Datasets:

yxchar

/

rct-20k-tlm

like 0

All 3 treatment arms demonstrated a significant improvement of about 5-6 points in HDRS-17 scores ( P < .001 for all ) , and no significant differences were observed between the treatment arms ( P > .05 for all ) .

Response rates in the intent-to-treat sample were 36 % for SAMe , 34 % for escitalopram , and 30 % for placebo .

Remission rates were 28 % for SAMe , 28 % for escitalopram , and 17 % for placebo .

No comparisons between treatment groups attained significance ( P > .05 for all ) .

Tolerability was good , with gastrointestinal side effects ( 19 % for stomach discomfort and 20 % for diarrhea ) as the most common in the SAMe arm .

Significant differences were observed between treatment groups for dizziness , anorgasmia , diminished mental acuity , and hot flashes ( P < .05 for all ) .

The results fail to support an advantage over placebo for either the investigational treatment SAMe or the standard treatment escitalopram for MDD .

ClinicalTrials.gov identifier : NCT00101452 .

Total weight loss induced by energy restriction is highly variable even under tightly controlled conditions .

Identifying weight-loss discriminants would provide a valuable weight management tool and insights into body weight regulation .

This study characterized responsiveness to energy restriction in adults from variables including the plasma metabolome , endocrine and inflammatory markers , clinical indices , body composition , diet , and physical activity .

Data were derived from a controlled feeding trial investigating the effect of 3-4 dairy product servings in an energy-restricted diet ( 2092 kJ/d reduction ) over 12 wk .

Partial least squares regression was used to identify weight-loss discriminants in 67 overweight and obese adults .

Linear mixed models were developed to identify discriminant variable differences in high - vs. low-weight-loss responders .

Both pre - and postintervention variables ( n = 127 ) were identified as weight-loss discriminants ( root mean squared error of prediction = 1.85 kg ; Q ( 2 ) = 0.43 ) .

Compared with low-responders ( LR ) , high-responders ( HR ) had greater decreases in body weight ( LR : 2.7 1.6 kg ; HR : 9.4 1.8 kg , P < 0.01 ) , BMI ( in kg/m ( 2 ) ; LR : 1.0 0.6 ; HR : 3.3 0.5 , P < 0.01 ) , and total fat ( LR : 2.2 1.1 kg ; HR : 8.0 2.1 kg , P < 0.01 ) .

Significant group effects unaffected by the intervention were determined for the respiratory exchange ratio ( LR : 0.86 0.05 ; HR : 0.82 0.03 , P < 0.01 ) , moderate physical activity ( LR : 127 52 min ; HR : 167 68 min , P = 0.02 ) , sedentary activity ( LR : 1090 99 min ; HR : 1017 110 min , P = 0.02 ) , and plasma stearate [ LR : 102,000 21,000 quantifier ion peak height ( QIPH ) ; HR : 116,000 24,000 QIPH , P = 0.01 ] .

Overweight and obese individuals highly responsive to energy restriction had accelerated reductions in adiposity , likely supported in part by higher lipid mobilization and combustion .

A novel observation was that person-to-person differences in habitual physical activity and magnitude of weight loss were accompanied by unique blood metabolite signatures .

This trial was registered at clinicaltrials.gov as NCT00858312 .

Endovascular repair of abdominal aortic aneurysm ( AAA ) has recently been made a class I indication in the treatment of AAA .

In comparison to the conventional open surgical treatment , endovascular AAA repair ( EVAR ) is associated with equivalent long-term morbidity and mortality rates .

Vascular surgeons perform majority of EVAR .

There are no reports for the long-term results of this intervention performed by interventional cardiologists .

We present one of the first reports of periprocedural and long-term outcomes of EVAR performed by interventional cardiologists .

Retrospective chart review on patients with attempted EVAR between September 2005 and January 2011 was performed .

Included cases were all consecutive patients who had attempted EVAR by interventional cardiologists .

During the study period EVAR was attempted in 170 patients , with 27 % being women .

The mean age was 74 years ( range 52-93 ) .

The endovascular graft placement was successful in 96 % ( 163/170 ) of patients .

Procedure failures were more common in women ( 6 of 46 vs 1 of 124 , P = 0.003 ) .

The 30-day mortality was 1.8 % ( 3 of 170 ) .

In patients with successful EVAR the mean follow-up was 30 months and mean length of hospital stay was 3.53.2 days .

Major periprocedural complications were noted in 9 % patients ( 15 of 167 ) .

