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###23297810 |
BACKGROUND Inappropriate use of antidepressants ( AD ) , defined as either continuation in the absence of a proper indication or continuation despite the lack of therapeutic efficacy , applies to approximately half of all long term AD users . |
METHODS We have designed a cluster randomized controlled clinical trial to assess the ( cost - ) effectiveness of an antidepressant cessation advice in the absence of a proper indication for maintenance treatment with antidepressants in primary care.We will select all patients using antidepressants for over 9 months from 45 general practices . |
METHODS Patients will be diagnosed using the Composite International Diagnostic Interview ( CIDI ) version 3.0 , extended with questions about the psychiatric history and previous treatment strategies . |
METHODS General practices will be randomized to either the intervention or the control group . |
METHODS In case of overtreatment , defined as the absence of a proper indication according to current guidelines , a cessation advice is given to the general practitioner . |
METHODS In the control groups no specific information is given . |
METHODS The primary outcome measure will be the proportion of patients that successfully discontinue their antidepressants at one-year follow-up . |
METHODS Secondary outcomes are dimensional measures of psychopathology and costs . |
CONCLUSIONS This study protocol provides a detailed overview of the design of the trial . |
CONCLUSIONS Study results will be of importance for refining current guidelines . |
CONCLUSIONS If the intervention is effective it can be used in managed care programs . |
BACKGROUND NTR2032 . |
###24687165 |
OBJECTIVE Recent studies show that cerebral - amyloid ( A ) deposition is associated with blood pressure and measures of arterial stiffness in nondemented individuals . |
OBJECTIVE To examine the association between measures of arterial stiffness and change in A deposition over time . |
METHODS Deposition of A was determined in a longitudinal observational study of aging by positron emission tomography using the Pittsburgh compound B twice 2 years apart in 81 nondemented individuals 83 years and older . |
METHODS Arterial stiffness was measured with a noninvasive and automated waveform analyzer at the time closest to the second positron emission tomography scan . |
METHODS All measures were performed under standardized conditions . |
METHODS Pulse wave velocity ( PWV ) was measured in the central ( carotid-femoral and heart-femoral PWV ) , peripheral ( femoral-ankle PWV ) , and mixed ( brachial-ankle PWV ) vascular beds . |
METHODS The change in A deposition over 2 years was calculated from the 81 individuals with repeat A-positron emission tomography . |
RESULTS The proportion of A-positive individuals increased from 48 % at baseline to 75 % at follow-up . |
RESULTS Brachial-ankle PWV was significantly higher among A-positive participants at baseline and follow-up . |
RESULTS Femoral-ankle PWV was only higher among A-positive participants at follow-up . |
RESULTS Measures of central stiffness and blood pressure were not associated with A status at baseline or follow-up , but central stiffness was associated with a change in A deposition over time . |
RESULTS Each standard deviation increase in central stiffness ( carotid-femoral PWV , P = .001 ; heart-femoral PWV , P = .004 ) was linked with increases in A deposition over 2 years . |
CONCLUSIONS This study showed that A deposition increases with age in nondemented individuals and that arterial stiffness is strongly associated with the progressive deposition of A in the brain , especially in this age group . |
CONCLUSIONS The association between A deposition changes over time and generalized arterial stiffness indicated a relationship between the severity of subclinical vascular disease and progressive cerebral A deposition . |
###19078934 |
BACKGROUND In a low socioeconomic-status population of Latina women , we evaluated the potential of storytelling ( ST ) as a culturally aligned narrative method to promote colorectal cancer ( CRC ) prevention and screening , compared to a risk tool ( RT ) - based intervention . |
METHODS Seventy-eight women were randomized in this pilot study to one of two brief interventions to communicate CRC risk reduction options : ST or an RT. . |
METHODS Measures of behavioral intentions relative to CRC prevention and screening were obtained following the intervention . |
