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Contrast-to-noise ratio and signal-to-noise ratio of group B were higher than those of group A ( both P < 0.001 ) .

There was no significant difference in subjective image quality scores between two groups ( P = 0.807 ) .

The interobserver agreement was excellent ( k = 0.836 ) .

There was no significant difference in diagnostic accuracy between the two groups ( P > 0.05 ) .

Compared with group A , radiation dose of group B was reduced by 50.3 % ( P < 0.001 ) .

High-pitch CTPA at 80 kVp can obtain sufficient image quality in normal-weight individuals with 20 ml of contrast agent and half the radiation dose of a conventional CTPA protocol .

CTPA is feasible at 80 kVp using only 20 ml of contrast agent .

High-pitch CTPA at 80 kVp has an effective dose under 1 mSv .

This CTPA protocol can obtain sufficient image quality in normal-weight individuals .

Families express a need for guidance in helping their loved ones with anorexia nervosa ( AN ) .

Guided self-help interventions can offer support to caregivers .

One hundred seventy-eight adult AN patients and their caregivers were recruited from 15 UK treatment centres .

Families were randomized to carers ' assessment , skills and information sharing ( C ) intervention + treatment as usual ( TAU ) or TAU alone .

Feedback forms were sent at 6months post-discharge and , if not returned , at 12months .

One hundred two ( 57 % ) patient forms ( n = 50TAU ; n = 52C ) and 115 ( 65 % ) caregiver forms ( n = 60TAU ; n = 55C ) were returned .

Two researchers coded data blind , using thematic analysis .

( i ) Caregivers and patients express a need for post-discharge support .

( ii ) Patients identify helpful and unhelpful support strategies , useful for developing future interventions .

( iii ) Patients could identify positive caregiver behaviour changes targeted in intervention .

( iv ) Guided self-help may benefit caregiver and sufferer , post-discharge .

Caregiver interventions can be a useful tool that will improve the cost effectiveness of inpatient treatment by enhancing the well-being of caregivers and patients .

Cardiac mortality and electrophysiological dysfunction both increase with age .

Heart rate variability ( HRV ) provides indices of autonomic function and electrophysiology that are associated with cardiac risk .

How habitual physical activity among older adults prospectively relates to HRV , including nonlinear indices of erratic sinus patterns , is not established .

We hypothesized that increasing the levels of both total leisure-time activity and walking would be prospectively associated with more favorable time-domain , frequency-domain , and nonlinear HRV measures in older adults .

We evaluated serial longitudinal measures of both physical activity and 24-hour Holter HRV over 5 years among 985 older US adults in the community-based Cardiovascular Health Study .

After multivariable adjustment , greater total leisure-time activity , walking distance , and walking pace were each prospectively associated with specific , more favorable HRV indices , including higher 24-hour standard deviation of all normal-to-normal intervals ( Ptrend = 0.009 , 0.02 , 0.06 , respectively ) and ultralow-frequency power ( Ptrend = 0.02 , 0.008 , 0.16 , respectively ) .

Greater walking pace was also associated with a higher short-term fractal scaling exponent ( Ptrend = 0.003 ) and lower Poincar ratio ( Ptrend = 0.02 ) , markers of less erratic sinus patterns .

Greater total leisure-time activity , and walking alone , as well , were prospectively associated with more favorable and specific indices of autonomic function in older adults , including several suggestive of more normal circadian fluctuations and less erratic sinoatrial firing .

Our results suggest potential mechanisms that might contribute to lower cardiovascular mortality with habitual physical activity later in life .

Our aim was to compare anatomical and functional outcome between vaginal colposuspension and transvaginal mesh .

This was a prospective randomized controlled trial in a teaching hospital .

Sixty-eight women with stage 3 anterior vaginal wall prolapse according to the Pelvic Organ Prolapse Quantification ( POP-Q ) system were assessed , randomized , and analyzed .

Patients were randomized to anterior colporrhaphy with vaginal colposuspension ( n = 35 ) or transvaginal mesh ( n = 33 ) .

Primary outcome was objective cure rate of the anterior vaginal wall , defined as POP-Q 1 at 2years .

Secondary outcomes were functional results , quality-of-life ( QoL ) scores , mesh-related morbidity , and onset of urinary incontinence .

The anatomical result for point Ba was significantly better at 2years in the mesh group ( -2.8 cm ) than in the colposuspension group ( -2.4 cm ) ( p = 0.02 ) .

Concerning POP-Q stages , the anatomical success rate at 2years was 84.4 % for colposuspension and 100 % for mesh ( p = 0.05 ) .

There were 5 anatomic recurrences ( 15.6 % ) in the colposuspension group .

The erosion rate was 6 % ( n = 2 ) .

No significant difference was noted regarding minor complications .

Analysis of QoL questionnaires showed overall improvement in both groups , with no significant difference between them .

The vaginal colposuspension technique of anterior vaginal wall prolapse repair gave good anatomical and functional results at 2years .

Transobturator vaginal mesh gave better 2-year anatomical results than vaginal colposuspension , with overall improvement in QoL in both groups .

Clinical studies evaluating the effects of medications on - cell function in type 2 diabetes ( T2DM ) are compromised by an inability to determine the actual baseline degree of - cell dysfunction independent of the reversible dysfunction induced by hyperglycemia ( glucotoxicity ) .

Short-term intensive insulin therapy ( IIT ) is a strategy for eliminating glucotoxicity before randomization .

This study determined whether liraglutide can preserve - cell function over 48 weeks in early T2DM following initial elimination of glucotoxicity with IIT .

