Prior differences in previous trauma exposure primarily drive the observed racial/ethnic differences in posttrauma depression and anxiety following a recent trauma.

BACKGROUND: Racial and ethnic groups in the USA differ in the prevalence of posttraumatic stress disorder (PTSD). Recent research however has not observed consistent racial/ethnic differences in posttraumatic stress in the early aftermath of trauma, suggesting that such differences in chronic PTSD rates may be related to differences in recovery over time. METHODS: As part of the multisite, longitudinal AURORA study, we investigated racial/ethnic differences in PTSD and related outcomes within 3 months after trauma. Participants (n = 930) were recruited from emergency departments across the USA and provided periodic (2 weeks, 8 weeks, and 3 months after trauma) self-report assessments of PTSD, depression, dissociation, anxiety, and resilience. Linear models were completed to investigate racial/ethnic differences in posttraumatic dysfunction with subsequent follow-up models assessing potential effects of prior life stressors. RESULTS: Racial/ethnic groups did not differ in symptoms over time; however, Black participants showed reduced posttraumatic depression and anxiety symptoms overall compared to Hispanic participants and White participants. Racial/ethnic differences were not attenuated after accounting for differences in sociodemographic factors. However, racial/ethnic differences in depression and anxiety were no longer significant after accounting for greater prior trauma exposure and childhood emotional abuse in White participants. CONCLUSIONS: The present findings suggest prior differences in previous trauma exposure partially mediate the observed racial/ethnic differences in posttraumatic depression and anxiety symptoms following a recent trauma. Our findings further demonstrate that racial/ethnic groups show similar rates of symptom recovery over time. Future work utilizing longer time-scale data is needed to elucidate potential racial/ethnic differences in long-term symptom trajectories.

Neuroendocrine stress response is moderated by sex and sex hormone receptor polymorphisms.

Sex hormones are significant regulators of stress reactivity, however, little is known about how genetic variation in hormone receptors contributes to this process. Here we report interactions between biological sex and repeat polymorphisms in genes encoding sex hormone receptors, and their effects on salivary cortisol reactivity in a sample of 100 participants (47 men & 53 women; 24.7 ±â€¯3.23 years). Three genes were investigated: estrogen receptors alpha (ESR1) and beta (ESR2), and the androgen receptor (AR). Participants were classified as carrying 'Short' or 'Long' alleles based on median splits of the repeat distribution for each gene. Measures of physiological reactivity were collected before and after exposure to a canonical laboratory stressor and converted to traditional summary measures for analyses. Overall, men exhibited greater cortisol (p = 0.001) and mean arterial pressure reactivity (p = 0.002), while women displayed elevated heart rate throughout the session (p = 0.02). The effect of polymorphisms on salivary cortisol was sex sensitive. ESR1 was associated with differential reactivity in men (p = 0.04), but not women (p = 0.24). ESR2 genotype interacted with sex such that each additional 'Long' allele was associated with a 6.4% decrease in salivary cortisol in men, but a 9.5% increase in the levels of women (p = 0.02 for interaction). For the X-linked AR, the 'Long' allele was associated with decreased cortisol levels in men (p = 0.047), but in women had no effect (p = 0.75). Together, these results provide evidence for the saliency of genetic variation in sex hormone receptors on stress reactivity in humans and highlight their important role as mediators of hormonal activity.

Different effects of basal insulin peglispro and insulin glargine on liver enzymes and liver fat content in patients with type 1 and type 2 diabetes.

AIMS: To compare effects of basal insulin peglispro (BIL), a hepatopreferential insulin, to insulin glargine (glargine) on aminotransferases and liver fat content (LFC) in patients with type 1 and type 2 diabetes (T1D, T2D). MATERIALS AND METHODS: Data from two Phase 2 and five Phase 3 randomized trials comparing BIL and glargine in 1709 T1D and 3662 T2D patients were integrated for analysis of liver laboratory tests. LFC, measured by magnetic resonance imaging (MRI) at baseline, 26 and 52 weeks, was analyzed in 182 T1D patients, 176 insulin-naïve T2D patients and 163 T2D patients previously treated with basal insulin. RESULTS: Alanine aminotransferase (ALT) increased in patients treated with BIL, was higher than in glargine-treated patients at 4-78 weeks (difference at 52 weeks in both T1D and T2D: 7 international units/litre (IU/L), P < .001), and decreased after discontinuation of BIL. More BIL patients had ALT ≥3× upper limit of normal (ULN) than glargine. No patient had ALT ≥3× ULN with bilirubin ≥2× ULN that was considered causally related to BIL. In insulin-naїve T2D patients, LFC decreased with glargine but was unchanged with BIL. In T1D and T2D patients previously treated with basal insulin, LFC was unchanged with glargine but increased with BIL. In all three populations, LFC was higher after treatment with BIL vs glargine (difference at 52 weeks: 2.2% to 5.3%, all P < .01). CONCLUSIONS: Compared to glargine, patients treated with BIL had higher ALT and LFC at 52-78 weeks. No severe drug-induced liver injury was apparent with BIL treatment for up to 78 weeks.

