pgf@alpha .", "thirty patients with chronic periodontitis were divided into @ groups of @ each .", "one group received @ mg of nimesulide ; one received @ mg of naproxen sodium ; and the third group received placebo tablets in a @ x @ regimen for @ days as an adjunct to srp .", "gt samples were obtained before drug intake and on day @ .", "plaque index ( pi ) and papillary bleeding index ( pbi ) scores were recorded at baseline , day @ , and at @ months ; probing depth ( pd ) and clinical attachment level ( cal ) were recorded at baseline and at @ months .", "the levels of pge@ were detected using an enzyme immunoassay ( eia ) , and the levels of pgf@alpha were analyzed by radioimmunoassay ( ria ) .", "differences among and within the groups were assessed using non-parametric statistical analysis .", "ten periodontally healthy individuals served as controls .", "all @ groups showed statistically significant reductions in pbi and pi on day @ and at @ months ( p < @ ) , and in pd and cal at @ months ( p < @ , p < @ , respectively ) .", "in the naproxen group , gt pge@ levels exhibited a significant decrease ( p < @ ) .", "however , the decrease of gt pge@ levels in the nimesulide group was insignificant ( p > @ ) , while a significant increase was observed in the placebo group ( p < @ ) on day @ .", "both the nimesulide and naproxen groups showed a significant decrease ( p < @ ) in pgf@alpha level , while the placebo group showed a significant increase ( p < @ ) .", "nimesulides , relatively selective cox-@ inhibitors , may have additional inhibitory effects on gt pgf@alpha levels in the first week following non-surgical periodontal treatment .", "however , nimesulide has an insignificant effect on reducing pge@ levels in gingival tissue .", "the determination of gt levels of cox-@ and cox-@ enzymes as well as pge@ and pgf@alpha in long-term studies may provide further support for the adjunctive use of selective cox-@ inhibitors in treatment of chronic periodontitis ." ]

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

[ "hemodilution induced by cardiopulmonary bypass ( cpb ) often prevents open heart operations without blood transfusion because of a large cpb-priming volume .", "a vacuum-assisted venous drainage system appears to overcome this problem and our previous experimental study demonstrated the beneficial effect of a vacuum-assisted cpb with a pressure relief valve .", "in this study , we clinically applied this novel system , and evaluated its efficacy by comparing it with the results of a conventional siphon-dependent drainage system .", "sixty patients undergoing open heart operation were divided into group v ( vacuum-assisted system , n = @ ) and group s ( siphon-dependent system , n = @ ) .", "the vacuum-assisted system contains a powerful vacuum generator and a pressure relief valve to keep the negative pressure in the reservoir constant when the blood suction is used .", "the cpb-priming volume was significantly smaller in group v ( v vs. s : @ + / -@ vs. @ + / -@ ml ; p < @ ) , resulting in the lower hemodilution in group v evidenced by the minimum hemoglobin level ( v vs. s : @ + / -@ vs. @ + / -@ mg/dl ; p < @ ) and blood transfusion rate ( v vs. s : @ vs. @ % ; p < @ ) .", "there were no significant differences in the plasma free hemoglobin level and the reduction ratio of plasma haptoglobin between the groups .", "these data demonstrate that this vacuum-assisted cpb can provide simplification of the cpb circuit , resulting in a smaller cpb-priming volume and lower hemodilution .", "this vacuum-assisted cpb may attenuate the negative effect of cpb by minimizing hemodilution and appears to be a useful modification to accomplish no blood-requiring open heart operations ." ]

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

[ "to compare ondansetron and domperidone for treatment of delayed nausea/vomiting ( dn/v ) following highly emetogenic chemotherapy , after attaining total suppression of emesis on the day of chemotherapy by mean of ondansetron ( combined with dexamethasone in the case of cisplatin-treated patients ) .", "domperidone ( @ x @ mg daily ) was compared with ondansetron ( @ x @ mg daily ) in a randomized double-bind placebo-controlled study .", "out of @ consecutive patients who received a first course of either cyclophosphamide and cisplatin for advanced stage ovarian cancer or cyclophosphamide , doxorubicin and @-fluoro-uracil for metastatic breast carcinoma , @ patients were eligible for entering the study .", "according to data from the literature these chemotherapeutic regimens with induce dn/v to a comparable degree .", "the patients were questioned daily from day @ through day @ by the same investigator and the severity of nausea or vomiting was scored on a numerical scale .", "emesis was totally suppressed in all patients on the day of chemotherapy .", "as to dn/v , @ out of @ patients receiving placebo required `` rescue '' medication versus none in the other two groups ( p < @ ) .", "only @ ( @ % ) patients were symptomatic with domperidone versus @ ( @ % ) symptomatic patients in the ondansetron-treated group ( p < @ ) .", "both drugs are effective , but domperidone ( @ x @ mg ) is more effective than ondansetron ( @ x @ mg ) for the prevention of the delayed nausea and/or vomiting which occur after highly emetogenic chemotherapy ( p < @ ) ." ]

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

[ "during spinal surgery , intraoperative monitoring of motor-evoked potentials ( meps ) is a useful means of assessing the intraoperative integrity of corticospinal pathways .", "however , meps are known to be particularly sensitive to the suppressive effects of inhalational halogenated anesthetic agents .", "to investigate the effects of increasing end-tidal concentrations of desflurane and sevoflurane anesthesia in a background of propofol and remifentanil with multipulse cortical stimulation on intraoperative monitoring of meps .", "in this randomized crossover trial , @ consecutive patients ( @ in each arm ) undergoing major spine surgery , under a background anesthetic of propofol ( @ to @ mcg/kg/min ) and remifentanil ( @ to @ mcg/kg/min ) , were randomly assigned to receive the sequence of inhalational agents studied : either des-sevo ( desflurane followed by sevoflurane ) ; or sevo-des ( sevoflurane followed by desflurane ) .", "multiples ( @ , @ , and @ ) of minimum alveolar concentration ( mac ) of desflurane and sevoflurane were administered .", "after a washout period of @ minutes using high fresh oxygen/air flows , each of the patients then received the other gas as the second agent .", "cortical stimulation was achieved with a train of @ equivalent square pulses , each @ ms in duration , delivered at @ ms intervals .", "mep recordings were made in the upper limb ( ul ) from first dorsal interosseus and lower limb ( ll ) from tibialis anterior with subdermal needle electrodes .", "at @ mac desflurane , there was no statistical significant difference in transcranial-evoked mep amplitudes from the baseline in both ul and ll stimulation .", "however , this was not the case for sevoflurane for which even a low concentration at @ mac significantly depressed mep amplitudes of ll ( but not ul ) from baseline value .", "desflurane at @ and @ mac depresses ll mep to @ % and @ % of baseline , respectively ( p < @ ) , whereas sevoflurane at @ , @ , and @ mac depresses ll mep to @ % , @ % , and @ % of baseline , respectively ( p < @ ) .", "there was no difference in latency of the responses at any mac .", "inhalational anesthetic agents ( sevoflurane > desflurane ) suppress mep amplitudes in a dose-dependent manner .", "the use of @ mac of desflurane ( but not sevoflurane ) provided good mep recordings acceptable for clinical interpretation for both upper and lls .", "the ll appears to be more sensitive to anesthetic-induced depression compared with the ul .", "all patients studied had normal neurological examination hence , these results may not be applicable to those with preexisting deficits ." ]

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

[ "to determine the effectiveness of amisulpride on depression in patients with schizophrenia , in comparison to risperidone .", "in this open-label , @-week study , patients with stable schizophrenia and a comorbid major or minor depressive episode ( dsm-iv ) taking risperidone were randomized into a risperidone-continuation group ( n = @ ) or an amisulpride-switch group ( n = @ ) .", "the main outcome measures were changes from baseline on the calgary depression scale for schizophrenia ( cdss ) and the beck depression inventory ( bdi ) .", "secondary efficacy measures included the positive and negative syndrome scale ( panss ) , and the global assessment of functioning .", "safety measures included treatment-emergent adverse events and extrapyramidal symptoms .", "the mean dose at endpoint was @ mg/day for risperidone and @ mg/day for amisulpride .", "improvements in the cdss and bdi scores were significantly greater in the amisulpride-switch group than in the risperidone-continuation group at weeks @ and @ , and at the endpoint .", "the amisulpride-switch group also showed a significantly greater reduction in the score for the panss depression/anxiety factor , and the total score from baseline to endpoint .", "no significant difference was observed between the two groups for treatment-emergent adverse events or change from baseline for extrapyramidal symptoms .", "switching from risperidone to amisulpride in patients with stable schizophrenia with comorbid depression improved depressive symptoms significantly compared to continuing with risperidone ." ]

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

[ "prolonged wakefulness impairs sustained vigilant attention , measured with the psychomotor vigilance task ( pvt ) , and induces a compensatory increase in sleep intensity in recovery sleep , quantified by slow-wave activity ( swa ) in the sleep electroencephalogram ( eeg ) .", "these effects of sleep deprivation are counteracted by the adenosine receptor antagonist caffeine , implying involvement of the adenosine neuromodulator/receptor system .", "to examine a role for adenosine a ( @a ) receptors , we investigated whether variation of the a ( @a ) receptor gene ( adora@a ) modified effects of caffeine on pvt and swa after sleep deprivation .", "a haplotype analysis of eight single-nucleotide polymorphisms of adora@a was performed in @ volunteers .", "in @ young men carrying five different allele combinations , we investigated the effects of prolonged waking and @ @ mg caffeine or @ @ mg modafinil on psychomotor vigilance , sleepiness , and the waking and sleep eeg .", "throughout extended wakefulness , the carriers of haplotype ht@ performed faster on the pvt than carriers of non-ht@ haplotype alleles .", "in haplotype ht@ , caffeine failed to counteract the waking-induced impairment of pvt performance and the rebound of swa in recovery sleep .", "however , caffeine was effective in non-ht@ allele carriers , and modafinil reduced the consequences of prolonged waking , independently of adora@a haplotype .", "common genetic variation of adora@a is an important determinant of psychomotor vigilance in rested and sleep-deprived state .", "it also modulates individual responses to caffeine after sleep deprivation .", "these findings demonstrate a role for adenosine a ( @a ) receptors in the effects of prolonged wakefulness on vigilant attention and the sleep eeg ." ]

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

[ "numerous medical and physiological conditions that might alter electroencephalography ( eeg ) , such as hypoglycaemia , hypothermia or hypovolaemia , were shown to result in the bispectral index ( bis ) indicating an incorrect hypnotic state .", "recently , acute normovolaemic haemodilution ( anh ) was shown to be associated with significant impairment of cognitive functions that could alter eeg and consequently bis monitoring , an eeg derived parameter .", "in a randomised clinical study , we assessed the effect of anh on bis monitoring before induction and after propofol target controlled infusion ( tci ) anaesthesia in @ unmedicated patients randomly allocated to anh with oxygen insufflation ( oxygen group ) , anh with air insufflation ( air group ) , or control group .", "with anh , mean bis values briefly declined in the oxygen group ( @ + / -@ ) and air group ( @ + / -@ ) before returning to baseline values .", "the loss of consciousness time was significantly shorter , with fewer propofol tci dose requirements , and bis was significantly higher in the oxygen group ( @ + / -@ min , @ + / -@ microg/ml , @ + / -@ ) and air group ( @ + / -@ min , @ + / -@ microg/ml , @ + / -@ ) , compared with the control group ( @ + / -@ min , @ + / -@ microg/ml , @ + / -@ ) , respectively .", "whereas , there was no significant difference in bis values between the oxygen group ( @ + / -@ ) , air group ( @ + / -@ ) and control group ( @ + / -@ ) at propofol tci @ microg/ml anaesthesia maintenance .", "bis values briefly declined with anh before returning to baseline values before anaesthesia induction .", "despite transient anh enhancement of propofol effect during induction , there was no significant difference in bis values with or without anh during propofol maintenance of anaesthesia ." ]

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

[ "the effects of aneurysm treatment modality ( clipping or coiling ) on the incidence of cerebral vasospasm and infarction after subarachnoid hemorrhage have not been clearly defined .", "we hypothesized that there may be a difference in angiographic and clinical vasospasm , cerebral infarction , and clinical outcome between patients undergoing clipping compared to coiling .", "a retrospective , exploratory analysis of @ patients randomized into the conscious-@ trial was conducted .", "patients underwent baseline and follow-up catheter angiography and computed tomography , as well as clinical assessments .", "radiology end points were adjudicated by central blinded review , and angiographic vasospasm was quantified by measurements of arterial diameters on catheter angiography .", "the effect of method of aneurysm treatment ( clipping [ n = @ ] or coiling [ n = @ ] ) on angiographic vasospasm , delayed ischemic neurological deficit , cerebral infarction , and clinical outcome was analyzed using univariate and multivariate logistic regression .", "propensity matching was used to adjust for differences in baseline risk factors between clipped and coiled patients .", "in all patients and the propensity-matched subset , aneurysm coiling was associated with a significantly reduced risk of angiographic vasospasm and delayed ischemic neurological deficit compared to clipping .", "cerebral infarction and clinical outcome were not associated with clipping or coiling .", "in this exploratory analysis , aneurysm coiling was associated with less angiographic vasospasm and delayed ischemic neurological deficit than surgical clipping , whereas no effect on cerebral infarction or clinical outcome was observed .", "whether this is attributable to differences in baseline risk factors between clipped and coiled patients or a true difference can not be proven here ." ]

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

[ "patients with becker muscular dystrophy ( bmd ) and duchenne muscular dystrophy lack neuronal nitric oxide synthase ( nnos ) .", "nnos mediates physiological sympatholysis , thus ensuring adequate blood supply to working muscle .", "in mice lacking dystrophin , restoration of nnos effects by a phosphodiesterase @ ( pde@ ) inhibitor ( sildenafil ) improves skeletal and cardiac muscle performance .", "sildenafil also improves blood flow in patients with bmd .", "we therefore hypothesized that sildenafil would improve blood flow , maximal work capacity , and heart function in patients with bmd .", "a randomized , double-blind , placebo-controlled crossover design with two @-week periods of treatment , separated by @-week washout was used .", "we assessed brachial artery blood flow during maximal handgrip exercise , @-minute walk test , maximal oxidative capacity , and life quality ; cardiac function was evaluated by magnetic resonance imaging ( mri ) at rest and during maximal handgrip exercise .", "muscle nnos and pde@ were tested with western blotting in @ patients .", "sixteen patients completed all skeletal muscle evaluations , and @ completed the cardiac mri investigations .", "sildenafil had no effect on any of the outcome parameters .", "no serious adverse effects were recorded .", "pde@ and nnos were deficient in @ of @ biopsies .", "despite positive evidence from animal models of dystrophinopathy and physiological findings in patients with bmd , this double-blind , placebo-controlled clinical study showed no effect of sildenafil on blood flow , maximal work capacity , and heart function in adults with bmd .", "this discrepancy may be explained by a significant downregulation of pde@ in muscle ." ]

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

[ "to observe the clinical efficacy of yiqi fumai injection ( yfi ) combined hydroxychloroquine sulfate tablet in the treatment of sjogren 's syndrome patients .", "eighty patients were randomly assigned to three groups .", "forty patients in group a were treated with yfi alone , @ g yfi added in @ ml normal saline for intravenous dripping , once daily .", "twenty patients in group b took hydroxychloroquine sulfate alone , @ g each time , twice daily .", "twenty patients in group c were treated with yfi and hydroxychloroquine sulfate tablet ( with the same dose and dosage as group a and b ) .", "fifteen days was taken as one course of treatment .", "the scores for dry mouth and dry eyes , the efficacy on salivary flow rate , schirmer test , erythrocyte sedimentation rate ( esr ) , c-reactive protein ( crp ) , and igg , and so on were compared among the three groups before and after treatment .", "there was no significant difference in the laboratory parameters and clinical symptoms among the three groups before treatment .", "after treatment obvious improvement of the scores for dry mouth , the salivary flow rate , schirmer test , esr , crp , and igg was shown in all the @ groups ( p < @ ) .", "besides , the optimal effect was shown in group c. its total effective rate was @ % ( @/@ ) , better than that of group a [ @ % ( @/@ ) ] and group b [ @ % ( @/@ ) ] , with no statistical difference ( chi@ = @ and @ , p > @ ) .", "yfu combined hydroxychloroquine sulfate tablet showed better effects in treating sjogren 's syndrome patients than using chinese medicine or western medicine alone ." ]

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

[ "to identify the clinical and laboratory predictors of clinical improvement in a cohort of myositis patients treated with rituximab .", "we analyzed data for @ patients with myositis ( @ with adult polymyositis [ pm ] , @ with adult dermatomyositis [ dm ] , and @ with juvenile dm ) in the rituximab in myositis trial .", "clinical improvement was defined as @ % improvement in at least @ of the following @ core set measures of disease activity : physician 's and patient 's / parent 's global assessment of disease activity , manual muscle testing , physical function , muscle enzymes , and extramuscular disease activity .", "we analyzed the association of the following baseline variables with improvement : myositis clinical subgroup , demographics , myositis damage , clinical and laboratory parameters , core set measures , rituximab treatment , and myositis autoantibodies ( antisynthetase , anti-mi-@ , anti-signal recognition particle , anti-transcription intermediary factor @ [ tif-@ ] , anti-mj , other autoantibodies , and no autoantibodies ) .", "all measures were univariately assessed for association with improvement using time-to-event analyses .", "a multivariable time-dependent proportional hazards model was used to evaluate the association of individual predictive factors with improvement .", "in the final multivariable model , the presence of an antisynthetase , primarily anti-jo-@ ( hazard ratio [ hr ] @ , p < @ ) , anti-mi-@ ( hr @ , p < @ ) , or other autoantibody ( hr @ , p = @ ) predicted a shorter time to improvement compared to the absence of autoantibodies .", "a lower physician 's global assessment of damage ( hr @ , p = @ ) and juvenile dm ( versus adult myositis ) ( hr @ , p = @ ) also predicted improvement .", "unlike autoantibody status , the predictive effect of physician 's global assessment of damage and juvenile dm diminished by week @ .", "rituximab treatment did not affect these associations .", "our findings indicate that the presence of antisynthetase and anti-mi-@ autoantibodies , juvenile dm subset , and lower disease damage strongly predict clinical improvement in patients with refractory myositis ." ]

