All patients were placed on a patient-controlled i v analgesia r

All patients were placed on a patient-controlled i.v. analgesia regimen with morphine after surgery. Time to the first morphine request and amount of morphine Belnacasan manufacturer consumption within 24h after surgery were compared in patients with and without TAP block. Plasma concentrations of local anesthetics were determined at 15, 30 and 60min after TAP block.

Results: Forty and 54 patients were allocated to the control and TAP group, respectively. The median time to the first morphine request was longer (555 vs 215min), and the median cumulative

morphine consumption within 24h was lower (5.3 vs 7.7mg) in the TAP group than in the control group. The maximum median concentrations of ropivacaine and bupivacaine after TAP block were 784 and 553ng/mL, respectively.

Conclusion: TAP block had additional analgesic effects to epidural morphine alone.”
“Ultraviolet B (UVB) radiation provokes the generation of reactive oxygen species (ROS) in the cells and skin, which induce oxidative stress in

the exposed cells, leading to photoaging and cancer. Using the human keratinocytes HaCaT cell line, we investigated the photoprotective effects of aucubin isolated from Eucommia ulmoides. Pretreatment with aucubin markedly suppressed UVB-induced oxidative stress, which manifests as a decrease in intracellular lipid peroxidation, elevation of MK-0518 catalase activity, and reduced glutathione content. In addition, aucubin significantly reduced expression of matrix metalloproteinase-1 (MMP-1) protein (54%) and mRNA. Taken together, these results suggest that aucubin may offer protection against UVB-induced oxidative stress and may be used as a potential agent in prevention of UVB-induced photoaging.”
“Purpose of review

Osteoarthritis is strongly linked to aging but the mechanisms for this link are incompletely understood. The recent literature was reviewed to find studies providing new insights into the connection between aging and osteoarthritis.

Recent findings

Basic aging studies in nonarticular cells suggest that a cell stress or cell damage response contributes to chronic inflammation that promotes

age-related diseases. This cellular response results in the senescence-associated secretory phenotype which has many of the characteristics of Etomoxir an osteoarthritic chondrocyte in terms of the cytokines, chemokines, and proteases produced. Oxidative stress can promote cell senescence and studies have shown a role for oxidative stress in altering cell signaling pathways in chondrocytes that can disrupt the response to growth factors. Mitochondria are an important source of reactive oxygen species and studies continue to support a role for the mitochondria in osteoarthritis, including work suggesting changes in energy production. Cell death occurs in osteoarthritic cartilage and recent studies suggest autophagy may play a role in determining if a cell lives or dies when stressed.

This response is similar to that seen after other types of injury

This response is similar to that seen after other types of injury. Where cochlear implantation differs is the predominance of fibrin and clot early after electrode insertion before infiltration by fibroblasts by the end of the first postoperative week. These results suggest that anti-inflammatory drugs aimed at reducing the extravasation of immunecompetent cells into the cochlea must be effective over the first LY3023414 in vitro few days after surgery. Whether this can be achieved through preoperative treatment alone, or whether therapy will need to continue postoperatively,

awaits further experimentation.”
“In this study, calcium antagonistic activity of sixteen hexahydroquinoline derivatives have been elucidated in rat ileum and rat thorasic aorta. In the studies on

isolated rat ileum, it has been observed that all compounds showed meaningfull activity. In rat thorasic aorta studies, compound 3a has been found more active than nicardipine.”
“Facial scars in children have a profound psychosocial impact and require early and aggressive treatment. In this age group in particular, however, attention must be placed on the methodology so as not to trigger additional trauma-whether physical or emotional-as a sequela to the treatment. We assess the safety and efficacy of fractional CO2 in a prospective study of pediatric facial scars from various etiologies. Twenty four children, age 2-16 years, underwent fractional CO2 laser resurfacing. Recovery, clinical response, and adverse events were monitored at 3 days, https://www.selleckchem.com/products/nu7026.html 1 week, 1 month, 2 months, and 6 months. Photographs taken before treatment and 2 months after final treatment were independently evaluated and scored by two physicians. All patients tolerated treatment well, with minimal erythema an edema. The clinical improvement was scored as excellent in 14 patients (58 %), good in 7 (29 %), and fair in 3 (13 %). No cases were graded as poor or worse.