RESULTS Mean scores for intent to obtain and recommend endoscopy to others were significantly better for participants receiving ST than RT ( P = .038 and P = .011 , respectively ) . |
RESULTS All participants expressed intent to increase fruit and vegetable consumption and physical activity in response to interventions . |
RESULTS Post-intervention perceptions of cancer risk and fear of CRC were not significantly different for participants receiving ST compared with RT. . |
RESULTS Pre - to post-intervention perceptions of risk increased in ST and decreased in RT , while decreases in fear were similar across both intervention groups . |
CONCLUSIONS Storytelling may be an effective approach for changing CRC risk-related behavioral intentions among Latinas . |
CONCLUSIONS Mediating factors ( such as perceived risk or fear ) often used to predict behavior change may not adequately explain the potential persuasive mechanisms of storytelling . |
###17520382 |
OBJECTIVE To evaluate enhanced recovery after surgery ( ERAS ) protocol in colorectal surgery . |
METHODS From september 2006 to February 2007 , 74 patients with colorectal cancer were randomly assigned to ERAS group and control group . |
METHODS The stress index , nutrition and metabolism index , intraoperative index and postoperative index were evaluated . |
RESULTS Six patients were excluded , 3 in ERAS group ( 2 cases received hepatectomy concomitantly and 1 case received partial ileum resection ) , and 3 in control group ( 1 case received hepatectomy and 1 case received colorectomy concomitantly , another presented asthma paroxysm ) . |
RESULTS So there were 34 cases in ERAS group and 34 cases in control , with no statistical differences in sex , age , BMI index and operation types . |
RESULTS Deviation of HOMA-IR index of ERAS was lower than the control ( P > 0.05 ) , the same as plasma cortisol at the 1st day after operation ( P < 0.05 ) , but plasma glucagons in the operation of ERAS group was higher than that of control ( P < 0.05 ) . |
RESULTS Plasma glucose 1st day after operation of ERAS group was lower than control ( P < 0.05 ) , while plasma triglyceride intraoperation , at 1st day , 2nd day after operation of ERAS was higher than control ( P < 0.05 ) . |
RESULTS Nitrogen negative balance of ERAS group was higher than control at 2nd day after surgery , but is lower intraoperation and at 6th day after operation ( P < 0.05 ) . |
RESULTS The time of exhaust gas and stool , time to eat fluidity and semi-fluidity , out-of-bed time and exercise time per-day , residual time and complication rate in ERAS group were better than those of control ( P < 0.05 ) . |
RESULTS Post-operative expenses of ERAS was lower than that of control ( P < 0.05 ) . |
CONCLUSIONS ERAS can decrease surgical stress , increase functional recovery and reduce complication rate . |
###11390121 |
OBJECTIVE To demonstrate equivalent efficacy for menopausal symptoms between Aerodiol nasal spray and reference oral estradiol therapy , and to investigate the endometrial safety and tolerability of Aerodiol in the long term . |
METHODS The efficacy of Aerodiol 300 microg , once daily , was compared with oral estradiol 2 mg/day in a randomized , double-blind trial . |
METHODS A statistical test of noninferiority was performed on the mean absolute Kupperman index ( KI ) obtained after 14 and 23 weeks of the two treatments . |
METHODS Long-term safety was assessed in a 1-year open-label study . |
METHODS The initial Aerodiol dose was 300 microg/day , and was adjusted if required . |
METHODS Endometrial biopsies were obtained at inclusion and at the end of the trial and examined independently by two pathologists . |
RESULTS In the equivalence trial , the KI improved similarly in the Aerodiol group ( n = 317 ) and the oral estradiol group ( n = 342 ) . |
RESULTS Aerodiol was shown statistically to be at least as effective as oral therapy ( P < 0.001 ) , but the incidences of mastalgia and withdrawal bleeding were significantly lower in the Aerodiol group ( P < 0.01 and P < 0.001 , respectively ) . |
RESULTS In the long-term safety trial ( n = 408 ) , the rate of Aerodiol treatment continuation at 12 months was 85 % , and there was no incidence of endometrial hyperplasia or cancer . |
RESULTS Aerodiol dose adaptation was performed by 29 % of women . |
CONCLUSIONS Aerodiol was shown to have equivalent efficacy to reference oral estradiol therapy , but with better gynaecological acceptability . |
CONCLUSIONS The endometrial safety of Aerodiol was confirmed in the long term , and the ability to adjust the dosage easily was of benefit to a substantial proportion of women . |
