pietrolesci/pubmed-200k-rct · Datasets at Hugging Face

labels class label 5 classes	text stringlengths 3 1.81k	uid int64 0 2.21M
0BACKGROUND	Damage control laparotomy , or abbreviated initial laparotomy followed by temporary abdominal closure ( TAC ) , intensive care unit resuscitation , and planned re-laparotomy , is frequently used to manage intra-abdominal bleeding and contamination among critically ill or injured adults .	2,211,100
0BACKGROUND	Animal data suggest that TAC techniques that employ negative pressure to the peritoneal cavity may reduce the systemic inflammatory response and associated organ injury .	2,211,101
0BACKGROUND	The primary objective of this study is to determine if use of a TAC dressing that affords active negative pressure peritoneal therapy , the ABThera Open Abdomen Negative Pressure Therapy System , reduces the extent of the systemic inflammatory response after damage control laparotomy for intra-abdominal sepsis or injury as compared to a commonly used TAC method that provides potentially less efficient peritoneal negative pressure , the Barker 's vacuum pack .	2,211,102
2METHODS	The Intra-peritoneal Vacuum Trial will be a single-center , randomized controlled trial .	2,211,103
2METHODS	Adults will be intraoperatively allocated to TAC with either the ABThera or Barker 's vacuum pack after the decision has been made by the attending surgeon to perform a damage control laparotomy .	2,211,104
2METHODS	The study will use variable block size randomization .	2,211,105
2METHODS	On study days 1 , 2 , 3 , 7 , and 28 , blood will be collected .	2,211,106
2METHODS	Whenever possible , peritoneal fluid will also be collected at these time points from the patient 's abdomen or TAC device .	2,211,107
2METHODS	Luminex technology will be used to quantify the concentrations of 65 mediators relevant to the inflammatory response in peritoneal fluid and plasma .	2,211,108
2METHODS	The primary endpoint is the difference in the plasma concentration of the pro-inflammatory cytokine IL-6 at 24 and 48 h after TAC dressing application .	2,211,109
2METHODS	Secondary endpoints include the differential effects of these dressings on the systemic concentration of other pro-inflammatory cytokines , collective peritoneal and systemic inflammatory mediator profiles , postoperative fluid balance , intra-abdominal pressure , and several patient-important outcomes , including organ dysfunction measures and mortality .	2,211,110
1CONCLUSIONS	Results from this study will improve understanding of the effect of active negative pressure peritoneal therapy after damage control laparotomy on the inflammatory response .	2,211,111
1CONCLUSIONS	It will also gather necessary pilot information needed to inform design of a multicenter trial comparing clinical outcomes among patients randomized to TAC with the ABThera versus Barker 's vacuum pack .	2,211,112
0BACKGROUND	ClinicalTrials.gov identifier http://www.clicaltrials.gov/ct2/show/NCT01355094 .	2,211,113
3OBJECTIVE	To compare the effectiveness of manual therapy ( MT ) versus transcutaneous electrical nervous stimulation ( TENS ) in reducing the intensity of pain in patients with subacute or chronic neck pain ( NP ) attended at primary care physiotherapy units ( PCPU ) .	2,211,114
2METHODS	Randomised clinical trial .	2,211,115
2METHODS	Thirteen PCPU in 4 health districts of the Community of Madrid , Spain .	2,211,116
2METHODS	Ninety patients with subacute or chronic NP attended .	2,211,117
2METHODS	Lost after intervention : 3 .	2,211,118
2METHODS	At random , 47 patients were allocated to MT treatment and 43 to TENS .	2,211,119
2METHODS	Social and demographic characteristics and prognosis variables in the intervention groups were measured .	2,211,120
2METHODS	Intensity of pain before and after intervention was calculated by mean values on the analogue visual scale ( present moment , average and worst pain of the last 2 weeks ) .	2,211,121
2METHODS	Side-effects were also measured .	2,211,122
4RESULTS	Difference between before-and-after pain was 21.83 mm ( 95 % CI , 13.71-29 .95 ) for the group treated with Transcutaneous electrical nervous stimulation and 22.87 mm ( 95 % CI , 17.11-28 .64 ) for manual therapy .	2,211,123
4RESULTS	The difference in averages on comparing the 2 procedures for improvement was 1.04 ( 95 % CI , -8.66 % to 10.75 % ) .	2,211,124
