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

labels class label 5 classes	text stringlengths 3 1.81k	uid int64 0 2.21M
0BACKGROUND	The emergence of HIV as a chronic condition means that people living with HIV are required to take more responsibility for the self-management of their condition , including making physical , emotional and social adjustments .	0
0BACKGROUND	This paper describes the design and evaluation of Positive Outlook , an online program aiming to enhance the self-management skills of gay men living with HIV .	1
2METHODS	This study is designed as a randomised controlled trial in which men living with HIV in Australia will be assigned to either an intervention group or usual care control group .	2
2METHODS	The intervention group will participate in the online group program ` Positive Outlook ' .	3
2METHODS	The program is based on self-efficacy theory and uses a self-management approach to enhance skills , confidence and abilities to manage the psychosocial issues associated with HIV in daily life .	4
2METHODS	Participants will access the program for a minimum of 90 minutes per week over seven weeks .	5
2METHODS	Primary outcomes are domain specific self-efficacy , HIV related quality of life , and outcomes of health education .	6
2METHODS	Secondary outcomes include : depression , anxiety and stress ; general health and quality of life ; adjustment to HIV ; and social support .	7
2METHODS	Data collection will take place at baseline , completion of the intervention ( or eight weeks post randomisation ) and at 12 week follow-up .	8
1CONCLUSIONS	Results of the Positive Outlook study will provide information regarding the effectiveness of online group programs improving health related outcomes for men living with HIV .	9
0BACKGROUND	ACTRN12612000642886 .	10
0BACKGROUND	The aim of this study was to evaluate the efficacy , safety and complications of orbital steroid injection versus oral steroid therapy in the management of thyroid-related ophthalmopathy .	11
2METHODS	A total of 29 patients suffering from thyroid ophthalmopathy were included in this study .	12
2METHODS	Patients were randomized into two groups : group I included 15 patients treated with oral prednisolone and group II included 14 patients treated with peribulbar triamcinolone orbital injection .	13
2METHODS	Only 12 patients in both groups ( 16 female and 8 male ) completed the study .	14
4RESULTS	Both groups showed improvement in symptoms and in clinical evidence of inflammation with improvement of eye movement and proptosis in most cases .	15
4RESULTS	Mean exophthalmometry value before treatment was 22.6 1.98 mm that decreased to 18.6 0.996 mm in group I , compared with 23 1.86 mm that decreased to 19.08 1.16 mm in group II .	16
4RESULTS	Mean initial clinical activity score was 4.75 1.2 and 5 1.3 for group I and group II before treatment , respectively , which dropped to 0.83 1.2 and 0.83 1.02 , 6 months after treatment , respectively .	17
4RESULTS	There was no change in the best-corrected visual acuity in both groups .	18
4RESULTS	There was an increase in body weight , blood sugar , blood pressure and gastritis in group I in 66.7 % , 33.3 % , 50 % and 75 % , respectively , compared with 0 % , 0 % , 8.3 % and 8.3 % in group II .	19
4RESULTS	No adverse local side effects were observed in group II .	20
1CONCLUSIONS	Orbital steroid injection for thyroid-related ophthalmopathy is effective and safe .	21
1CONCLUSIONS	It eliminates the adverse reactions associated with oral corticosteroid use .	22
3OBJECTIVE	The aim of this prospective randomized study was to examine whether active counseling and more liberal oral fluid intake decrease postoperative pain , nausea and vomiting in pediatric ambulatory tonsillectomy .	23
2METHODS	Families , whose child was admitted for ambulatory tonsillectomy or adenotonsillectomy , were randomly assigned to the study groups ( n = 116 ; 58 families in each group ) .	24
2METHODS	The intervention group received the fasting instructions with face-to-face counseling for the child 's active preoperative nutrition , and the control group the fasting instructions according to the hospital 's standard procedure .	25
2METHODS	The level of postoperative pain and nausea was scored in the postanesthesia care unit ( PACU ) during the first postoperative hour , as well as at 2 , 4 , 8 and 24h postoperatively .	26
2METHODS	The first scoring in PACU was performed by the attending nurse with a 0-10 scale .	27
2METHODS	The rest of the estimations were made independently and simultaneously by the children using a VAS scale , and by the parents using a 0-10 scale .	28
4RESULTS	The children in the control group were in more pain in the PACU than the children in the intervention group , and the difference between the groups was statistically significant ( p = 0.0002 ) .	29
4RESULTS	All pain scores , according to the children and the parents , increased after the surgery .	30
4RESULTS	In both groups the highest score values were found at home 8h after surgery , and no significant difference was found between the study groups .	31
4RESULTS	On the first postoperative morning , the children in the control group were in pain ( p = 0.047 ) .	32
4RESULTS	The children did not have significant nausea in the PACU , but the nausea increased postoperatively .	33