Clinical and histopathological profile of BRAF V600E mutation in conventional papillary thyroid carcinoma in a Filipino population.

UNLABELLED: BRAF V600E is a possible biomarker for risk stratification and prognostication in papillary thyroid carcinoma. Studies on its association with aggressive clinicopathological features among East Asian populations are limited. This study examines the clinical and histopathological features of this mutation in Filipinos with conventional papillary thyroid carcinoma. METHODS: Formalin-fixed, paraffin embedded thyroid tissue blocks of papillary carcinoma for the study period January 2010 to December 2012 were retrieved. Slides were reviewed and described according to tumour size, variant type, sclerosis, multifocality, subcapsular location, extra-thyroidal extension, nodal metastasis, and nodal extracapsular spread. Medical records were reviewed for patient demographics and characteristics. Mutation status was determined using realtime polymerase chain reaction and sequencing. RESULTS: Sixty-five patients were included in this study. BRAF V600E mutation prevalence was 38.46%. The mutation positive group was predominantly female, young (mean age 36 years), with tumour size less than 4 cm, and late-stage disease. Extra-thyroidal extension (60%), significant sclerosis (96%), and subcapsular tumour location (72%) were the most frequent findings. Eighty-three percent of patients with nodal metastasis had extracapsular spread. CONCLUSIONS: Compared to some Asian populations, this study of Filipino patients shows a lower prevalence of BRAF V600E mutation. The clinical and histopathological features of mutation positive patients raise important issues regarding extent of surgical excision and appropriate management of neck metastasis for this group.

Randomized double-blind clinical trial comparing basal insulin peglispro and insulin glargine, in combination with prandial insulin lispro, in patients with type 2 diabetes: IMAGINE 4.

AIMS: To evaluate the efficacy and safety of basal insulin peglispro (BIL) with those of insulin glargine, both in combination with prandial insulin lispro, in patients with type 2 diabetes (T2D). METHODS: In this phase III, multicentre, double-blind, 26-week study, we randomized patients with T2D [glycated haemoglobin (HbA1c) ≥7 and <12%, on ≥1 insulin injections daily) to BIL (n = 691) or glargine (n = 678), in combination with lispro. RESULTS: At week 26, the primary objective of non-inferiority of BIL versus glargine for HbA1c reduction was achieved (least squares mean difference -0.21%; 95% confidence interval -0.31 to -0.11%), with statistical superiority of BIL with multiplicity adjustment (p < 0.001). HbA1c at baseline was 8.4% versus 8.5% for BIL versus glargine and at 26 weeks it was 6.8% versus 7.0%. At 26 weeks, more patients reached HbA1c <7% with BIL than with glargine (63.3% vs 53.3%; p < 0.001), the nocturnal hypoglycaemia rate (≤3.9 mmol/l) was lower with BIL (0.51 vs 0.92 events/30 days; p < 0.001), but the daytime hypoglycaemia rate was higher with BIL (5.47 vs 4.53 events/30 days; p < 0.001). The total hypoglycaemia relative rate was 1.10 (p = 0.053). At 26 weeks, patients in the BIL group had lower fasting serum glucose levels, higher basal insulin dosing, with no statistically significant difference in prandial or total insulin dosing, reduced glucose variability and less weight gain (1.3 kg vs 2.2 kg) compared with the glargine group. The BIL group had higher mean triglyceride and aminotransferase levels. CONCLUSIONS: In patients with T2D, BIL with insulin lispro provided greater improvement in glycaemic control with less nocturnal hypoglycaemia, lower glucose variability and less weight gain compared with glargine. The daytime hypoglycaemia rate and mean triglyceride and aminotransferase levels were higher with BIL.