1CONCLUSIONS	TENS and MT significantly reduce patients ' perceived intensity of pain , although there were no differences between the 2 groups.There are no conclusive results for the alternative physiotherapy treatments that determine a clear strategy of intervention .	2,211,125
0BACKGROUND	Formoterol and salmeterol differ in their relative intrinsic activity at airway beta ( 2 ) - adrenoceptors , with formoterol being a full agonist .	2,211,126
0BACKGROUND	The homozygous glycine-16 polymorphism of the beta ( 2 ) - adrenoceptor occurs in approximately 40 % of patients and is known to predispose to agonist-induced downregulation and desensitization .	2,211,127
3OBJECTIVE	To evaluate possible differences in intrinsic beta ( 2 ) - adrenoceptor agonist activity between salmeterol and formoterol in terms of their functional antagonism against methacholine-induced bronchoconstriction ( the primary end point ) in genetically susceptible patients who exhibited the homozygous glycine-16 polymorphism .	2,211,128
2METHODS	Eighteen patients with mild-to-moderate persistent asthma receiving inhaled corticosteroid who expressed the homozygous glycine-16 genotype were randomized to completion ( mean [ SEM ] age , 35.8 [ 3.2 ] years ; mean FEV ( 1 ) , 76.9 [ 2.5 ] % predicted ) .	2,211,129
2METHODS	Patients received three different treatments for 1 week in randomized , double-blind , crossover fashion , with a 1-week washout period between treatments : formoterol , 12 microg bid ; salmeterol , 50 microg bid ; and placebo .	2,211,130
2METHODS	For each of the randomized treatment periods , there were three separate methacholine challenges : baseline after washout , 12 h after the first dose , and 12 h after the last dose .	2,211,131
4RESULTS	Both salmeterol and formoterol exhibited significantly ( p < 0.05 ) greater bronchoprotection than placebo for their effects after single or repeated dosing , although there was no significant difference between the two drugs .	2,211,132
4RESULTS	The geometric mean fold protection vs placebo ( 95 % confidence interval [ CI ] ) for the first dose was 1.6-fold ( 95 % CI , 1.1 to 2.2 ) for salmeterol and 1.9-fold ( 95 % CI , 1.1 to 3.2 ) for formoterol , and for last dose was 1.6-fold ( 95 % CI , 1.2 to 2.3 ) for salmeterol and 1.9-fold ( 95 % CI , 1.2 to 2.8 ) for formoterol .	2,211,133
4RESULTS	Salmeterol and formoterol produced significant ( p < 0.05 ) increases in FEV ( 1 ) and forced expiratory flow after 25 to 75 % of vital capacity has been expelled , after the first but not the last dose compared to placebo , while there were significant ( p < 0.05 ) improvements in domiciliary peak flows during treatment with both drugs .	2,211,134
1CONCLUSIONS	Our results showed no difference between formoterol and salmeterol in the degree of functional antagonism against methacholine-induced bronchoconstriction at the end of a 12-h dosing interval in patients who expressed the homozygous glycine-16 genotype .	2,211,135
1CONCLUSIONS	There was a significant residual degree of bronchoprotection after 1 week of treatment , which was not significantly different compared to the first-dose effect .	2,211,136
0BACKGROUND	Rehabilitation care is an important part of comprehensive care for MS patients .	2,211,137
0BACKGROUND	Little is known about the number of physiatry residents who are interested in providing care to individuals with multiple sclerosis [ MS ] .	2,211,138
3OBJECTIVE	This study examines factors that influence physiatry residents ' interest in providing care to MS patients .	2,211,139
2METHODS	We randomly sampled half of all Accreditation Council for Graduate Medical Education-certified physical medicine and rehabilitation residency programs in the continental United States and Puerto Rico .	2,211,140
2METHODS	Surveys were received from 74 % of programs ( Stage 1 response rate ) and from 221 residents ( 45 % Stage 2 response rate ) .	2,211,141
4RESULTS	Residents expressing interest in providing MS care were more likely to be female , Asian , and to select statements emphasizing multidisciplinary care approaches and a community of dedicated professional colleagues as positive features of MS patient care .	2,211,142
4RESULTS	Residents interested in teaching and with more education debt were marginally more likely to express interest in MS care .	2,211,143
1CONCLUSIONS	Medical education should emphasize the need for physical medicine and rehabilitative care among individuals with MS , the ability of physiatrists to improve the functional status and quality of life for MS patients , and the team-based nature of MS care .	2,211,144