4RESULTS	Four hours after surgery the children were most nauseous according to all estimations ( 60 % , n = 116 ) .	34
4RESULTS	More than half of the children vomited and most vomited clotted blood .	35
4RESULTS	Nausea and vomiting decreased during the evening of the surgery , but six children vomited the next morning , four of them vomited blood .	36
4RESULTS	The incidence and intensity of postoperative nausea and vomiting between the intervention and control groups were not statistically significant .	37
4RESULTS	However , preoperative nutritional counseling and more liberal per oral fluid intake appeared to have a positive effect on the children 's well-being and helped them to better tolerate postoperative nausea and vomiting .	38
1CONCLUSIONS	The preoperative counseling about active preoperative nutrition significantly reduces the child 's pain during the first posttonsillectomy hours and might prepare the child to better tolerate the stress of potential postoperative nausea and vomiting .	39
3OBJECTIVE	To explore the effects of GengNianLe ( GNL , also called perimenopausal depression relieving formula ) , a defined formula of Chinese medicinal herbs in relieving perimenopausal depression in Chinese women .	40
2METHODS	Between September 2004 and April 2008 , 47 Chinese women were randomized into a GNL group ( n = 21 ) and a control group which received tibolone ( n = 26 ) using a randomization chart .	41
2METHODS	Depression was rated with the 24-item Hamilton Depression Scale ( HAMD ) .	42
2METHODS	The serum levels of follicle stimulating hormone ( FSH ) , luteinizing hormone ( LH ) , and estradiol ( E ( 2 ) ) were detected before and after the treatment .	43
4RESULTS	After 12 weeks of treatment , HAMD scores in both groups decreased significantly ( p < 0.05 ) with no significant difference between the groups ( p > 0.05 ) .	44
4RESULTS	The levels of FSH decreased significantly and the level of E ( 2 ) increased significantly in both groups , and they changed more in the control group .	45
4RESULTS	No side-effect of treatment was reported in either group during treatment .	46
1CONCLUSIONS	The Chinese medicinal formula GNL showed promise in relieving perimenopausal depression and merits further study .	47
0BACKGROUND	Topical formulations of nonsteroidal anti-inflammatory drugs ( NSAIDs ) are generally considered to be safer alternatives to oral NSAIDs due to lower systemic absorption .	48
0BACKGROUND	We conducted randomized , crossover studies that compared the pharmacokinetics ( PK ) , bioequivalence and safety of topical diclofenac sodium 2 % twice daily ( BID ) , diclofenac sodium 1.5 % four times daily ( QID ) and oral diclofenac sodium in healthy subjects .	49
2METHODS	The results of three bioequivalence studies are reviewed .	50
2METHODS	Healthy adult subjects ( n = 76 ) applied topical diclofenac sodium 2 % solution ( 40.4 mg/2 mL ) BID ; or 1.5 % solution ( 19.3 mg/40 drops ) QID to each knee for 7.5 consecutive days separated by a washout period .	51
2METHODS	Subjects ( n = 22 ) in one study also received oral diclofenac sodium 75 mg BID for 7.5 days .	52
2METHODS	Plasma diclofenac concentrations were determined from serial blood samples collected on Days 1 and 8 ( steady state ) , and diclofenac PK parameters were estimated by noncompartmental methods .	53
4RESULTS	The studies demonstrated comparable bioequivalence between the 2 % and 1.5 % topical solutions as well as lower systemic exposure compared to oral dosing ( approximately 93 % less ) .	54
4RESULTS	Daily systemic exposure was comparable between the two formulations with only a 12 % difference in the AUCss ( 0-24 ) ( p = 0.140 ) .	55
4RESULTS	Furthermore , both topical solutions demonstrated delayed elimination with a t ( 1/2 ) of 4 - to 6-fold longer , as compared to oral diclofenac .	56
4RESULTS	The 2 % solution provided more consistent dosing relative to the 1.5 % solution when comparing AUCss ( 0-24 ) and Cmaxss across studies .	57
4RESULTS	Mild application site reactions were the most common treatment-emergent adverse event reported with topical diclofenac .	58
1CONCLUSIONS	The steady-state PK profile of topical diclofenac 2 % solution administered BID is similar to that of the 1.5 % solution administered QID .	59
1CONCLUSIONS	Systemic exposure to diclofenac is substantially lower after topical application as compared to oral administration .	60
1CONCLUSIONS	( Study 2 was registered with ClinicalTrials.gov ; NCT01202799 ; https://clinicaltrials.gov/ct2/results?term=01202799&Search=Search ) .	61
0BACKGROUND	No long-term studies have been reported on the effect of training programs on driving after stroke .	62
3OBJECTIVE	The authors ' primary aim was to determine the effect of simulator versus cognitive rehabilitation therapy on fitness-to-drive at 5 years poststroke .	63
3OBJECTIVE	A second aim was to investigate differences in clinical characteristics between stroke survivors who resumed and stopped driving .	64
2METHODS	In a previously reported randomized controlled trial , 83 stroke survivors received 15 hours of simulator training ( n = 42 ) or cognitive therapy ( n = 41 ) .	65
2METHODS	In this 5-year follow-up study , 61 participants were reassessed .	66
2METHODS	Fitness-to-drive decisions were obtained from medical , visual , neuropsychological , and on-road tests ; 44 participants ( simulator group , n = 21 ; cognitive group , n = 23 ) completed all assessments .	67