No adverse events were noted. The study supports the use of fractional CO2 resurfacing of pediatric facial scars as well tolerated and effective. Given the particularly rapid healing and clinical improvement of pediatric Selleckchem Compound C skin, fractional CO2 treatment should be offered early to mitigate both the physical and psychosocial stigmata of scars as early as possible.”
“Hypothesis: Unintentional electrical stimulation of the facial nerve by cochlear implants occurs when advanced otosclerosis invades the endosteum of both the upper basal turn of the cochlea (UBTC) and the facial nerve canal (FNC) and all the bone between these 2 structures.

Background: A complication of cochlear implantation is facial nerve stimulation (FNS) known to be more common in otosclerosis.

In this study, 41 children with spastic cerebral palsy were asses

In this study, 41 children with spastic cerebral palsy were assessed, and 56 normally developed children were included as control. Parameters such as body compositions, basal metabolic

rate, body resistance, liquid compartment, and capacitance of patients and control group were measured and analyzed statistically. Basal metabolic rate, body mass index, PXD101 clinical trial extracellular liquid, intracellular liquid, body capacitance, and resistance differed significantly compared to the control group (P < .01), whereas extracellular mass, lean body mass, body cell mass, and fat mass did not differ significantly compared to the control group (P > .05). Parameters such as basal metabolic rate, body composition, and body resistance can be determined using the bioelectrical impedance method in children with cerebral palsy.”
“Background & aims: The association of fatigue with decreased physical performance and underlying mechanisms are poorly understood in Crohn’s disease (CD). We aimed to measure and compare self-reported fatigue with skeletal muscle fatigue in CD subjects and healthy controls, and to identify associated

factors that may be amenable to change.

Methods: Demographic and clinical data were collected and fatigue assessed using the Fatigue Impact Scale (FIS) in 27 consecutive CD patients and 22 matched healthy controls. Circulating cytokines and growth factors were measured. Microbiology inhibitor The rate of quadriceps muscle fatigue

was assessed NVP-LDE225 ic50 using an isokinetic dynamometer as the decrement of force with 30 contractions performed over a 5-minute period.

Results: Compared with healthy controls, CD patients reported greater levels of fatigue (mean global FIS score 45.3 vs 10.5, physical dimension score 12.3 vs 2.7 respectively; each p < 0.01) and muscle fatigue (-5.2 vs -1.3 Nm min(-1); p < 0.05). The two indices were correlated (r = -0.52 in CD; p < 0.01). Patients with CD had lower mean serum IGF-1 levels (16.1 vs 25.4 pmol/L, p < 0.01) and higher oxidative stress (TBARS assay 4.3 vs 3.9 mu M, p < 0.05). On multivariate analysis, low serum vitamin D, IGF-1 and magnesium, and higher IL-6 levels were associated with increased muscle fatigue (all p <= 0.05).

Conclusion: Subjects with CD had more muscle fatigue than matched healthy controls and this correlated well with self-reported fatigue. Of circulating factors that were independently associated with increased muscle fatigue, vitamin D, magnesium and IGF-1 could be targeted in future studies to reduce fatigue and improve physical performance. Crown Copyright (C) 2013 Published by Elsevier B.V. on behalf of European Crohn’s and Colitis Organisation. All rights reserved.

We propose somatosensory evoked potential (SEP) as a complementar

We propose somatosensory evoked potential (SEP) as a complementary measure to assess the integrity of sensory pathways. We used the focal experimental autoimmune encephalomyelitis (EAE) model, in which focal demyelinating lesions were induced by injecting cytokine-ethidium bromide into dorsal white matter after MOG-IFA immunization. Both the SEP and BBB measures reflected injury; however, the SEP was uniformly and consistently altered after

the injury whereas the BBB varied widely. The results suggest that the SEP measures are more sensitive and reliable markers of focal spinal cord BI 2536 mouse demyelination compared to the behavioral measures like the BBB score.”
“Ampakines are a class of putative nootropic drug designed to positively modulate the AMPA receptor and have been investigated as a potential treatment for cognitive disorders such as Alzheimer’s Disease. Nonetheless, some ampakines such as CX717 have been incompletely characterized in behavioural VX-689 cost pharmacological studies. Therefore, in this study, we attempted to further characterize the effects of the ampakine, CX717 (20 mg/kg s.c), on the performance of