0BACKGROUND	We conducted a retrospective evaluation of the overall safety of drotrecogin alfa ( activated ) in surgical patients with severe sepsis enrolled in PROWESS .	2,211,145
2METHODS	A blinded Surgical Evaluation Committee ( SEC ) verified surgical patients as having undergone a significant operative procedure within 30 days prior to enrollment .	2,211,146
2METHODS	Serious and treatment-emergent bleeding events , both during the study drug infusion period ( 120 h ) and the entire 28-day study period were analyzed by surgical status and by treatment assignment .	2,211,147
2METHODS	Statistical analysis was performed using Fisher 's exact test .	2,211,148
4RESULTS	Serious bleeding rates during infusion in the surgical patients were 3.1 % ( 7/228 ) and 0 % ( 0/246 ) in the drotrecogin alfa ( activated ) and placebo groups , respectively ( p = 0.006 ) .	2,211,149
4RESULTS	Treatment-emergent bleeding rates during infusion in the surgical patients were 16.7 % ( 38/228 ) and 7.7 % ( 19/246 ) in the drotrecogin alfa ( activated ) and placebo groups , respectively ( p = 0.003 ) .	2,211,150
4RESULTS	None of the treatment-emergent bleeding events was fatal .	2,211,151
4RESULTS	Of seven drotrecogin alfa ( activated ) serious bleeding events , six were procedure-related .	2,211,152
4RESULTS	The serious bleeding rates within each treatment group were statistically indistinguishable between the medical and surgical patients .	2,211,153
4RESULTS	However , the medical patients had numerically higher treatment-emergent bleeding rates than the surgical patients within each treatment group .	2,211,154
4RESULTS	Despite this observation , overall surgical patients received more transfusions of red blood cells , of platelets , and of fresh frozen plasma than their medical counterparts .	2,211,155
1CONCLUSIONS	Although treatment of surgical patients with drotrecogin alfa ( activated ) for severe sepsis is associated with a higher incidence of serious bleeding and subsequent treatment - emergent bleeding events , the magnitude of this increase is small and clinically acceptable .	2,211,156
0BACKGROUND	Non-steroidal anti-inflammatory drugs ( NSAIDs ) are widely used to treat osteoarthritis ( OA ) , though their long-term efficacy is uncertain .	2,211,157
0BACKGROUND	We report a comparison of the symptomatic responses to therapy with tiaprofenic acid , indomethacin and placebo over 5 yr .	2,211,158
2METHODS	A parallel-group , randomized , single-blind trial of patients with knee OA recruited 812 patients from 20 centres ; 307 patients received tiaprofenic acid ( 300 mg b.d. ) , 202 indomethacin ( 25 mg t.d.s. ) and 303 matching placebo for up to 5 yr .	2,211,159
2METHODS	At the end of the parallel-group study , patients receiving tiaprofenic acid or placebo entered a 4-week blinded cross-over study of tiaprofenic acid or placebo , both given for 2 weeks .	2,211,160
2METHODS	Assessments were at baseline , 4 weeks , then at 6-month intervals for up to 5 yr in the parallel group study and at 2-week intervals in the cross-over study .	2,211,161
2METHODS	They comprised pain scores , duration of morning stiffness , patients ' global assessments , paracetamol consumption , adverse reactions , withdrawals and functional outcomes .	2,211,162
4RESULTS	There were significant falls in overall pain scores in patients receiving NSAIDs compared with placebo at 4 weeks in the parallel-group phase .	2,211,163
4RESULTS	Thereafter there were no advantages favouring active therapy .	2,211,164
4RESULTS	In the cross-over phase , pain scores were significantly lower in patients receiving tiaprofenic acid than placebo .	2,211,165
4RESULTS	Patients who had been receiving long-term tiaprofenic acid showed significant rises in their pain scores when receiving placebo therapy and vice versa .	2,211,166
4RESULTS	Adverse events were reported by 61 % of patients receiving tiaprofenic acid , 63 % on indomethacin and 51 % on placebo .	2,211,167
4RESULTS	Potentially severe side-effects were rare ; for example , there were only three cases of gastrointestinal bleeding on NSAIDs .	2,211,168
4RESULTS	The pattern of withdrawal was similar in patients taking NSAIDs and placebo in the parallel-group study ; at 48 weeks 53 % of the patients remained on tiaprofenic acid , 50 % on indomethacin and 54 % on placebo .	2,211,169
1CONCLUSIONS	NSAIDs significantly reduce overall pain over 4 weeks .	2,211,170