2METHODS	The primary outcome measures were fitness-to-drive decision and current driving status .	68
4RESULTS	The authors found that 5 years after stroke , 18 of 30 participants ( 60 % ) in the simulator group were considered fit to drive , compared with 15 of 31 ( 48 % ) in the cognitive group ( P = .36 ) ; 34 of 61 ( 56 % ) participants were driving .	69
4RESULTS	Current drivers were younger ( P = .04 ) , had higher Barthel scores ( P = .008 ) , had less comorbidity ( P = .01 ) , and were less severely depressed ( P = .02 ) than those who gave up driving .	70
1CONCLUSIONS	The advantage of simulator-based driving training over cognitive rehabilitation therapy , evident at 6 months poststroke , had faded 5 years later .	71
1CONCLUSIONS	Poststroke drivers were younger and less severely affected and depressed than nondrivers .	72
0BACKGROUND	The potential of insecticide-treated bednets ( ITNs ) to contribute to child survival has been well documented in randomised controlled trials .	73
0BACKGROUND	ITN coverage has increased rapidly in Kenya from 7 % in 2004 to 67 % in 2006 .	74
0BACKGROUND	We aimed to assess the extent to which this investment has led to improvements in child survival .	75
2METHODS	A dynamic cohort of about 3500 children aged 1-59 months were enumerated three times at yearly intervals in 72 rural clusters located in four districts of Kenya .	76
2METHODS	The effect of ITN use on mortality was assessed with Poisson regression to take account of potential effect-modifying and confounding covariates .	77
4RESULTS	100 children died over 2 years .	78
4RESULTS	Overall mortality rates were much the same in the first and second years of the study ( 14.5 per 1000 person-years in the first year and 15.4 per 1000 person-years in the second ) .	79
4RESULTS	After adjustment for age , time period , and a number of other possible confounding variables , ITN use was associated with a 44 % reduction in mortality ( mortality rate ratio 0.56 , 95 % CI 0.33-0 .96 ; p = 0.04 ) .	80
4RESULTS	This level of protection corresponds to about seven deaths averted for every 1000 ITNs distributed .	81
1CONCLUSIONS	A combined approach of social marketing followed by mass free distribution of ITNs translated into child survival effects that are comparable with those seen in previous randomised controlled trials .	82
0BACKGROUND	Cortical stimulation mapping ( CSM ) commonly uses visual naming to determine resection margins in the dominant hemisphere of patients with epilepsy .	83
0BACKGROUND	Visual naming alone may not identify all language sites in resection-prone areas , prompting additional tasks for comprehensive language mapping .	84
3OBJECTIVE	To demonstrate word-finding distinctions between visual , auditory , and reading modalities during CSM and the percentage of modality-specific language sites within dominant hemisphere subregions .	85
2METHODS	Twenty-eight patients with epilepsy underwent CSM by the use of visual , auditory , and sentence-completion tasks .	86
2METHODS	Hierarchical logistic regression analyzed errors to identify language sites and provide modality-specific percentages within subregions .	87
4RESULTS	The percentage of sites classified as language sites based on auditory naming was twice as high in anterior temporal regions compared with visual naming , marginally higher in posterior temporal areas , and comparable in parietal regions .	88
4RESULTS	Sentence completion was comparable to visual and auditory naming in parietal regions and lower in most temporal areas .	89
4RESULTS	Of 470 sites tested with both visual and auditory naming , 95 sites were distinctly auditory , whereas 48 sites were distinctly visual .	90
4RESULTS	The remaining sites overlapped .	91
1CONCLUSIONS	Distinct cortical areas were found for distinct input modalities , with language sites in anterior tip regions found most often by using auditory naming .	92
1CONCLUSIONS	The vulnerability of anterior temporal tip regions to resection in this population and distinct sites for each modality suggest that a multimodality approach may be needed to spare crucial language sites , if sparing those sites can be shown to significantly reduce the rate of postoperative language deficits without sacrificing seizure control .	93
3OBJECTIVE	To determine if suppressive acyclovir therapy given to term gravidas experiencing a first episode of genital herpes simplex virus ( HSV ) - infection during pregnancy decreases the need for cesarean delivery for that indication .	94
2METHODS	Forty-six pregnant women with first episodes of genital herpes during pregnancy were randomly assigned to receive oral acyclovir 400 mg or placebo , three times per day , from 36 weeks ' gestation until delivery as part of a prospective , double-blind trial .	95
2METHODS	Herpes simplex virus cultures were obtained when patients presented for delivery .	96
2METHODS	Vaginal delivery was permitted if no clinical recurrence was present ; otherwise , a cesarean was performed .	97
2METHODS	Neonatal HSV cultures were obtained and infants were followed-up clinically .	98
4RESULTS	None of the 21 patients treated with acyclovir and nine of 25 ( 36 % ) treated with placebo had clinical evidence of recurrent genital herpes at delivery ( odds ratio [ OR ] 0.04 , 95 % confidence interval [ CI ] 0.002-0 .745 ; P = .002 ) .	99