rats in a 5 choice serial reaction time (5CSRTT) and object recognition memory task, using rats with cognitive deficits caused by bilateral vestibular deafferentation (BVD) as a model. In the 5CSRTT, when the stimulus duration was varied from 5 to 2 sec, the number of incorrect responses was significantly greater for the BVD group compared to sham controls, but significantly less for the CX717 groups, with no significant interaction. With changes in inter-trial interval (ITI), there was a significant effect of surgery/drug and a significant effect of ITI on premature responses, and the BVD group treated with CX717 showed

significantly fewer premature responses than the other groups. In the object recognition memory task, CX717 significantly reduced total exploration time and the exploration towards the novel object in both sham and BVD animals. These results suggest that CX717 can reduce the number of incorrect this website responses in both sham and BVD rats and enhance inhibitory control specifically in BVD rats, in the 5CSRTT. On the other hand, CX717 produced a detrimental effect in the object recognition memory task.”
“Background: HIV infection among substance abusers is a growing concern in the United States. Little research, however, has examined the provision of HIV/AIDS services in substance abuse treatment programs.

Methods: This study examines the provision of onsite HIV/AIDS services in a nationally representative sample of 345 privately funded substance abuse treatment programs. Data were collected via face-to-face interviews with administrators and/or clinical directors of treatment programs in 2007-2008.

Respiratory syncytial virus (RSV) was the agent that was most com

Respiratory syncytial virus (RSV) was the agent that was most commonly found (3.8% specific hospitalization

rate). Children receiving adequate RSV prophylaxis (90.5%) had a 58.2% (95% confidence interval: 37.6-78.3) reduction in RSV hospitalization. Risk factors for admission included malnourishment, infant age, male gender, chromosome alterations, wheezing, inadequate RSV prophylaxis fulfillment, and siblings <11 years of age. Pediatric intensive care unit care was required in Selleck Birinapant 21.8% of the admissions and 9 patients (0.34%) died.

Conclusions: Hospital admission rate and severity of ARI remain as important issues in hemodynamically significant congenital heart disease patients. The strict fulfillment of prophylactic recommendations against RSV is the only protective factor that can be modulated to decrease the ARI hospital admission rate.”
“Introduction: Different types of grafts have been described in urethral reconstruction (UR), with penile skin graft (PSG) and buccal mucosa graft (BMG) as the most frequently used ones. It still remains unclear whether one graft is superior in terms of success when compared to the other. Material and Methods: A systematic review of the

literature was performed searching the MEDLINE database with the following selleck search strategy: ‘urethroplasty’ AND ‘penile skin’/'urethroplasty’ AND ‘buccal mucosa’. 266 and 144 records were retrieved for urethroplasty with PSG and BMG,

respectively. These records were reviewed to identify papers where PSG and BMG were used in UR and where individualized data on success were available within the same series. Results: 18 papers were found eligible for further analysis. In total, 428 and 483 patients were respectively treated with JNK inhibitor in vivo PSG or BMG. If available, follow-up duration was 64.1 versus 42.1 months (p < 0.0001) and stricture length 6.2 versus 4.6 cm (p < 0.0001) for PSG and BMG, respectively. Success of UR with PSG was 81.8 versus 85.9% with BMG (p = 0.01). Conclusions: Success of UR using BMG is significantly better compared to PSG. Results might be seriously biased by a longer follow-up duration and stricture length for PSG compared to BMG. Copyright (c) 2012 S. Karger AG, Basel”
“The stabilization effect, an increase of the reverse transition temperature T(C) with ferroelectric aging time, was recently found in acceptor doped ferroelectrics. Such an effect has found a microscopic explanation in the symmetry-conforming principle of point defects, which also accounts for a similar stabilization effect in ferroelastic/martensite materials. However, such a microscopic model is difficult to use to make a quantitative/semiquantitative evaluation of the aging process. In the present work, we propose a single-domain thermodynamic model that provides a semiquantitative fit to the experimentally observed stabilization kinetics.