1CONCLUSIONS	This short-term responsiveness is retained , and even after several years of therapy with tiaprofenic acid pain scores increased over 2 weeks when it was changed to placebo .	2,211,171
1CONCLUSIONS	Our results do not show long-term benefits from the use of NSAIDs in OA and the majority of patients had persisting pain and disability despite therapy .	2,211,172
0BACKGROUND	Traditional teacher-centred education strategies often do not meet the needs and student abilities of adult learning .	2,211,173
0BACKGROUND	The introduction of small learning groups requires considerable increases in staff .	2,211,174
0BACKGROUND	Problem-based learning could increase the motivation to acquire knowledge but without being as staff-intensive .	2,211,175
2METHODS	Medical students ( n = 98 ) in their fourth clinical semester were randomly assigned to either a structured course ( SC ) or problem-based learning ( PBL ) for surgery .	2,211,176
2METHODS	Their motivation and acceptance of the courses were recorded at the end of term in anonymous questionnaires using Likert scales , with scores ranging from 1 ( very good ) to 6 ( unsatisfactory ) .	2,211,177
4RESULTS	Both course structure and the teachers received much better ratings from the PBL students ( P < 0.01 each ) .	2,211,178
4RESULTS	The motivation of students to deal with surgical problems beyond the course material was significantly higher after PBL , with 1.8 ( 0.7 ) , than after the structured course with 3.1 ( 1.2 ) ( P < 0.01 ) .	2,211,179
4RESULTS	The overall rating was substantially worse for the structured course , with 3.1 ( 1.2 ) than for PBL at 1.4 ( 0.6 ) ( P < 0.01 ) .	2,211,180
1CONCLUSIONS	Problem-based learning in the surgical curriculum increases student acceptance and motivation with little demand on staff .	2,211,181
1CONCLUSIONS	It should be increasingly implemented .	2,211,182
3OBJECTIVE	To determine effects of daily intake of 1/2 cup pinto beans , black-eyed peas or carrots ( placebo ) on risk factors for coronary heart disease ( CHD ) and diabetes mellitus ( DM ) in free-living , mildly insulin resistant adults over an 8 week period .	2,211,183
2METHODS	Randomized , crossover 3x3 block design .	2,211,184
2METHODS	Sixteen participants ( 7 men , 9 women ) received each treatment for eight-weeks with two-week washouts .	2,211,185
2METHODS	Fasting blood samples collected at beginning and end of periods were analyzed for total cholesterol ( TC ) , low density lipoprotein cholesterol ( LDL-C ) , high density lipoprotein cholesterol , triacylglycerols , high-sensitivity C-reactive protein , insulin , glucose , and hemoglobin A1c .	2,211,186
4RESULTS	A significant treatment-by-time effect impacted serum TC ( p = 0.026 ) and LDL ( p = 0.033 ) after eight weeks .	2,211,187
4RESULTS	Paired t-tests indicated that pinto beans were responsible for this effect ( p = 0.003 ; p = 0.008 ) .	2,211,188
4RESULTS	Mean change of serum TC for pinto bean , black-eyed pea and placebo were -19 + / - 5 , 2.5 + / - 6 , and 1 + / - 5 mg/dL , respectively ( p = 0.011 ) .	2,211,189
4RESULTS	Mean change of serum LDL-C for pinto bean , black-eyed pea and placebo were -14 + / - 4 , 4 + / - 5 , and 1 + / - 4 mg/dL , in that order ( p = 0.013 ) .	2,211,190
4RESULTS	Pinto beans differed significantly from placebo ( p = 0.021 ) .	2,211,191
4RESULTS	No significant differences were seen with other blood concentrations across the 3 treatment periods .	2,211,192
1CONCLUSIONS	Pinto bean intake should be encouraged to lower serum TC and LDL-C , thereby reducing risk for CHD .	2,211,193
0BACKGROUND	Recombinant human parathyroid hormone ( 1-34 ) ( rhPTH ( 1-34 ) ) given by injection is a new seventh class drug of biological products , which is prepared by adopting gene recombination technique .	2,211,194
0BACKGROUND	rhPTH ( 1-34 ) is mainly used to treat osteoporosis , especially for postmenopausal women .	2,211,195
0BACKGROUND	This study compared the clinical efficacy and safety of rhPTH ( 1-34 ) with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China .	2,211,196
2METHODS	Two hundred and five women with osteoporosis were enrolled in a 6-month , multicenter , randomized , controlled study .	2,211,197
2METHODS	They were randomized to receive either rhPTH ( 1-34 ) 20 microg ( 200 U ) daily or elcatonin 20 U weekly .	2,211,198
2METHODS	Lumbar spine ( L1-4 ) and femoral neck bone mineral density ( BMD ) , as well as biochemical markers of bone turnover were measured .	2,211,199