0BACKGROUND

The emergence of HIV as a chronic condition means that people living with HIV are required to take more responsibility for the self-management of their condition , including making physical , emotional and social adjustments .

0

0BACKGROUND

This paper describes the design and evaluation of Positive Outlook , an online program aiming to enhance the self-management skills of gay men living with HIV .

1

2METHODS

This study is designed as a randomised controlled trial in which men living with HIV in Australia will be assigned to either an intervention group or usual care control group .

2

2METHODS

The intervention group will participate in the online group program ` Positive Outlook ' .

3

2METHODS

The program is based on self-efficacy theory and uses a self-management approach to enhance skills , confidence and abilities to manage the psychosocial issues associated with HIV in daily life .

4

2METHODS

Participants will access the program for a minimum of 90 minutes per week over seven weeks .

5

2METHODS

Primary outcomes are domain specific self-efficacy , HIV related quality of life , and outcomes of health education .

6

2METHODS

Secondary outcomes include : depression , anxiety and stress ; general health and quality of life ; adjustment to HIV ; and social support .

7

2METHODS

Data collection will take place at baseline , completion of the intervention ( or eight weeks post randomisation ) and at 12 week follow-up .

8

1CONCLUSIONS

Results of the Positive Outlook study will provide information regarding the effectiveness of online group programs improving health related outcomes for men living with HIV .

9

0BACKGROUND

ACTRN12612000642886 .

10

0BACKGROUND

The aim of this study was to evaluate the efficacy , safety and complications of orbital steroid injection versus oral steroid therapy in the management of thyroid-related ophthalmopathy .

11

2METHODS

A total of 29 patients suffering from thyroid ophthalmopathy were included in this study .

12

2METHODS

Patients were randomized into two groups : group I included 15 patients treated with oral prednisolone and group II included 14 patients treated with peribulbar triamcinolone orbital injection .

13

2METHODS

Only 12 patients in both groups ( 16 female and 8 male ) completed the study .

14

4RESULTS

Both groups showed improvement in symptoms and in clinical evidence of inflammation with improvement of eye movement and proptosis in most cases .