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

[ "to assess treatment discontinuation and concomitant use of other antipsychotics among individuals initiated on olanzapine or risperidone for the treatment of schizophrenia .", "using data from the quebec health insurance plan and the quebec database for hospitalization , we conducted a population-based cohort study of patients for whom a first claim for olanzapine or risperidone was submitted between @ january @ and @ august @ .", "included were @ patients with schizophrenia whom we followed from the date of the first claim for olanzapine or risperidone either to discontinuation date , end of eligibility for the drug plan , @ days , date of moving out of the province , or date of death .", "we used cox regression models to compute hazards ratios ( hrs ) of having the treatment discontinued and logistic regression models to compute odds ratios ( ors ) among persisting patients of having any concomitant antipsychotic prescription .", "all models were adjusted for age , sex , schizophrenia disorder , comorbidity , region , beneficiary type , substance use disorder , and prior hospitalization for mental illness .", "compared with risperidone users ( n = @ ) , discontinuation rates were lower for olanzapine users ( n = @ ; hr = @ ; @ % ci , @ to @ ) .", "the odds of receiving any concomitant antipsychotic prescription did not differ statistically between olanzapine and risperidone users ( or @ ; @ % ci , @ to @ ) .", "the study results suggest that new users of olanzapine were less likely to discontinue their initial treatment than were new users of risperidone , although discontinuation was high in both groups .", "among those who persisted , concomitant use of other antipsychotics did not differ between olanzapine users and risperidone users ." ]

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

[ "to compare closure times , cuff healing , and postoperative dyspareunia between barbed and traditional sutures during laparoscopic total hysterectomy .", "a randomized clinical trial ( canadian task force classification i ) .", "a university hospital .", "sixty-three women undergoing total laparoscopic hysterectomy .", "total laparoscopic hysterectomy was performed using standard techniques .", "the vaginal cuff closure method was randomized to barbed suture ( quill ; angiotech pharmaceuticals , inc. , vancouver , canada ) or standard suture ( vicryl ; ethicon inc. , somerville , nj ) .", "the time required for cuff closure was documented .", "patients were examined postoperatively to assess cuff healing , and a standardized sexual function questionnaire was administered preoperatively and at @ months postoperatively .", "the mean vaginal cuff closure time was @ minutes versus @ minutes in the barbed versus standard suture group ( p = @ ) .", "cuff healing appeared similar between the @ groups .", "rates of dyspareunia , partner dyspareunia , and sexual function were similar in both groups at @ months postoperatively .", "vaginal cuff closure times were significantly faster among attendings compared with residents/fellows ( @ vs. @ minutes , respectively ; p < @ ) .", "the study was designed to have a statistical power of @ % to detect a difference of @ minutes in cuff closure time between the @ groups ( level of @ ) .", "laparoscopic vaginal cuff closure times are similar when using barbed sutures and braided sutures ." ]

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

[ "the veterans health administration ( vha ) oversees the largest integrated healthcare system in the united states .", "the feasibility of a large-scale , nationwide , group-randomized implementation trial of vha outpatient practices has not been reported .", "we describe the recruitment and enrollment of such a trial testing a clinician-directed , internet-delivered intervention for improving the care of postmyocardial infarction patients with multiple comorbidities .", "with a recruitment goal of @ eligible community-based outpatient clinics , parent vha facilities ( medical centers ) were recruited because they oversee their affiliated clinics and the research conducted there .", "eligible facilities had at least four vha-owned and - operated primary care clinics , an affiliated institutional review board ( irb ) , and no ongoing , potentially overlapping , quality-improvement study .", "between december @ and december @ , in two consecutive phases , we used initial and then intensified recruitment strategies .", "overall , @ of @ ( @ % ) eligible facilities were recruited .", "of the @ clinics and @ clinicians associated with the @ facilities , @ ( @ % ) clinics and @ ( @ % ) clinicians participated .", "the median time from initial facility contact to clinic enrollment was @ days , which decreased by over one-third from the first to the second recruitment phase ( medians : @ and @ days , respectively ; p < @ ) , when more structured recruitment with physician recruiters was implemented and a dedicated irb manager was added to the coordinating center staff .", "large group-randomized trials benefit from having dedicated physician investigators and irb personnel involved in recruitment .", "a large-scale , nationally representative , group-randomized trial of community-based clinics is feasible within the vha or a similar national healthcare system ." ]

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

[ "computerized reminder systems increase influenza and pneumococcal vaccination rates , but computerized standing order systems have not been previously described or evaluated .", "to determine the effects of computerized physician standing orders compared with physician reminders on inpatient vaccination rates .", "randomized trial of @ general medicine patients discharged from @ of @ study wards during a @-month period ( november @ , @ , through december @ , @ ) composed of @ overlapping influenza seasons at an urban public teaching hospital .", "the hospital 's computerized physician order entry system identified inpatients eligible for influenza and pneumococcal vaccination .", "for patients with standing orders , the system automatically produced vaccine orders directed to nurses at the time of patient discharge .", "for patients with reminders , the computer system provided reminders to physicians that included vaccine orders during routine order entry sessions .", "vaccine administration .", "during the approximately @ months of the influenza season , @ % of all hospitalized patients were identified as eligible for influenza vaccination .", "twenty-two percent of patients hospitalized during the entire @ months of the study were found eligible for pneumococcal vaccination .", "patients with standing orders received an influenza vaccine significantly more often ( @ % ) than those patients with reminders ( @ % ) ( p < @ ) .", "patients with standing orders received a pneumococcal vaccine significantly more often ( @ % ) than those with reminders ( @ % ) ( p < @ ) .", "computerized standing orders were more effective than computerized reminders for increasing both influenza and pneumococcal vaccine administration .", "our findings suggest that computerized standing orders should be used more widely for this purpose ." ]

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

[ "to determine whether use of a single heat and moisture exchanger ( hme ) for < or = @ hrs affects efficiency , resistance , level of bacterial colonization , frequency rate of nosocomial pneumonia , and cost compared with changing the hme every @ hrs .", "prospective , controlled , randomized , unblinded study .", "surgical intensive care unit at a university teaching hospital .", "a total of @ consecutive patients requiring mechanical ventilation for > @ hrs .", "patients were randomized to one of three groups : a ) hygroscopic hme ( aqua + ) changed every @ hrs ( hhme-@ ) ; b ) hydrophobic hme ( duration hme ) changed every @ hrs ( hme-@ ) ; and c ) hygroscopic hme ( aqua + ) changed every @ hrs ( hhme-@ ) .", "devices in all groups could be changed at the discretion of the staff when signs of occlusion or increased resistance were identified .", "daily measurements of inspired gas temperature , inspired relative humidity , and device resistance were made .", "additionally , daily cultures of the patient side of the device were accomplished .", "the frequency rate of nosocomial pneumonia was made by using clinical criteria .", "ventilatory support variables , airway care , device costs , and clinical indicators of humidification efficiency ( sputum volume , sputum efficiency ) were also recorded .", "prolonged use of both hygroscopic and hydrophobic devices did not diminish efficiency or increase resistance .", "there was no difference in the number of colony-forming units from device cultures over the @-day period and no difference between colony-forming units in devices changed every @ hrs compared with devices changed after @ hrs .", "the average duration of use was @ + / -@ hrs in the hhme-@ group , @ + / -@ hrs in the hme-@ group , and @ + / -@ hrs in the hhme-@ group .", "mean absolute humidity was greater for the hygroscopic devices ( @ + / -@ mg of h@o/l ) compared with the hydrophobic devices ( @ + / -@ mg of h@o/l ) .", "the frequency rate of nosocomial pneumonia was @ % ( @:@ ) in the hhme-@ group , @ % ( @:@ ) in the hme-@ group , and @ % ( @:@ ) in the hhme-@ group .", "pneumonia rates per @ ventilatory support days were @:@ in the hhme-@ group , @:@ in the hme-@ group , and @:@ in the hhme-@ group .", "costs per day were $ @ for the hhme-@ group , $ @ for the hme-@ group , and $ @ for the hhme-@ group .", "changing the hydrophobic or hygroscopic hme after @ days does not diminish efficiency , increase resistance , or alter bacterial colonization .", "the frequency rate of nosocomial pneumonia was also unchanged .", "use of hmes for > @ hrs , up to @ hrs , is safe and cost effective ." ]

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

[ "the prognostic utility of circulating plasma microrna in patients with acute coronary syndromes ( acs ) has been proposed but not yet demonstrated .", "we set out to investigate circulating microrna levels in patients incurring recent acs and examined associations with neurohormones , cardiac structure and function , and survival over @ years of follow-up .", "an initial screen of @ micrornas was performed in @ acs patients and @ healthy controls .", "candidates identified from the initial screen ( mir-@-@p , mir-@ , mir-@b , mir-@ and mir-@a ) were validated in a further cohort of @ patients at baseline ( ~ @ days post-acs ) and at @ and @ months post-acs , and compared with @ controls .", "in the validation cohort , significantly higher levels in patients were replicated for mir-@-@p , mir-@ and mir-@b ( @-fold , @-fold and @-fold , respectively , adjusted p < @ ) .", "lower levels of mir-@ were not replicated and mir-@a was undetectable .", "from baseline to @ months post-admission , mir-@-@p and mir-@ remained elevated in patients compared to controls ( adjusted p < @ ) , with no further change in levels between @ and @ months ; whereas mir-@b fell to control levels by @ months .", "baseline levels of mir-@ in the lowest tertile were significantly associated with readmission for heart failure ( log-rank p < @ ) .", "in combination with nt-probnp and lvef , mir-@ significantly improved risk stratification ( p < @ ) .", "our study identifies mir-@ as a novel candidate biomarker for post-acs prognosis beyond existing biomarkers of lvef and nt-probnp .", "moreover circulating mir-@-@p was markedly elevated in patients for at least a year post-acs and may be a stable biomarker for acs ." ]

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

[ "ongoing growth in health care expenditures and changing patterns in the demand for health care challenge societies worldwide .", "the chronic care model ( ccm ) , combined with classification for care needs based on kaiser permanente ( kp ) triangle , may offer a suitable framework for change .", "the aim of the present study is to investigate the effectiveness of embrace , a population-based model for integrated elderly care , regarding patient outcomes , service use , costs , and quality of care .", "the ccm and the kp triangle were translated to the dutch setting and adapted to the full elderly population living in the community .", "a randomized controlled trial with balanced allocation was designed to test the effectiveness of embrace .", "eligible elderly persons are @ years and older and enrolled with one of the participating general practitioner practices .", "based on scores on the intermed-elderly self-assessment and groningen frailty indicator , participants will be stratified into one of three strata : ( a ) robust ; ( b ) frail ; and ( c ) complex care needs .", "next , participants will be randomized per stratum to embrace or care as usual .", "embrace encompasses an elderly care team per general practitioner practice , an electronic elderly record system , decision support instruments , and a self-management support and prevention program - combined with care and support intensity levels increasing from stratum a to stratum c. primary outcome variables are patient outcomes , service use , costs , and quality of care .", "data will be collected at baseline , twelve months after starting date , and during the intervention period .", "this study could provide evidence for the effectiveness of embrace .", "the netherlands national trial register ntr@ ." ]

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

[ "to study the suppressive effect of inhalation of a selective beta @-adrenergic bronchodilator terbutaline , and the effect of an intravenous anticholinergic , atropine , on fentanyl-induced coughing .", "we studied @ asa class i patients , aged @-@ yr , scheduled for elective surgery , randomized into four groups .", "fifteen minutes before bolus fentanyl ( @ micrograms.kg-@ , iv ) , patients inhaled either normal saline ( @ ml ; group i , n = @ ) or terbutaline ( @ mg in @ ml normal saline ; group @ , n = @ ) via a jet nebulizer .", "after inhalation of normal saline , patients in group @ ( n = @ ) received sterile water iv instead of fentanyl .", "patients in group @ ( n = @ ) were pretreated with atropine ( @ mg.kg-@ , iv ) @ min before iv fentanyl bolus .", "the onset , frequency and intensity of cough were observed immediately by an anaesthetist blinded to the study .", "the cough frequency was higher in groups i ( @ % ) and @ ( @ % ) than in groups @ ( @ % ) and @ ( @ % ) ( p < @ ) .", "the onset time and intensity of cough showed no difference among groups .", "no truncal rigidity was observed in patients receiving fentanyl bolus iv .", "the blood pressure , heart rate , and peripheral oxygen saturation did not change in groups @ , @ , and @ , while patients in group @ showed an increase in heart rate ( @ + / - @ % ) .", "the inhalation of a selective beta @-adrenergic bronchodilator , terbutaline , effectively inhibited fentanyl-induced cough , whereas atropine , an antimuscarinic vagolytic , had no efficacy .", "our results suggest that bronchoconstriction may underlie the mechanism on fentanyl-induced cough ." ]

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

[ "this prospective randomized clinical study investigated the efficacy and safety of @ % hypertonic saline hydroxyethyl starch @/@ @ ( @ % nacl/hes @/@ @ ) in comparison with @ % mannitol in the treatment of increased intracranial pressure ( icp ) .", "forty neurosurgical patients at risk of increased icp were randomized to receive either @ % nacl/hes @/@ @ or @ % mannitol at a defined infusion rate , which was stopped when icp was < @ mmhg .", "of the @ patients , @ patients received @ % nacl/hes @/@ @ and @ received mannitol @ % .", "in eight patients , icp did not exceed @ mmhg so treatment was not necessary .", "both drugs decreased icp below @ mmhg ( p < @ ) ; @ % nacl/hes @/@ @ within @ ( @-@ @ ) min ( all results are presented as median ( minimum-maximum range ) ) and mannitol within @ ( @-@ @ ) min ( p < @ ) .", "@ % nacl/hes @/@ @ caused a greater decrease in icp than mannitol ( @ % vs @ % ; p < @ ) .", "the cerebral perfusion pressure was increased from @ ( @-@ ) mmhg to @ ( @-@ ) mmhg by infusion with @ % nacl/hes @/@ @ ( p < @ ) and from @ ( @-@ ) mmhg to @ ( @-@ ) mmhg with mannitol ( p < @ ) .", "the mean arterial pressure was increased by @ % during the infusion of @ % nacl/hes @/@ @ but was not altered by mannitol .", "there were no clinically relevant effects on electrolyte concentrations and osmolarity in the blood .", "the mean effective dose to achieve an icp below @ mmhg was @ ( @-@ @ ) ml/kg for @ % nacl/hes @/@ @ and @ ( @-@ @ ) ml/kg for mannitol ( p < @ ) .", "@ % nacl/hes @/@ @ is more effective than mannitol @ % in the treatment of increased icp .", "a dose of @ ml/kg of @ % nacl/hes @/@ @ can be recommended as effective and safe .", "the advantage of @ % nacl/hes @/@ @ might be explained by local osmotic effects , because there were no clinically relevant differences in hemodynamic clinical chemistry parameters ." ]

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

[ "low cognitive ability and developmental delays have been implicated in the causation of mental illness .", "to examine the prevalence , socio-demographic characteristics , psychopathology and social functioning profiles of people with low intelligence and recurrent psychotic illness .", "a multi-centre randomised controlled trial of case management provided the opportunity to explore associations between mental illness and borderline intellectual functioning ( assessed using the national adult reading test ) .", "overall prevalence of borderline intelligence was @ % .", "significant positive associations were shown with : being black caribbean ; having a father who worked in a manual occupation ; lower educational achievement ; having had special education ; longer course of illness .", "those with borderline intelligence had greater disability and were more likely to suffer extrapyramidal side-effects and show evidence of negative symptoms .", "educational achievement , history of special education and social class were the best socio-demographic predictors of intellectual level .", "many patients who attend generic psychiatric services have considerable intellectual deficits .", "this may lead to difficulties in other domains of adaptive functioning , and merits further investigation as well as clinical vigilance ." ]

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

[ "epidemiological studies suggest a protective effect of n-@ fatty acids derived from fish ( eicosapentaenoic acid [ epa ] and docosahexaenoic acid [ dha ] ) against cognitive decline .", "for - linolenic acid ( ala ) obtained from vegetable sources , the effect on cognitive decline is unknown .", "we examined the effect of n-@ fatty acid supplementation on cognitive decline in coronary heart disease patients .", "the analysis included @ coronary patients ( @ % men ) aged @ to @ years who participated in a double-blind placebo-controlled trial of n-@ fatty acids and cardiovascular diseases ( alpha omega trial ) .", "by using a @ @ factorial design , patients were randomly assigned to margarines that provided @ mg/d of epa-dha , @ g/d of ala , both epa-dha and ala , or placebo for @ months .", "cognitive function was assessed by the mini-mental state examination ( mmse ) at baseline and after @ months .", "the effect of n-@ fatty acids on change in mmse score was assessed using analysis of variance .", "logistic regression analysis was used to examine the effects on risk of cognitive decline , defined as a decrease of @ or more points in mmse score or incidence of dementia .", "patients in the active treatment groups had an additional intake of @ mg of epa-dha , @ g of ala , or both .", "the overall mmse score in this cohort was @ @ points , which decreased by @ @ points during follow-up .", "changes in mmse score during intervention did not differ significantly between epa-dha and placebo ( -@ vs -@ points , p = @ ) or between ala and placebo ( -@ vs -@ points , p = @ ) .", "the risk of cognitive decline was @ ( @ % confidence interval : @-@ @ , p = @ ) for epa-dha ( vs placebo ) and @ ( @-@ @ , p = @ ) for ala ( vs placebo ) .", "this large intervention study showed no effect of dietary doses of n-@ fatty acids on global cognitive decline in coronary heart disease patients ." ]

