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Extended-spectrum β-lactamase (ESBL)-producing Enterobacterales are an increasing cause of complicated urinary tract infections (UTIs). Reliance on carbapenems to treat these infections accelerates resistance, underscoring the urgent need for effective oral transition options to preserve last-line agents and lessen healthcare burden. We conducted a multicenter, open-label, randomized, noninferiority trial at four tertiary hospitals in South Korea (November 2022-June 2025). Adults hospitalized with complicated UTIs due to ESBL-producing Enterobacterales who improved after 3-7 days of intravenous antibiotics were randomized (1:1) to either continue intravenous carbapenem or β-lactam/β-lactamase inhibitor therapy or switch to oral fosfomycin trometamol (3 g once daily). The primary outcome was clinical cure, defined as resolution of urinary tract infection-related symptoms and signs within 4 days after completion of treatment. Secondary outcomes included microbiological cure, readmission, adverse events, and 30-day recurrence. Of the 344 screened patients, 299 were randomized (152 oral fosfomycin; 147 intravenous therapy). Clinical cure occurred in 92.8% of the oral fosfomycin group and 95.2% of the intravenous group (risk difference, -2.47%; 95% CI -7.84 to 2.89), confirming noninferiority. Microbiological cure was similarly high in both groups: urine (98.0% vs 96.6%) and blood (97.3% vs 97.5%). Safety profiles and 30-day outcomes were also comparable. Oral fosfomycin was noninferior to continued intravenous therapy when used as oral transition therapy for complicated UTIs caused by ESBL-producing Enterobacterales. These findings provide evidence to support oral fosfomycin transition as a carbapenem-sparing antibiotic stewardship strategy for patients with complicated UTIs caused by ESBL-producing Enterobacterales. KCT0007669.

Immune checkpoint inhibitor (ICI) monotherapy for patients with recurrent, unresectable, or metastatic (RUM) head and neck squamous cell carcinoma (HNSCC) is associated with poor outcomes. Low-dose, hypofractionated, quad-shot radiotherapy (QSRT) may enhance the efficacy of ICIs. To evaluate the efficacy and toxic effects of ICIs in combination with QSRT for patients with RUM HNSCC that is amenable to QSRT. This single-arm, phase 2, nonrandomized clinical trial was conducted at a single, academic, National Cancer Institute-designated Comprehensive Cancer Center and included patients with RUM HNSCC who were going to receive treatment with pembrolizumab monotherapy and had a targetable site in the head and neck that was amenable to QSRT (based on location, prior radiotherapy dose, and tolerance). Patients were enrolled and treated between February 2021 and May 2024. Pembrolizumab (200 mg/m2) was administered every 3 weeks until disease progression, intolerance, or a maximum duration of 2 years. QSRT comprised 14.8 Gy in four 3.7-Gy fractions that were delivered twice daily on consecutive days. QSRT courses were delivered cyclically between pembrolizumab cycles. The primary outcome was overall response rate per Response Evaluation Criteria in Solid Tumors, version 1.1, in patients with at least 1 response assessment. Secondary outcomes were progression-free survival (PFS), overall survival (OS), and clinician-rated (Common Terminology Criteria for Adverse Events, version 5.0) and patient-reported (patient-reported outcomes version of the Common Terminology Criteria for Adverse Events, version 1.0) adverse effects (AEs). Of the 29 individuals who were screened, 21 enrolled, and 15 patients (median [range] age, 61 [33-86] years) were eligible for response analysis: 5 women (33.3%), 10 men (66.7%), 9 individuals with oropharyngeal/oral cavity primary tumors, and 14 current/former smokers (93.3%). Fourteen patients had received prior systemic therapy, and 11 had received prior RT. Among evaluable patients, the overall response rate was 47% (95% CI, 21%-73%). Median PFS and OS among the treated patients (n = 20) were 9.2 months (95% CI, 3-17) and 14.9 months (95% CI, 5 to not estimable), respectively. For the 15 patients who were evaluable for the primary end point, median PFS was 11.5 months (95% CI, 5.1 to not estimable), and median OS was 15.3 months (95% CI, 6.3 to not estimable). Grade 3 and 4 AEs occurred for 6 and 2 patients, respectively. Patient-reported AEs did not substantially change over time. This nonrandomized trial demonstrated the feasibility of pembrolizumab plus QSRT for patients with RUM HNSCC and provides preliminary evidence of a potential benefit to this novel combination that warrants investigation in future randomized clinical trials. ClinicalTrials.gov Identifier: NCT04454489.