15

4RESULTS

Mean exophthalmometry value before treatment was 22.6 1.98 mm that decreased to 18.6 0.996 mm in group I , compared with 23 1.86 mm that decreased to 19.08 1.16 mm in group II .

16

4RESULTS

Mean initial clinical activity score was 4.75 1.2 and 5 1.3 for group I and group II before treatment , respectively , which dropped to 0.83 1.2 and 0.83 1.02 , 6 months after treatment , respectively .

17

4RESULTS

There was no change in the best-corrected visual acuity in both groups .

18

4RESULTS

There was an increase in body weight , blood sugar , blood pressure and gastritis in group I in 66.7 % , 33.3 % , 50 % and 75 % , respectively , compared with 0 % , 0 % , 8.3 % and 8.3 % in group II .

19

4RESULTS

No adverse local side effects were observed in group II .

20

1CONCLUSIONS

Orbital steroid injection for thyroid-related ophthalmopathy is effective and safe .

21

1CONCLUSIONS

It eliminates the adverse reactions associated with oral corticosteroid use .

22

3OBJECTIVE

The aim of this prospective randomized study was to examine whether active counseling and more liberal oral fluid intake decrease postoperative pain , nausea and vomiting in pediatric ambulatory tonsillectomy .

23

2METHODS

Families , whose child was admitted for ambulatory tonsillectomy or adenotonsillectomy , were randomly assigned to the study groups ( n = 116 ; 58 families in each group ) .

24

2METHODS

The intervention group received the fasting instructions with face-to-face counseling for the child 's active preoperative nutrition , and the control group the fasting instructions according to the hospital 's standard procedure .

25

2METHODS

The level of postoperative pain and nausea was scored in the postanesthesia care unit ( PACU ) during the first postoperative hour , as well as at 2 , 4 , 8 and 24h postoperatively .

26

2METHODS

The first scoring in PACU was performed by the attending nurse with a 0-10 scale .

27

2METHODS

The rest of the estimations were made independently and simultaneously by the children using a VAS scale , and by the parents using a 0-10 scale .

28

4RESULTS

The children in the control group were in more pain in the PACU than the children in the intervention group , and the difference between the groups was statistically significant ( p = 0.0002 ) .

29

4RESULTS

All pain scores , according to the children and the parents , increased after the surgery .

30

4RESULTS

In both groups the highest score values were found at home 8h after surgery , and no significant difference was found between the study groups .

31

4RESULTS

On the first postoperative morning , the children in the control group were in pain ( p = 0.047 ) .

32

4RESULTS

The children did not have significant nausea in the PACU , but the nausea increased postoperatively .

33

4RESULTS

Four hours after surgery the children were most nauseous according to all estimations ( 60 % , n = 116 ) .

34

4RESULTS

More than half of the children vomited and most vomited clotted blood .

35

4RESULTS

Nausea and vomiting decreased during the evening of the surgery , but six children vomited the next morning , four of them vomited blood .

36

4RESULTS

The incidence and intensity of postoperative nausea and vomiting between the intervention and control groups were not statistically significant .

37

4RESULTS

However , preoperative nutritional counseling and more liberal per oral fluid intake appeared to have a positive effect on the children 's well-being and helped them to better tolerate postoperative nausea and vomiting .

38

1CONCLUSIONS

The preoperative counseling about active preoperative nutrition significantly reduces the child 's pain during the first posttonsillectomy hours and might prepare the child to better tolerate the stress of potential postoperative nausea and vomiting .

39

3OBJECTIVE

To explore the effects of GengNianLe ( GNL , also called perimenopausal depression relieving formula ) , a defined formula of Chinese medicinal herbs in relieving perimenopausal depression in Chinese women .

40

2METHODS

Between September 2004 and April 2008 , 47 Chinese women were randomized into a GNL group ( n = 21 ) and a control group which received tibolone ( n = 26 ) using a randomization chart .

41

2METHODS

Depression was rated with the 24-item Hamilton Depression Scale ( HAMD ) .

42

2METHODS

The serum levels of follicle stimulating hormone ( FSH ) , luteinizing hormone ( LH ) , and estradiol ( E ( 2 ) ) were detected before and after the treatment .

43

4RESULTS

After 12 weeks of treatment , HAMD scores in both groups decreased significantly ( p < 0.05 ) with no significant difference between the groups ( p > 0.05 ) .