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

[ "very low-carbohydrate diets are widely used for weight loss yet few controlled studies have determined how these diets impact cardiovascular risk factors compared to more traditional low-fat weight loss diets .", "the primary purpose of this study was to compare a very low-carbohydrate and a low-fat diet on fasting blood lipids , ldl subclasses , postprandial lipemia , and insulin resistance in overweight and obese women .", "thirteen normolipidemic , moderately overweight ( body fat > @ % ) women were prescribed two hypocaloric ( -@ kcal/day ) diets for @ week periods , a very low-carbohydrate ( < @ % carbohydrate ) and a low-fat ( < @ % fat ) diet .", "the diets were consumed in a balanced and randomized fashion .", "two fasting blood draws were performed on separate days and an oral fat tolerance test was performed at baseline , after the very low-carbohydrate diet , and after the low-fat diet .", "compared to corresponding values after the very low-carbohydrate diet , fasting total cholesterol , ldl-c , and hdl-c were significantly ( p < or = @ ) lower , whereas fasting glucose , insulin , and insulin resistance ( calculated using the homeostatic model assessment ) were significantly higher after the low-fat diet .", "both diets significantly decreased postprandial lipemia and resulted in similar nonsignificant changes in the total cholesterol/hdl-c ratio , fasting triacylglycerols , oxidized ldl , and ldl subclass distribution .", "compared to a low-fat weight loss diet , a short-term very low-carbohydrate diet did not lower ldl-c but did prevent the decline in hdl-c and resulted in improved insulin sensitivity in overweight and obese , but otherwise healthy women .", "small decreases in body mass improved postprandial lipemia , and therefore cardiovascular risk , independent of diet composition ." ]

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

[ "more than @ % of stroke survivors experience residual deficits of the paretic upper limb/hand .", "standard rehabilitation generates modest gains .", "stimulation delivered to the surviving primary motor cortex in the stroke-affected hemisphere has been considered a promising adjunct .", "however , recent trials challenge its advantage .", "we discuss our pilot clinical trial that aims to address factors implicated in divergent success of the approach .", "we assess safety , feasibility and efficacy of targeting an alternate locus during rehabilitation - the premotor cortex .", "in anticipating variance across patients , we measure neural markers differentiating response from non-response .", "in a randomized , sham-controlled , double-blinded pilot clinical study , patients with chronic stroke ( n = @ ) are assigned to receive transcranial direct current stimulation delivered to the premotor cortex or sham during rehabilitation of the paretic arm/hand .", "patients receive the designated intervention for @ min , twice a day for @ days a week for @ weeks .", "we assess hand function and patients ' reports of use of paretic hand .", "a general linear mixed methods model will analyze changes from pre - to post-intervention .", "responders and non-responders will be compared upon baseline level of function , and neural substrates , including function and integrity of output tracts , bi-hemispheric balance , and lesion profile .", "incidence of adverse events will be compared using fisher 's exact test , while rigor of blinding will be assessed with chi-square analysis to ascertain feasibility .", "variable success of cortical stimulation in rehabilitation can be related to gaps in theoretical basis and clinical investigation .", "given that most patients with severe deficits have damage to the primary motor cortex or its output pathways , it would be futile to target stimulation to this site .", "we suggest targeting premotor cortex because it contributes substantially to descending output , a role that is amplified with greater damage to the motor cortex .", "with regards to clinical investigation , paired cortical stimulation in rehabilitation has been compared to rehabilitation alone in unblinded trials or to unconvincing sham conditions .", "transcranial direct current stimulation , a noninvasive technique of brain stimulation , which offers a more effective placebo and has a favorable safety-feasibility profile , may improve scientific rigor .", "neural markers of response would help inform patient selection for future clinical trials so we can address limitations of recent negative studies .", "nct@ ." ]

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

[ "to evaluate the effect of circumcision and/or antibiotic prophylaxis on periurethral flora and associated bacteriuria in male children with and without vesicoureteral reflux ( vur ) .", "the study included @ boys with low-grade vur and @ healthy boys ( control ) without vur .", "the boys with vur were randomized as antibiotic prophylaxis only and antibiotic prophylaxis plus circumcision .", "the boys without vur were randomized as circumcision group and followed-up group without circumcision .", "periurethral swab and urine cultures were obtained from the participants at the beginning of the study , and at @st , @rd , @th , @th , and @th month .", "the groups were compared in terms of positive periurethral and urine cultures .", "the positive periurethral culture rate was significantly lower in the circumcised boys at all measurement times .", "the positive urine culture rate in the circumcised boys was lower than in the uncircumcised boys .", "subgroup analysis based on age groups showed that age did not affect these statistical differences .", "circumcision decreases colonization of periurethral bacterial pathogenic flora .", "in boys with low-grade vur , circumcision plus antibiotic prophylaxis prevented recurrent and febrile urinary tract infections ." ]

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

[ "to evaluate the effectiveness of different brief intervention strategies at reducing hazardous or harmful drinking in the probation setting .", "offender managers were randomized to three interventions , each of which built on the previous one : feedback on screening outcome and a client information leaflet control group , @ min of structured brief advice and @ min of brief lifestyle counselling .", "a pragmatic multicentre factorial cluster randomized controlled trial .", "the primary outcome was self-reported hazardous or harmful drinking status measured by alcohol use disorders identification test ( audit ) at @ months ( negative status was a score of < @ ) .", "secondary outcomes were audit status at @ months , experience of alcohol-related problems , health utility , service utilization , readiness to change and reduction in conviction rates .", "follow-up rates were @ % at @ months and @ % at @ months .", "at both time points , there was no significant advantage of more intensive interventions compared with the control group in terms of audit status .", "those in the brief advice and brief lifestyle counselling intervention groups were statistically significantly less likely to reoffend ( @ and @ % , respectively ) than those in the client information leaflet group ( @ % ) in the year following intervention .", "brief advice or brief lifestyle counselling provided no additional benefit in reducing hazardous or harmful drinking compared with feedback on screening outcome and a client information leaflet .", "the impact of more intensive brief intervention on reoffending warrants further research ." ]

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

[ "the high levels of glucose , glucose degradation products ( gdps ) , and lactate buffer present in standard peritoneal dialysis ( pd ) solutions contribute to peritoneal damage , malnutrition , and dyslipidemia .", "therefore , we studied the feasibility of a pd regimen as low as possible in glucose and gdps .", "in a prospective @-week study , patients new to continuous ambulatory pd ( capd ) were randomized to either a standard pd regimen ( spd ; @ dwells glucose - / lactate-based ) or a low glucose-gdp regimen ( nepp ; @ dwell amino acids , @ dwell icodextrin , and two dwells bicarbonate/lactate-buffered glucose-based solution ) .", "results obtained during a @-week study period for @ new capd patients ( @ nepp , @ spd ) were analyzed .", "intraperitoneal glucose load was lower in the nepp group ( @ + / - @ vs @ + / - @ g/day at @ weeks , p < @ ) .", "dialysis efficacy , ultrafiltration , weight , blood pressure , and laboratory results were similar in the groups , whereas , in the nepp group , cancer antigen @ in dialysate effluents decreased less but dialysate-to-plasma ratios were slightly higher .", "short-term treatment of new capd patients with a pd regimen low in glucose and gdps is feasible .", "dialysis efficacy , ultrafiltration , and metabolic consequences are similar to those during a standard glucose-lactate-based regimen , whereas peritoneal transport seems slightly higher and preservation of mesothelial cell mass better during nepp ." ]

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

[ "the purpose of this study was to investigate whether the knee joint dynamics during a forward lunge could be modulated by experimentally induced vastus medialis pain in healthy subjects .", "randomised cross-over study .", "biomechanical movement laboratory .", "@ healthy subjects were included .", "one subject was excluded during data collection .", "the subjects performed forward lunges before , during and @ minutes after induction of experimental quadriceps muscle pain .", "muscle pain was induced using hypertonic saline ( @ % ) injected intramuscularly .", "isotonic saline ( @ % ) was used as control .", "three-dimensional movement analyses were performed and inverse dynamics were used to calculate joint kinematics and kinetics for ankle , knee and hip joints .", "electromyographic ( emg ) signals of the hamstrings and quadriceps muscles were recorded .", "during and after pain , significant decreases in knee joint dynamics and emg recordings were observed .", "the study shows that local pain in the quadriceps is capable of modulating movements with high knee joint dynamics .", "the results may have implications in the management of muscle pain and prevention of injuries during activities involving the knee joint ." ]

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

[ "the object of this study was to determine , taking into account uncertainty on cost and outcome parameters , the cost-effectiveness of high-dose chemotherapy ( hdc ) compared with conventional chemotherapy for advanced breast cancer patients .", "an analysis was conducted for @ patients included in a randomized clinical trial designed to evaluate the benefits , in terms of disease-free survival and overall survival , of adding a single course of hdc to a four-cycle conventional-dose chemotherapy for breast cancer patients with axillary lymph node invasion .", "costs were estimated from a detailed observation of physical quantities consumed , and the kaplan-meier method was used to evaluate mean survival times .", "incremental cost-effectiveness ratios were evaluated successively considering disease-free survival and overall survival outcomes .", "handling of uncertainty consisted in construction of confidence intervals for these ratios , using the truncated fieller method .", "the cost per disease-free life year gained was evaluated at @,@ euros , a value that seems to be acceptable to society .", "however , handling uncertainty shows that the upper bound of the confidence interval is around @,@ euros , which is nearly three times higher .", "moreover , as no difference was demonstrated in overall survival between treatments , cost-effectiveness analysis , that is a cost minimization , indicated that the intensive treatment is a dominated strategy involving an extra cost of @,@ euros , for no added benefit .", "adding a single course of hdc led to a clinical benefit in terms of disease-free survival for an additional cost that seems to be acceptable , considering the point estimate of the ratio .", "however , handling uncertainty indicates a maximum ratio for which conclusions have to be discussed ." ]

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

[ "the condition of patients after percutaneous transluminal angioplasty is influenced among others by the subsequent development of restenoses and reocclusions .", "the objective of the submitted work was to assess whether oral administration of heparan sulphate can influence the development of restenoses after percutaneous transluminal angioplasty in the pelvic and femoropopliteal region .", "@ patients ( @ men and @ women , age @-@ years ) were divided into four groups .", "percutaneous transluminal angioplasty was performed either on account stenosis in the aortoiliac or femoropopliteal area .", "( the original number was @ patients , @ patients were eliminated : the reasons were technical failure of the intervention procedure , reocclusion , the patient was lost from records . )", "as antiaggregant the patients were given acetylsalicylic acid , @ mg/day : patients included in the heparan group were given heparan sulphate ( hemovasal , manetti and roberts ) @ mg/day for a period of @ - @ months .", "as compared with controls , the patients treated with heparan sulphate had within the @ - @ month period a significantly longer claudication distance ( p < @ ) , a higher doppler index ( p < @ ) and maximal blood flow in the feet .", "heparan sulphate administration to patients after percutaneous transluminal angioplasty on account of stenosis of the aortoiliac or femoropopliteal area improves some angiological parameters which can suggest a slighter tendency of early restenosis ." ]

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

[ "the aim of screening is to detect a cancer in the preclinical state .", "however , a false-positive or a false-negative test result is a real possibility .", "we describe invasive breast cancer progression in the canadian national breast screening study and construct progression models with and without covariates .", "the effect of risk factors on transition intensities and false-negative probability is investigated .", "we estimate the transition rates , the sojourn time and sensitivity of diagnostic tests for women aged @-@ and @-@ .", "although younger women have a slower transition rate from healthy state to preclinical , their screen-detected tumour becomes evident sooner .", "women aged @-@ have a higher mortality rate compared with younger women .", "the mean sojourn times for women aged @-@ and @-@ are @ years ( @ % ci : @ , @ ) and @ years ( @ % ci : @ , @ ) , respectively .", "sensitivity of diagnostic procedures for older women is estimated to be @ ( @ % ci : @ , @ ) , while women aged @-@ have a lower sensitivity ( @ , @ % ci : @ , @ ) .", "age is the only factor that affects the false-negative probability .", "for women aged @-@ , ` age at entry ' , ` history of breast disease ' and ` families with breast cancer ' are found to be significant for some of the transition rates .", "for the age-group @-@ , ` age at entry ' , ` history of breast disease ' , ` menstruation length ' and ` number of live births ' are found to affect the transition rates .", "modelling and estimating the parameters of cancer progression are essential steps towards evaluating the effectiveness of screening policies .", "the parameters include the transition rates , the preclinical sojourn time , the sensitivity , and the effect of different risk factors on cancer progression ." ]

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

[ "glutathione s-transferases ( gsts ) are polymorphic superfamily of detoxification enzymes that detoxify therapeutic drugs and various carcinogens .", "we undertook a case-control study in northern indian population based sample consisting of @ patients and @ controls to evaluate association of null genotype in gstm@ and gstt@ along with polymorphism in gstp@ ( a -- > g ) with breast cancer risk .", "genotyping analyses were performed by pcr-based methods , and odds ratios ( ors ) were calculated by unconditional logistic regression analysis adjusting for various confounding factors .", "in this case-control study , we observed a positive correlation between family history of breast cancer and risk of breast cancer ( or = @ ; @ % ci = @-@ @ ) .", "we found a significantly increased breast cancer risk associated with gstm@ null genotype ( or = @ ; @ % ci = @-@ @ ) and homozygote mutants in gstp@ ( or = @ ; @ % ci = @-@ @ ) .", "however , we found no association between gstt@ null genotype with overall breast cancer risk ( or = @ ; @ % ci = @-@ @ ) .", "the three-way combination of gstp@ @aa/ag and null genotypes for both gstm@ and gstt@ resulted in fourfold increase in breast cancer risk ( or = @ ; @ % ci = @-@ @ ) .", "the findings of this study are in line with previously published reports that show an overall association with gstm@ and gstp@ polymorphisms with breast cancer risk .", "our results suggest that the variants in low penetrance genes such as gstm@ , gstt@ and gstp@ are associated with an increased breast cancer risk thereby suggesting their contribution in the etiology of breast cancer ." ]

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

[ "the absorption of irrigation fluid during transurethral resection of the prostate ( turp ) is determined primarily by hydrostatic pressure in the bladder and prostatic venous pressure .", "in comparison to spontaneously breathing patients , patients undergoing mechanical ventilation with positive pressure have a raised central venous pressure and a reduced venous return , both of which can influence intravascular absorption .", "the purpose of the prospective study was to compare the effects of general ( ga ) and spinal anaesthetic ( sa ) techniques on the perioperative absorption of irrigating fluid in patients undergoing turp .", "forty patients undergoing turp were randomised and assigned either to group ga or sa .", "irrigating fluid absorption was traced by adding @ % ( w/v ) ethanol to the irrigating fluid .", "perioperative blood ethanol concentration ( bec ) , haemoglobin concentration , haematocrit , serum sodium concentration and central venous pressure ( cvp ) were measured at @-min intervals during turp and at @-min intervals while patients were recovering .", "absorption routes were indexed by the bec and changes in serum sodium concentrations .", "where the bec was greater than @ mg.ml-@ , absorption of irrigating fluid was assumed .", "for assessing the volume of irrigating fluid absorbed , the maximum bec , the absorption rate , the area under the bec curve ( auc ) , and the volumes calculated according to the hahn nomogram ( volin ) for each patient were taken into consideration .", "there were @ cases of irrigating fluid absorption in patients receiving ga ( @ % ) , and @ in those receiving sa ( @ % ) .", "cvp was significantly lower in spontaneously breathing patients with sa as compared to those with ga ( p < @ ) .", "in patients with irrigating fluid absorption the maximum bec ( p < @ ) , as well as the rate of irrigant fluid absorption ( p < @ ) , were significantly higher amongst patients receiving sa .", "in this group , the calculated area under the curve and the absorbed fluid volumes determined with the nomogram were significantly increased ( p < @ ) .", "the absorption of irrigation fluid during the turp is significantly more marked amongst spontaneously breathing patients with regional anaesthesia in comparison to patients undergoing general anaesthesia with positive pressure ventilation .", "the markedly lower central venous pressure before the start of irrigation should be considered as a possible cause of this effect ." ]

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

[ "the use of placebo in clinical trials has been vigorously debated .", "placebo control may be useful in disease states , such as stage @ and stage @ hypertension as defined by the sixth report of the joint national committee on detection , evaluation and treatment of high blood pressure ( jnc vi ) , in which response rates for placebo are high or close to response rates for effective therapies , or when established interventions have significant adverse effects .", "to compare rates for the control of blood pressure and adverse effects of placebo vs active treatment in patients with stage @ and stage @ hypertension .", "this study is a randomized controlled trial evaluating the blood pressure response and adverse effects of placebo vs @ active treatments administered in @ veterans affairs hypertension centers .", "the @ subjects of the veterans affairs cooperative study receiving single-drug therapy for hypertension were randomly allocated to receive treatment with @ of @ active drugs ( n = @ ) or placebo ( n = @ ) .", "treatment success was defined as maintaining a diastolic blood pressure of less than @ mm hg for at least @ year .", "we compared treatment success rates for the control of blood pressure and adverse effects of placebo vs active treatment .", "using the kaplan-meier method , we also compared rates of discontinuation from placebo vs active drug treatment over time as a result of adverse drug effects and blood pressure exceeding safety limits .", "at the end of the titration phase , @ patients who were treated with placebo ( @ % ) achieved a goal diastolic blood pressure lower than @ mm hg and @ ( @ % ) achieved success at @ year .", "older white patients who received placebo had a success rate of @ % vs @ % to @ % for the other age-race subgroups .", "the rates of discontinuation as a result of adverse drug effects were @ % for patients receiving placebo vs @ % for patients receiving active treatment ( p = @ ) .", "the rates of discontinuation for blood pressure being too high were @ % for patients receiving placebo vs @ % for patients receiving active treatment ( p = @ ) .", "placebo control provides an important benchmark for both efficacy and adverse effects .", "it continues to have an appropriate place in certain therapeutic trials , particularly those involving the treatment of stage @ and stage @ hypertension ." ]