We previously demonstrated in a randomized controlled trial that antibiotic prescribing feedback to family physicians reduced antibiotic use. However, that trial did not evaluate for patient harms from potential under-prescribing of antibiotics. To evaluate the safety of an antibiotic audit and feedback intervention. We performed a post hoc secondary analysis of a randomized controlled trial that compared an intervention group, who received a mailed antibiotic prescribing peer comparison feedback letter, compared with a control group who did not receive a letter. The initial trial was limited to patients aged 65 years or older due to availability of pharmacy claims data. The primary outcome was an emergency department visit or hospital admission for a bacterial infection. The outcome was assessed at 6 months post-intervention using administrative data claims data and multivariable linear regression models. The initial trial was registered (NCT04594200). We included 4879 physicians-3909 intervention physicians and 970 control physicians. There were 37 345 severe infection events in the 6 month post-intervention period. The observed mean (SD) of all severe infection events per physician was 7.73 (12.42) for control and 7.64 (11.91) for intervention groups. The model-based adjusted mean difference was -0.23 (95% CI, -0.92 to 0.45; P = 0.505). In this post hoc analysis of a randomized controlled trial comparing antibiotic prescribing feedback versus no feedback to physicians in primary care, there was no evidence of severe bacterial infection complications associated with reduced antibiotic prescribing. These findings support antibiotic peer comparison feedback as a safe and effective tool to reduce unnecessary antibiotic prescribing.

Military sexual trauma (MST) is associated with substantial psychiatric sequelae, but treatment options lack evidence-based protocols tailored to this specific trauma. To evaluate the efficacy of a MST-focused treatment using an 8-week virtual delivery format compared with an active control treatment to reduce symptoms of posttraumatic stress disorder (PTSD). This randomized clinical trial compared Warrior Renew (MST-focused group) with Health and Wellness (active control group) at baseline, week 8 (after treatment), and week 16 (follow-up). The study was conducted at 2 Veterans Affairs health care systems in the Pacific Northwest region of the US. Participant enrollment occurred from July 19, 2023, to March 24, 2025. Veterans aged 18 to 75 years with a history of MST-related PTSD symptoms were recruited via informational letters, self-referral, and clinician referral. Participants were randomized 1:1 to the MST-focused group or active control group. Analysis of participants with baseline data was based on the intention-to-treat principle. The MST-focused treatment targets themes of MST using cognitive and experiential strategies, including imagery reprocessing. The active control targets health and well-being, including behavioral engagement with weekly goals. Both treatments consisted of 8 weekly, 90-minute sessions delivered via telehealth in groups separated by sex. The primary outcome was change in PTSD symptom severity from baseline to week 8, which was measured by the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) and the Posttraumatic Cognitions Inventory (PTCI). A linear mixed model was used to compare outcomes of the treatments at weeks 8 and 16. Of the 191 veterans who consented, 140 (mean [SD] age, 50.6 [14.7] years; 71 males [50%]) completed baseline assessments and were included in the intent-to-treat analyses. Participants in the MST-focused group showed significant score improvements from baseline to week 8 on the PCL-5 (-7.97; 95% CI, -11.01 to -4.92; P&#x2009;<&#x2009;.001) and the PTCI (-19.99; 95% CI, -26.86 to -13.12; P&#x2009;<&#x2009;.001), which were maintained at week 16. Active control group participants also showed significant score improvements on the PCL-5 and PTCI; however, the MST-focused group demonstrated greater score improvements on the PTCI (-9.61; 95% CI, -18.98 to -0.25; P&#x2009;=&#x2009;.04) and the PTCI self-blame subscale (-3.10; 95% CI, -5.30 to -0.90; P&#x2009;=&#x2009;.006) compared with the active control group. Additionally, only participants in the MST-focused group exceeded a 10-point score threshold indicating meaningful change on the PCL-5 at week 16. Women in the MST-focused group demonstrated greater results on the PCL-5 over the control group (-5.90; 95% CI, -11.58 to -0.22; P&#x2009;=&#x2009;.04) at week 8. Both treatments had low dropout rates (around 11%). This randomized clinical trial showed that both treatments demonstrated efficacy in reducing PTSD symptoms, but the MST-focused treatment compared with the active control demonstrated greater improvements in posttraumatic cognitions. The results support the use of the MST-focused group treatment for PTSD symptoms associated with MST. ClinicalTrials.gov Identifier: NCT05776719.