Site-Specific Neutrophil Migration and CXCL2 Expression in Periodontal Tissue.

The oral microbial community is the best-characterized bacterial ecosystem in the human host. It has been shown in the mouse that oral commensal bacteria significantly contribute to clinically healthy periodontal homeostasis by influencing the number of neutrophils that migrate from the vasculature to the junctional epithelium. Furthermore, in clinically healthy tissue, the neutrophil response to oral commensal bacteria is associated with the select expression of the neutrophil chemokine CXCL2 but not CXCL1. This preliminary study examined the contribution of commensal bacteria on neutrophil location across the tooth/gingival interface. Tissue sections from the root associated mesial (anterior) of the second molar to the root associated distal (posterior) of the second molar were examined for neutrophils and the expression of the neutrophil chemokine ligands CXCL1 and CXCL2. It was found that both the number of neutrophils as well as the expression of CXCL2 but not CXCL1 was significantly increased in tissue sections close to the interdental region, consistent with the notion of select tissue expression patterns for neutrophil chemokine expression and subsequent neutrophil location. Furthermore, mice gavaged with either oral Streptococcus or Lactobacillus sp. bacteria induced a location pattern of neutrophils and CXCL2 expression similar to the normal oral flora. These data indicate for the first time select neutrophil location and chemokine expression patterns associated with clinically healthy tissue. The results reveal an increased inflammatory load upon approaching the interproximal region, which is consistent with the observation that the interproximal region often reveals early clinical signs of periodontal disease.

Application of a theoretical framework to foster a cardiac-diabetes self-management programme.

AIM: This paper analyses and illustrates the application of Bandura's self-efficacy construct to an innovative self-management programme for patients with both type 2 diabetes and coronary heart disease. BACKGROUND: Using theory as a framework for any health intervention provides a solid and valid foundation for aspects of planning and delivering such an intervention; however, it is reported that many health behaviour intervention programmes are not based upon theory and are consequently limited in their applicability to different populations. The cardiac-diabetes self-management programme has been specifically developed for patients with dual conditions with the strategies for delivering the programme based upon Bandura's self-efficacy theory. This patient group is at greater risk of negative health outcomes than that with a single chronic condition and therefore requires appropriate intervention programmes with solid theoretical foundations that can address the complexity of care required. SOURCES OF EVIDENCE: The cardiac-diabetes self-management programme has been developed incorporating theory, evidence and practical strategies. DISCUSSION: This paper provides explicit knowledge of the theoretical basis and components of a cardiac-diabetes self-management programme. Such detail enhances the ability to replicate or adopt the intervention in similar or differing populations and/or cultural contexts as it provides in-depth understanding of each element within the intervention. CONCLUSION: Knowledge of the concepts alone is not sufficient to deliver a successful health programme. Supporting patients to master skills of self-care is essential in order for patients to successfully manage two complex, chronic illnesses. IMPLICATIONS FOR NURSING PRACTICE OR HEALTH POLICY: Valuable information has been provided to close the theory-practice gap for more consistent health outcomes, engaging with patients for promoting holistic care within organizational and cultural contexts.

Peer supporters for cardiac patients with diabetes: a randomized controlled trial.

AIMS: To determine whether incorporation of patient peer supporters in a Cardiac-Diabetes Self-Management Program (Peer-CDSMP) led to greater improvement in self-efficacy, knowledge and self-management behaviour in the intervention group compared to a control group. BACKGROUND: Promoting improved self-management for those with diabetes and a cardiac condition is enhanced by raising motivation and providing a model. Peer support from former patients who are able to successfully manage similar conditions could enhance patient motivation to achieve better health outcomes and provide a model of how such management can be achieved. While studies on peer support have demonstrated the potential of peers in promoting self-management, none have examined the impact on patients with two co-morbidities. METHODS: A randomized controlled trial was used to develop and evaluate the effectiveness of the Peer-CDSMP from August 2009 to December 2010. Thirty cardiac patients with type 2 diabetes were recruited. The study commenced in an acute hospital, follow-up at participants' homes in Brisbane, Australia. RESULTS: While both the control and intervention groups had improved self-care behaviour, self-efficacy and knowledge, the improvement in knowledge was significantly greater for the intervention group. CONCLUSIONS: Significant improvement in knowledge was achieved for the intervention group. Absence of significant improvements in self-efficacy and self-care behaviour represents an inconclusive effect; further studies with larger sample sizes are recommended.