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

[ "transradial approach catheterization is now widely used in coronary angiography and angioplasty .", "the ulnar artery , which is one of the two terminal branches of the brachial artery , may be a potential approach for cardiac catheterization .", "the aim of this study was to evaluate the safety and feasibility of a transulnar approach for coronary catheterization in non-selective patients .", "a total of @ consecutive patients were randomly assigned to transulnar approach ( tua ) group ( n = @ ) or transradial approach ( tra ) group ( n = @ ) upon arrival at the catheterization laboratory .", "allen 's test and inverse allen 's test were not routinely performed .", "ultrasound-doppler assessment of the forearm artery was performed before the procedure , two days after the procedure , and @ days after the procedure .", "the primary endpoints of study were the rate of successful artery cannulation and the access-site related complications .", "the secondary endpoints included the number of needle punctures , total time for the procedure , and major adverse cardiac events ( mace ) .", "successful puncture of the objective artery was obtained in @ % of the patients in the tua group , and @ % of the patients in the tra group ( p > @ ) .", "there was no significant difference in hematoma complications between the two groups ( @ % vs. @ % , p = @ ) .", "a motor abnormality of the hand was observed in one patient in the tua group .", "there were no arteriovenous fistula or pseudoaneurysm observed in our study .", "three ( @ % ) patients in the tua group and @ ( @ % ) patients in the tra group had occlusion of the access artery ( p = @ ) , but none of the patients had symptoms or signs of hand ischemia .", "there were no significant differences in mace between the two groups during follow-up .", "the transulnar approach is an effective and safe technique for coronary catheterization in non-selective patients ." ]

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

[ "in a previous observational study , thoracic epidural analgesia ( tea ) after open renal surgery resulted in clinically relevant postvoid residuals ( pvrs ) .", "this study aimed to investigate the individual contribution of epidurally administrated drugs and surgery in bladder dysfunction .", "in this single-center , parallel-group , randomized ( computer-generated list ) , double-blind superiority trial , @ patients undergoing open renal surgery were equally allocated to receive epidural bupivacaine ( @ % ) alone or with fentanyl ( @ g/ml ) .", "patients underwent urodynamic investigations before tea and during tea preoperatively and postoperatively .", "primary outcome was the difference ( ) in pvr between before tea and postoperatively during tea .", "secondary outcomes were changes in detrusor pressure at maximum flow rate , bladder compliance , and pvr between different time points .", "median pvr ( ml ) from baseline to postoperatively was @ ( range , -@ to @ ; p = @ ) in the bupivacaine group and @ ( range , @-@ ; p value less than @ ) in the bupivacaine/fentanyl group , with no difference between groups ( @ % confidence interval , -@ to @ ; p = @ ) .", "detrusor pressure at maximum flow rate ( cm h ( @ ) o ) from baseline was more pronounced in the bupivacaine/fentanyl than that in the bupivacaine group preoperatively ( -@ ; range , -@ to -@ ; p value less than @ vs. -@ ; range , -@ to @ ; p = @ ) ( p = @ ) and postoperatively ( -@ ; range , -@ to @ ; p value less than @ vs. -@ ; range , -@ to @ ; p = @ ) ( p = @ ) .", "surgery did not affect pvrs , but a decreased bladder compliance was observed in both groups .", "no adverse events occurred .", "thoracic epidurally administrated bupivacaine resulted in clinically relevant pvrs based on impaired detrusor function .", "the addition of fentanyl enhanced this effect without generating greater pvrs .", "after surgery , the voiding phase was not further impaired ; however , bladder compliance was decreased ." ]

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

[ "melasma , also known as mask of pregnancy , is a common , acquired hypermelanosis seen in women with fitzpatrick skin types ii-v , and is often recalcitrant to treatment with depigmentation agents .", "glycolic acid has been added to hydroquinone formulations in the past to enhance their depigmentation effects , but may cause irritation , leading to postinflammatory hyperpigmentation .", "to assess the safety and efficacy of a cream containing @ % hydroquinone , @ % buffered glycolic acid , vitamins c and e , and sunscreen ( glyquin , icn pharmaceuticals , costa mesa , usa ) vs. a cream containing sunscreen alone in the depigmentation of epidermal melasma of the face .", "thirty-nine hispanic women , fitzpatrick skin types iii-v , with bilateral epidermal melasma were enrolled in a randomized controlled trial lasting @ weeks .", "patients underwent twice-daily full-face application with the study cream or with the cream containing sunscreen only .", "changes in pigmentation were measured using a mexameter , the melasma area and severity index ( masi ) , and a global evaluation by the patient and blind investigator .", "safety evaluations were performed at each follow-up visit .", "thirty-five patients completed the trial .", "irritation was more common with the study cream , but resolved with temporary cessation of cream application and the addition of moisturizers .", "mexameter results demonstrated a significant decrease in the degree of pigmentation using the study cream compared with the cream containing sunscreen alone ( p < @ ) .", "fifteen of @ patients ( @ % ) using the study cream improved , whereas only two of @ patients ( @ % ) improved using sunscreen alone .", "a cream containing @ % hydroquinone , @ % buffered glycolic acid , vitamins c and e , and sunscreen is safe and effective in the treatment of melasma ." ]

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

[ "to compare the effect of acupoint injection desensitization with autoblood and routine combined therapy for treatment of chronic urticaria .", "two hundred patients with chronic urticaria were randomly divided into an acupoint injection with autoblood ( aja ) group and a medicine group , @ cases in each group .", "the aja group was treated by acupoint injection desensitization with autoblood and dazhui ( gv @ ) , fengfu ( gv @ ) , feishu ( bl @ ) , neiguan ( pc @ ) and etc. were selected , @-@ acupoints each time , once every three days , @ days for a course .", "the therapeutic effect was assessed after one course .", "the medicine group was treated with external application of dexamethasone acetate cream , twice a day , and oral administration of setastine hydrochloride , twice a day , @ mg each time and the treatment duration was the same as that in the aja group .", "the clinical cured rate was @ % ( @/@ ) in the aja group , which was superior to that of @ ( @/@ ) in the medicine group ( p < @ ) .", "the acupoint injection desensitization with autoblood has obvious therapeutic effect on chronic urticaria with no apparent dependence and rebound problem ." ]

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

[ "explicit criteria for determining potentially inappropriate medication consumption in elderly were elaborated by beers et al. .", "these lists have been used worldwide to evaluate medical prescriptions but there is little epidemiologic evidence demonstrating negative consequences of inappropriate medication use .", "it has been reported that some drugs could increase the risk of falls , which are a frequent and serious problem in elderly population .", "we aimed to evaluate the association between the use of potentially inappropriate medications and the risk of falls .", "the @c study is a multicentre prospective cohort study conducted in france with @ years of follow-up .", "non-institutionalized men and women aged @ years or over ( n = @ ) were randomly selected from electoral rolls .", "data on socio-demographic , medical characteristics and medication use ( based on self-reports and data from the national healthcare insurance ) were collected .", "use of inappropriate medication for elderly was defined from established criteria .", "data about falls were collected at the two follow-up examinations ( @ years and @ years after baseline ) .", "the association between the exposure to inappropriate medications and the risk of falls was evaluated using multivariate models ( cox model and logistic regression ) .", "@ % of subjects reported inappropriate medication use at baseline and @ % at least two of the three examinations ; @ % had fallen @ times or more during follow-up .", "overall , inappropriate medication users had an increased risk of falling .", "this increase was mainly due to the use of long-acting benzodiazepines ( adjusted odds ratio ( or ) = @ , @ % confidence interval : [ @-@ @ ] , in both occasional and regular users ) , other inappropriate psychotropics ( adjusted or = @ [ @-@ @ ] in regular users ) , or medication with anticholinergic properties ( adjusted or = @ [ @-@ @ ] in regular users ) .", "neither occasional , nor regular use of short - or intermediate-acting benzodiazepines was associated with an increased risk of falling .", "further analysis in long-acting benzodiazepines users did not show any dose-effect relation between the number of prescriptions filled over a @-year period and the risk of falling .", "our study showed that use of inappropriate medications was associated with an increased risk of falling in elderly persons .", "this increase was mainly due to long-acting benzodiazepines and other inappropriate psychotropics , and to medications with anticholinergic properties ." ]

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

[ "to evaluate postoperative pain using a multimodal analgesic protocol in women with uterine fibroids managed with minimally invasive myomectomy .", "a prospective randomised trial was designed to evaluate the postoperative pain of women treated with minimally invasive myomectomy , using a multimodal analgesic protocol ( consisting of perioperative pharmaceutical agents of local and systemic action adjuvant to the classic anaesthesia protocol ) .", "ninety-five premenopausal women were assessed for minimally invasive myomectomy ( laparoscopic myomectomy and laparoscopically assisted myomectomy ) .", "ninety-two women were included in the final analysis and were randomly allocated in two groups using sealed envelopes : group i ( n = @ ) consisted of women who received the multimodal analgesic protocol and was compared with group ii ( n = @ ) who did not receive the protocol .", "the main outcome measure was the postoperative pain score at @ and @ h after surgery , according to the visual analog scale ( vas ) .", "additionally , time for bowel peristalsis return , duration of hospitalisation and full recuperation to normal activity were also measured .", "significantly lower vas scores for postoperative pain , earlier return of bowel peristalsis and fewer hours of hospitalisation were observed in the group in which multimodal analgesia was used .", "the days for the full recuperation to normal activity were similar between the two groups .", "in the setting of minimally invasive myomectomy , the use of a multimodal analgesic protocol improved postoperative recovery , resulting in earlier hospital discharge ." ]

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

[ "a study of daily physical activity was performed with @ preterm infants to evaluate changes in body weight and bone mineralization .", "subjects were matched by birth weight and gestational age and randomly assigned to the physical activity ( pa ; n = @ ) or to the control ( c ; n = @ ) program .", "pa consisted of range of motion against passive resistance to all extremities for @ to @ minutes daily .", "peripheral dual-energy x-ray of the right forearm ( ulna and radius ) ; biomarkers of bone formation ( serum type i collagen c-terminal propeptide [ picp ] ) and resorption ( urine pyridinoline cross-links of collagen [ pyd ] ) ; serum calcium , phosphate , alkaline phosphatase , parathyroid hormone ( pth ) , and @ , @ - ( oh ) ( @ ) vitamin d ; and urine levels of calcium , phosphate , and creatinine were obtained .", "all measurements were made at study entry and at @ kg of body weight .", "despite a similar nutrient intake at advised levels for preterm infants , gains in body weight ( g ) and forearm bone length ( cm ) , bone area ( ba ; cm ( @ ) ) , bone mineral content ( bmc ; mg ) , and fat-free mass ( g ) were greater in pa infants .", "forearm bone mineral density and fat mass gains did not differ between groups .", "serum picp levels remained constant in pa infants but decreased in c infants suggesting a slower rate of bone formation .", "urine pyd or bone resorption activity was similar between groups .", "a higher level of serum pth was observed in pa infants at @ kg of body weight ; however , the change from study entry to completion did not differ between groups .", "all other serum and urine values were similar and within normal limits .", "a daily pa program promotes greater gains in body weight , forearm length , ba , bmc , and fat-free mass in premature infants ." ]

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

[ "the aim was to correlate the color doppler flow activity pre - and postradiotherapy , using transrectal color doppler ultrasonography ( cdus ) and the @ year positive biopsy rate after radiotherapy in patients with prostate cancer .", "analysis was carried out in @ out of @ patients who had undergone treatment with @d-conformal radiotherapy ( @d-crt ) to prostate and seminal vesicles .", "patients were randomized to receive @ gy in @ fractions in @ weeks ( arm a ) and @ gy in @ fractions in @ weeks , @ fractions per week ( arm b ) .", "color doppler flow activity ( cdfa ) was evaluated calculating the vascularization index ( vi ) , defined as the ratio between the colored and total pixels in the whole and peripheral prostate , delineated by a radiation oncologist on cdus images , using ecovasc a home-made software .", "the difference between the @ year post - and pre-@d-crt maximum vi ( vimax ) , named deltavimax , was calculated in the whole and peripheral prostate for each patient .", "then , deltavimax and the detected @ year biopsy outcome were analyzed using the receiver operating characteristics ( roc ) technique .", "the vimax increased or decreased in patients with positive or negative biopsies , respectively , compared to the value before rt in both arms .", "the area under the roc curve for deltavimax in the whole and peripheral prostate is equal to @ and @ , respectively .", "the avimax index , comparing cdfa at @ years compared to that before rt , allows the @ year postradiotherapy positive biopsy rate to be predicted ." ]

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

[ "in a previous study we investigated the analgesic efficacy of metamizol .", "after laparoscopic operations , in particular , the reduction of postoperative opioid requirements within the first @ h after surgery attained clinical relevance ( -@ % ) .", "in the present study we investigated the analgesic efficacy of supplementary diclofenac .", "@ patients , scheduled for minor orthopaedic surgery , laparoscopic cholecystectomy or resection of the thyroid gland , participated in a doubleblind , randomised , placebo-controlled study .", "the setting was comparable to our previous study , apart from the supplementary administration of diclofenac .", "before induction of anaesthesia , verum-treated patients received a diclofenac suppository ( @ mg ) , in addition to metamizol ( @ g/@ ml nacl @ % intravenous over @ min ) .", "these infusions were repeated at @h and @h .", "in addition to the third infusion , the patients received a further diclofenac suppository ( @ mg ) .", "cumulated doses of buprenorphine ( pca , patient-controlled analgesia ) , pain scores ( @-@ ) , blood pressure , pulse and side effects were recorded during the first @ h and again at @ h.", "all verum-treated patients had significantly less pain immediately after surgery and required lower cumulated doses of buprenorphine during the first @ h after operation ( laparoscopic cholecystectomy -@ % , minor orthopaedic surgery -@ % , resection of thyroid gland -@ % ) .", "combination of metamizol and diclofenac cause a clinically relevant reduction in opioid requirements , in particular after minor orthopaedic surgery and resection of the thyroid gland .", "there is no need for supplementary diclofenac following laparoscopic surgery ." ]

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

[ "the medicare accountable care organization ( aco ) programs encourage integration of providers into large groups and reward provider groups for improving quality , but not explicitly for reducing health care disparities .", "larger group size and better overall quality may or may not be associated with smaller disparities .", "to examine differences in patient characteristics between provider groups sufficiently large to participate in aco programs and smaller groups ; the association between group size and racial disparities in quality ; and the association between quality and disparities among larger groups .", "using @ medicare claims for @ million beneficiaries with cardiovascular disease or diabetes and linked data on provider groups , we compared racial differences in quality by provider group size , adjusting for patient characteristics .", "among larger groups , we used multilevel models to estimate correlations between group performance on quality measures for white beneficiaries and black-white disparities within groups .", "four process measures of quality , hospitalization for ambulatory care-sensitive conditions ( acscs ) related to cardiovascular disease or diabetes , and hospitalization for any acsc .", "beneficiaries served by larger groups were more likely to be white and live in areas with less poverty and more education .", "larger group size was associated with smaller disparities in low-density lipoprotein ( ldl ) cholesterol testing and retinal exams , but not in other process measures or hospitalization for acscs .", "among larger groups , better quality for white beneficiaries in one measure ( hospitalization for acscs related to cardiovascular disease or diabetes ) was correlated with smaller racial disparities ( r = @ ; p = @ ) , but quality was not correlated with disparities in other measures .", "larger provider group size and better performance on quality measures were not consistently associated with smaller racial disparities in care for medicare beneficiaries with cardiovascular disease or diabetes .", "aco incentives rewarding better quality for minority groups and payment arrangements supporting aco development in disadvantaged communities may be required for acos to promote greater equity in care ." ]

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

[ "selective serotonin reuptake inhibitors have been reported to increase the risk of upper gastrointestinal tract bleeding .", "the wide use of these drugs makes such potential risk a public health concern , and identification of factors that may increase or minimize such risk is necessary .", "to test the association of selective serotonin reuptake inhibitors and venlafaxine hydrochloride therapy with upper gastrointestinal tract bleeding , to identify subgroups of patients at particularly increased risk , and to explore whether acid-suppressing agents may be effective in minimizing risk .", "nested case-control study .", "general practice database from the united kingdom .", "one thousand three hundred twenty-one patients with upper gastrointestinal tract bleeding referred to a consultant or hospital and @ @ control subjects matched for age , sex , and calendar year of the index date .", "main outcome measure risk of bleeding associated with selective serotonin reuptake inhibitors and effect of acid-suppressing agents .", "the percentage of current users of selective serotonin reuptake inhibitors ( @ % ) or venlafaxine ( @ % ) among case subjects was significantly higher than in matched control subjects ( @ % and @ % ; adjusted odds ratio [ or ] , @ ; @ % confidence interval [ ci ] , @-@ @ , and or , @ ; @ % ci , @-@ @ , respectively ) .", "an interaction with nonsteroidal anti-inflammatory drugs ( or , @ ; @ % ci , @-@ @ ) was observed , in particular among those not using acid-suppressing agents ( or , @ ; @ % ci , @-@ @ ) compared with users of these drugs ( or , @ ; @ % ci , @-@ @ ) .", "in addition , an interaction with antiplatelet drugs in nonusers of acid-suppressing agents was suggested ( or , @ ; @ % ci , @-@ @ ) compared with users of these drugs ( or , @ ; @ % ci , @-@ @ ) .", "antidepressants with a relevant blockade action on the serotonin reuptake mechanism increase the risk of upper gastrointestinal tract bleeding .", "the increased risk may be of particular relevance when these drugs are associated with nonsteroidal anti-inflammatory drugs .", "our study findings also provide evidence that use of acid-suppressing agents limits such increased risk ." ]