Wide-awake local anesthesia no tourniquet (WALANT) is increasingly used for flexor tendon repair, but comparative data versus general/regional anesthesia(GA/RA) are limited. The aims of the WAFER trial were to generate high quality comparative data on WALANT versus GA/RA for flexor tendon repair and assess the feasibility of performing a large multicenter trial of this nature. WAFER was a multicenter, assessor-blinded, parallel-group RCT with embedded qualitative and health economic components across four major hand units. Patients were randomized on a 1:1 basis to have flexor tendon repair under GA/RA or WALANT. The primary feasibility outcomes were recruitment, retention and trial acceptability in addition to clinical outcomes which included range of motion (Total-active-motion score), grip/pinch strength, finger circumference, complications and patient reported outcome measures(PROMS) (Michigan-Hand-Questionnaire, EQ-5D-5L). Qualitative interviews were conducted with clinicians and participants to assess acceptability and equipoise. Economic analyses summarized intra-operative costs and impact on productivity. The primary analysis set was per-protocol. Sixty participants were randomized across all sites (30 WALANT; 30 GA/RA); 56 were analyzed per-protocol. At 6 months, mean TAM score(SE) for GA/RA was 67.6(5.6) vs 60.3(6.3) in the WALANT group. Tendon rupture was reported in two patients in the GA/RA group and three in the WALANT group. PROMs improved over time in both groups, patients in the WALANT arm reported consistently higher MHQ scores across domains. Participants in WALANT arm returned to work earlier than participants in GA/RA arm (mean 3.0 vs 6.7weeks). Intra-operative costs were lower with WALANT by 54% (-&#xa3;398, 95% CI -&#xa3;509 to -&#xa3;287). A pragmatic comparison of WALANT versus GA/RA with tourniquet for primary flexor tendon repair is deliverable and safe. Inter-arm clinical differences were small; however, WALANT showed lower intra-operative costs and a signal for earlier return to work.

Recurrent acute rhinosinusitis (RARS) decreases quality of life. The effects of endoscopic sinus surgery (ESS) in RARS are understudied. To compare the quality of life between patients with RARS who had surgery and medical treatment vs medical treatment alone. This is an open-label randomized clinical trial with 2 parallel groups with a 6-month follow-up. Patients referred to Oulu University Hospital Otolaryngology Clinic between May 2020 and June 2024 were recruited to participate in the trial. Inclusion criteria were adults with physician-diagnosed RARS episodes occurring at least 3 times during the past 6 months, 4 times during the past year, or twice per year for 3 consecutive years. Conservative treatment had been insufficient for symptom relief. Data collection and analyses were planned before commencing recruitment. Data collection was performed from May 2020 to December 2024, and analysis from January 2025 to January 2026. The operative group received ESS and medical treatment, and the conservative group received medical treatment alone. The main outcome was the difference between groups in mean SinoNasal Outcome Test 22 (SNOT-22) score change from baseline to a 6-month follow-up. The SNOT-22 questionnaire measures rhinosinusitis-related quality of life. Sinonasal symptoms, number of health care visits, antibiotic courses, absences from work or study, and the adverse effects of operative treatment were also studied. A total of 59 patients (mean [SD] age, 40 [14] years; 52 women [88%]) were recruited, 30 in the operative and 29 in the conservative group. Intention-to-treat analysis of the primary outcomes was performed. The mean SNOT-22 score change from baseline to 6 months was greater after ESS compared to medical treatment only (difference, 22.41 points (95% CI, 13.67-31.10 points). Per-protocol analyses of secondary outcomes supported the primary findings for the most part. Only 4 patients received intervention for an operative complication (3 infections, 1 synechia with septal perforation). In this randomized clinical trial, ESS improved patient-related outcomes at a 6-month follow-up in adults with RARS. Conservative treatment had no clinically meaningful effect. These results suggest that ESS is an effective treatment without major problems. ClinicalTrials.gov Identifier: NCT04241016.