During follow-up , six patients ( 3.5 % ) required re-intervention and additional 16 patients died with no aneurysm related deaths .

EVAR primarily performed by interventional cardiologists demonstrates high periprocedural and long-term success rates .

A higher EVAR failure rate has been observed in women .

Anorexia nervosa ( AN ) is a severe illness with high rates of relapse .

Exposure and Response Prevention for AN ( AN-EXRP ) is a new approach that specifically addresses maladaptive eating behavior by targeting eating-related fear and anxiety .

The aim of this study was to evaluate AN-EXRP as an adjunctive strategy to improve eating behavior during weight restoration , at a pivotal moment when treatment goals shift toward relapse prevention .

A randomized controlled trial was conducted to compare AN-EXRP with a comparison condition , Cognitive Remediation Therapy ( CRT ) .

Hospitalized patients with AN ( n = 32 ) who had achieved weight restoration to a BMI > 18.5 kg/m ( 2 ) received 12 sessions of either AN-EXRP or CRT .

Outcome was assessed by change in caloric intake in an objective assessment of eating behavior .

The average test meal caloric intake of participants who received AN-EXRP increased from 352263 kcal at baseline to 401215 kcal post-treatment , while that of participants who received CRT decreased from 501232 kcal at baseline to 424221 kcal post-treatment [ t ( 28 ) = 2.5 , p = .02 ] .

Improvement in intake was significantly associated with improvement in eating-related anxiety ( Spearman 's = 0.40 , p = .03 ) .

These data demonstrate that AN-EXRP , compared to a credible comparison intervention , is associated with better caloric intake in a laboratory meal over time in AN .

Additional studies are required to determine whether incorporation of these techniques into a longer treatment program leads to enduring and clinically significant change .

Aggressive behaviour in psychosis is not uncommon .

Community provision for people with psychosis has left informal caregivers to take on a greater role in their care .

However , few studies have explored links between patient-initiated violence in mental health caregiving relationships and caregiver functioning .

Our study investigated caregiver reports of aggressive acts committed by their relative with psychosis and their links to caregiver appraisals of the caregiving relationship and caregiver outcomes .

Caregivers of patients with a recent relapse of psychosis , recruited to a psychological therapy trial , completed the audiotaped Camberwell Family Interview at baseline .

This semi-structured interview includes questions on the quality of the relationship between caregiver and patient , and patient history of violence .

Seventy-two transcripts of interviews were assessed for reports of patient-initiated violence .

One-half of the caregiver sample ( 52.9 % ) reported an incident of patient-initiated violence during their interview ; 62.2 % of these involved violence toward themselves , and 24.3 % toward property .

Reports of patient violence were associated with caregiver ratings of hostility expressed toward patients , lower self-esteem , and emotion-focused coping .

People caring on their own were more likely to report incidents of patient violence .

Younger patients , males , and inpatients were more frequently identified as having a history of this kind of violence .

Our findings suggested that caregiver reports of patient-initiated violence in psychosis are not uncommon .

Mental health staff need to be aware of the risks of such violence for caregivers of people with psychosis , and consider appropriate procedures for minimizing it .

Positive-pressure ventilation during transport of intubated patients is generally delivered via a hand-pressurized device .

Of these devices , self-inflating resuscitators ( SIR ) and flow-inflating resuscitators ( FIR ) constitute the two major types used .

Selection of a particular device for transport , however , remains largely an institutional practice .

To evaluate the hypothesis that transport ventilation goals of intubated pediatric patients are better achieved using an FIR compared to an SIR .

This randomized crossover simulation study compared the performance of SIR and FIR among anesthesia providers in a pediatric transport scenario .

Subjects hand-ventilated a test lung while simultaneously maneuvering a stretcher bed to simulate patient transport .

Hand ventilation was carried out using a Jackson-Rees circuit ( FIR ) and a Laerdal pediatric silicone resuscitator ( SIR ) .

The primary outcome was the proportion of total breaths delivered within the predefined target PIP/PEEP range ( 30 + / - 3 , 10 + / - 3 cm H2O ) .

Secondary outcomes included proportion of total breaths delivered with operationally defined unacceptable breath variables ( PIP > 35 cm H2O or PEEP < 5 cm H2O ) .

Overall , participants were four times more likely to deliver target breaths and one-third less likely to deliver unacceptable breaths using the FIR compared to the SIR .

When comparing device performance , a 44 % increase in the proportions of target breaths and a 40.4 % decrease in unacceptable breaths using the FIR were observed ( P < 0.0001 for both ) .