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

[ "the use of combination inhaled budesonide and formoterol as maintenance and reliever therapy significantly improves the risk and the time to exacerbations in asthma .", "to explore the mechanisms underlying the effect of the reliever dose on exacerbations by examining the effect of combination therapy on the allergen challenge model when given after allergen exposure .", "in a randomized , double-blind crossover study , single doses of budesonide/formoterol ( @/@ mug ) , formoterol ( @ mug ) , budesonide ( @ mug ) , or placebo were administered during the acute bronchoconstriction response ( early airway response ) immediately after allergen inhalation in @ patients with mild asthma .", "allergen-induced late airway response ( lar ) , sputum inflammatory markers , airway hyperresponsiveness , and exhaled nitric oxide were measured .", "all active treatments significantly attenuated the lar , with budesonide/formoterol significantly better than its monocomponents ( maximum fev ( @ ) fall : placebo , [ mean + / - sem ] @ % + / - @ % ; budesonide/formoterol , @ % + / - @ % ; formoterol , @ % + / - @ % ; budesonide , @ % + / - @ % ) .", "allergen-induced change in methacholine pc ( @ ) was significantly attenuated by budesonide/formoterol , but not by its monocomponents .", "sputum cell counts and exhaled nitric oxide increased significantly after all allergen challenges , with no significant attenuation by any of the treatments .", "therapy with combination and formoterol alone , but not budesonide , significantly reduced the early airway response .", "a single dose of budesonide/formoterol was superior to its monocomponents in attenuating the allergen-induced lar and airway hyperresponsiveness .", "these effects may represent the contribution of the reliever dose to the budesonide/formoterol maintenance and reliever regimen .", "the protective effect against allergic airway responses with a single reliever dose of budesonide/formoterol is predominantly related to greater functional antagonism of airway smooth muscles ." ]

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

[ "to evaluate the efficacy and safety of zinc in the treatment of acute gastroenteritis ( age ) in children in poland .", "children aged @ to @ months with age were enrolled in a randomized , double-blind , placebo-controlled trial in which they received zinc sulfate ( @ or @ mg/day depending on age ) or placebo for @ days .", "a total of @ of @ children recruited were available for intention-to-treat analysis .", "the primary outcome was the duration of diarrhea .", "in the experimental group ( n = @ ) compared with the control group ( n = @ ) , there was no significant difference in the duration of diarrhea ( p > @ ) .", "similarly , there was no significant difference in the groups in secondary outcome measures such as stool frequency on days @ , @ , and @ , vomiting frequency , intravenous fluid intake , and the number of children with diarrhea lasting > @ days .", "children living in a country where zinc deficiency is rare do not appear to benefit from the use of zinc in the treatment of age ." ]

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

[ "antipsychotic medications improve psychosis but often induce a state of dysphoria in patients .", "blockade of the dopamine d ( @ ) receptors , which is thought to mediate their efficacy , has also been implicated in producing this adverse subjective experience .", "the authors present the first double-blind controlled study to examine the relationship between striatal and extrastriatal dopamine d ( @ ) receptor binding potential and occupancy values and adverse subjective experience .", "patients with recent-onset psychosis ( n = @ ) were randomly assigned to low or high doses of olanzapine or risperidone .", "subjective experiences , motor side effects , and striatal and extrastriatal dopamine d ( @ ) receptors ( determined with [ ( @ ) c ] raclopride and [ ( @ ) c ] flb @ pet scans , respectively ) were evaluated after @ weeks of continuous antipsychotic treatment .", "higher dopamine d ( @ ) receptor occupancy and binding potentials in the striatal ( dorsal and ventral ) , temporal , and insular regions were associated with subjective experience .", "the finding was confirmed with two convergent methods of analysis ( region-of-interest and voxel-based statistics ) , and the same relationship was observed using two different dopamine receptor measures ( observed binding potential values and age - and sex-corrected occupancy values ) .", "higher d ( @ ) receptor occupancy is associated with negative subjective experience in patients taking risperidone or olanzapine .", "these negative subjective effects may be related to the high discontinuation rates seen in usual practice .", "understanding the neurobiological mechanism of these negative subjective experiences and developing antipsychotics with novel ( i.e. , non d ( @ ) ) mechanisms may be critical in improving the treatment of psychosis ." ]

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

[ "to compare the clinical efficacy of warmed irrigation fluid and room-temperature fluid in decreasing perioperative hypothermia during arthroscopic rotator cuff surgery .", "in this prospective , randomized , comparative study , warmed ( @c ) arthroscopic irrigation fluid ( group w , n = @ ) or room-temperature irrigation fluid ( group rt , n = @ ) was used without intraoperative warming devices during arthroscopic shoulder surgery in @ patients .", "the serial core body temperature and the last and lowest core body temperatures were measured by use of an esophageal stethoscope with a thermometer and a digital tympanic thermometer at @-minute intervals during the operation and recovery period , respectively .", "when patients arrived in the postanesthesia care unit ( pacu ) after surgery , they were warmed immediately and monitored thereafter for body temperature and development of hypothermia-related adverse effects such as postoperative shivering and cardiac events .", "we evaluated the changes in the patients ' weight and prothrombin time on postoperative day @ and the hemoglobin level and visual analog scale pain score immediately after the operation and on postoperative day @ .", "the @ groups did not differ in demographic and surgical data and incidence of intraoperative hypothermia ( @ of @ [ @ % ] in group rt and @ of @ [ @ % ] in group w , p = @ ) .", "the core body temperatures decreased throughout the surgery and increased linearly in the pacu , without any intergroup differences ( p > @ ) .", "all patients were normothermic within @ hour of arrival in the pacu .", "the @ groups did not differ in postoperative weight change , prothrombin time , hemoglobin level , or postoperative visual analog scale pain score ( all p > @ ) .", "postoperative shivering occurred in @ patients and @ patient in group rt and group w , respectively .", "no cardiac events occurred in either group .", "warmed irrigation fluid was not superior to room-temperature irrigation fluid in reducing the occurrence of perioperative hypothermia during arthroscopic shoulder surgery .", "level i , randomized controlled trial ." ]

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

[ "acute radiation proctitis is the most relevant complication of pelvic radiation and is still mainly treated supportively .", "considering the negative impact of acute proctitis symptoms on patients ' daily activities and the potential relationship between the severity of acute radiation injury and late damage , misoprostol was tested in the prevention of acute radiation-induced proctitis .", "a total of @ patients who underwent radiotherapy for prostate cancer were entered into this phase iii randomized , placebo-controlled , double-blind study with misoprostol or placebo suppositories .", "radiation-induced toxicity was evaluated weekly during radiotherapy using the common toxicity criteria .", "between the placebo and the misoprostol groups , no significant differences in proctitis symptoms occurred : @ % of patients in each group had grade @ toxicity , and @ % in the placebo group and @ % in the misoprostol group had grade @ toxicity .", "no differences were found in onset or symptom duration .", "comparing the peak incidence of patients ' toxicity symptoms , significantly more patients experienced rectal bleeding in the misoprostol group ( p = @ ) .", "misoprostol given as a once-daily suppository did not decrease the incidence and severity of radiation-induced acute proctitis and may increase the incidence of acute bleeding ." ]

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

[ "although dietary restriction often results in initial weight loss , the majority of obese dieters fail to maintain their reduced weight .", "diet-induced weight loss results in compensatory increase of hunger , craving and decreased ghrelin suppression that encourage weight regain .", "a high protein and carbohydrate breakfast may overcome these compensatory changes and prevent obesity relapse .", "in this study @ obese ( bmi @ kg/m ( @ ) ) , sedentary non diabetic adult men and women ( @years ) were randomized to a low carbohydrate breakfast ( lcb ) or an isocaloric diet with high carbohydrate and protein breakfast ( hcpb ) .", "anthropometric measures were assessed every @weeks .", "fasting glucose , insulin , ghrelin , lipids , craving scores and breakfast meal challenge assessing hunger , satiety , insulin and ghrelin responses , were performed at baseline , after a diet intervention period ( week @ ) and after a follow-up period ( week @ ) .", "at week @ , groups exhibited similar weight loss : @ kg in lcb group vs. @ kg in hcpb group , p = @ .", "from week @ to week @ , lcb group regained @ kg , while the hcpb group lost additional @ kg .", "ghrelin levels were reduced after breakfast by @ % and @ % following the hcpb and lcb , respectively .", "satiety was significantly improved and hunger and craving scores significantly reduced in the hcpb group vs. the lcb group .", "a high carbohydrate and protein breakfast may prevent weight regain by reducing diet-induced compensatory changes in hunger , cravings and ghrelin suppression .", "to achieve long-term weight loss , meal timing and macronutrient composition must counteract these compensatory mechanisms which encourage weight regain after weight loss ." ]

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

[ "the purpose of this study was to investigate the significance of the possible negative interaction between aspirin and angiotensin-converting enzyme ( ace ) inhibitors .", "several provocative reports have recently suggested that aspirin is unsafe in patients with heart failure and has negative interaction with ace inhibitors that might attenuate their beneficial effects upon survival .", "we analyzed mortality data of @,@ patients with coronary artery disease screened for the bezafibrate infarction prevention trial .", "a total of @,@ patients ( @ % ) were treated with ace inhibitors .", "of them , @ patients ( @ % ) used aspirin .", "five-year mortality was lower among patients on ace inhibitors and aspirin than patients on ace inhibitors without aspirin ( @ % vs. @ % ; p < @ ) .", "after adjusting for confounders , treatment with aspirin and ace inhibitors remained associated with lower mortality risk than using ace inhibitors only ( relative risk [ rr ] = @ ; @ % confidence interval [ ci ] = @ to @ ) .", "subgroup analysis of @ patients with congestive heart failure treated with ace inhibitors revealed @ patients ( @ % ) on aspirin and @ patients not on aspirin .", "although clinical characteristics and therapy were similar , patients taking aspirin experienced lower mortality than patients who did not ( @ % vs. @ % ; p = @ ) .", "after adjustment , treatment with aspirin was still associated with lower mortality ( rr = @ ; @ % ci = @ to @ ) .", "among coronary artery disease patients with and without heart failure who are treated with ace inhibitors , the use of aspirin was associated with lower mortality than treatment without aspirin .", "our findings contradict the claim that aspirin attenuates the beneficial effect of ace inhibitors and supports its use in patients with coronary artery disease treated with ace inhibitors ." ]

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

[ "this study was conducted to compare the efficacy of @ % fluorometholone and @ % pranoprofen in cases with chronic allergic conjunctivitis .", "in an investigator-masked trial , patients with chronic allergic conjunctivitis were randomized to treatment with @ times daily @ % pranoprofen ( pn ) or @ % fluorometholone ( fl ) eye drops for @ weeks .", "a @-point rating scale assessing the severity of @ symptoms and @ signs ( @ = none , @ = mild , @ = moderate , and @ = severe ) was used .", "a linear mixed model was used to explore the rate of score changes .", "regression analysis was used to evaluate the relation between clinical outcome and age .", "a total of @ patients were enrolled at the baseline .", "there were no significant differences in the demographics and baseline skin prick scores between both groups .", "mean baseline scores in pn and fl group were @ @ and @ @ , respectively .", "the scores rapidly decreased to @ @ and @ @ on day @ , respectively .", "fluorometholone showed a more rapid effect compared with pranoprofen during the first week of treatment ( p < @ ) but not later .", "regression analysis showed that age was negatively associated with response to fluorometholone ( younger than @ years ) .", "the intraocular pressure increased by @ mm hg in the fl group and decreased by @ mm hg in the pn group on day @ ( p > @ ) .", "both fluorometholone and pranoprofen were effective for management of cases with chronic allergic conjunctivitis .", "fluorometholone provided more rapid relief as compared with pranoprofen .", "the effect of fluorometholone was more pronounced in younger patients ." ]

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

[ "chronic condition management in general practice is projected to account for @ % of all consultations by @ .", "general practices under present workforce conditions will be unable to meet this demand .", "nurse led collaborative care models of chronic disease management have been successful overseas and are proposed as one solution .", "this article provides an interim report on a prospective randomised trial to investigate the acceptability , cost effectiveness and feasibility of a nurse led model of care for chronic conditions in australian general practice .", "a qualitative study focused on the impact of this model of care through the perceptions of practice staff from one urban and one regional practice in queensland , and one victorian rural practice .", "primary benefits of the collaborative care model focused on increased efficiency and communication between practice staff and patients .", "the increased degree of patient self responsibility was noted by all and highlights the motivational aspect of chronic disease management ." ]

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

[ "the aim of this study was to determine whether changes in local skin temperature over which the infusion catheters pass when using insulin pump therapy and the choice of rapid-acting insulin analog influence the risk of catheter occlusion .", "twenty healthy volunteers were assigned to wear insulin pumps primed with insulin glulisine and insulin aspart in a randomized order each for a duration of @ days and a temperature probe ( taped to the skin near the insulin catheter ) .", "to reproduce the effect of subcutaneous infusion , the insulin catheter was inserted into an absorbent sponge in a plastic bag strapped to the subject 's abdomen .", "basal infusion rates were programmed at @ iu/h , and @-iu boluses were given three times a day with meals .", "average skin temperature ranged between @ c and @ c for insulin glulisine and @ c and @ c for insulin aspart , with no difference in skin temperature between treatments or between the first and second week of the study .", "nine occlusions were seen in eight subjects with an overall rate of occlusion of @ % ( @ % confidence interval , @-@ @ % ) and were more likely to occur in the second week .", "on an individual level the risk of occlusion was similar for insulin glulisine and insulin aspart ( odds ratio , @ % ; p = @ ) .", "overall , in this small study simulating subcutaneous insulin infusion , the rate of catheter occlusion was low and unaffected by local fluctuations in ambient skin temperature .", "there was no significant difference between the two rapid-acting insulin analogs tested .", "where occlusions occurred , they were more likely to happen beyond the manufacturer 's recommended @-h limit for catheter use ." ]

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

[ "ultrasound guidance for central venous catheterization improves success rates and decreases complications when compared to the landmark technique .", "prior research has demonstrated that arterial and/or posterior vein wall puncture still occurs despite real-time ultrasound guidance .", "the inability to maintain visualization of the needle tip may contribute to these complications .", "this study aims to identify whether long-axis or short-axis approaches to ultrasound-guided vascular access afford improved visibility of the needle tip .", "a prospective trial was conducted at a level i trauma center with an emergency medicine residency .", "medical students and residents placed needles into vascular access tissue phantoms using long-axis and short-axis approaches .", "ultrasound images obtained at the time of vessel puncture were then reviewed .", "primary outcome measures were visibility of the needle tip at the time of puncture and total time to successful puncture of the vessel .", "all subjects were able to successfully obtain simulated blood from the tissue phantom .", "mean time to puncture was @ seconds in the long-axis group and @ seconds in the short-axis group ( p = @ ) .", "needle tip visibility at the time of vessel puncture was higher in the long-axis group ( @/@ , @ % ) as opposed to the short-axis group ( @/@ , @ % ) ( p = @ ) .", "in a simulated vascular access model , the long-axis approach to ultrasound-guided vascular access was associated with improved visibility of the needle tip during vessel puncture .", "this approach may help decrease complications associated with ultrasound-guided central venous catheterization and should be prospectively evaluated in future studies ." ]

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

[ "to evaluate the effect of preventive medicine for residents living around mosquito breeding water during rest period of malaria by delimiting a certain range .", "the study adopted the stratified cluster random sampling method to select subjects from @ counties in the high epidemic area along and north of the huai river since march @ .", "then the villages of @ counties were stratified into five levels according to the case reported in year @ , and one village was randomly selected from each level , thereby @ villages were selected in total@-@ subjects were interviewed in each village , and in total @ @ subjects were recruited in the study .", "the five selected villages in each county were allocated to three intervention groups according to the block randomization method .", "the first intervention group included @ villages , @ people ; the second intervention group was consisted of @ villages , @ people ; the non-intervention group had @ villages , @ people .", "the basic information of the subjects were collected by questionnaire to analyze the relation between malaria cases and the distribution of the mosquito breeding water , then accordingly delimited the range for preventive medicine .", "group @ received the delimiting preventive medicine treatment , group @ received routine medicine treatment , while non-treatment group received no treatment .", "the morbidity , standardized morbidity , net change of morbidity ( the d-value of the standardized morbidity before and after the intervention ) , age-specified incidence , and the protective rate ( pr ) , effectiveness index ( ie ) and the capture rate of the delimited method group were then calculated .", "group @ had @ ( @ % ) people taking medicine and group @ had @ ( @ % ) people .", "in @ , before the prevention conducting , the high incidence aging group in the first , second and nonintervention group was separately people aging @ - @ , @ - @ and @ years old ; whose incidence was @ ( @/@ ) , @ ( @/@ ) and @ ( @/@ ) respectively .", "after the intervention , the high incidence aging groups in the first and second intervention group changed to the population over @ years old , with incidence at @ ( @/@ ) and @ ( @/@ ) respectively ; while the high incidence aging groups in the nonintervention group changed to people aging between @-@ years old , with the rate at @ ( @/@ ) .", "in @ , the morbidity of malaria in the first , second intervention group and nonintervention group was separately @ ( @/@ ) , @ ( @/@ ) and @ ( @/@ ) ; while the standardized incidence was separately @ , @ and @ .", "in @ , after the prevention conducting , the morbidity in the three groups was @ ( @/@ ) , @ ( @/@ ) and @ ( @/@ ) , respectively ; while the standardized incidences was @ , @ and @ , respectively .", "the net value of changes of morbidity in the three groups was separately @ % , @ % and @ % .", "the difference in net values of changes of morbidity between intervention group @ and @ had statistical significance ( ( @ ) = @ , p < @ ) .", "comparing with the nonintervention group , the pr and ie in intervention group @ was separately @ % and @ ; while the capture rate was @ % ( @/@ ) .", "the delimiting preventive medicine treatment during rest period of malaria was very effective for eliminating the potential infection source of malaria and reducing the morbidity of malaria ." ]