Antibiotic resistance undermines conventional Helicobacter pylori (H.&#x2009;pylori) eradication therapies. Tegoprazan-amoxicillin (TA) dual therapy is a promising alternative, but its efficacy and safety compared with other treatment regimens remain unclear. The aim of this meta-analysis was to comprehensively evaluate the efficacy and safety of TA dual therapy in eradicating H.&#x2009;pylori. PubMed, Embase, CENTRAL, and Web of Science were searched from inception to December 2025. Eligible randomized controlled trials (RCTs) compared TA dual therapy with bismuth-containing quadruple therapy (BQT) or proton pump inhibitor (PPI)-based high-dose dual therapy (PPI-HDDT) in adults with H.&#x2009;pylori infection. The outcomes were H.&#x2009;pylori eradication rate, adverse events, and medication adherence. Evidence quality was assessed via GRADE. Six RCTs (n&#x2009;=&#x2009;1909) were included. TA dual therapy showed no significant difference in eradication rate compared with BQT (n&#x2009;=&#x2009;5 RCTs, ITT analysis: 78.0% vs. 81.4%, RR&#x2009;=&#x2009;0.97, 95% CI: 0.88-1.05, p&#x2009;=&#x2009;0.44; PP analysis: 84.6% vs. 86.2%, RR&#x2009;=&#x2009;0.96, 95% CI: 0.87-1.06, p&#x2009;=&#x2009;0.39; low-quality evidence), confirmed by trial sequential analysis. TA dual therapy had a lower overall adverse event rate (11.3% vs. 22.5%, RR&#x2009;=&#x2009;0.50, 95% CI: 0.37-0.67, p&#x2009;<&#x2009;0.00001; moderate-quality evidence) but similar adherence (95.7% vs. 94.5%, RR&#x2009;=&#x2009;1.01, 95% CI: 0.99-1.03, p&#x2009;=&#x2009;0.31; moderate-quality evidence) compared with BQT. Efficacy and safety were comparable between TA dual therapy and PPI-HDDT (n&#x2009;=&#x2009;1 RCT). The TA dual therapy exhibits similar efficacy compared with BQT and PPI-HDDT for H.&#x2009;pylori eradication, with a better safety profile compared with BQT. However, its overall eradication efficacy is suboptimal, necessitating further regimen optimization in the future.

Pulmonary arterial hypertension (PAH) remains progressive despite contemporary background therapy. Sotatercept is a novel activin signaling inhibitor that targets pulmonary vascular remodeling and may improve clinical and hemodynamic outcomes. To evaluate the efficacy, hemodynamic effects, and safety of sotatercept in patients with PAH. Systematic review and meta-analysis of randomized controlled trials (RCTs). Five electronic databases were searched through October 2, 2025, for eligible RCTs. Time-to-event outcomes were analyzed using pooled individual patient data with hazard ratios (HRs), while secondary outcomes were assessed using random-effects risk ratios (RRs) and mean differences (MDs), with 95% confidence intervals (CI). Trial-sequential analysis (TSA) evaluated the conclusiveness of results. In four RCTs (n&#x2009;=&#x2009;889), sotatercept reduced clinical worsening or death by 77% (HR 0.23, 95% CI 0.16-0.32, p&#x2009;<&#x2009;0.001) and prolonged event-free survival by ~40&#x2009;weeks. World Health Organization (WHO) functional class improved in 40.3% vs 24.3% (RR 1.71, 95% CI 1.32-2.21), and 6-minute walk distance increased by MD 30.27&#x2009;m (95% CI 13.45-47.08), while pulmonary vascular resistance (PVR) declined significantly (MD -247&#x2009;dyn&#xb7;s&#xb7;cm-5, 95% CI -301.7; -192.2). Serious adverse events were slightly less frequent with sotatercept (26.2% vs 31.7%, RR 0.83); however, total bleeding (37.9% vs 18.7%, RR 2.00), epistaxis (26.7% vs 5.4%, RR 4.89), and telangiectasia (19.8% vs 6.4%, RR 3.24) were more common. TSA revealed conclusiveness in clinical worsening, WHO functional class, and PVR, as well as increases in bleeding events and epistaxis. Sotatercept significantly improves clinical outcomes and extends event-free survival in PAH, with an acceptable safety profile; however, caution is warranted regarding bleeding events. These results support its role as an add-on therapy in PAH management. PROSPERO ID: CRD420251166414. New hope for pulmonary hypertension: sotatercept significantly improves exercise capacity and reduces disease progressionPulmonary arterial hypertension (PAH) is a serious and progressive condition in which high blood pressure in the lungs places strain on the heart, often leading to heart failure and death. Current treatments help control symptoms but rarely stop the disease from getting worse. Sotatercept is a new medication that targets abnormal blood vessel growth and helps restore normal vessel function. This study combined results from four high-quality clinical trials including 889 adults with PAH who were already receiving standard therapy. Half the participants received sotatercept injections every three weeks, and the other half received placebo. Researchers looked at how long patients remained free from major disease events, such as hospitalization or worsening symptoms, and also measured exercise capacity and heart&#x2013;lung function. Patients who received sotatercept were 77% less likely to experience disease worsening or death compared with those on placebo. On average, they could walk about 30&#x2009;meters farther during a six-minute walk test, and their heart pressures and blood vessel resistance improved significantly. The drug also increased overall event-free survival by around 40&#x2009;weeks. While most side effects were mild or moderate, nosebleeds and small visible blood vessel spots on the skin (telangiectasia) were more common with sotatercept, and a few patients experienced higher hemoglobin levels or mild decreases in platelets. Overall, sotatercept was well tolerated and showed strong evidence of improving daily function and reducing the risk of clinical deterioration. These findings support its use as an additional therapy for adults with PAH who continue to have symptoms despite standard treatments. Further long-term studies are recommended to confirm its impact on survival and long-term safety.

