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  • Citation tools Download this article to citation manager Crawshaw Dickon P , Helliwell Philip S , Hensor Elizabeth M A , Hay Elaine M , Aldous Simon J , Conaghan Philip G et al. Exercise therapy after corticosteroid injection for moderate to severe shoulder pain: large pragmatic randomised trial BMJ 2010; 340 :c3037
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    In the initiation population (n = 797 in each cohort), children prescribed small-particle ICS versus standard size-particle ICS experienced greater odds of asthma control (adjusted odds ratio, ; 95% CI, -) and lower severe exacerbation rate (adjusted rate ratio, ; 95% CI, -). Step-up outcomes (n = 206 in each cohort) were also significantly better for small-particle ICS, with asthma control adjusted odds ratio of (95% CI, -) and exacerbations adjusted rate ratio of (95% CI, -). The number needed to treat with small-particle ICS to achieve 1 additional child with asthma control was 17 (95% CI, 9-107) for the initiation population and 5 (95% CI, 3-78) for the step-up population. Outcomes were not significantly different for stepped-up small-particle ICS dose versus ICS/LABA combination (n = 185 in each cohort).

    Results in 386 patients CSWD (n = 191), CCS (n = 195) are presented (CSWD; CCS). No differences were observed at 5 years in the proportion of patients experiencing: primary end point (composite of death, graft loss, or moderate/severe acute rejection) (30/191 (%); 28/195 (%)), patient death (11/191(%);13/195 (%)), death-censored graft loss (11/191 (%); 7/195(%)), biopsy confirmed acute rejection (BCAR) (34/191 (%); 21/195 (%), P = ), moderate/severe acute rejection (15/191 (%); 12/195 (%)). Kaplan Meier analyses of the primary end point and its components also showed no differences; but BCAR was higher with CSWD (P = ). Increased BCAR episodes were primarily corticosteroid-sensitive Banff 1A rejections: the incidence of antibody-treated BCAR was similar between groups (11/191 (%); 13/195 (%)). No differences in renal function were observed at 5 years: mean serum creatinine ( +/- ; +/- mg/dL), or Cockroft Gault calculated creatinine clearance ( +/- ; +/- mL/min). CSWD was associated with improved serum triglycerides (evaluated by mean and median change from baseline) at all time points (except at 5 years measured by mean change). Weight change also demonstrated changes favoring CSWD (median change from baseline at 5 years: vs. kg, P = ). New onset diabetes after transplant (NODAT) was similar with respect to proportions who required treatment (23/107 (%)); 18/86 (%); however, fewer CSWD patients required insulin for NODAT at 5 years (4/107 (%)); 10/86 (%), P = ). Changes in HgA1c values (from baseline) were lower in CSWD patients at all time points except 4 years.

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