“The different natural oils epoxidized with 3-chloroperben


“The different natural oils epoxidized with 3-chloroperbenzoic

acid were crosslinked with diepoxy reactive diluents, bisphenol A propoxylate diglycidyl ether, and 3,4-epoxycyclohexylmethyl-3,4-epoxyclohexane-carboxylate, using AG-881 Metabolism inhibitor cationic initiator at 60 degrees C and photoinitiators at the room temperature. The insoluble fraction of the polymeric products was 59-90%. The Young modulus of the crosslinked polymer films ranged from 2 to 861 MPa. The 10% weight loss temperatures of the crosslinked polymers estimated by thermogravimetric analysis were in the range from 250 to 420 degrees C. The water vapor transmission rate of the crosslinked biopolymer films ranged from 6 to 49 g/m(2)/24 h. Biochemical oxygen demand and biodegradation in soil of the crosslinked polymers were studied. The crosslinked polymers showed higher biodegradation rate than cellulose, starch, and polyvinylalcohol. (C) 2009 Wiley Periodicals, Inc. J Appl Polym Sci 115: 2028-2038, 2010″
“This noninterventional single-arm study explored effectiveness and behavioral outcomes in intellectually disabled patients treated with topiramate for epilepsy. Data from 21 patients diagnosed with cerebral palsy were available for evaluation.

Behavioral changes were assessed using the validated Aberrant Behavior Checklist and Matson Evaluation of Social Skills for individuals with Severe Retardation (MESSIER) scales. Some improvement CX-6258 supplier in nearly all behavioral aspects was observed under concomitant topiramate therapy; for example, the Aberrant Behavior Checklist total score changed from 33.7 +/- 25.8 to 25.3 +/- 19.1

(P = 0.047). In addition, seizure frequency decreased from 16.1 +/- 22.2/4 weeks to 12.2 +/- 17.0/4 weeks (N = 2 1, P = 0.164). Fifty-two percent of the patients experienced at least 50% seizure reduction during the 24-week treatment period. The safety profile is in accordance with the current Summary of Product Characteristics of Topiramate. Two unexpected deaths were attributed to sudden unexpected death in epilepsy. (C) 2009 Elsevier Inc. All rights reserved.”
“Study Design. Prospective, controlled, observational outcome study using clinical, radiographic, and patient/physician-based questionnaire data, with patient outcomes at 12 months selleck chemicals follow-up.

Objective. To validate appropriateness criteria for low back surgery.

Summary of Background Data. Most surgical treatment failures are attributed to poor patient selection, but no widely accepted consensus exists on detailed indications for appropriate surgery.

Methods. Appropriateness criteria for low back surgery have been developed by a multispecialty panel using the RAND appropriateness method. Based on panel criteria, a prospective study compared outcomes of patients appropriately and inappropriately treated at a single institution with 12 months follow-up assessment. Included were patients with low back pain and/or sciatica referred to the neurosurgical department.

There was considerable variability of patients with chronic condi

There was considerable variability of patients with chronic conditions across practices, irrespective of whether ICPC-2-diagnoses or prescribed drugs were used to code clinical encounters. Obvious check details discrepancies between diagnoses and therapies across major disease categories

existed.

CONCLUSIONS: This study describes the current situation of EMRs in terms of the ability to measure the burden of chronic conditions in primary care practices. The results illustrate a need of action for this specific topic and the results of this study will be incorporated into the functional specification of EMRs of a planned eHealth project in Swiss primary care.”
“Background: A lower core body temperature set point has been suggested to be a factor that could potentially predispose humans to develop obesity.

Objective: We tested the hypothesis that obese individuals have lower core temperatures than those in normal-weight individuals.

Design: In study 1, nonobese [body mass index (BMI;

in kg/m(2)) <30] and obese (BMI >= 30) adults swallowed wireless core temperature-sensing capsules, and we measured core temperatures continuously for 24 h. In study 2, normal-weight (BMI of 18-25) and obese subjects swallowed temperature-sensing capsules to measure core temperatures continuously for >= 48 h and kept activity logs. We constructed daily, 24-h core temperature profiles for analysis.

Results: Mean (+/- SE) daily core body temperature did not differ significantly between the 35 nonobese and 46 obese subjects (36.92 +/- 0.03 degrees Volasertib C compared with 36.89 +/- 0.03 degrees C; P = 0.44). Core temperature 24-h profiles did not differ significantly between 11 normal-weight and 19 obese subjects (P = 0.274). Women had a mean core body temperature approximate to 0.23 degrees C greater than that of men (36.99 +/- 0.03 degrees C compared with 36.76 +/-

0.03 degrees C; P < 0.0001).