Surface electromyography (sEMG) is a promising biofeedback method for swallowing intervention. Current sensors are either costly rigid platforms or short-lived wearables. We developed a second-generation flexible wearable sEMG patch (i-Phagia) designed to record submental muscle activity. This study validated the signal quality and preclinical performance of i-Phagia against conventional sensors in two age groups. A randomized crossover study involved 30 young (17 women, 13 men; aged 18-29 years) and 30 older healthy adults (17 women, 13 men; aged 50-82 years). Participants completed liquid and semisolid swallows under two conditions: with i-Phagia sensors and with conventional sensors, in a counterbalanced order. Comparisons focused on signal-based factors (signal-to-noise ratio [SNR], baseline amplitude, and normalized mean sEMG amplitude), as well as safety, satisfaction, and placement efficiency. SNR and baseline amplitude were examined with linear mixed models and equivalence tests; Pearson correlations were used to analyze normalized mean sEMG amplitude. Safety/adverse effects were assessed with descriptive statistics, while satisfaction and efficiency were analyzed with linear mixed models. SNR values were equivalent between sensor types (effect size: -0.0178; confidence interval [CI] [-0.2226, 0.2004]); however, the i-Phagia patch showed significantly lower baseline amplitude than conventional sensors (effect size: 0.48; CI [0.3144, 0.6422]), indicating better signal quality. High correlations (r > .7) between normalized sEMG amplitudes across swallows suggest consistent muscle activity patterns across sensors. No pain was reported; skin redness was rare but twice as common after removing conventional sensors. Satisfaction was higher (p < .0001), and application was more efficient with i-Phagia (M = 1:28 vs. 2:19, p < .05). The optimized i-Phagia patch is safe, provides signal quality comparable to conventional sensors, and shows advantages in user satisfaction and placement efficiency. These findings support its feasibility for future clinical testing as a wearable sEMG option for swallowing rehabilitation. https://doi.org/10.23641/asha.32608575.

Recombinant human prourokinase (rhPro-UK) has been investigated as an alternative thrombolytic agent to alteplase for acute ischemic stroke (AIS). While alteplase remains the standard of care, uncertainties persist regarding whether rhPro-UK provides similar efficacy and safety outcomes. This systematic review and meta-analysis aimed to compare intravenous rhPro-UK with alteplase in patients with AIS. A systematic literature search was conducted in PubMed, Embase, and Cochrane Central up to January 2025. Randomized controlled trials (RCTs) comparing intravenous rhPro-UK with alteplase were included. Outcomes of interest were functional recovery (modified Rankin Scale [mRS] 0-1 and 0-2 at 90 days), early neurological improvement (National Institutes of Health Stroke Scale [NIHSS] reduction within 24 hours), intracranial hemorrhage, all-cause mortality, and recurrent stroke. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated under a random-effects model. Risk of bias was assessed with the Cochrane RoB 2 tool. Three RCTs involving 2295 patients were included (1209 treated with rhPro-UK; 1148 with alteplase). No statistically significant differences were observed between groups for intracranial hemorrhage (OR 1.04; 95% CI: 0.73-1.48), mRS 0-1 at 90 days (OR 0.91; 95% CI: 0.77-1.08), mRS 0-2 at 90 days (OR 0.95; 95% CI: 0.79-1.14), early NIHSS improvement (OR 0.94; 95% CI: 0.79-1.11), all-cause mortality (OR 1.16; 95% CI: 0.66-2.03), or recurrent stroke (OR 0.72; 95% CI: 0.31-1.66). Intravenous rhPro-UK demonstrated comparable efficacy and safety to alteplase in AIS, supporting its role as a potential alternative thrombolytic, particularly in regions with limited access to alteplase.