###20369533 |
OBJECTIVE To observe the operative technique and clinical effects of hidden tension suture after tibiofibular fracture fixation with absorbable thread . |
METHODS From October 2003 to October 2008 , 203 patients ( 220 sides ) with tibiofibular fracture underwent hidden tension suture ( test group , 102 cases of 112 sides ) and the common interrupted suture ( control group , 101 cases of 108 sides ) , including 179 males and 24 females with an median age of 36 years ( 3-75 years ) . |
METHODS Fracture was caused by traffic accident in 170 cases , by heavy bruise in 21 cases , and by falling from height in 12 cases . |
METHODS There were 186 cases of single-side fracture , and 17 cases of double-side fracture . |
METHODS Of them , 127 sides were closed fracture , and 93 sides were open fracture ( including 38 sides of type I , 45 sides of type II , and 10 sides of type IIIA according to Gustilo classification for the open fracture ) . |
METHODS The locations were upper tibia in 55 sides , middle tibia in 126 sides , and lower tibia in 39 sides . |
METHODS The X-ray films showed that there were transverse fractures in 65 sides , oblique fractures in 53 sides , spiral fractures in 45 sides , and comminuted fractures in 57 sides . |
METHODS No blood vessel injury , osteofascial compartment syndrome and pressure syndrome were observed . |
METHODS The time from injury to operation was 2 hours to 7 days with an average of 2 days . |
METHODS Of 220 sides , 45 sides were fixed by interlocking nails , others by internal steel plate . |
RESULTS In control group , healing by first intention was achieved in 70 cases ( 69.3 % ) and healing by secondary intention in 31 cases ( 30.7 % ) ; in test group , healing by first intention was achieved in 93 cases ( 91.2 % ) and healing by secondary intention in 9 cases ( 8.8 % ) ; and showing significant difference ( P < 0.05 ) . |
RESULTS All patients were followed up for 6 months to 2 years ( average 9 months ) . |
RESULTS No complication occurred in test group , and scar was obvious in the control group . |
CONCLUSIONS The hidden tension suture with absorbable thread can be a good alternative for the incision healing after tibiofibular fracture fixation . |
CONCLUSIONS It deals with the problems of the incision tension and difficult-to-suture , and is good for the incision healing after operation . |
###21641516 |
OBJECTIVE To observe the effect of regular yogic practices and self-discipline in reducing body fat and elevated lipids in CAD patients . |
METHODS In this study one hundred seventy ( 170 ) subjects , of both sexes having coronary artery disease were randomly selected form Department of Cardiology . |
METHODS Subjects were divided in to two groups randomly in yoga group and in non-yoga group , eighty five ( 85 ) in each group . |
METHODS Out of these ( 170 subjects ) , one hundred fifty four ( 154 ) completed the study protocol . |
METHODS TIME LINE : The yogic intervention consisted of 35-40 min/day , five days in a week till six months in the Department of Physiology CSMMU UP Lucknow . |
METHODS Body fat testing and estimation of lipid profile were done of the both groups at zero time and after six months of yogic intervention in yoga group and without yogic intervention in non yoga group . |
RESULTS In present study , BMI ( p < 0.04 ) , fat % ( p < 0.0002 ) , fat free mass ( p < 0.04 ) , SBP ( p < 0.002 ) , DBP ( p < 0.009 ) , heart rate ( p < 0.0001 ) , total cholesterol ( p < 0.0001 ) , triglycerides ( p < 0.0001 ) , HDL ( p < 0.0001 ) and low density lipoprotein ( p < 0.04 ) were changed significantly . |
CONCLUSIONS Reduction of SBP , DBP , heart rate , body fat % , total cholesterol , triglycerides and LDL after regular yogic practices is beneficial for cardiac and hypertensive patients . |
CONCLUSIONS Therefore yogic practices included in this study are helpful for the patients of coronary artery disease . |
###20131031 |
OBJECTIVE To observe the effect of Chinese medicine therapy for strengthening-Pi and nourishing-Shen ( SPNS ) in preventing lamivudine induced YMDD mutation and its immunological mechanism . |
METHODS One hundred and sixty chronic hepatitis B ( CHB ) patients with positive HBeAg were equally assigned to two groups at random : the observation group and the control group . |
METHODS Patients in the observation group were treated with lamivudine combined with SPNS , and those in the control group were treated with lamivudine only , with the treatment lasting for 52 weeks in total . |