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Randomized Order (randomized + order)
Selected AbstractsComparison of the Melbourne Assessment of Unilateral Upper Limb Function and the Quality of Upper Extremity Skills Test in hemiplegic CPDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 12 2008K Klingels MSc This study investigated interrater reliability and measurement error of the Melbourne Assessment of Unilateral Upper Limb Function (Melbourne Assessment) and the Quality of Upper Extremity Skills Test (QUEST), and assessed the relationship between both scales in 21 children (15 females, six males; mean age 6y 4mo [SD 1y 3mo], range 5,8y) with hemiplegic CP. Two raters scored the videotapes of the assessments independently in a randomized order. According to the House Classification, three participants were classified as level 1, one participant as level 3, eight as level 4, three as level 5, one participant as level 6, and five as level 7. The Melbourne Assessment and the QUEST showed high interrater reliability (intraclass correlation 0.97 for Melbourne Assessment; 0.96 for QUEST total score; 0.96 for QUEST hemiplegic side). The standard error of measurement and the smallest detectable difference was 3.2% and 8.9% for the Melbourne Assessment and 5.0% and 13.8% for the QUEST score on the hemiplegic side. Correlation analysis indicated that different dimensions of upper limb function are addressed in both scales. [source] Influence of drinking method on tooth-surface pH in relation to dental erosionEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 6 2004Ann-Katrin Johansson The aim of this investigation was to study the intraoral pH response on tooth surfaces in relation to dental erosion during and after drinking a sugar-free cola-type soft drink. Six different methods of drinking were tested in a randomized order: holding; short-sipping; long-sipping; gulping; nipping; and sucking. Two methods of pH measurement were used in two series of individuals. In the first series, pH was measured by using the microtouch method in 12 healthy adults at three dental erosion-prone sites: 11 palatally; 11 buccally; and at the mesiobuccal cusp tip of 16. In the second series, pH was measured by using the telemetric method in 6 healthy individuals, producing continuous recordings of pH by means of a glass electrode in a specified approximal area. The two series showed similar results, although the telemetric method generally recorded larger pH falls. Holding the drink in the mouth before swallowing led to the most pronounced pH drop, followed by the long-sipping method. Gulping resulted in only a small decrease of pH. No differences among the three intraoral sites were found when analyzed by using the microtouch method. The conclusion from this study is that the drinking method strongly affects tooth-surface pH and thereby the risk for dental erosion. It therefore seems appropriate to include advice on the method of drinking in dietary counseling related to dental erosion. [source] Clinical tests in distinguishing between persons with or without craniomandibular or cervical spinal pain complaintsEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 6 2000Corine M. Visscher The recognition of a craniomandibular or cervical spinal pain is usually based upon the pain complaint of the patient, reported during an oral history, and the pain responses provoked in a clinical examination. Often used clinical tests are palpation, and function tests like dynamic/static tests or active movements. The relative importance of these tests for the recognition of the musculoskeletal pain is important. Therefore, it was the aim of the present study to determine which test, or combination of tests, best discriminates between persons with or without craniomandibular and/or cervical spinal pain complaints. Two hundred and fifty persons participated. From each person, a standardized oral history was taken. Then, in a randomized order and using a blind design, physical examinations of the craniomandibular system and of the neck were performed. Forward stepwise logistic regression analyses showed that the dynamic/static tests discriminated better between persons with and without pain complaints than the other tests did. In conclusion, in studies to the coexistence of craniomandibular and cervical spinal pain, it may be a good choice to base the recognition of these disorders on the pain complaints reported in the oral history which are verified by the pain response of the dynamic/static tests. [source] Advanced dental maturity in children with juvenile rheumatoid arthritisEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 3 2000Arto Lehtinen The subjects of the investigation comprised 95 girls and 73 boys with juvenile rheumatoid arthritis (JRA), and 102 girls and 66 boys representing healthy controls, all with a chronological age from 6.3 to 14.4 yr. The dental development was assessed from panoramic radiographs using a seven-tooth model. The radiographs were evaluated on three separate occasions with a minimum interval of one month in a randomized order, and blind with respect to absence or presence of JRA. In both JRA patients and healthy controls, dental maturity was ahead of chronological age. In addition, dental maturity was significantly advanced in JRA patients with 0.26 yr in girls and 0.28 yr in boys. It is tentatively suggested that the advanced dental development in JRA patients compared with healthy children was partly an effect of treatment with cortisone, while the influence of the disorder per se remains to be elucidated. [source] A randomized, double-blind trial demonstrating bioequivalence of the current recombinant activated factor VII formulation and a new robust 25°C stable formulationHAEMOPHILIA, Issue 5 2007B. V. BYSTED Summary., Recombinant activated factor VIIa (rFVIIa) is a well-established treatment for bleeding episodes in patients with congenital or acquired haemophilia A or B with inhibitors to factors VIII and IX and patients with FVII deficiency. The aim of this trial was to demonstrate bioequivalence between the currently marketed (rFVIIa/NovoSeven®) and a new rFVIIa formulation (VII25) stable at up to 25°C. Furthermore, short-term safety and tolerability of VII25 and pharmacokinetics of both formulations were investigated. In this single-centre, randomized, double-blind, two-way cross-over trial, healthy male subjects received one intravenous bolus injection of rFVIIa and one of VII25, both at 90 ,g kg,1, in a randomized order 2,3 weeks apart. Mean VII25/rFVIIa ratio for area under the plasma activity-time curve from time 0 to last quantifiable activity (primary bioequivalence endpoint), was 0.93, 90% confidence interval (CI) (0.89,0.96), within the predefined bioequivalence range (0.80,1.25). Secondary pharmacokinetic parameters were comparable between formulations. No serious adverse events were observed. Six mild or moderate treatment-emergent adverse events were reported in five subjects. Coagulation-related parameter profiles were similar between rFVIIa and VII25. No clinically abnormal changes were observed for laboratory parameters and no subjects developed FVIIa antibodies. This trial demonstrated bioequivalence between the currently available rFVIIa and VII25 stable at up to 25°C. VII25's ,user-friendly' formulation removes the inconvenience of storing/transporting at 2,8°C, and as the drug substance is the same, the activity and safety established for rFVIIa is maintained. [source] Enhancement of activity of the primary visual cortex during processing of emotional stimuli as measured with event-related functional near-infrared spectroscopy and event-related potentialsHUMAN BRAIN MAPPING, Issue 1 2008Martin J. Herrmann Abstract In this study we investigated whether event-related near-infrared spectroscopy (NIRS) is suitable to measure changes in brain activation of the occipital cortex modulated by the emotional content of the visual stimuli. As we found in a previous pilot study that only positive but not negative stimuli differ from neutral stimuli (with respect to oxygenated haemoglobin), we now measured the event-related EEG potentials and NIRS simultaneously during the same session. Thereby, we could evaluate whether the subjects (n = 16) processed the positive as well as the negative emotional stimuli in a similar way. During the task, the subjects passively viewed positive, negative, and neutral emotional pictures (40 presentations were shown in each category, and pictures were taken from the International Affective Picture System, IAPS). The stimuli were presented for 3 s in a randomized order (with a mean of 3 s interstimulus interval). During the task, we measured the event-related EEG potentials over the electrode positions O1, Oz, O2, and Pz and the changes of oxygenated and deoxygenated haemoglobin by multichannel NIRS over the occipital cortex. The EEG results clearly show an increased early posterior negativity over the occipital cortex for both positive as well as negative stimuli compared to neutral. The results for the NIRS measurement were less clear. Although positive as well as negative stimuli lead to significantly higher decrease in deoxygenated