0BACKGROUND

Damage control laparotomy , or abbreviated initial laparotomy followed by temporary abdominal closure ( TAC ) , intensive care unit resuscitation , and planned re-laparotomy , is frequently used to manage intra-abdominal bleeding and contamination among critically ill or injured adults .

2,211,100

0BACKGROUND

Animal data suggest that TAC techniques that employ negative pressure to the peritoneal cavity may reduce the systemic inflammatory response and associated organ injury .

2,211,101

0BACKGROUND

The primary objective of this study is to determine if use of a TAC dressing that affords active negative pressure peritoneal therapy , the ABThera Open Abdomen Negative Pressure Therapy System , reduces the extent of the systemic inflammatory response after damage control laparotomy for intra-abdominal sepsis or injury as compared to a commonly used TAC method that provides potentially less efficient peritoneal negative pressure , the Barker 's vacuum pack .

2,211,102

2METHODS

The Intra-peritoneal Vacuum Trial will be a single-center , randomized controlled trial .

2,211,103

2METHODS

Adults will be intraoperatively allocated to TAC with either the ABThera or Barker 's vacuum pack after the decision has been made by the attending surgeon to perform a damage control laparotomy .

2,211,104

2METHODS

The study will use variable block size randomization .

2,211,105

2METHODS

On study days 1 , 2 , 3 , 7 , and 28 , blood will be collected .

2,211,106

2METHODS

Whenever possible , peritoneal fluid will also be collected at these time points from the patient 's abdomen or TAC device .

2,211,107

2METHODS

Luminex technology will be used to quantify the concentrations of 65 mediators relevant to the inflammatory response in peritoneal fluid and plasma .

2,211,108

2METHODS

The primary endpoint is the difference in the plasma concentration of the pro-inflammatory cytokine IL-6 at 24 and 48 h after TAC dressing application .

2,211,109

2METHODS

Secondary endpoints include the differential effects of these dressings on the systemic concentration of other pro-inflammatory cytokines , collective peritoneal and systemic inflammatory mediator profiles , postoperative fluid balance , intra-abdominal pressure , and several patient-important outcomes , including organ dysfunction measures and mortality .

2,211,110

1CONCLUSIONS

Results from this study will improve understanding of the effect of active negative pressure peritoneal therapy after damage control laparotomy on the inflammatory response .

2,211,111

1CONCLUSIONS

It will also gather necessary pilot information needed to inform design of a multicenter trial comparing clinical outcomes among patients randomized to TAC with the ABThera versus Barker 's vacuum pack .

2,211,112

0BACKGROUND

ClinicalTrials.gov identifier http://www.clicaltrials.gov/ct2/show/NCT01355094 .

2,211,113

3OBJECTIVE

To compare the effectiveness of manual therapy ( MT ) versus transcutaneous electrical nervous stimulation ( TENS ) in reducing the intensity of pain in patients with subacute or chronic neck pain ( NP ) attended at primary care physiotherapy units ( PCPU ) .

2,211,114

2METHODS

Randomised clinical trial .

2,211,115

2METHODS

Thirteen PCPU in 4 health districts of the Community of Madrid , Spain .

2,211,116

2METHODS

Ninety patients with subacute or chronic NP attended .

2,211,117

2METHODS

Lost after intervention : 3 .

2,211,118

2METHODS

At random , 47 patients were allocated to MT treatment and 43 to TENS .

2,211,119

2METHODS

Social and demographic characteristics and prognosis variables in the intervention groups were measured .

2,211,120

2METHODS

Intensity of pain before and after intervention was calculated by mean values on the analogue visual scale ( present moment , average and worst pain of the last 2 weeks ) .

2,211,121

2METHODS

Side-effects were also measured .

2,211,122

4RESULTS

Difference between before-and-after pain was 21.83 mm ( 95 % CI , 13.71-29 .95 ) for the group treated with Transcutaneous electrical nervous stimulation and 22.87 mm ( 95 % CI , 17.11-28 .64 ) for manual therapy .

2,211,123

4RESULTS

The difference in averages on comparing the 2 procedures for improvement was 1.04 ( 95 % CI , -8.66 % to 10.75 % ) .