Conclusions: 4SC-202 mouse Obesity is not generally associated with a reduced core body temperature. It may be necessary to study individuals with function-altering mutations in core temperature-regulating genes to determine whether differences in the core body temperature set point affect the regulation of human body weight. These trials were registered at clinicaltrials.gov as NCT00428987 and NCT00266500. Am J Clin Nutr 2011;93:963-7.”
“This report contains a technical note and 2 case reports of the “”all-on-4″” treatment of the highly resorbed mandible. The use of 4 angled implants directed toward the midline of the mandible at 30 degrees angles provides the advantage of increased implant length and adequate insertion torque for immediate temporization. The technique engages or perforates the inferior border with implants placed in a spaced distribution to avoid fracture of the mandible. The technique is proposed as an alternative to bone graft reconstruction.

An analysis is developed to predict the Raman shift in deformed s

An analysis is developed to predict the Raman shift in deformed silicon that takes

into account all the components of the stress or strain tensor; the results selleck of the model are then used as inputs to the analysis for direct comparison with measured peak shifts as a function of distance from the TSV. Good agreement between the measured and predicted peak shifts is obtained for the case of the intact oxide stack. A discrepancy between the measured and predicted shifts was observed adjacent to the TSV with the oxide stack removed; further modeling suggests the discrepancy is explained by the formation of a small void at the TSV-silicon interface during etching. The combined measurement-modeling approach serves to both validate the model, in this case for TSV design, and to extend the measurement capability https://www.selleckchem.com/products/ipi-145-ink1197.html of confocal Raman microscopy to complex stress fields. (C) 2011 American Institute of Physics. [doi:10.1063/1.3644971]“
“The ligand activated transcription factor aryl hydrocarbon receptor (AhR) has been studied for many decades in toxicology as the ligand for the environmental contaminant dioxin. However,

AhR has recently emerged as a critical physiological regulator of immune responses affecting both innate and adaptive systems, and several AhR ligands with different pharmacological profiles have recently been studied. The current review discusses new insights into the role of AhR signalling and AhR ligands on the regulation of the immune system, with a focus on regulatory T cells which maintain immune tolerance. Notably, AhR is expressed and modulates the development of two induced regulatory CD4(+) T cell subsets, the forkhead box P3-positive (Foxp3(+)) regulatory T cells (iTreg) and the IL-10-secreting type

1 regulatory T (T(R)1) cells, through different signalling pathways. We will finally discuss www.selleckchem.com/products/BKM-120.html how AhR ligands could be exploited to alleviate human autoimmune diseases. Clearly, drugs targeted against AhR should promote the development of new strategies to fight against autoimmune diseases.”
“Global ischemia selectively induces CA1 neuronal death in the hippocampus. Pretreatment with non-lethal ischemia (i.e. ischemic preconditioning) prevents CA1 neuronal death induced by lethal ischemia. While ischemic tolerance is a well-known phenomenon, the underlying molecular mechanisms are not fully understood. Cytoskeletal proteins including alpha-spectrin, tau, and microtubule-associated protein 2 (MAP-2) are indispensable for the maintenance of neuronal homeostasis. Here, we report the effects of ischemic preconditioning on the ischemia-induced degradation of cytoskeletal proteins alpha-spectrin, tau, and MAP-2 in the rat CA1 region. We found that most neurons of the CA1 region had died after 5 min of ischemia. However, exposing the brain to 3 min of ischemic preconditioning 3 days earlier significantly reduced the number of neuronal death.

Fibrinogen and high-sensitivity CRP levels were significantly

Fibrinogen and high-sensitivity CRP levels were significantly LY2606368 purchase higher in group HP than in group CP. Conclusion: Alterations in PDMP levels correlated with the presence of atherothrombotic lesions, and PDMP levels are expected to be useful as a clinical indicator, reflecting the presence of intracranial atherosclerotic lesions in the acute phase of cerebral infarction.”
“Testicular cancer (TC) is the most common cancer in young men, and its incidence is increasing. The low mortality rate makes quality of life (QOL) an important issue in this patient group. This study aimed

to develop a supplementary module of the EORTC QLQ-C30 questionnaire to assess TC-specific aspects of QOL.