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

[ "to investigate whether nasal salmon calcitonin ( ct ; @ u/day ) given in addition to calcium helps to restore the bone mass after parathyroidectomy ( ptx ) in patients with primary hyperparathyroidism ( phpt ) .", "twenty patients with phpt were enrolled after successful ptx and received @ g calcium per os daily for @ year .", "they were randomly assigned either to nasal ct ( ct group ) or to no treatment .", "the bone mass was measured using dual-energy x-ray absorptiometry at multiple sites .", "eight patients in each group completed the study .", "after @ months , the bone mass increased significantly at whole-body level and at lumbar spine in both groups , increased at hip and epiphyses of tibia or radius in the ct group only , and did not change at diaphyses of tibia and radius in either group .", "bone mass increases after ptx for phpt in patients receiving oral calcium .", "ct may help to restore the bone mass at sites of the appendicular skeleton , where trabecular bone predominates ." ]

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

[ "to compare two dosing regimens for caffeine citrate in the periextubation period for neonates born at less than @ weeks gestation in terms of successful extubation and adverse effects .", "a multicentre , randomised , double blind , clinical trial .", "four tertiary neonatal units within australia .", "infants born less than @ weeks gestation ventilated for more than @ hours .", "two dosing regimens of caffeine citrate ( @ v @ mg/kg/day ) for periextubation management .", "treatment started @ hours before a planned extubation or within six hours of an unplanned extubation .", "failure to extubate within @ hours of caffeine loading or reintubation and ventilation or doxapram within seven days of caffeine loading .", "a total of @ neonates were enrolled .", "a significant reduction in failure to extubate was shown for the @ mg/kg/day dosing group ( @ % v @ % ; relative risk @ ; @ % confidence interval ( ci ) @ to @ ; number needed to treat @ ( @ % ci @ to @ ) ) .", "a significant difference in duration of mechanical ventilation was shown for infants of less than @ weeks gestation receiving the high dose of caffeine ( mean ( sd ) days @ ( @ ) v @ ( @ ) ; p = @ ) .", "no difference in adverse effects was detected in terms of mortality , major neonatal morbidity , death , or severe disability or general quotient at @ months .", "this trial shows short term benefits for a @ mg/kg/day dosing regimen of caffeine citrate for neonates born at less than @ weeks gestation in the periextubation period , without evidence of harm in the first year of life ." ]

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

[ "there is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations ( mms ) on their offspring 's growth .", "we evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth .", "the hypothesis was that prenatal mms and early invitation to food supplementation would increase physical growth in the offspring during @-@ months and a combination of these interventions would further improve these outcomes .", "in the large , randomized minimat trial ( maternal and infant nutrition interventions in matlab ) , bangladesh , @ pregnant women were enrolled between november @ and october @ and their children were followed until march @ .", "participants were randomized into six groups comprising @ mg fe and @ g folic acid ( fe@f ) , @ mg fe and @ g folic acid ( fe@f ) or mms combined with either an early ( immediately after identification of pregnancy ) or a later usual ( at the time of their choosing , i.e. , usual care in this community ) program invitation to food supplementation .", "the anthropometry of @ children was followed from birth to @ months , and @ children were available for analysis at @ months .", "there were no differences in characteristics of mothers and households among the different intervention groups .", "the average birth weight was @ g and birth length was @ cm , with no difference among intervention groups .", "early invitation to food supplementation ( in comparison with usual invitation ) reduced the proportion of stunting from early infancy up to @ months for boys ( p = @ ) , but not for girls ( p = @ ) .", "mms resulted in more stunting than standard fe@f ( p = @ ) .", "there was no interaction between the food and micronutrient supplementation on the growth outcome .", "early food supplementation in pregnancy reduced the occurrence of stunting during @-@ months in boys , but not in girls , and prenatal mms increased the proportion of stunting in boys .", "these effects on postnatal growth suggest programming effects in early fetal life .", "isrctn : isrctn@ ." ]

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

[ "cognitive remediation ( cr ) preceding cognitive-behavioural therapy for psychosis ( cbtp ) was trialled within routine clinical services , with the hypothesis that following first-episode non-affective psychosis cr would enhance cbtp efficacy by improving neuropsychological performance .", "a total of @ patients with dsm-iv non-affective psychoses waiting for routine cbtp were randomized to computerized cr over @ weeks , supported by a trained support worker , or time-matched social contact ( sc ) .", "primary outcome was the blind-rated psychotic symptoms rating scale ( psyrats ) .", "secondary outcomes included measures of cbtp progress , cognition , symptoms , insight and self-esteem : all at baseline , after cr ( @ weeks ) and after cbtp ( @ weeks ) .", "psyrats and global neuropsychological efficacy were tested using mixed-effects models with a grouptime interaction term .", "measures of cbtp progress and some neuropsychological measures were modelled by regression .", "there was no significant difference between the cr and sc groups in psyrats ( grouptime coefficient @ , @ % confidence interval -@ to @ , p = @ ) .", "however , after cr cbtp was shorter [ median @ sessions , interquartile range ( iqr ) @-@ after cr ; median @ , iqr @-@ after sc ; model p = @ ] and linked to better insight ( p = @ ) .", "global cognition did not improve significantly more after cr ( p = @ ) but executive function did ( wisconsin card sort , p = @ ) .", "cbtp courses preceded by cr were far shorter but achieved the same outcome as cbtp preceded by an active control , consistent with neuropsychological improvement enhancing cbtp .", "cr was delivered by staff with minimal training , offering the potential to reduce the costs of cbtp considerably ." ]

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

[ "knee arthroplasty is the treatment of choice for gonarthrosis .", "the development of minimally invasive surgery ( mis ) requires assessing results based on the classical approaches and this is the purpose of our study .", "randomized , prospective study comparing two groups ; one underwent mis ( @ patients ) and the second one a classical approach ( @ patients ) ; both groups were comparable .", "the following variables were assessed in the immediate postoperative period and at @ and @ years : blood loss , pain according to the vas , flexion and extension and quality of life measured with the sf-@ .", "in the immediate postoperative period we observed statistically significant differences ( p < @ ) in favor of the mis approach in pain , hospital stay and blood loss .", "however , this was not observed at @ and @ years concerning pain , quality of life and range of motion .", "we observed an improvement in the functional scale and quality of life compared with the preoperative status , without any differences when both groups were compared .", "the mis technique results in a better immediate postoperative period , but no differences were seen in the choice of the approach @ and @ years after surgery ." ]

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

[ "conventional percutaneous transhepatic varices embolization ( ptve ) has rarely been used in recent years due to high rates of variceal recurrence and rebleeding .", "herein we report a modified ptve with @-octyl cyanoacrylate ( @-oca ) in which the whole lower esophageal and peri or para-esophageal varices , the submucosal varices , and the advertitial plexus of the cardia and fundus were sufficiently obliterated .", "we compared this ptve with endoscopic band ligation ( evl ) in the treatment of esophageal variceal bleeding .", "in this prospective randomized controlled trial , cirrhotic patients with acute or recent esophageal variceal bleeding were assigned randomly to ptve ( @ patients ) or evl ( @ patients ) groups .", "upper gastrointestinal ( ugi ) rebleeding , esophageal variceal rebleeding , and survival were followed-up .", "computerized tomography ( ct ) scanning and portal venography were used to observe @-oca distribution .", "during the follow-up period ( median @ and @ months in the ptve and evl groups , respectively ) ugi rebleeding developed in eight patients in the ptve group and @ patients in evl group ( p = @ ) .", "recurrent bleeding from esophageal varices occurred in three patients in the ptve group and twelve in the evl group ( p = @ , relative risk @ , @ % confidence interval @-@ @ ) .", "multivariate cox analysis indicated that the treatment was the only factor predictive of rebleeding .", "a kaplan-meier curve showed there was no significant difference between survival in the two groups ( p = @ ) .", "with the whole lower esophageal and peri or para-esophageal varices , the submucosal varices , and the adventitial plexus of the cardia and fundus sufficiently obliterated by @-oca , this modified ptve was more effective than evl in the management of esophageal varices recurrence and rebleeding .", "survival in these two groups was not significantly different , however ." ]

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

[ "pemphigus vulgaris ( pv ) is a severe blistering disease involving the skin and mucous membranes .", "the most common causes of death in these patients are adverse effects of drugs , and infection .", "skin lesions are one of the important sources of infection .", "thus , any local treatment that could reduce healing time of lesions and consequently reduce the total dosage of drugs needed to treat is favourable .", "to evaluate the efficacy of epidermal growth factor ( egf ) in reducing healing time of lesions in patients with pemphigus vulgaris .", "in this randomized , double-blind , within-patient , left/right , controlled trial , @ hospitalized patients with pathologial and immunohistologial ( direct and indirect immunoflourecence ) proven pemphigus vulgaris ( pv ) were chosen .", "in addition , all patients had at least one appropriate pemphigus lesion on each side of the body that had not healed after @-week systemic therapy and sterile saline washing .", "egf ( @ microg/g ) in @ % silver sulfadiazine cream vs. @ % silver sulfadiazine cream alone was applied randomly on one side of the body .", "kaplan-meier survival analysis suggested that median time to heal with application of egf plus silver sulfadiazine cream was @ days , in comparison with @ days for silver sulfadiazine cream alone ( log-rank test , p = @ ) .", "no intervention-related adverse effect was observed during the study .", "egf can significantly reduce healing time of skin lesions in patients with pemphigus vulgaris , at least when this cream base is applied ( cochrane skin group identifier : csg@ ) ." ]

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

[ "nafamostat mesilate ( fut-@ ) is a synthetic serine protease inhibitor that inactivates coagulation , fibrinolysis , and platelet aggregation .", "nafamostat mesilate may suppress the blood-foreign surface reaction similar to biocompatible materials by blocking factor xiia .", "we performed an in vitro study of cardiopulmonary bypass ( cpb ) with fresh human blood among the following three groups : standard cpb sets ( c ) , biocompatible cpb sets ( b ) , and standard cpb sets with fut-@ ( @ mg/l ) ( f ) .", "a clinical study using these same cpb groups also was performed in @ patients undergoing aortocoronary bypass operations ( @ patients each ) .", "we injected fut-@ at @ mg/h during cpb .", "in the in vitro study , both groups b and f showed significantly lower levels of coagulation factors , thrombin-antithrombin iii complex , fibrinopeptide a , beta-thromboglobulin , complement c@a , granulocyte elastase , and free hemoglobin than group c at the conclusion of the study .", "thrombin-antithrombin iii complex and free hemoglobin in group f also were lower than in group b.", "the platelet count remained at a higher level in group f than in the other groups .", "separation of bradykinin was suppressed most significantly in group f.", "in the clinical study , group f also showed significantly lower levels of alpha @-plasmin inhibitor plasmin complex and c@a than both groups c and b.", "there were minimal levels of free hemoglobin in group f.", "nafamostat mesilate may contribute major beneficial effects toward conservation of blood during cpb and prevention of coagulopathy after cpb ." ]

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

[ "the aim of this study was to determine the resistance and fracture strength values of the bone with the use of biomechanical tests in different consolidation periods of mandibular distraction osteogenesis .", "in this study , @ mature male new zeland rabbits were used .", "after distraction , rabbits were separated into @ groups to experience @ , @ , and @ weeks ' consolidation periods .", "nonoperated hemimandibles of @ rabbits were used as a control group .", "after @ days ' latency period , @-mm distraction was applied twice a day , i.e. , @ mm/d lengthening .", "after the @-mm lengthening application , we left the animals for @ , @ , or @ months of consolidation period .", "bending stress and strength values of the bone at fracture point were measured with the use of a @-point bending test .", "there were significant differences between the control and @ study groups regarding bending stress and strength values .", "in addition , each study group was significantly different from each other .", "bending stress and fracture strength of the bone may not reach that of normal bone after completion of @ months ' consolidation .", "it should be considered to keep in place extraoral appliances or comfortable intraoral distractors for a long period ." ]

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

[ "the association between homocysteine and isolated systolic hypertension in older adults was evaluated using a case-control design , and the relationship between homocysteine and clinical or subclinical atherosclerosis was explored .", "cases were @ adults > or = @ years with a systolic blood pressure of > or = @ mm hg and diastolic blood pressure < @ mm hg .", "one hundred seventy-one control subjects had the same criteria except systolic blood pressures were < @ mm hg .", "all had normal creatinine levels .", "homocysteine levels were performed on fasting blood samples that had been stored at -@ degrees c. atherosclerosis was defined as either a history of clinical disease , an internal carotid stenosis of > or = @ % by duplex scan , or an ankle/arm pressure ratio of < @ .", "the median homocysteine value was @ micromol/l for cases and @ for control subjects ( p < @ ) .", "after control for potential confounders , homocysteine remained significantly associated with systolic hypertension ( p = @ ) .", "for the hypertensive group , there was no apparent association between level of homocysteine and prevalence of atherosclerosis .", "however , among the normotensive group , the prevalence of atherosclerosis went from @ % in the lowest quintile of homocysteine values to @ % in the fifth quintile , with an odds ratio of @ ( fifth quintile in comparison to the first , p < @ ) .", "after adjustment for age , sex , systolic blood pressure , cholesterol , and smoking , this odds ratio increased to @ ( p < @ ) .", "elevated levels of homocysteine may be related to the cause of isolated systolic hypertension in some individuals .", "in normotensive older adults , homocysteine appears to be an independent risk factor for atherosclerosis ." ]

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

[ "to compare awareness of hypoglycaemia and physiological responses to hypoglycaemia with human and porcine insulin in diabetic patients who reported loss of hypoglycaemia awareness after transferring to human insulin .", "double blind randomised crossover study of clinical experience and physiological responses during slow fall hypoglycaemic clamping with porcine and human insulin .", "clinical investigation unit of teaching hospital recruiting from diabetes clinics of five teaching hospitals and one district general hospital .", "@ patients with insulin dependent diabetes mellitus of more than five years ' duration who had reported altered hypoglycaemia awareness within three months of transferring to human insulin .", "glycaemic control and frequency of hypoglycaemic episodes during two months ' treatment with each insulin .", "glucose thresholds for physiological and symptomatic responses during clamping .", "glycaemic control did not change with either insulin .", "@ hypoglycaemic episodes ( eight severe ) were reported with human insulin and @ ( nine severe ) with porcine insulin ( @ % confidence interval -@ to @ , p = @ ) .", "@ episodes of biochemical hypoglycaemia occurred with human insulin versus @ with porcine insulin ( -@ to @ , p = @ ) .", "during controlled hypoglycaemia the mean adrenaline response was @ nmol/l/@ min for both insulins ; neurohormonal responses were triggered at @ ( se @ ) versus @ ( @ ) mmol/l of glucose for adrenaline and @ ( @ ) versus @ ( @ ) mmol/l for subjective awareness .", "these data suggest that human insulin per se does not affect the presentation of hypoglycaemia or the neurohumoral , symptomatic , and cognitive function responses to hypoglycaemia in insulin dependent diabetic patients with a history of hypoglycaemia unawareness ." ]

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

[ "motivational interviewing ( mi ) is effective in promoting behavioural changes in patients with substance abuse and smoking .", "however , its effectiveness on health outcomes in cardiac rehabilitation patients is unclear .", "a randomized controlled trial .", "a total of @ patients assessed as having poor motivation attended a cardiac rehabilitation programme from february @ to june @ .", "patients ( n = @ ) in the control group received usual care while those in the experimental group ( n = @ ) received usual care plus four sessions of mi , each lasting @-@min .", "clinical and psychological outcomes and health-related quality of life were measured at baseline and @ months after entering the programme .", "descriptive statistics , independent t-test , pearson chi-squared test , and generalized estimating equations models were used to analyse the data .", "there was no significant difference between the two groups on clinical outcomes ( all p-values > @ ) .", "patients in the experimental group had higher increases in health-related quality of life ( sf-@ ) scores in the aspects of general health ( @ , @ % ci @-@ @ ; p = @ ) and role limitation due to emotional problems ( @ , @ % ci @-@ @ ; p = @ ) .", "however , they reported significantly higher increases in anxiety levels ( hospital anxiety and depression scale ) than those in the control group ( @ , @ % ci @-@ @ ; p = @ ) .", "the short-term effectiveness of mi on clinical outcomes and health-related quality of life in poorly motivated cardiac rehabilitation patients is limited .", "mi , however , was shown to increase anxiety levels of patients during the study period ( @ months ) .", "more evidence is needed to better understand this phenomenon in the future studies ." ]

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

[ "the uncertainty surrounding dietary requirements for selenium ( se ) is partly due to limitations in biomarkers of se status that are related to health outcomes .", "in this study we determined the effect of different doses and forms of se on gene expression of selenoprotein s ( seps@ ) , selenoprotein w ( sepw@ ) and selenoprotein r ( sepr ) , and responses to an immune function challenge , influenza vaccine , were measured in order to identify functional markers of se status .", "a @ week human dietary intervention study was undertaken in @ volunteers who received placebo , @ , @ or @ g/day se-enriched yeast ( se-yeast ) or meals containing unenriched or se-enriched onions ( @ g/day ) .", "gene expression was quantified in rna samples extracted from human peripheral blood mononuclear cells ( pbmc 's ) using quantitative rt-pcr .", "there was a significant increase in sepw@ mrna in the se-enriched onion group ( @ g/day ) compared with the unenriched onion group .", "sepr and sepw@ did not change significantly over the duration of the supplementation period in the control or se-yeast groups , except at week @ when sepw@ mrna levels were significantly lower in the @ g/day se-yeast group compared to the placebo group .", "levels of seps@ mrna increased significantly @ days after the influenza vaccine challenge , the magnitude of the increase in seps@ gene expression was dose-dependent , with a significantly greater response with higher se supplementation .", "this novel finding provides preliminary evidence for a role of seps@ in the immune response , and further supports the relationship between se status and immune function .", "clinicaltrials.gov [ nct@ ] ." ]