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During exercise, fine hemodynamic adjustments are essential to ensure adequate energy supply. Although cyclic treadmill exercise has been widely studied, isometric exercise with Handgrip (HG) has gained relevance in conditioning and rehabilitation contexts, yet data on the acute hemodynamic effects of combining these modalities remain scarce. In this context, the present study tested the hypothesis that isometric contraction with HG modifies the hemodynamic responses of Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Double Product (DP) during cyclic treadmill exercise. A clinical trial was conducted with 40 young, active or irregularly active men, using a crossover design in which three protocols were applied: protocol 1 without HG, protocol 2 with HG at 30% of handgrip strength (HGS), and protocol 3 with HG at 60% of HGS. The exercise sessions were performed on a treadmill and consisted of four blocks of 2&#xa0;min at 50% of heart rate reserve, followed by 1&#xa0;min at 30%. Statistical analysis was carried out using Kruskal-Wallis and Friedman tests with appropriate post hoc procedures. The results demonstrated that protocols 2 and 3 significantly increased SBP and DBP compared to protocol 1 (p&#xa0;<&#xa0;0.05), while DP was significantly higher only in protocol 3 (p&#xa0;<&#xa0;0.01). Heart rate increased throughout exercise in all protocols (p&#xa0;<&#xa0;0.05), with no differences between them. Additionally, HG did not modify the hemodynamic response during recovery. Overall, HG promotes increases in SBP, DBP, and DP during treadmill exercise without altering HR. Durante el ejercicio, los ajustes hemodin&#xe1;micos precisos son esenciales para garantizar un suministro energ&#xe9;tico adecuado. Si bien el ejercicio c&#xed;clico en cinta rodante ha sido ampliamente estudiado, el ejercicio isom&#xe9;trico con agarre manual (AG) ha cobrado relevancia en contextos de acondicionamiento y rehabilitaci&#xf3;n, aunque los datos sobre los efectos hemodin&#xe1;micos agudos de la combinaci&#xf3;n de estas modalidades siguen siendo escasos. En este contexto, el presente estudio puso a prueba la hip&#xf3;tesis de que la contracci&#xf3;n isom&#xe9;trica con AG modifica las respuestas hemodin&#xe1;micas de la frecuencia card&#xed;aca (FC), la presi&#xf3;n arterial sist&#xf3;lica (PAS), la presi&#xf3;n arterial diast&#xf3;lica (PAD) y el doble producto (DP) durante el ejercicio c&#xed;clico en cinta rodante. Se realiz&#xf3; un ensayo cl&#xed;nico con 40 hombres j&#xf3;venes, activos o con actividad irregular, utilizando un dise&#xf1;o cruzado en el que se aplicaron tres protocolos: protocolo 1 sin AG, protocolo 2 con AG al 30% de la fuerza de agarre manual (GAM) y protocolo 3 con AG al 60% de la GAM. Las sesiones de ejercicio se realizaron en una cinta rodante y consistieron en cuatro bloques de 2 minutos al 50% de la reserva de frecuencia card&#xed;aca, seguidos de 1 minuto al 30%. Se realiz&#xf3; un an&#xe1;lisis estad&#xed;stico utilizando las pruebas de Kruskal&#x2010;Wallis y Friedman con los procedimientos post hoc apropiados. Los resultados demostraron que los protocolos 2 y 3 aumentaron significativamente la PAS y la PAD en comparaci&#xf3;n con el protocolo 1 (p&#xa0;<&#xa0;0.05), mientras que la PAD fue significativamente mayor solo en el protocolo 3 (p&#xa0;<&#xa0;0.01). La frecuencia card&#xed;aca aument&#xf3; durante el ejercicio en todos los protocolos (p&#xa0;<&#xa0;0.05), sin diferencias entre ellos. Adem&#xe1;s, la HG no modific&#xf3; la respuesta hemodin&#xe1;mica durante la recuperaci&#xf3;n. En general, la HG promueve aumentos en la PAS, la PAD y la PAD durante el ejercicio en cinta rodante sin alterar la frecuencia card&#xed;aca.

MINST treatment was more effective in reducing median periodontal outcomes at 12-month follow-up than the conventional approach. Across 12-months follow-up, the overall PPD reduction was significantly influenced by a high number of cigarettes/day, erratic/non-compliance supportive treatment, high no. pockets &#x2265;&#x2009;4&#x2009;mm BoP+, number of pockets 4-5&#x2009;mm, number of pockets &#x2265;&#x2009;6&#x2009;mm, and by high FMBS.