44

4RESULTS

The levels of FSH decreased significantly and the level of E ( 2 ) increased significantly in both groups , and they changed more in the control group .

45

4RESULTS

No side-effect of treatment was reported in either group during treatment .

46

1CONCLUSIONS

The Chinese medicinal formula GNL showed promise in relieving perimenopausal depression and merits further study .

47

0BACKGROUND

Topical formulations of nonsteroidal anti-inflammatory drugs ( NSAIDs ) are generally considered to be safer alternatives to oral NSAIDs due to lower systemic absorption .

48

0BACKGROUND

We conducted randomized , crossover studies that compared the pharmacokinetics ( PK ) , bioequivalence and safety of topical diclofenac sodium 2 % twice daily ( BID ) , diclofenac sodium 1.5 % four times daily ( QID ) and oral diclofenac sodium in healthy subjects .

49

2METHODS

The results of three bioequivalence studies are reviewed .

50

2METHODS

Healthy adult subjects ( n = 76 ) applied topical diclofenac sodium 2 % solution ( 40.4 mg/2 mL ) BID ; or 1.5 % solution ( 19.3 mg/40 drops ) QID to each knee for 7.5 consecutive days separated by a washout period .

51

2METHODS

Subjects ( n = 22 ) in one study also received oral diclofenac sodium 75 mg BID for 7.5 days .

52

2METHODS

Plasma diclofenac concentrations were determined from serial blood samples collected on Days 1 and 8 ( steady state ) , and diclofenac PK parameters were estimated by noncompartmental methods .

53

4RESULTS

The studies demonstrated comparable bioequivalence between the 2 % and 1.5 % topical solutions as well as lower systemic exposure compared to oral dosing ( approximately 93 % less ) .

54

4RESULTS

Daily systemic exposure was comparable between the two formulations with only a 12 % difference in the AUCss ( 0-24 ) ( p = 0.140 ) .

55

4RESULTS

Furthermore , both topical solutions demonstrated delayed elimination with a t ( 1/2 ) of 4 - to 6-fold longer , as compared to oral diclofenac .

56

4RESULTS

The 2 % solution provided more consistent dosing relative to the 1.5 % solution when comparing AUCss ( 0-24 ) and Cmaxss across studies .

57

4RESULTS

Mild application site reactions were the most common treatment-emergent adverse event reported with topical diclofenac .

58

1CONCLUSIONS

The steady-state PK profile of topical diclofenac 2 % solution administered BID is similar to that of the 1.5 % solution administered QID .

59

1CONCLUSIONS

Systemic exposure to diclofenac is substantially lower after topical application as compared to oral administration .

60

1CONCLUSIONS

( Study 2 was registered with ClinicalTrials.gov ; NCT01202799 ; https://clinicaltrials.gov/ct2/results?term=01202799&Search=Search ) .

61

0BACKGROUND

No long-term studies have been reported on the effect of training programs on driving after stroke .

62

3OBJECTIVE

The authors ' primary aim was to determine the effect of simulator versus cognitive rehabilitation therapy on fitness-to-drive at 5 years poststroke .

63

3OBJECTIVE

A second aim was to investigate differences in clinical characteristics between stroke survivors who resumed and stopped driving .

64

2METHODS

In a previously reported randomized controlled trial , 83 stroke survivors received 15 hours of simulator training ( n = 42 ) or cognitive therapy ( n = 41 ) .

65

2METHODS

In this 5-year follow-up study , 61 participants were reassessed .

66

2METHODS

Fitness-to-drive decisions were obtained from medical , visual , neuropsychological , and on-road tests ; 44 participants ( simulator group , n = 21 ; cognitive group , n = 23 ) completed all assessments .

67

2METHODS

The primary outcome measures were fitness-to-drive decision and current driving status .

68

4RESULTS

The authors found that 5 years after stroke , 18 of 30 participants ( 60 % ) in the simulator group were considered fit to drive , compared with 15 of 31 ( 48 % ) in the cognitive group ( P = .36 ) ; 34 of 61 ( 56 % ) participants were driving .

69

4RESULTS

Current drivers were younger ( P = .04 ) , had higher Barthel scores ( P = .008 ) , had less comorbidity ( P = .01 ) , and were less severely depressed ( P = .02 ) than those who gave up driving .

70

1CONCLUSIONS

The advantage of simulator-based driving training over cognitive rehabilitation therapy , evident at 6 months poststroke , had faded 5 years later .