2,211,124

1CONCLUSIONS

TENS and MT significantly reduce patients ' perceived intensity of pain , although there were no differences between the 2 groups.There are no conclusive results for the alternative physiotherapy treatments that determine a clear strategy of intervention .

2,211,125

0BACKGROUND

Formoterol and salmeterol differ in their relative intrinsic activity at airway beta ( 2 ) - adrenoceptors , with formoterol being a full agonist .

2,211,126

0BACKGROUND

The homozygous glycine-16 polymorphism of the beta ( 2 ) - adrenoceptor occurs in approximately 40 % of patients and is known to predispose to agonist-induced downregulation and desensitization .

2,211,127

3OBJECTIVE

To evaluate possible differences in intrinsic beta ( 2 ) - adrenoceptor agonist activity between salmeterol and formoterol in terms of their functional antagonism against methacholine-induced bronchoconstriction ( the primary end point ) in genetically susceptible patients who exhibited the homozygous glycine-16 polymorphism .

2,211,128

2METHODS

Eighteen patients with mild-to-moderate persistent asthma receiving inhaled corticosteroid who expressed the homozygous glycine-16 genotype were randomized to completion ( mean [ SEM ] age , 35.8 [ 3.2 ] years ; mean FEV ( 1 ) , 76.9 [ 2.5 ] % predicted ) .

2,211,129

2METHODS

Patients received three different treatments for 1 week in randomized , double-blind , crossover fashion , with a 1-week washout period between treatments : formoterol , 12 microg bid ; salmeterol , 50 microg bid ; and placebo .

2,211,130

2METHODS

For each of the randomized treatment periods , there were three separate methacholine challenges : baseline after washout , 12 h after the first dose , and 12 h after the last dose .

2,211,131

4RESULTS

Both salmeterol and formoterol exhibited significantly ( p < 0.05 ) greater bronchoprotection than placebo for their effects after single or repeated dosing , although there was no significant difference between the two drugs .

2,211,132

4RESULTS

The geometric mean fold protection vs placebo ( 95 % confidence interval [ CI ] ) for the first dose was 1.6-fold ( 95 % CI , 1.1 to 2.2 ) for salmeterol and 1.9-fold ( 95 % CI , 1.1 to 3.2 ) for formoterol , and for last dose was 1.6-fold ( 95 % CI , 1.2 to 2.3 ) for salmeterol and 1.9-fold ( 95 % CI , 1.2 to 2.8 ) for formoterol .

2,211,133

4RESULTS

Salmeterol and formoterol produced significant ( p < 0.05 ) increases in FEV ( 1 ) and forced expiratory flow after 25 to 75 % of vital capacity has been expelled , after the first but not the last dose compared to placebo , while there were significant ( p < 0.05 ) improvements in domiciliary peak flows during treatment with both drugs .

2,211,134

1CONCLUSIONS

Our results showed no difference between formoterol and salmeterol in the degree of functional antagonism against methacholine-induced bronchoconstriction at the end of a 12-h dosing interval in patients who expressed the homozygous glycine-16 genotype .

2,211,135

1CONCLUSIONS

There was a significant residual degree of bronchoprotection after 1 week of treatment , which was not significantly different compared to the first-dose effect .

2,211,136

0BACKGROUND

Rehabilitation care is an important part of comprehensive care for MS patients .

2,211,137

0BACKGROUND

Little is known about the number of physiatry residents who are interested in providing care to individuals with multiple sclerosis [ MS ] .

2,211,138

3OBJECTIVE

This study examines factors that influence physiatry residents ' interest in providing care to MS patients .

2,211,139

2METHODS

We randomly sampled half of all Accreditation Council for Graduate Medical Education-certified physical medicine and rehabilitation residency programs in the continental United States and Puerto Rico .

2,211,140

2METHODS

Surveys were received from 74 % of programs ( Stage 1 response rate ) and from 221 residents ( 45 % Stage 2 response rate ) .

2,211,141

4RESULTS

Residents expressing interest in providing MS care were more likely to be female , Asian , and to select statements emphasizing multidisciplinary care approaches and a community of dedicated professional colleagues as positive features of MS patient care .

2,211,142

4RESULTS

Residents interested in teaching and with more education debt were marginally more likely to express interest in MS care .

2,211,143

1CONCLUSIONS

Medical education should emphasize the need for physical medicine and rehabilitative care among individuals with MS , the ability of physiatrists to improve the functional status and quality of life for MS patients , and the team-based nature of MS care .