haemoglobin than neutral stimuli, this was not found for the oxygenated haemoglobin. Hum Brain Mapp 29:28,35, 2008. © 2007 Wiley-Liss, Inc. [source] Cuffed endotracheal tubes in children reduce sevoflurane and medical gas consumption and related costsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2010S. ESCHERTZHUBER Background: This study aims to evaluate sevoflurane and anaesthetic gas consumption using uncuffed vs. cuffed endotracheal tubes (ETT) in paediatric surgical patients. Methods: Uncuffed or cuffed ETT were used in paediatric patients (newborn to 5 years) undergoing elective surgery in a randomized order. Duration of assessment, lowest possible fresh gas flow (minimal allowed FGF: 0.5 l/min) and sevoflurane concentrations used were recorded. Consumption and costs for sevoflurane and medical gases were calculated. Results: Seventy children (35 uncuffed ETT/35 cuffed ETT), aged 1.73 (0.01,4.80) years, were enrolled. No significant differences in patient characteristics, study period and sevoflurane concentrations used were found between the two groups. Lowest possible FGF was significantly lower in the cuffed ETT group [1.0 (0.5,1.0) l/min] than in the uncuffed ETT group [2.0 (0.5,4.3) l/min], P<0.001. Sevoflurane consumption per patient was 16.1 (6.4,82.8) ml in the uncuffed ETT group and 6.2 (1.1,14.9) ml in the cuffed ETT group, P=0.003. Medical gas consumption was 129 (53,552) l in the uncuffed ETT group vs. 46 (9,149) l in the cuffed ETT group, P<0.001. The total costs for sevoflurane and medical gases were 13.4 (6.0,67.3),/patient in the uncuffed ETT group and 5.2 (1.0,12.5),/patient in the cuffed ETT group, P<0.001. Conclusions: The use of cuffed ETT in children significantly reduced the costs of sevoflurane and medical gas consumption during anaesthesia. Increased costs for cuffed compared with uncuffed ETT were completely compensated by a reduction in sevoflurane and medical gas consumption. [source] Increased volume of coverage for abdominal contrast-enhanced MR angiography with two-dimensional autocalibrating parallel imaging: Initial experience at 3.0 TeslaJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2009Darren P. Lum MD Abstract Purpose: To assess the feasibility and the quality of abdominal three-dimensional (3D) contrast enhanced MR angiograms acquired at 3.0 Tesla (T) using a new 2D-accelerated autocalibrating parallel reconstruction method for Cartesian sampling (2D-ARC). Materials and Methods: With institutional review board approval and written informed consent, a prospective trial in 6 normal healthy volunteers and 23 patients referred for evaluation of suspected renovascular disease was performed. The volunteers underwent abdominal MRA with and without 2D-ARC acceleration. Images were evaluated independently by two blinded vascular radiologists in randomized order. Vessel conspicuity was rated on a five-point scale. Evaluation for significant differences between the scores for each technique was performed using a Wilcoxon signed-rank test. Results: In the series of six volunteers, no statistical significance was found between the image quality scores for 2D-ARC accelerated and nonaccelerated exams. A high proportion of the 23 clinical 2D-ARC exams were graded as diagnostic (vessel conspicuity score ,2; Reader 1, 96%; Reader 2, 100%) for overall image quality. Conclusion: Subjective image quality of 2D-ARC accelerated MRA was equivalent to the conventional MRA method. However, the 2D-ARC accelerated sequence provided a 3.5-fold increase in imaging volume, complete abdominal coverage, and a 30% reduction in voxel volume, all within the same acquisition time. J. Magn. Reson. Imaging 2009;30:1093,1100. © 2009 Wiley-Liss, Inc. [source] Acute Ethanol Effects on Brain Activation in Low- and High-Level Responders to AlcoholALCOHOLISM, Issue 7 2010Ryan S. Trim Background:, A low level of response (LR) to alcohol is an important endophenotype associated with an increased risk of alcoholism. However, little is known about how neural functioning may differ between individuals with low and high LRs to alcohol. This study examined whether LR group effects on neural activity varied as a function of acute alcohol consumption. Methods:, A total of 30 matched high- and low-LR pairs (N = 60 healthy young adults) were recruited from the University of California, San Diego, and administered a structured diagnostic interview and laboratory alcohol challenge followed by two functional magnetic resonance imaging (fMRI) sessions under placebo and alcohol conditions, in randomized order. Task performance and blood oxygen