71

1CONCLUSIONS

Poststroke drivers were younger and less severely affected and depressed than nondrivers .

72

0BACKGROUND

The potential of insecticide-treated bednets ( ITNs ) to contribute to child survival has been well documented in randomised controlled trials .

73

0BACKGROUND

ITN coverage has increased rapidly in Kenya from 7 % in 2004 to 67 % in 2006 .

74

0BACKGROUND

We aimed to assess the extent to which this investment has led to improvements in child survival .

75

2METHODS

A dynamic cohort of about 3500 children aged 1-59 months were enumerated three times at yearly intervals in 72 rural clusters located in four districts of Kenya .

76

2METHODS

The effect of ITN use on mortality was assessed with Poisson regression to take account of potential effect-modifying and confounding covariates .

77

4RESULTS

100 children died over 2 years .

78

4RESULTS

Overall mortality rates were much the same in the first and second years of the study ( 14.5 per 1000 person-years in the first year and 15.4 per 1000 person-years in the second ) .

79

4RESULTS

After adjustment for age , time period , and a number of other possible confounding variables , ITN use was associated with a 44 % reduction in mortality ( mortality rate ratio 0.56 , 95 % CI 0.33-0 .96 ; p = 0.04 ) .

80

4RESULTS

This level of protection corresponds to about seven deaths averted for every 1000 ITNs distributed .

81

1CONCLUSIONS

A combined approach of social marketing followed by mass free distribution of ITNs translated into child survival effects that are comparable with those seen in previous randomised controlled trials .

82

0BACKGROUND

Cortical stimulation mapping ( CSM ) commonly uses visual naming to determine resection margins in the dominant hemisphere of patients with epilepsy .

83

0BACKGROUND

Visual naming alone may not identify all language sites in resection-prone areas , prompting additional tasks for comprehensive language mapping .

84

3OBJECTIVE

To demonstrate word-finding distinctions between visual , auditory , and reading modalities during CSM and the percentage of modality-specific language sites within dominant hemisphere subregions .

85

2METHODS

Twenty-eight patients with epilepsy underwent CSM by the use of visual , auditory , and sentence-completion tasks .

86

2METHODS

Hierarchical logistic regression analyzed errors to identify language sites and provide modality-specific percentages within subregions .

87

4RESULTS

The percentage of sites classified as language sites based on auditory naming was twice as high in anterior temporal regions compared with visual naming , marginally higher in posterior temporal areas , and comparable in parietal regions .

88

4RESULTS

Sentence completion was comparable to visual and auditory naming in parietal regions and lower in most temporal areas .

89

4RESULTS

Of 470 sites tested with both visual and auditory naming , 95 sites were distinctly auditory , whereas 48 sites were distinctly visual .

90

4RESULTS

The remaining sites overlapped .

91

1CONCLUSIONS

Distinct cortical areas were found for distinct input modalities , with language sites in anterior tip regions found most often by using auditory naming .

92

1CONCLUSIONS

The vulnerability of anterior temporal tip regions to resection in this population and distinct sites for each modality suggest that a multimodality approach may be needed to spare crucial language sites , if sparing those sites can be shown to significantly reduce the rate of postoperative language deficits without sacrificing seizure control .

93

3OBJECTIVE

To determine if suppressive acyclovir therapy given to term gravidas experiencing a first episode of genital herpes simplex virus ( HSV ) - infection during pregnancy decreases the need for cesarean delivery for that indication .

94

2METHODS

Forty-six pregnant women with first episodes of genital herpes during pregnancy were randomly assigned to receive oral acyclovir 400 mg or placebo , three times per day , from 36 weeks ' gestation until delivery as part of a prospective , double-blind trial .

95

2METHODS

Herpes simplex virus cultures were obtained when patients presented for delivery .

96

2METHODS

Vaginal delivery was permitted if no clinical recurrence was present ; otherwise , a cesarean was performed .

97

2METHODS

Neonatal HSV cultures were obtained and infants were followed-up clinically .

98

4RESULTS

None of the 21 patients treated with acyclovir and nine of 25 ( 36 % ) treated with placebo had clinical evidence of recurrent genital herpes at delivery ( odds ratio [ OR ] 0.04 , 95 % confidence interval [ CI ] 0.002-0 .745 ; P = .002 ) .

99

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