Switching currents limited by single phase slips in one-dimensional superconducting Al nanowires.

An aluminum nanowire switches from superconducting to normal as the current is increased in an upsweep. The switching current (I(s)) averaged over upsweeps approximately follows the depairing critical current (I(c)) but falls below it. Fluctuations in I(s) exhibit three distinct regions of behaviors and are nonmonotonic in temperature: saturation well below the critical temperature T(c), an increase as T(2/3) at intermediate temperatures, and a rapid decrease close to T(c). Heat dissipation analysis indicates that a single phase slip is able to trigger switching at low and intermediate temperatures, whereby the T(2/3) dependence arises from the thermal activation of a phase slip, while saturation at low temperatures provides striking evidence that the phase slips by macroscopic quantum tunneling.

Crystal orientation and thickness dependence of the superconducting transition temperature of tetragonal FeSe1-x thin films.

Superconductivity was recently found in the tetragonal phase FeSe. A structural transformation from tetragonal to orthorhombic (or monoclinic, depending on point of view) was observed at low temperature, but was not accompanied by a magnetic ordering as commonly occurs in the parent compounds of FeAs-based superconductors. Here, we report the correlation between structural distortion and superconductivity in FeSe(1-x) thin films with different preferred growth orientations. The films with preferred growth along the c axis show a strong thickness dependent suppression of superconductivity and low temperature structural distortion. In contrast, both properties are less affected in the films with (101) preferred orientation. These results suggest that the low temperature structural distortion is closely associated with the superconductivity of this material.

Innovative self-management programme for diabetics following coronary care unit admission.

BACKGROUND: Evidence indicates self-management programmes based on improving self-efficacy in managing diabetes can reduce the risk of a further cardiac event. Many current cardiac rehabilitation or diabetes self-management programmes do not address the needs of people with both type 2 diabetes and a critical cardiac condition in their transition from coronary care unit (CCU) to home. AIMS/METHODS: The aim was to develop and pilot test a Cardiac-Diabetes Self-Management Program (CDSMP) using an experimental design. FINDINGS/CONCLUSION: Results demonstrated the feasibility of the CDSMP for CCU patients with type 2 diabetes in their transition to home, and a full study is warranted.

Audit of patients with type 2 diabetes following a critical cardiac event.

BACKGROUND: Evidence indicates that type 2 diabetes leads to complications such as a cardiac event, which often requires admission to a coronary care unit (CCU). Although there is a considerable body of knowledge about the management and characteristics of people with type 2 diabetes and myocardial infraction, there are few reports of the disease and demographic characteristics of the entire group of patients with diabetes admitted to a CCU. PURPOSE: To gain greater understanding of the characteristics of patients with diabetes hospitalized for a critical cardiac event in order to assist in the development of an appropriate self-management programme for CCU patients with diabetes. METHODS: Data were collected retrospectively from computerized records and charts of all patients with diabetes admitted to the CCU from 1 January 2000 to 31 December 2003. FINDINGS: The proportion of type 2 diabetic patients admitted to CCU with a critical cardiac event over the 4-year study period was consistent at 14.7%, 233 in 1589 patients. More than 22% of CCU patients with diabetes were readmitted to hospital within 28 days compared with only 6% of CCU patients without diabetes. Predictors for readmission and length of stay were also examined. CONCLUSIONS: A considerable proportion of a CCU population had type 2 diabetes and these patients had significantly higher readmission rates. The implications of this study for the development of a self-management programme for patients with diabetes who experienced a critical cardiac event are discussed. IMPLICATIONS FOR PRACTICE: Innovative programmes are required to reduce the rate of readmission for patients with both diabetes and a critical cardiac event. These should: 1 ensure transition programmes, such as self-management, commence within the CCU environment and continue following discharge, and 2 integrate diabetes and cardiac self-management programmes to condense the large amount of information provided to patients for managing two serious conditions.

Evidence for macroscopic quantum tunneling of phase slips in long one-dimensional superconducting Al wires.

Quantum phase slips have received much attention due to their relevance to superfluids in reduced dimensions and to models of cosmic string production in the early universe. Their establishment in one-dimensional superconductors has remained controversial. Here we study the nonlinear current-voltage characteristics and linear resistance in long superconducting Al wires with lateral dimensions approximately 5 nm. We find that, in a magnetic field and at temperatures well below the superconducting transition, the observed behaviors can be described by the nonclassical, macroscopic quantum tunneling of phase slips, and are inconsistent with the thermal activation of phase slips.