2,211,144

0BACKGROUND

We conducted a retrospective evaluation of the overall safety of drotrecogin alfa ( activated ) in surgical patients with severe sepsis enrolled in PROWESS .

2,211,145

2METHODS

A blinded Surgical Evaluation Committee ( SEC ) verified surgical patients as having undergone a significant operative procedure within 30 days prior to enrollment .

2,211,146

2METHODS

Serious and treatment-emergent bleeding events , both during the study drug infusion period ( 120 h ) and the entire 28-day study period were analyzed by surgical status and by treatment assignment .

2,211,147

2METHODS

Statistical analysis was performed using Fisher 's exact test .

2,211,148

4RESULTS

Serious bleeding rates during infusion in the surgical patients were 3.1 % ( 7/228 ) and 0 % ( 0/246 ) in the drotrecogin alfa ( activated ) and placebo groups , respectively ( p = 0.006 ) .

2,211,149

4RESULTS

Treatment-emergent bleeding rates during infusion in the surgical patients were 16.7 % ( 38/228 ) and 7.7 % ( 19/246 ) in the drotrecogin alfa ( activated ) and placebo groups , respectively ( p = 0.003 ) .

2,211,150

4RESULTS

None of the treatment-emergent bleeding events was fatal .

2,211,151

4RESULTS

Of seven drotrecogin alfa ( activated ) serious bleeding events , six were procedure-related .

2,211,152

4RESULTS

The serious bleeding rates within each treatment group were statistically indistinguishable between the medical and surgical patients .

2,211,153

4RESULTS

However , the medical patients had numerically higher treatment-emergent bleeding rates than the surgical patients within each treatment group .

2,211,154

4RESULTS

Despite this observation , overall surgical patients received more transfusions of red blood cells , of platelets , and of fresh frozen plasma than their medical counterparts .

2,211,155

1CONCLUSIONS

Although treatment of surgical patients with drotrecogin alfa ( activated ) for severe sepsis is associated with a higher incidence of serious bleeding and subsequent treatment - emergent bleeding events , the magnitude of this increase is small and clinically acceptable .

2,211,156

0BACKGROUND

Non-steroidal anti-inflammatory drugs ( NSAIDs ) are widely used to treat osteoarthritis ( OA ) , though their long-term efficacy is uncertain .

2,211,157

0BACKGROUND

We report a comparison of the symptomatic responses to therapy with tiaprofenic acid , indomethacin and placebo over 5 yr .

2,211,158

2METHODS

A parallel-group , randomized , single-blind trial of patients with knee OA recruited 812 patients from 20 centres ; 307 patients received tiaprofenic acid ( 300 mg b.d. ) , 202 indomethacin ( 25 mg t.d.s. ) and 303 matching placebo for up to 5 yr .

2,211,159

2METHODS

At the end of the parallel-group study , patients receiving tiaprofenic acid or placebo entered a 4-week blinded cross-over study of tiaprofenic acid or placebo , both given for 2 weeks .

2,211,160

2METHODS

Assessments were at baseline , 4 weeks , then at 6-month intervals for up to 5 yr in the parallel group study and at 2-week intervals in the cross-over study .

2,211,161

2METHODS

They comprised pain scores , duration of morning stiffness , patients ' global assessments , paracetamol consumption , adverse reactions , withdrawals and functional outcomes .

2,211,162

4RESULTS

There were significant falls in overall pain scores in patients receiving NSAIDs compared with placebo at 4 weeks in the parallel-group phase .

2,211,163

4RESULTS

Thereafter there were no advantages favouring active therapy .

2,211,164

4RESULTS

In the cross-over phase , pain scores were significantly lower in patients receiving tiaprofenic acid than placebo .

2,211,165

4RESULTS

Patients who had been receiving long-term tiaprofenic acid showed significant rises in their pain scores when receiving placebo therapy and vice versa .

2,211,166

4RESULTS

Adverse events were reported by 61 % of patients receiving tiaprofenic acid , 63 % on indomethacin and 51 % on placebo .

2,211,167

4RESULTS

Potentially severe side-effects were rare ; for example , there were only three cases of gastrointestinal bleeding on NSAIDs .

2,211,168

4RESULTS

The pattern of withdrawal was similar in patients taking NSAIDs and placebo in the parallel-group study ; at 48 weeks 53 % of the patients remained on tiaprofenic acid , 50 % on indomethacin and 54 % on placebo .

2,211,169

1CONCLUSIONS

NSAIDs significantly reduce overall pain over 4 weeks .