level-dependent response contrast to high relative to low working memory load in an event-related visual working memory (VWM) task were examined across 120 fMRI sessions. Results:, Both LR groups performed similarly on the VWM task across conditions. A significant LR group by condition interaction effect was observed in inferior frontal and cingulate regions, such that alcohol attenuated the LR group differences found under placebo (p < 0.05). The LR group by condition effect remained even after controlling for cerebral blood flow, age, and typical drinking quantity. Conclusions:, Alcohol had differential effects on brain activation for low- and high-LR individuals within frontal and cingulate regions. These findings represent an additional step in the search for physiological correlates of a low LR and identify brain regions that may be associated with the low LR response. [source] Airway closure in anesthetized infants and children: influence of inspiratory pressures and volumesACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2002A. Thorsteinsson Background: Cyclic opening and closing of lung units during tidal breathing may be an important cause of iatrogenic lung injury. We hypothesized that airway closure is uncommon in children with healthy lungs when inspiratory pressures are kept low, but paradoxically may occur when inspiratory pressures are increased. Methods: Elastic equilibrium volume (EEV) and closing capacity (CC) were measured with a tracer gas (SF6) technique in 11 anesthetized, muscle-relaxed, endotracheally intubated and artificially ventilated healthy children, aged 0.6,13 years. Airway closing was studied in a randomized order at two inflation pressures, +20 or +30 cmH2O, and CC and CC/EEV were calculated from the plots obtained when the lungs were exsufflated to ,20 cmH2O. (CC/EEV >1 indicates that airway closure might occur during tidal breathing). Furthermore, a measure of uneven ventilation, multiple breath alveolar mixing efficiency (MBAME), was obtained. Results: Airway closure within the tidal volume (CC/EEV >1) was observed in four and eight children (not significant, NS) after 20 and 30 cmH2O inflation, respectively. However, CC30/EEV was >CC20/EEV in all children (P,0.001). The MBAME was 75±7% (normal) and did not correlate with CC/EEV. Conclusion: Airway closure within tidal volumes may occur in artificially ventilated healthy children during ventilation with low inspiratory pressure. However, the risk of airway closure and thus opening within the tidal volume increases when the inspiratory pressures are increased. [source] 12 Effects of synchronized intestinal electrical stimulation on small intestinal motility in dogsNEUROGASTROENTEROLOGY & MOTILITY, Issue 6 2006J YIN Our previous studies showed that synchronized gastric electrical stimulation enhanced antral contractions, accelerated gastric emptying in dogs. It has never been reported whether synchronized electrical stimulation could improve small intestinal motility. The aim of this study was to investigate the effects of synchronized intestinal electrical stimulation (SIES) on small bowel motility in both fasting and fed states in dogs. Methods:, Five healthy female dogs (18,24 kg) were equipped with a duodenal cannula for the measurement of small bowel motility using manometry. Two pairs of bipolar electrodes were implanted on the small intestinal serosa with an interval of 25 cm; the first one was 10 cm beyond the pylorus and used for stimulation. The experiment was consisted of four sessions in each dog with a randomized order. In the fasting state, 20 min after occurrence of phase III, SIES was initiated and maintained for 45 min, small bowel motility was recorded during the entire experiment, and no stimulation was performed in the control session. In other two sessions, dogs were fed with solid meal at the beginning of the experiment; glucagon (0.1 mg kg1) was injected 20 min after feeding, SIES was initiated at the same time for 20 min followed by 20 min recovery period. The stimulus was composed of train of pulses with on-time of 0.5 s, frequency of 20 Hz, pulse width of 2 ms and amplitude of 4 mA. Results:, 1). In the fasting state, SIES induced small intestinal contractions during phase I. The motility index was 5.2 ± 0.6 in the control session and significantly increased to 10.3 ± 0.7 with SIES (P = 0.003). 