Gene expression pattern associated with radiotherapy sensitivity in cervical cancer.

UNLABELLED: The objective of the present preliminary study was to determine if a difference in the pattern of gene expression exists between tumors that were subsequently found to be sensitive to radiotherapy and tumors found to be resistant to radiotherapy. PATIENTS AND METHODS: A total of 16 patients with invasive squamous cell carcinoma of the uterine cervix were included in this study. All patients were treated with standardized radiotherapy alone. Ten of the tumors were clinically radiosensitive and six were radioresistant. Total RNA, extracted from tumor specimens obtained prior to treatment, was hybridized onto an oligonucleotide microarray with probe sets complementary to over 20,000 transcripts. The genes were first subjected to a statistical filter to identify genes with statistically significant differential expression levels between those that were radiosensitive and those that were radioresistant. A back-propagation neural network was then constructed to model the differences so that patterns could be easily identified. RESULTS: Although a number of genes were found to express differentially between radiosensitive and radioresistant tumors; the 10 most discriminating genes were used to construct the model. Using the expressions from these 10 genes, we found that neural networks constructed from random subsets of the whole data were capable of predicting radiotherapy responses in the remaining subset, which appears stable within the dataset. DISCUSSION: This study shows that such an approach has the potential to differentiate tumor radiosensitivity, although confirmation of such a pattern using other larger independent datasets is necessary before firm conclusions can be drawn.

Transition between quantum states in a parallel-coupled double quantum dot.

Strong electron and spin correlations in a double quantum dot (DQD) can give rise to different quantum states. We observe a continuous transition from a Kondo state exhibiting a single-peak Kondo resonance to another exhibiting a double peak by increasing the interdot coupling (t) in a parallel-coupled DQD. The transition into the double-peak state provides evidence for spin entanglement between the excess electrons on each dot. Toward the transition, the peak splitting merges and becomes substantially smaller than t because of strong Coulomb effects. Our device tunability bodes well for future quantum computation applications.

Patient-controlled analgesia versus conventional intramuscular injection: a cost effectiveness analysis.

BACKGROUND: In previous studies comparing patient-controlled-analgesia and intramuscular pain management have been unable to provide conclusive evidence of the benefits of either method of postoperative pain control. AIM: The purpose of the study was to compare the efficacy and cost-effectiveness of intravenous patient-controlled-analgesia with intermittent intramuscular morphine for Chinese women in the first 24 hours following elective gynaecological surgery. METHODS: A randomized control design was used. The main outcomes were level of pain and cost for the two types of pain management. Participants indicated their level of pain at rest and when deep breathing or coughing on a 100 mm Visual Analogue Scale, on seven occasions within 24 postoperative hours. Costs for the two types of pain management were based on the costs of equipment, drugs and nursing time. RESULTS: A total of 125 women participated in the study. Mean pain level over the 24 hours in the patient-controlled-analgesia group was significantly lower than in the intramuscular group (P < 0.001). Mean pain level over the seven occasions for the patient-controlled-analgesia group was 11.83 points (95% CI 7.14-16.52) lower when at rest and 11.73 points (95% CI 5.96-17.50) lower during motion than the intramuscular group. Cost per patient was $81.10 (Hong Kong) higher for patient-controlled-analgesia than for intramuscular pain management. Women in the patient-controlled-analgesia group had significantly greater satisfaction with pain management than those in the intramuscular group (P < 0.001), but reported significantly more episodes of nausea (P < 0.05). CONCLUSIONS: While patient-controlled-analgesia was more costly, it was also more effective than conventional on-demand intramuscular opioid injections after laparotomy for gynaecological surgery.

Prevention of oral mucositis in paediatric patients treated with chemotherapy; a randomised crossover trial comparing two protocols of oral care.

This study compared the efficacy of two protocols for oral care using either chlorhexidine or benzydamine as oral rinses to alleviate mucositis in children undergoing chemotherapy. Eligible participants were randomised to receive either protocol for 3 weeks in a two-period crossover design. The occurrence of ulcerative lesions and severity of mucositis were measured at baseline and twice weekly, using the modified Oral Assessment Guide (OAG). Data were continuously analysed by plotting them directly on predefined sequential charts. According to this sequential analysis, the study could be terminated at the 34th within subject comparison, with a statistically significant reduction in ulcerative lesions (P<0.05) and severity of mucositis (P<0.05) in children on the chlorhexidine protocol. These findings suggest that chlorhexidine together with oral care might be helpful in alleviating mucositis when given prophylactically to children on chemotherapy, but the therapeutic benefit needs to be confirmed in a larger trial.