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

[ "to provide preliminary evidence on the effectiveness and optimal dosage of megestrol acetate for older persons with impaired appetite after hospitalization .", "randomized clinical trial .", "acute care hospital .", "forty-seven older persons ( mean age @ ) who were recently discharged from an acute care hospital and had fair or poor appetite .", "participants were randomized to placebo or megestrol acetate suspension @ mg , @ mg , or @ mg daily for @ weeks .", "appetite , health-related quality of life , and adverse effects were measured at baseline and @ , @ , and @ days .", "serum nutritional markers were measured at baseline and @ and @ days .", "during the course of the study , there were no significant differences between treatment groups on any of the appetite questions , although participants in the @-mg and @-mg groups demonstrated significant improvement from baseline on some questions .", "at @ days , prealbumin increased in a dose-response relationship across the four groups ( by @ , @ , @ , and @ mg/dl , respectively ) .", "participants in the @-mg and @-mg groups demonstrated greater improvement in prealbumin levels at @ days than those receiving placebo ( p = @ and p = @ , respectively ) and those in the @-mg group also demonstrated improvement at @ days ( p = @ ) .", "at @ days , no participant taking placebo had a morning serum cortisol level less than @ ng/ml ( the lower limit of normal ) .", "in contrast , @ % , @ % , and @ % of those taking @ mg , @ mg and @ mg , respectively , had values below this level ; by @ days , these percentages were @ % , @ % , @ % , and @ % , respectively .", "no patient reported clinical symptoms of adrenal insufficiency .", "diarrhea developed in three subjects , and thromboembolism occurred in two receiving active treatment .", "megestrol acetate at doses of @ mg and @ mg increases prealbumin in recently hospitalized older persons .", "cortisol suppression is common at higher doses and may be persistent .", "in this small study , the drug did not confer benefit on other nutritional or clinical outcomes ." ]

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

[ "people with non-diabetic hyperglycaemia might be at risk of lacking adequate control for cardiovascular risk factors .", "our aim was to determine the extent of health care utilization and provision in primary care and to evaluate the risk of cardiovascular disease in persons with an elevated risk score in a stepwise diabetes screening programme .", "a total of @,@ non-diabetic patients , aged @-@ years , from @ practices in the netherlands were invited to participate in a screening programme starting with a questionnaire .", "those with an elevated score , underwent further glucose testing .", "screened participants with type @ diabetes ( n = @ ) , impaired glucose tolerance ( igt ) ( n = @ ) , impaired fasting glucose ( ifg ) ( n = @ ) , and normal glucose tolerance ( ngt ) ( n = @ ) were compared after three years regarding use of medication , care provider encounters and occurrence of cvd .", "in all glucose regulation categories cardiovascular medication was prescribed more frequently during follow-up with the strongest increase in diabetic patients .", "number of practice visits was higher in diabetic patients compared to those in the other categories .", "glucose , lipids , and blood pressure were measured most frequently in diabetic patients .", "numbers of cardiovascular events in participants with ngt , ifg , igt and diabetes were @ , @ , @ and @ per @,@ person-years ( non significant ) , respectively .", "after three years of follow-up , screened non-diabetic participants with an elevated risk score had cardiovascular event rates comparable with diabetic patients .", "screened non-diabetic persons are at risk of lacking optimal control for cardiovascular risk factors while screen-detected diabetic patients were controlled adequately ." ]

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

[ "to comparatively study the efficacy and maternal and fetal side-effects of two doses of bupivacaine associated with morphine and clonidine , administered by the subarachnoid route for cesarean section .", "the study included @ pregnant women at term , distributed into two groups .", "gi : bupivacaine @ mg ( @ ml ) + clonidine @ g ( @ ml ) + morphine @ g ( @ ml ) and gii : bupivacaine @ mg ( @ ml ) + clonidine @ g ( @ ml ) + morphine @ g ( @ ml ) .", "the following parameters were assessed : onset and maximum level of sensory block ; quality of intraoperative and postoperative analgesia ; degree and duration of motor block ; maternal repercussions and apgar score .", "the onset of sensory block , quality of intraoperative analgesia and total duration of analgesia were similar in both groups ; maximum extent of sensory block predominated in t@ ; maximum degree of motor block ( bromage @ ) ; time motor block regression was significantly longer in gii ; hemodynamic , respiratory repercussions , adverse maternal effects and apgar scores were similar between groups .", "in both groups , there was a predominance of drowsy or sleeping patients .", "the addition of morphine and clonidine to low doses of hyperbaric bupivacaine produced adequate anesthesia for cesarean section and good postoperative analgesia , without any maternal and fetal repercussions ." ]

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

[ "in men , the stimulation of gh and inhibition of lh secretion by testosterone requires aromatization to estradiol .", "tamoxifen , a selective estrogen receptor modulator ( serm ) , possesses central estrogen antagonistic effect but peripheral hepatic agonist effect , lowering igf-i .", "thus , tamoxifen is likely to perturb the neuroendocrine regulation of gh and gonadal axes .", "raloxifene , a serm , is used for therapy of osteoporosis in both sexes .", "its neuroendocrine effects in men are poorly understood .", "the aim was to compare the impact of raloxifene and tamoxifen on gh-igf-i and gonadal axes in healthy men .", "we conducted a randomized , open-label crossover study .", "ten healthy men were randomized to @-wk sequential treatment with tamoxifen ( @ and @ mg/d ) and raloxifene ( @ and @ mg/d ) , with a @-wk intervening washout period .", "we measured the gh response to arginine and circulating levels of igf-i , lh , fsh , testosterone , and shbg .", "tamoxifen , but not raloxifene , significantly reduced igf-i levels by @ % ( p < @ ) and increased shbg levels by @ % ( p < @ ) at the higher therapeutic dose .", "there was a nonstatistically significant trend toward a reduction in the gh response to arginine with both serms .", "both drugs significantly increased lh , fsh , and testosterone concentrations .", "the mean increase in testosterone ( @ vs. @ % ; p < @ ) and lh ( @ vs. @ % ; p < @ ) was significantly greater with tamoxifen than with raloxifene treatment .", "tamoxifen , but not raloxifene , reduces igf-i levels .", "both serms stimulate the gonadal axis , with tamoxifen imparting a greater effect .", "we conclude that in therapeutic doses , raloxifene perturbs the gh and gonadal axes to a lesser degree than tamoxifen ." ]

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

[ "based on the rationale that the ablation of thyroid remnant can effectively reduce the risk for recurrence of differentiated thyroid carcinoma ( dtc ) and hence decrease the case fatality rate .", "this randomized controlled trial was designed to assess the value of hydrochlorothiazide in the ablation of thyroid remnant with @i .", "thirty consecutive dtc patients with thyroid remnant after thyroid surgery were divided into two groups by randomization , the hydrochlorothiazide group received hydrochlorothiazide @ mg tid for @ days , the control group received placebo .", "responses to treatment were evaluated by the increment of thyroid @i uptake rate at @ h and the augmentation of @i absorbed dose .", "in the hydrochlorothiazide group , the @ h @i uptake rate was about ( @ + / -@ ) times larger than that before treatment , the absorbed dose was about ( @ + / -@ ) times larger than that before treatment .", "and in comparison with the control group , the @ h @i uptake rate of the hydrochlorothiazide group was significantly increased and the @i absorbed dose was significantly augmented .", "hydrochlorothiazide is effective for increasing @ h @i uptake rate and augmenting @i absorbed dose of thyroid remnant ." ]

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

[ "single doses of inhaled beclomethasone or inhaled cromolyn , given before allergen inhalation , inhibit allergen-induced late asthmatic responses ( lars ) and increased airway responsiveness ( delta log methacholine pc@ ) .", "we hypothesized that when given @ hours after allergen , beclomethasone might work better than cromolyn .", "in @ patients with mild , stable , atopic asthma with lars or delta log pc@ or both , we performed a double-blind , double-dummy , random-order trial comparing a single dose of inhaled beclomethasone ( @ micrograms ) , cromolyn ( @ mg ) , and placebo , administered @ hours after allergen challenge on lar and delta log pc@ .", "the treatment effect on lar was significant ( p < @ ) .", "the lar after beclomethasone ( @ % + / - @ % ) was significantly less than after cromolyn ( @ % + / - @ % ) or placebo ( @ % + / - @ % ) ; cromolyn was not different from placebo .", "there was a borderline treatment effect on delta log pc@ ( p = @ ) with beclomethasone ( @ + / - @ ) less than placebo ( @ + / - @ ) but not less than cromolyn ( @ + / - @ ) .", "beclomethasone ( @ micrograms ) administered @ hours after allergen challenge markedly inhibited the lar and had a small effect on allergen-induced airway responsiveness .", "cromolyn ( @ mg ) was not effective on maximal lar ; a small effect on the early part of the lar was suggested ." ]

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

[ "cultural differences in socialization can lead to characteristic differences in how we perceive the world .", "consistent with this influence of differential experience , our perception of faces ( e.g. , preference , recognition ability ) is shaped by our previous experience with different groups of individuals .", "here , we examined whether cultural differences in social practices influence our perception of faces .", "japanese , chinese , and asian-canadian young adults made relative age judgments ( i.e. , which of these two faces is older ? )", "for east asian faces .", "cross-cultural differences in the emphasis on respect for older individuals was reflected in participants ' latency in facial age judgments for middle-age adult faces -- with the japanese young adults performing the fastest , followed by the chinese , then the asian-canadians .", "in addition , consistent with the differential behavioural and linguistic markers used in the japanese culture when interacting with individuals younger than oneself , only the japanese young adults showed an advantage in judging the relative age of children 's faces .", "our results show that different sociocultural practices shape our efficiency in processing facial age information .", "the impact of culture may potentially calibrate other aspects of face processing ." ]

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

[ "to examine the feasibility of using an emotional expression intervention with patients with cancer and test the hypothesis that emotional expression improves psychosocial adjustment .", "sequentially randomized pretest/post-test design with repeated measures .", "two radiation therapy ( rt ) facilities .", "women completing rt for stage i or ii breast cancer , who spoke and read english , were independent in self-care , and provided written consent .", "subjects ( n = @ ) were middle-aged ( mean = @ years ) , caucasian , married , and well educated .", "following a baseline interview , subjects were sequentially randomized to an attentional control group , a single dose , or a three-dose emotional expression writing group .", "interventions were administered at the time of completion of rt. .", "follow-up telephone interviews were completed at @ , @-@ , @ , and @ weeks post-rt .", "positive and negative affect , intrusiveness of thoughts , use of avoidant coping , side effect severity , trait negative affectivity , content of written essay , and themes derived from content analysis .", "a high level of acceptance and completion of emotional expression existed , but no effect of the intervention on psychosocial adjustment was evident .", "process measures in the three-dose group changed as expected .", "no relationship existed between content changes and outcome measures .", "emotional expression is feasible for patients with cancer , but the efficacy of the intervention in improving mood and decreasing cognitive intrusion and avoidance was not supported .", "emotional expression processes were consistent with those seen in other samples and may influence outcomes that were not addressed in this study .", "more extensive testing is needed , including additional outcome variables .", "essays reveal concerns around communication , recurrence , and health behavior changes that should be considered in practice ." ]

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

[ "pre-eclampsia and intrauterine growth restriction ( iugr ) are among the most common causes of fetal and maternal morbidity and mortality .", "the aim of this study was to examine the value of uterine artery doppler in the second subsequent pregnancy in a low risk population for the prediction of pre-eclampsia and iugr at any gestational age .", "patients were randomized into two different groups : group a ( nine patients ) with positive notching both at week @ and @ in both pregnancies ; group b ( five patients ) with bilateral positive notching at week @ and @ only in the second pregnancy .", "during the second pregnancy iugr rate was @ % in patients of group a and @ % in patients of group b ( p = @ ) .", "during the first pregnancy iugr reached @ % in group a and @ % in group b ( p = @ ) .", "in conclusion no significant increase of iugr has been detected if the abnormal maternal doppler ultrasound recurs in subsequent pregnancies ." ]

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

[ "assessment of genotypic change in hiv protease during treatment with saquinavir ( sqv ) in combination with zidovudine ( zdv ) and/or zalcitabine ( ddc ) , to determine the influence of such changes on viral phenotype and response to treatment .", "virologic substudies of phase iii clinical trials nv@ and sv@ .", "population sequencing of hiv protease genes amplified from pre - and post-treatment plasma .", "phenotyping of peripheral blood mononuclear cell ( pbmc ) - derived virus isolates , and genotyping of proviral dna clones amplified from pbmc used in the expansion of virus isolates .", "in both trials the incidence of met@ remained at < or = @ % in subjects receiving sqv in combination with ddc ( with or without zdv ) for @ year .", "a val@ substitution was observed in two out of @ subjects after @ weeks and in two out of @ subjects after @ weeks .", "in @ out of @ nv@ subjects with viral load rebound during sqv monotherapy these substitutions were associated with the rebound .", "in subjects treated with sqv plus ddc , rebound was associated with sqv resistance in six out of @ cases and ddc resistance in five out of @ cases .", "the incidences of non-bru residues at positions @ , @ and @ were increased significantly ( p < @ , fisher 's exact test ) after sqv treatment with or without zdv .", "however , comparison of genotypic and phenotypic data showed that these changes were not associated with reduced sensitivity to sqv .", "virological failure during combination therapy can be due to resistance to either treatment drug , emphasising the need to change both the reverse transcriptase inhibitor and the protease inhibitor .", "only val@ and met@ correlated directly with the development of reduced drug sensitivity during treatment with sqv in vivo ." ]

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

[ "cluster immunotherapy represents an interesting alternative to conventional up-dosing schedules because it allows achieving the maintenance dose within a shorter time interval .", "in this study , the efficacy and safety of cluster immunotherapy with a high polymerized allergen extract of a grass/rye pollen mixture have been evaluated in a randomized , double-blind , placebo-controlled , multicenter study .", "in total , @ patients with allergic rhinoconjunctivitis due to grass pollen were randomized @:@ to verum or placebo group .", "a short cluster up-dosing schedule of only @week was applied to achieve the maintenance dose which was administered monthly during the study period of @year .", "total combined symptom and medication score ( tcs ) was defined as primary outcome parameter .", "secondary outcome parameters were individual symptom and medication scores , ` well days , ' global improvement as well as immunological effects and nasal allergen challenge .", "the safety profile was evaluated based on the european academy of allergy and clinical immunology grading system .", "significant reduction in the verum compared to the placebo group ( intention-to-treat , population , verum : n = @ ; placebo : n = @ ) was found regarding tcs ( p = @ ) , rhinoconjunctivitis total symptom score ( rtss , p = @ ) , and total rescue medication score ( trms , p = @ ) .", "additionally , secondary outcomes such as ` well days , ' nasal challenge results , and increase of specific igg@ were in favor of the active treatment .", "all systemic adverse reactions ( @ % of all injections in the verum group ) were of mild intensity .", "no severe reactions related to the study medication were observed .", "cluster immunotherapy with high polymerized grass pollen extracts resulted in significant clinical efficacy and has been shown to be a safe treatment for grass pollen-allergic patients ." ]

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

[ "to investigate the effects of xanthigen ( brown marine algae fucoxanthin + pomegranate seed oil ( pso ) ) on body weight , body fat , liver lipids , and blood biochemistry ; and xanthigen and its individual components on resting energy expenditure ( ree ) in obese , non-diabetic female volunteers with non-alcoholic fatty liver disease ( nafld ) and normal liver fat ( nlf ) content .", "sixteen-week , double-blind , randomized , placebo-controlled study .", "food record data , body composition , ree ( only @ volunteers with nafld ) and blood sample analysis were assessed weekly for @ weeks in @ non-diabetic , obese premenopausal women with liver fat content above @ % ( nafld ) n = @ , and below @ % ( nlf ) n = @ .", "xanthigen-@ / @ mg ( @ mg pso + @ mg brown seaweed extract containing @ mg fucoxanthin ) resulted in statistically significant reduction of body weight ( @ + / - @ kg nafld group and @ + / - @ kg nlf group , p < @ ) , waist circumference ( nafld group only ) , body ( @ + / - @ kg nafld group , p < @ ; @ + / - @ kg nlf group , p < @ ) and liver fat content , liver enzymes ( nafld group only ) , serum triglycerides and c-reactive protein .", "weight loss and reduction in body and liver fat content occurred earlier in patients with nlf than in patients with nafld .", "fucoxanthin ( > @ mg ) and xanthigen-@ / @ mg ( @ mg pso + @ mg brown seaweed extract containing @ mg fucoxanthin ) significantly increased ree in nafld subjects compared to placebo .", "xanthigen promoted weight loss , reduced body and liver fat content , and improved liver function tests in obese non-diabetic women .", "xanthigen and fucoxanthin also increased ree .", "this product may be considered a promising food supplement in the management of obesity ." ]