Hand ventilation during patient transport is superior using the FIR compared to the SIR to achieve target ventilatory goals and avoid unacceptable ventilatory cycles .

To examine efficacy of hysteroscopic removal of polyps and myomas on health-related quality of life and symptom severity at 1-year postprocedure .

Randomized , prospective , comparative setting clinical trial ( Canadian Task Force classification II-2 ) .

Nine outpatient obstetrics and gynecology practices and hospitals in the United States .

Women 18 to 55years of age with polyps and/or type 0 or I myomas 1.5 and 3.0 cm .

Treatment of polyps and fibroids with the MyoSure device .

A total of 118 lesions ( 76 polyps , 42 myomas ) were removed .

Among the 118 pathologies removed , 53 were removed in an office setting ( 28 myomas , 25 polyps ) , and 55 were removed in an ambulatory surgical center ( ASC ) setting ( 14 myomas , 41 polyps ) .

The mean percentage of pathology removed was 95.96.8 % for fibroids and 99.9 0.7 % for polyps .

Symptom severity as measured by the Uterine Fibroid Symptom-Quality of Life ( UFS-QOL ) scale improved significantly ( p < .01 ) between baseline ( mean score of 67.515.4 ) and 12months postprocedure ( mean score of 22.322.6 ) .

The Health-Related Quality of Life ( HRQOL ) scale also improved significantly ( p < .01 ) between baseline ( mean score 38.723.3 ) and 12months postprocedure ( mean score of 83.924.4 ) .

Both the office and ASC groups demonstrated a statistically significant ( p < .01 ) improvement in UFS-QOL and HRQOL .

For women with intrauterine polyps and/or myomas who experienced abnormal uterine bleeding , hysteroscopic morcellation with the MyoSure device provided significant , durable health-related , quality-of-life improvements up to 12months postprocedure .

These findings were the same for patients treated in both an office-based setting and ASCs .

To evaluate the effects of a home-monitoring device with tele-monitoring compared with standard care in detection of progression to choroidal neovascularization ( CNV ) associated with age-related macular degeneration ( AMD ) , the leading cause of blindness in the US .

Participants , aged 55 to 90 years , at high risk of developing CNV associated with AMD were recruited to the HOme Monitoring of Eye ( HOME ) Study , an unmasked , multi-center , randomized trial of the ForeseeHome ( FH ) device plus standard care vs. standard care alone .

The FH device utilizes preferential hyperacuity perimetry and tele-monitoring to detect changes in vision function associated with development of CNV , potentially prior to symptom and visual acuity loss .

After establishing baseline measurements , subsequent changes on follow-up are detected by the device , causing the monitoring center to alert the clinical center to recall participants for an exam .

Standard care consists of instructions for self-monitoring visual changes with subsequent self-report to the clinical center .

The primary objective of this study is to determine whether home monitoring plus standard care in comparison with standard care alone , results in earlier detection of incident CNV with better present visual acuity .

The primary outcome is the decline in visual acuity at CNV diagnosis from baseline .

Detection of CNV prior to substantial vision loss is critical as vision outcome following anti-angiogenic therapy is dependent on the visual acuity at initiation of treatment .

HOME Study is the first large scale study to test the use of home tele-monitoring system in the management of AMD patients .

Avastin Biomarkers In lunG And 3D Innovative anaLysis ( ABIGAIL ) , which is a phase II , open-label , randomized study , investigated correlations between biomarkers and best overall response to bevacizumab plus platinum-doublet chemotherapy for patients with advanced/recurrent non-small-cell lung cancer .

Patients received bevacizumab ( 7.5 or 15 mg/kg , 3-weekly until disease progression/unacceptable toxicity ) plus carboplatin/gemcitabine or carboplatin/paclitaxel ( maximum six cycles ) .

Plasma samples ( baseline/throughout treatment ) were analyzed for vascular endothelial growth factor ( VEGF ) - A ( baseline only ) , VEGF receptors ( VEGFR-1 / VEGFR-2 ) , basic fibroblast growth factor , E-selectin , intercellular adhesion molecule-1 , and placental growth factor ( baseline only ) .

Tumor samples ( primary specimen ) were analyzed for VEGF-A , VEGFR-1 / VEGFR-2 , neuropilin ( NRP ) , and CD31 .

Response was evaluated at baseline and every 6 weeks ( Response Evaluation Criteria in Solid Tumors ) .

Patients were randomized to receive chemotherapy plus 7.5 mg/kg ( n = 154 ) or 15 mg/kg ( n = 149 ) bevacizumab .