Compliance with a pelvic muscle exercise program as a causal predictor of urinary stress incontinence amongst Chinese women.

AIM: To determine the importance and contribution of compliance in a pelvic muscle exercise program as a factor in reducing the severity of urinary stress incontinence amongst Chinese women. METHODS: Two hundred fourteen women presenting with urinary stress incontinence who agreed to undertake a program of pelvic muscle exercises were recruited into the study. Incontinence (wetting episodes), pelvic muscle strength, exercises compliance, correctness of pelvic muscle exercise technique, duration of stress incontinence, and previous history of pelvic surgery were recorded on four occasions: baseline (first clinic session) and second to fourth clinic sessions. Demographic data were also collected at baseline. Stepwise multiple regression analyses were used to determine the relative importance of compliance to exercise regime in predicting the severity of incontinence. Path analysis was used to provide a summary description of the influence of compliance on the outcomes over the four visits. RESULTS: The pelvic muscle training program appears to be able to reduce the overall urinary incontinence episodes by 85.2% and achieved a 73.1% increase in pelvic muscle strength. Although the number of wetting episodes in any visit are causally linked to that recorded in previous visit, those who were more compliant had a greater reduction. Age, mode of delivery, menopausal status, history of pelvic surgery, and duration of incontinence did not appear to contribute significantly to predicting incontinence. CONCLUSION: Compliance with pelvic muscle exercises significantly contributed to a reduction in urinary stress incontinence.

Customizing fetal biometric charts.

OBJECTIVE: To study the effects of maternal and pregnancy characteristics on fetal biometric size using longitudinal ultrasound measurements and to construct customized models for fetal biometric size charts. METHODS: A cohort of 533 healthy pregnant women with normal singleton pregnancies were recruited for regular ultrasound examination for fetal biometry between 24 and 40 weeks' gestation. Multilevel modeling was used to construct models of fetal head size, femur length and abdominal circumference. Variables of maternal and pregnancy characteristics including booking weight and height, age, parity and fetal sex were included in the construction of the customized fetal biometric size charts. RESULTS: Increased fetal head size and abdominal circumference were significantly associated with extremes of maternal age. Maternal height had a statistically significant influence on biparietal diameter. Maternal booking weight had an influence on fetal abdominal circumference and femur length. Fetal sex was found to have a statistically significant influence on the final regression models of biparietal diameter, head circumference and femur length. Parity had an influence on fetal head circumference and abdominal circumference. CONCLUSIONS: Maternal and pregnancy characteristics have a significant influence on in-utero fetal biometry. We produced models to construct customized fetal biometric size charts. Further validation studies are necessary to evaluate the clinical usefulness of such customized fetal biometric size charts.

Palliation of oral mucositis symptoms in pediatric patients treated with cancer chemotherapy.

This prospective randomized 2-period crossover study aimed at comparing the efficacy of 2 oral care protocols differing in the type of mouthwashes: chlorhexidine versus benzydamine in alleviating oral mucositis symptoms for children undergoing chemotherapy. Forty subjects were randomly allocated to receive either chlorhexidine first then benzydamine protocols or benzydamine first then chlorhexidine protocols. Each protocol was started on the first day of chemotherapy and continued for 21 days. Subjects were evaluated in intervals of 3 to 4 days using the World Health Organization (WHO) grading for mucositis and 10-cm visual analogue scale for oral symptoms evaluations. Among 34 evaluable subjects, 26% and 48% of them using chlorhexidine and benzydamine had WHO grade II mucositis, respectively (P < .05). The results revealed a significant difference in mean area under the curve (AUC) of mouth pain (1.35 +/- 2.26 versus 3.09 +/- 3.21) (P = .05), and a trend of a lessening of mean AUC of difficulty in eating/chewing (2.49 +/- 3.74 versus 2.71 +/- 4.1) (P = .82) and swallowing (1.34 +/- 3.31 versus 1.91 +/- 4.03) (P = .53) for subjects receiving chlorhexidine compared to those receiving benzydamine. In conclusion, chlorhexidine may be helpful in palliating mucositis symptoms for children in chemotherapy. The beneficial effect, however, is small and needs to be confirmed in a larger trial.