2). In the fed state, glucagon substantially and significantly inhibited small intestinal motility. The motility index was 11.3 ± 0.7 after feeding and reduced to 3.4 ± 0.5 with glucagon injection (P < 0.001). SIES significantly enhanced glucagon-induced small intestinal postprandial hypomotility. The motility index was 3.4 ± 0.5 in the control session and increased to 6.0 ± 0.3 with the presence of SIES (P = 0.03). Conclusions:, Intestinal electrical stimulation synchronized with intestinal slow waves induces intestinal contractions during phase I and enhanced small intestinal postprandial hypomotility induced by glucagon. SIES may have the therapeutic potential for treating small intestinal motility disorders. (Supported by a grant from American Diabetes Association). [source] 22 Comparison of multichannel electrogastrograms obtained with the use of three different electrode typesNEUROGASTROENTEROLOGY & MOTILITY, Issue 6 2006K JONDERKO Background/Aims:, Multichannel recording of the gastric myoelectrical activity (GMA) is a promising evolution of electrogastrography. In the study we searched for electrodes the most suitable to obtain high quality multi-channel electrogastrograms. Methods:, Twelve young volunteers (9 F, 3 M, aged 24.3 ± 0.6 years) underwent on separate days three four-channel electrogastrographic recordings of the GMA: 30 min fasted and 90 min after a solid meal stimulation. The electrogastrograms were recorded in randomized order with 3M Red Dot class Ag/AgCl electrodes designed primarily for long-term electrocardiographic monitoring: type2222 (conductive area, CA/total area, TA): 2.00/10.24 cm2, type2271 2.54/29.64 cm2, type2660 11.64/11.64 cm2 (total surface conductive!) and subsequently analysed with Polygram NetÔ EGG 311224 software (Medtronic, USA). Electrical resistance between active electrodes relative to the reference one was measured with a digital ohmmeter before and after the recording session. Results:, Type2660 yielded consistently higher electrical resistance than the other electrode types, moreover in the case of type2271 and type2660 electrical conductivity significantly improved at the end of the recording relative to the basal measurement. Analysis of variance involving the relative time-share of normogastria, meal-induced change in dominant power, as well as a set of parameters unique for the multichannel electrogastrography and intended to characterize the so-called spatial displacement of the gastric slow waves did not reveal any statistically significant effect of the electrode type on the parameters of the multichannel electrogastrogram. Although, when particular numerical data were inspected, type2271 was found to perform slightly worse than the other electrode types. Type2271 was also rated the less handy among the electrodes tested. Conclusion:, Multichannel surface electrogastrography seems to be technically feasible with any type of high quality Ag/AgCl electrodes available on the market, whereas small dimensions enabling easy placement on the abdomen may be a feature favouring the choice of a particular electrode type for this examination. [source] Randomized Double-blind Placebo Controlled Crossover Study of Acetaminophen, Ibuprofen, Acetaminophen/Hydrocodone, and Placebo for the Relief of Pain From a Standard Painful StimulusACADEMIC EMERGENCY MEDICINE, Issue 9 2009James R. Miner MD Abstract Objectives:, The objective was to compare subjects' change in perceived acute pain from an identical painful stimulus after receiving three separate, commonly used pain medications and placebo. Methods:, This was an institutional review board,approved, randomized, double-blind crossover study of healthy human volunteers. Subjects received 1000 mg of acetaminophen, 800 mg of ibuprofen, the combination of 650 mg of acetaminophen with 10 mg of hydrocodone, or placebo (800 mg of lactose) in a randomized order over four separate occasions each 1 week apart. Prior to receiving the drug on each study day, subjects placed their nondominant hand in a bath of 0°C water for 45 seconds. The bath was divided into two sections; the larger was the reservoir of cooled water monitored at 0°C, and the other half was filled from constant overflow. Water drained from the overflow section into the cooling unit and was then pumped up into the base of the reservoir through a diffusion grid. Subjects completed a 100-mm visual analog scale (VAS) representing perceived pain during the exposure. The cold water exposure and VAS were repeated 1 hour after receiving the study drug, and then subjects were observed for side effects for 4 hours. Data were compared using descriptive statistics, 95% confidence intervals (CIs), and repeated-measures analysis of variance (ANOVA). Results:, Twenty-five subjects were enrolled. The mean VAS preexposure was 56.9 mm (±15.1 mm; range = 5 to 92 