Questionnaire development was conducted according to guidelines from the EORTC Quality of Life Group. Phase I comprised https://www.selleckchem.com/products/OSI-906.html generation of QOL issues relevant to TC patients through a literature search and interviews with patients and experts. Phase II included operationalization and assessment of item relevance. In phase III, items were pre-tested in a cross-cultural sample to assess issues such as understandability and intrusiveness of items.

In

phase I and II, an initial list of 69 QOL issues possibly relevant to TC patients was refined through patient and expert interviews. The remaining 37 issues were operationalized into items and assessed for OSI-906 inhibitor relevance and priority in an expert sample (n = 28) and a patient sample (n = 62) from Austria, Canada and the Netherlands. After revision of the item list, 26 items were considered eligible for pre-testing in phase III, in which 156 patients from Australia, Austria, Italy and Spain participated. All items passed criteria for pre-testing, thus forming the new EORTC QLQ-TC26.

The newly developed EORTC QLQ-TC26 is now available in several languages to assess QOL in TC patients receiving treatment and in TC survivors. Phase IV of questionnaire development will comprise international field

testing, including extensive analysis of psychometric characteristics of the EORTC QLQ-TC26.”
“Purpose: Cell adhesion to extracellular matrix (ECM) proteins is mediated by the integrin family and has been known to modify radiation sensitivity and resistance in several cell types, including cancer cells. In particular, beta 1 integrin signaling has been implicated in the progression and metastasis of various cancers and has been shown to facilitate resistance to radiation therapy.

Conclusion: In this mini-review, we provide a brief overview of integrin targeting in radiation therapy. We specifically focus on the updated findings of b1 integrin-mediated signaling pathways after exposure to ionising radiation (IR) using in vitro and in vivo experimental models, which could represent promising therapeutic targets for breast cancer.

They reported

one incident of detachment of the catheter

They reported

one incident of detachment of the catheter from the abdominal wall. They also noted a statistically significant decrease in vital capacity and FEV1 in enterally fed patients. There was no difference in length of stay or anastomotic complications. They concluded that there was no indication for routine use of immediate postoperative enteral feeding in those patients without significant preoperative malnutrition. A Third report randomized their post-oesophagectomy patients into enteral feeding via jejunostomy (n = 20) versus crystalloid only (n = 20). The also found no difference in length of stay, anastomotic leak rate or mortality. One catheter was removed due to concerns over SC79 PI3K/Akt/mTOR inhibitor respiratory function. They also concluded that there was no measurable benefit in early enteral feeding. The last of these 4 studies randomized patients into naso-duodenal feeding (n = 71) and jejunostomy feeding groups (n = 79). As in previous trials, they found no statistically significant difference between length of stay or anastomotic leak rates. Mortality was

higher in the jejunostomy group, although the team did not attribute the deaths to the catheter. They found both methods equally effective in providing postoperative nutrition. In summary, all the trials concluded that routine postoperative enteral nutrition was feasible, but there was no evidence suggesting that it conferred any clinical benefits.”
“Ghrelin is secreted mainly in the stomach and plays a role in food intake regulation. Morbidly obese (MO) individuals report a decline in appetite after DAPT sleeve gastrectomy (SG), presumably due, in part, to ghrelin cell

removal. Ghrelin cell distribution and expression were determined in three areas of resected stomach specimens from MO patients subjected to SG.

Resected stomach specimens from 20 MO patients undergoing SG were analyzed. Real-time polymerase chain reaction of ghrelin mRNA and immunohistostaining selleck chemicals llc for ghrelin cells in three stomach regions (fundus, body, and pre-antral areas) were performed. Body mass index (BMI) and total plasma ghrelin levels were obtained before and 3 months postoperatively.

Ghrelin mRNA was detected throughout the stomach, its expression decreasing from the fundus towards the antrum. The relative quantification for ghrelin mRNA expression was 0.043, 0.026, and 0.015 at the fundus, body, and pre-antral region, respectively (P = 0.05, fundus vs. pre-antral region). Average ghrelin cell counts declined from 60 +/- 40 to 45 +/- 20 and 39 +/- 13 cells/high power fields in the fundus, body, and pre-antral region, respectively. Three months after surgery, total plasma ghrelin levels decreased from 1,676 +/- 470 to 1,179 +/- 188 pg/ml (P < 0.00001) and BMI dropped from 46 +/- 6 to 38 +/- 5 kg/m(2) (P < 0.00001).