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

[ "to compare the accuracy of axillary dissection with that of axillary node biopsy for staging of lymph nodes in operable breast cancer .", "randomised study .", "district hospital , oestersund , sweden .", "@ women with operable breast cancer who presented between @-@ and @-@ .", "women were randomised ( n = @ in each group ) to have either axillary dissection ( in which all fat tissue was removed from the axilla ) or biopsy ( in which the lower half of the axillary fat , together with obviously malignant nodes were removed for histopathological examination ) .", "number of nodes harvested by each method , and number that contained metastases .", "nodes that contained metastases were found in @ of the patients in the dissection group and @ of those who had undergone biopsy alone .", "the median ( range ) yield of nodes in the dissection group was @ ( @-@ ) and in the biopsy group @ ( @-@ ) , p < @ .", "in only two patients ( one in each group ) were no nodes identified .", "patients without histologically confirmed node metastases were followed up for a median of @ months ; one in the biopsy group had a metastatic node detected three months after operation .", "during the last @ operations the surgeon was asked to assess clinically whether the patients had involved nodes or not ; this had a sensitivity of @ % and a specificity of @ % .", "axillary node dissection and biopsy give similar results in the staging of breast cancer .", "perioperative clinical judgement is unsatisfactory ." ]

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

[ "a pilot trial was carried out to determine if a focussed narrative interview could alleviate the components of suffering and anxiety and depression in advanced cancer patients .", "patients recruited were invited to participate in a focussed narrative interview and reflect on their perspectives on their sense of `` meaning '' , regarding suffering and their psychological , physical , social and spiritual well being - the emphasis was on allowing the patient to tell their story .", "patients were encouraged to share what resources they themselves had utilised in addition to what professional care they may have received , to maintain a sense of well being .", "patients with advanced metastatic disease were recruited from hospices in the north west of england - the only exclusion criteria were not being able to understand written and spoken english and a non cancer diagnosis .", "at recruitment patients were asked to complete a numerical scale for suffering ; the brief edinburgh depression scale , edmonton symptom assessment scale ( esas ) , facit spiritual well being questionnaire , demographic information was collected and patients were randomised to either the intervention arm of the trial or the usual care arm of the study .", "patients in both groups were invited to complete each measure at @ , @ and @ weeks .", "one hundred people were recruited into the study - @ were randomised to intervention group and @ to control group .", "the median age of patients was @ years age range ( @-@ years ) and @ % of patients were female .", "at baseline the ecog performance of @ % of patients recruited was @ or @ .", "the median survival of all patients in the study was @ days ( range @ days to still alive at end of study ) .", "there was no significant difference at any timepoint in scores on suffering measure between intervention group and control group .", "at each time point the intervention demonstrated mean improvement in scores for depression and anxiety on esas - the greatest changes for both depression and anxiety were seen at @ weeks .", "this pilot randomised controlled trial of a focussed narrative intervention demonstrated an improvement in mean changes in scores for depression and anxiety at @ , @ , and @ weeks .", "we suggest this intervention may have beneficial effects on depression and anxiety , but a larger powered trial is required to determine the full effects ." ]

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

[ "the aim of this study was to investigate the efficacy and safety of @ mg vardenafil orodispersible tablet ( odt ) vs. placebo in a general population of men with erectile dysfunction ( ed ) .", "this was a double-blind , multicentre , randomised , parallel-group , placebo-controlled study conducted at @ centres in australia , canada , mexico and the united states .", "subjects aged > or = @ years , with ed for at least @ months , were randomised to receive @ weeks of on-demand treatment with either @ mg vardenafil odt or placebo .", "each treatment group was stratified such that approximately half of the subjects were aged > or = @ years .", "primary efficacy variables were the erectile function domain of the international index of erectile function ( iief-ef ) and sexual encounter profile questions @ ( sep@ ) and @ ( sep@ ) .", "secondary variables included sep diary questions @ , @ , @ and @ , the patient version of the treatment satisfaction scale ( tss ) and the global assessment question ( gaq ) .", "of the @ men enrolled in the study ( @ % aged > or = @ years ) , @ were included in the intent-to-treat population ( vardenafil odt , n = @ ; placebo , n = @ ) .", "vardenafil odt therapy was statistically significantly superior to placebo for all primary ( i.e. iief-ef , sep@ , sep@ ) and secondary efficacy variables ( p < @ ) .", "treatment-emergent adverse events were mostly mild to moderate in severity , and comparable in both incidence and type with those of the film-coated tablet formulation .", "treatment with @ mg vardenafil odt , taken on demand , significantly improved erectile function and was effective and well tolerated in a broad population of men with ed ." ]

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

[ "although several plaque indices exist , they rarely assess in detail the plaque adjacent to the gingival margin , an area most important for periodontal health .", "this study aims to develop a new marginal plaque index ( mpi ) and to assess its validity and treatment sensitivity compared to the internationally accepted turesky modification of the quigley and hein index ( tqhi ) .", "data from two studies with n = @ and n = @ participants , respectively , are reported here .", "convergence of mpi with tqhi and concurrent and predictive validity with papillary bleeding index were assessed , as was treatment sensitivity to a treatment of proximal hygiene ( study @ ) or toothbrushing ( study @ ) , respectively .", "convergent validity with tqhi is very good .", "concurrent and predictive validity parameters of the mpi are similar to the tqhi .", "the treatment sensitivity of mpi exceeds tqhi by far .", "this results in a reduction by > @ % of the sample size needed to discover significant treatment effects .", "as expected , the largest treatment sensitivity was observed for proximal mpi measures in study @ , whereas study @ showed largest effects for cervical measures .", "mpi appears to be a valid plaque-scoring system that assesses plaque at the gingival margin .", "it responds with high sensitivity to treatments aimed at plaque reduction at the gingival margin .", "its treatment sensitivity and capacity to differentiate between proximal and cervical plaque make it a promising tool for periodontal research ." ]

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

[ "data regarding effects of lower-dose gh on cardiopulmonary function in gh-deficient ( ghd ) adults are limited .", "the objective was to assess effects of lower-dose gh on exercise capacity and echocardiographic parameters in ghd adults .", "the study was a @-month double-blind , placebo-controlled randomized trial .", "the study was conducted at the general clinical research center .", "thirty hypopituitary adults with ghd were studied .", "subjects were randomized to recombinant human gh or placebo for @ months , followed by open-label recombinant human gh for @ months .", "primary endpoints were exercise duration , maximal oxygen consumption , and left ventricular ejection fraction .", "secondary endpoints were echocardiographic indices of systolic and diastolic function , left ventricular mass , lipids , and body composition .", "in the @-month double-blind phase , mean gh dose was @ mg/d .", "mean igf-i sd score increased from -@ to -@ .", "exercise duration , maximal oxygen consumption , left ventricular ejection fraction , and other echocardiographic parameters were normal at baseline and did not change .", "gh decreased total and low-density lipoprotein cholesterol by @ % ( p = @ ) and @ % ( p = @ ) ( p = @ vs. placebo ) .", "mean lean body mass increased by @ kg ( p = @ ) , fat mass decreased by @ kg ( p = @ ) , and percent body fat decreased by @ % ( p = @ ) , although between-group changes were not significant .", "human gh did not improve exercise performance or echocardiographic parameters or decrease fat mass but significantly decreased total and low-density lipoprotein cholesterol , increased igf-i , and increased lean body mass .", "these results indicate that responses to human gh are variable and should be assessed at baseline and during treatment ." ]

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

[ "the age-related eye disease study ( areds ) demonstrated that antioxidant and zinc supplementation decreases progression to advanced age-related macular degeneration ( amd ) in patients with moderate to severe disease .", "we evaluated the interaction of genetics and type of nutritional supplement on progression from moderate to advanced amd .", "genetic analysis of a randomized , prospective clinical trial .", "white patients with areds category @ amd in @ eye and areds categories @ through @ amd in the fellow eye enrolled in the areds with available peripheral blood-derived dna ( @ ) .", "subjects were evaluated for known amd genetic risk markers and treatment category .", "the progression rate to advanced amd was analyzed by genotypes and areds treatment group using cox regression .", "the effect of inherited gene polymorphisms on treatment group-specific rate of progression to advanced amd .", "over an average of @ years , individuals with @ or @ complement factor h ( cfh ) risk alleles derived maximum benefit from antioxidants alone .", "in these patients , the addition of zinc negated the benefits of antioxidants .", "treatment with zinc and antioxidants was associated with a risk ratio ( rr ) of @ with @ cfh risk alleles ( p = @e-@ ) , compared with outcomes for patients without cfh risk alleles .", "patients with age-related maculopathy sensitivity @ ( arms@ ) risk alleles derived maximum benefit from zinc-containing regimens , with a deleterious response to antioxidants in the presence of arms@ risk alleles .", "treatment with antioxidants was associated with an rr of @ for those with @ arms@ risk allele and @ for those with @ arms@ risk alleles ( p = @e-@ ) , compared with patients with no arms@ risk alleles .", "individuals homozygous for cfh and arms@ risk alleles derived no benefit from any category of areds treatment .", "individuals with moderate amd could benefit from pharmacogenomic selection of nutritional supplements .", "in this analysis , patients with no cfh risk alleles and with @ or @ arms@ risk alleles derived maximum benefit from zinc-only supplementation .", "patients with one or two cfh risk alleles and no arms@ risk alleles derived maximum benefit from antioxidant-only supplementation ; treatment with zinc was associated with increased progression to advanced amd .", "these recommendations could lead to improved outcomes through genotype-directed therapy ." ]

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

[ "vitiligo is an acquired skin disorder that is characterized by well-defined , often symmetric white patches .", "although current therapeutic modalities are directed toward increasing melanocyte melanin production , few treatment modalities address the immunologic nature of the disease .", "to determine whether excimer laser , a known therapeutic modality , in combination with tacrolimus , a topical immunomodulator , accelerate response time and/or improve the degree of response in patients with this disorder .", "eight subjects diagnosed with vitiligo were recruited to participate in this institutional review board-approved double-blind , placebo-controlled study .", "twenty-four symmetric vitiliginous patches ( elbows , knees ) from eight subjects received excimer laser treatment three times per week for @ treatments or @ weeks .", "additionally , topical tacrolimus @ % ointment ( protopic ) and placebo ( aquaphor ) were applied to randomized patches ( left or right ) twice daily throughout the length of the trial .", "vitiliginous patches were monitored with photographs at baseline , every @ weeks , and @ months after treatment .", "biopsies were performed on subjects with significant results .", "twenty vitiliginous patches from six subjects qualified for evaluation .", "fifty percent of patches treated with combination excimer laser and tacrolimus achieved a successful response ( @ % repigmentation ) compared with @ % for the placebo group .", "subjects who responded successfully repigmented faster ( @ % ) with combination therapy compared with excimer laser alone .", "additionally , three subjects experienced transient hyperpigmentation in lesions treated with combination therapy .", "combining topical immunomodulators with known phototherapeutic modalities may represent a key advancement in the treatment of disease ." ]

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

[ "mild primary hyperparathyroidism ( phpt ) is a common disease especially in middle-aged and elderly women .", "the diagnosis is frequently made incidentally and treatment strategies are widely discussed .", "to study the effect of parathyroidectomy ( ptx ) compared with observation ( obs ) on biochemistry , safety , bone mineral density ( bmd ) , and new fractures .", "prospective , randomized controlled study ( siph study ) , with a @-year follow-up .", "the study was conducted at multicenter , tertiary referral centers .", "of @ randomized patients with mild phpt , biochemical data were available for @ patients after @ years , with a mean age at inclusion of @ years ( obs group , @ males ) and @ years ( ptx group , @ males ) .", "parathyroidectomy vs observation .", "biochemistry , bmd , and new radiographic vertebral fractures .", "serum-calcium and pth-levels normalized after surgery and did not deteriorate by observation .", "bmd z-scores were normal at inclusion in the lumbar spine ( ls ) and femoral neck ( fn ) .", "for ls , bmd z-scores were stable for @ years with observation , but decreased in fn ( p < @ ) .", "after surgery , bmd z-scores increased significantly in both compartments ( p < @ for both ) , with a highly significant treatment effect of surgery compared to observation ( p < @ ) .", "during follow-up , five new clinically unrecognized vertebral fractures were found in @ females , all in the obs group ( p = @ ) .", "even though new vertebral fractures occurred only in the observation group , the frequency was not significantly different from the surgery group .", "longer follow-up is needed before firm conclusions can be drawn about the long-term safety of observation , as opposed to surgery ." ]

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

[ "to observe the effectiveness and safety of electroacupuncture ( ea ) at neimadian ( extra ) and neiguan ( pc @ ) for analgesia after thoracic surgery .", "one hundred and twenty cases of thoracic surgery were randomly divided into an electroacupuncture ( ea ) group ( @ cases ) and a medication group ( @ cases ) .", "ea was applied at neimadian ( extra ) and neiguan ( pc @ ) for postoperation analgesia in the ea group , while patient-controlled intravenous analgesia ( pcia ) was applied in the medication group .", "the score of visual analogue scale ( vas ) , analgesia effect , safety and beta-endorphin level after the treatment in both groups were compared .", "compared with those before the treatment , the vas scores in every time point after surgery were decreased ( all p < @ ) , which were lower in the ea group ( p < @ ) .", "the excellent and good rates were @ % ( @/@ ) and @ % ( @/@ ) seperately , the analgesia effect in the ea group ( @ h after operation ) was superior to that in the medication group ( p < @ ) .", "the safety degree in ea group was higher to that in the medication group ( p < @ ) .", "compared with that before the treatment , the beta-endorphin level in two groups after treatment was both increased , which was higher in the ea group ( p < @ ) .", "electroacupuncture at neimadian ( extra ) and neiguan ( pc @ ) has better analgesia effect ( @ h after operation ) and safety than pica on analgesia after thoracic surgery ." ]

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

[ "to determine whether manual wheelchair configuration impacts how well a person who has acquired brain injury ( abi ) related hemiparesis performs functional tasks from his or her wheelchair .", "multi-treatment cross-over design .", "inpatient rehabilitation hospital .", "nineteen patients with abi resulting in hemiparesis undergoing inpatient rehabilitation ( average of @ days post-injury ( @ days ) ; age range , @-@ ; @ with mechanical brain injury , @ with cerebral vascular accident ) .", "participants in the study were placed in two different wheelchair configurations ( position one and position two ) and were randomized as to which position they were placed in first .", "all outcome measures were taken twice on each individual within each wheelchair configuration during two consecutive days .", "timed forward wheeling ( tfw ) , modified functional reach test ( mfr ) , visual analogue scale for comfort ( vas ) , transfer score from the functional independence measure ( fim ) , measurement of popliteal fossa to front of cushion .", "the position two seating group 's tfw was significantly faster than the position one seating group at both time points .", "there were no significant differences in the mfr scores , vas comfort scale scores , and fim transfer score between the two groups .", "a wheelchair configuration with no seat slope , solid backrest mounted at @ degree ( @ degrees ) seat to back angle , and use of a solid seat insert with a flat foam cushion ( position two ) results in greater efficiency in foot propulsion for individuals with abi than a wheelchair configuration with one inch of seat slope , solid backrest mounted at @ degree ( @ degrees ) seat to back angle , and no solid seat insert with a gel/foam contoured cushion ( position @ ) ." ]

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

[ "to compare the efficacy of applying hot dry air versus dry air at room temperature to the throat of patients with a newly acquired common cold using a symptom severity score .", "a randomised single-blind controlled trial with a treatment duration of @ days and a follow-up period of @ days was conducted at a sauna in berlin , germany .", "between november @ and march @ and between september @ and april @ , @ patients with symptoms of the common cold were randomly assigned to an intervention group ( n = @ ) and a control group ( n = @ ) .", "participants in the intervention group inhaled hot dry air within a hot sauna , dressed in a winter coat , whereas participants in the control group inhaled dry air at room temperature within a hot sauna , also dressed in a winter coat .", "area under the curve ( auc ) summarising symptom severity over time ( days @ , @ , @ and @ ) , symptom severity scores for individual days , intake of medication for the common cold and general ill feeling .", "no significant difference between groups was observed for auc representing symptom severity over time ( intervention group mean , @ [ sem , @ ] ; control group mean , @ [ sem , @ ] ; group difference , -@ [ @ % ci , -@ to @ ] ; p = @ ) .", "however , significant differences between groups were found for medication use on day @ ( p = @ ) , symptom severity score on day @ ( p = @ ) , and participants ' ratings of the effectiveness of the therapy on day @ ( p = @ ) .", "inhaling hot air while in a sauna has no significant impact on overall symptom severity of the common cold .", "clinicaltrials.gov identifier nct@ ." ]

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

[ "exenatide is an adjunctive therapy for type @ diabetes , and preliminary evidence suggests that its glucoregulatory effects may be similar in the absence of oral therapy .", "study a was a randomized , double-blind , placebo-controlled study of @ patients with type @ diabetes that received either @ microg twice-daily , @ microg once-daily , or @ microg once-daily exenatide or placebo for @ days in the absence of background pharmacotherapy .", "study b was an open-label extension of a short-term study of @ patients with type @ diabetes treated with metformin or diet and exercise .", "patients received exenatide @ microg twice-daily for @ weeks followed by @ microg for @ weeks .", "subjects treated with metformin continued oral therapy .", "monotherapeutic treatment with @ microg of exenatide twice-daily for @ days resulted in significant mean reductions in glycosylated hemoglobin ( a@c ) of -@ + / - @ % and fasting plasma glucose of -@ + / - @ mg/dl compared to increases of +@ + / - @ % and +@ + / - @ mg/dl with placebo .", "self-monitored blood glucose profiles showed significant mean reductions in daily blood glucose concentrations in exenatide-treated patients compared to placebo .", "exenatide treatment for @ weeks in an open-label extension study resulted in similar mean reductions from baseline in a@c and body weight in patients treated with diet and exercise alone ( -@ + / - @ % and -@ + / - @ kg , respectively ) as those treated on a background of metformin ( -@ + / - @ % and -@ + / - @ kg , respectively ) .", "in both studies , the most frequent adverse events were gastrointestinal and predominantly mild to moderate in intensity .", "incidence of mild-to-moderate hypoglycemia was low , with no severe hypoglycemia .", "exenatide twice-daily monotherapy resulted in glycemic improvements and reductions in body weight comparable to that of exenatide combination therapy with metformin in patients with type @ diabetes ." ]