2,211,170

1CONCLUSIONS

This short-term responsiveness is retained , and even after several years of therapy with tiaprofenic acid pain scores increased over 2 weeks when it was changed to placebo .

2,211,171

1CONCLUSIONS

Our results do not show long-term benefits from the use of NSAIDs in OA and the majority of patients had persisting pain and disability despite therapy .

2,211,172

0BACKGROUND

Traditional teacher-centred education strategies often do not meet the needs and student abilities of adult learning .

2,211,173

0BACKGROUND

The introduction of small learning groups requires considerable increases in staff .

2,211,174

0BACKGROUND

Problem-based learning could increase the motivation to acquire knowledge but without being as staff-intensive .

2,211,175

2METHODS

Medical students ( n = 98 ) in their fourth clinical semester were randomly assigned to either a structured course ( SC ) or problem-based learning ( PBL ) for surgery .

2,211,176

2METHODS

Their motivation and acceptance of the courses were recorded at the end of term in anonymous questionnaires using Likert scales , with scores ranging from 1 ( very good ) to 6 ( unsatisfactory ) .

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4RESULTS

Both course structure and the teachers received much better ratings from the PBL students ( P < 0.01 each ) .

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4RESULTS

The motivation of students to deal with surgical problems beyond the course material was significantly higher after PBL , with 1.8 ( 0.7 ) , than after the structured course with 3.1 ( 1.2 ) ( P < 0.01 ) .

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4RESULTS

The overall rating was substantially worse for the structured course , with 3.1 ( 1.2 ) than for PBL at 1.4 ( 0.6 ) ( P < 0.01 ) .

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1CONCLUSIONS

Problem-based learning in the surgical curriculum increases student acceptance and motivation with little demand on staff .

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1CONCLUSIONS

It should be increasingly implemented .

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3OBJECTIVE

To determine effects of daily intake of 1/2 cup pinto beans , black-eyed peas or carrots ( placebo ) on risk factors for coronary heart disease ( CHD ) and diabetes mellitus ( DM ) in free-living , mildly insulin resistant adults over an 8 week period .

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2METHODS

Randomized , crossover 3x3 block design .

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2METHODS

Sixteen participants ( 7 men , 9 women ) received each treatment for eight-weeks with two-week washouts .

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2METHODS

Fasting blood samples collected at beginning and end of periods were analyzed for total cholesterol ( TC ) , low density lipoprotein cholesterol ( LDL-C ) , high density lipoprotein cholesterol , triacylglycerols , high-sensitivity C-reactive protein , insulin , glucose , and hemoglobin A1c .

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4RESULTS

A significant treatment-by-time effect impacted serum TC ( p = 0.026 ) and LDL ( p = 0.033 ) after eight weeks .

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4RESULTS

Paired t-tests indicated that pinto beans were responsible for this effect ( p = 0.003 ; p = 0.008 ) .

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4RESULTS

Mean change of serum TC for pinto bean , black-eyed pea and placebo were -19 + / - 5 , 2.5 + / - 6 , and 1 + / - 5 mg/dL , respectively ( p = 0.011 ) .

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4RESULTS

Mean change of serum LDL-C for pinto bean , black-eyed pea and placebo were -14 + / - 4 , 4 + / - 5 , and 1 + / - 4 mg/dL , in that order ( p = 0.013 ) .

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4RESULTS

Pinto beans differed significantly from placebo ( p = 0.021 ) .

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4RESULTS

No significant differences were seen with other blood concentrations across the 3 treatment periods .

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1CONCLUSIONS

Pinto bean intake should be encouraged to lower serum TC and LDL-C , thereby reducing risk for CHD .

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0BACKGROUND

Recombinant human parathyroid hormone ( 1-34 ) ( rhPTH ( 1-34 ) ) given by injection is a new seventh class drug of biological products , which is prepared by adopting gene recombination technique .

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0BACKGROUND

rhPTH ( 1-34 ) is mainly used to treat osteoporosis , especially for postmenopausal women .

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0BACKGROUND

This study compared the clinical efficacy and safety of rhPTH ( 1-34 ) with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China .

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2METHODS

Two hundred and five women with osteoporosis were enrolled in a 6-month , multicenter , randomized , controlled study .

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2METHODS

They were randomized to receive either rhPTH ( 1-34 ) 20 microg ( 200 U ) daily or elcatonin 20 U weekly .

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2METHODS

Lumbar spine ( L1-4 ) and femoral neck bone mineral density ( BMD ) , as well as biochemical markers of bone turnover were measured .

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