mm). The mean decrease in VAS after receiving the study drug for acetaminophen was 10.2% (95% CI = ,1.4 to 20.4), for ibuprofen was ,6.6% (95% CI = ,16.5 to 3.20), for acetaminophen/hydrocodone was 9.5% (95% CI = 1.4 to 20.4), and for placebo was ,6.9% (95% CI = ,15.2 to 1.4). The range in change in pain scores for all agents was ,91.3% to 57.6%. Mild side effects (nausea, dizziness, or somnolence) were reported in 11 subjects (44%) after receiving acetaminophen/hydrocodone; no other side effects were reported. Conclusions:, There was a wide range of changes in pain scores from this identical painful stimulus after receiving the study medications. Acetaminophen and acetaminophen/hydrocodone resulted in a similar decrease in pain (10.2 and 9.5%), while ibuprofen and placebo had a similar lack of effect (,6.6 and ,6.9%). Forty-four percent of subjects receiving acetaminophen/hydrocodone reported mild side effects; no other side effects were seen. In this noninflammatory pain model, the VAS is not able to distinguish differences in pain relief between acetaminophen and acetaminophen/hydrocodone or ibuprofen and placebo. [source] Reaction time during semi-automated kinetic perimetry (SKP) in patients with advanced visual field lossACTA OPHTHALMOLOGICA, Issue 1 2010Katarzyna Nowomiejska Abstract. Purpose:, This study aimed to evaluate reaction time (RT) in patients with advanced visual field (VF) loss using semi-automated kinetic perimetry (SKP). Methods:, Seventy-eight patients with advanced VF loss caused by glaucoma (31) or retinitis pigmentosa (19), homonymous VF loss caused by post-chiasmal lesions (18) and unilateral anterior ischaemic optic neuropathy (AION) (10) were examined with SKP (Octopus 101 perimeter). One eye in each patient was enrolled. Additionally, VFs in the 10 healthy fellow eyes of the patients with AION were compared with those in the 10 affected eyes. Reaction time was assessed during the SKP session by presenting kinetic stimuli (III4e) with constant angular velocities of 3 °/second moving linearly along so-called ,RT vectors' at four different locations inside the III4e isoptre. Each stimulus presentation was repeated four times in randomized order. Results:, The geometric mean RT was 794 ms (95% reference interval [RI] 391,1615 ms) in patients with glaucoma, 702 ms (95% RI 306,1608 ms) in patients with retinitis pigmentosa and 675 ms (95% RI 312,1460 ms) in patients with hemianopia. Increases in RT for every 1 ° of eccentricity were 1%, 0.9% and 0.4%, respectively. The geometric mean RT in the 10 patients with unilateral optic neuropathy was 644 ms in affected eyes and 435 ms in unaffected eyes, reflecting an increase of 51% (95% confidence interval 42,62%). Conclusions:, We found substantial inter-subject variability in RT in patients with advanced VF loss. It is possible to correct the position of the isoptres by assessing individual RT. There were no relevant differences in RT between the disease groups. Reaction time increases with eccentricity. In monocular disease (AION), RT is prolonged, compared with in healthy fellow eyes. However, in clinical routine the RT-related displacement of isoptres is negligible in the vast majority of cases. [source] Multiple doses of secretin in the treatment of autism: a controlled studyACTA PAEDIATRICA, Issue 5 2002E Sponheim Dramatic effects on autistic behaviour after repeated injections of the gastrointestinal hormone secretin have been referred in a number of case reports. In the absence of curative and effective treatments for this disabling condition, this information has created new hope among parents. Although controlled studies on the effect of mainly one single dose have not documented any effect, many children still continue to receive secretin. Six children enrolled in a double-blind, placebo-controlled crossover study in which each child was its own control. Human synthetic secretin, mean dose 3.4 clinical units, and placebo were administered intravenously in randomized order every 4th wk, on three occasions each. The measurement instruments were the visual analogue scale (VAS) and the aberrant behaviour checklist (ABC). Statistically significant differences were found for placebo in 3 out of 6 children and for secretin in one child, using parental ratings only (VAS scores). Differences were small and lacked clinical significance, which was in accordance with the overall impression of the parents and teachers and visual inspection of graphs. Conclusion: In this placebo-controlled study, multiple doses of secretin did not produce any symptomatic improvement. [source] | ||||||||||