In this double-blind , randomized , placebo-controlled trial , 51 patients with T2DM of 2.6 1.9 years ' duration and an A1C of 6.8 0.8 % ( 51 8.7 mmol/mol ) completed 4 weeks of IIT before randomization to daily subcutaneous liraglutide or placebo injection , with serial assessment of - cell function by Insulin Secretion-Sensitivity Index-2 ( ISSI-2 ) on oral glucose tolerance test performed every 12 weeks .

The primary outcome of baseline-adjusted ISSI-2 at 48 weeks was higher in the liraglutide group than in the placebo group ( 339.8 27.8 vs. 229.3 28.4 , P = 0.008 ) .

Baseline-adjusted HbA1c at 48 weeks was lower in the liraglutide group ( 6.2 0.1 % vs. 6.6 0.1 % , P = 0.055 ) ( 44 1.1 vs. 49 1.1 mmol/mol ) .

At each quarterly assessment , > 50 % of participants on liraglutide had an HbA1c 6.0 % ( 42 mmol/mol ) and glucose tolerance in the nondiabetic range .

Despite this level of glycemic control , no difference was found in the incidence of hypoglycemia between the liraglutide and placebo groups ( P = 0.61 ) .

Two weeks after stopping treatment , however , the beneficial effect on ISSI-2 of liraglutide versus placebo was entirely lost ( 191.9 24.7 vs. 238.1 25.2 , P = 0.20 ) .

Liraglutide provides robust enhancement of - cell function that is sustained over 48 weeks in early T2DM but lost upon cessation of therapy .

To investigate the effectiveness of rectally administered indomethacin in the prophylaxis of post-endoscopic retrograde cholangiopancreatography ( ERCP ) pancreatitis and hyperamylasaemia in a multicentre study .

A prospective , randomised , placebo-controlled multicentre study in five endoscopic units was conducted on 686 patients randomised to receive a suppository containing 100 mg indomethacin , or an inert placebo , 10-15 min before ERCP .

Post-ERCP pancreatitis and hyperamylasaemia were evaluated 24 h following the procedure on the basis of clinical signs and laboratory parameters , and computed tomography/magnetic resonance imaging findings if required .

Twenty-one patients were excluded because of incompleteness of their data or because of protocol violation .

The results of 665 investigations were evaluated : 347 in the indomethacin group and 318 in the placebo group .

The distributions of the risk factors in the two groups did not differ significantly .

Pancreatitis developed in 42 patients ( 6.3 % ) : it was mild in 34 ( 5.1 % ) and severe in eight ( 1.2 % ) cases .

Hyperamylaesemia occurred in 160 patients ( 24.1 % ) .

There was no significant difference between the indomethacin and placebo groups in the incidence of either post-ERCP pancreatitis ( 5.8 % vs 6.9 % ) or hyperamylasaemia ( 23.3 % vs 24.8 % ) .

Similarly , subgroup analysis did not reveal any significant differences between the two groups .

100 mg rectal indomethacin administered before ERCP did not prove effective in preventing post-ERCP pancreatitis .

We sought to determine the incidence of newly diagnosed diabetes in treated elderly hypertensive patients and the prognostic impact of diabetes on long-term survival .

The Second Australian National Blood Pressure ( ANBP2 ) study randomized 6,083 hypertensive patients aged 65-84 years to angiotensin-converting enzyme inhibitor ( ACEI ) or thiazide diuretic-based therapy and followed them for a median of 4.1 years .

Long-term survival was determined in 5,678 patients over an additional median of 6.9 years after ANBP2 ( post-trial ) .

After ANBP2 , the cohort was classified into preexisting ( 7.2 % ) , newly diagnosed ( 5.6 % ) , and no diabetes ( 87.2 % ) groups .

A 44 % higher incidence of newly diagnosed diabetes was observed in patients randomized to thiazide diuretic compared with ACEI-based treatment .

The other predictors of newly diagnosed diabetes were having a higher body mass index , having a higher random blood glucose , and living in a regional location compared to major cities ( a geographical classification based on accessibility ) at study entry .

After completion of ANBP2 , compared with those with no diabetes , the preexisting diabetes group experienced higher cardiovascular ( hazards ratio ( HR ) = 1.65 ; 95 % confidence interval ( CI ) = 1.03-2 .65 ) and all-cause mortality ( HR = 1.40 ; 95 % CI = 1.02-1 .92 ) when adjusted for age , sex , and treatment .

A similar pattern was observed after including the post-trial period for cardiovascular ( HR = 1.52 ; 95 % CI = 1.20-1 .93 ) and all-cause mortality ( HR = 1.50 ; 95 % CI = 1.29-1 .73 ) .

However , when the newly diagnosed group was compared with the no diabetes group , no significant difference was observed in cardiovascular ( HR = 0.33 ; 95 % CI = 0.11-1 .05 ) or all-cause mortality ( HR = 0.76 ; 95 % CI = 0.47-1 .23 ) either during the ANBP2 trial or including post-trial follow-up ( cardiovascular : HR = 0.82 ; 95 % CI = 0.58-1 .17 ; all-cause mortality : HR = 1.04 ; 95 % CI = 0.85-1 .27 ) .

Long-term presence of diabetes reduces survival .

Compared with thiazide diuretics , ACEI-based antihypertensives may delay the development of diabetes in those at risk and thus potentially improve cardiovascular outcome in the elderly .

Obesity is associated with a risk of gastroesophageal reflux disease .

The pharmacodynamic efficacy of proton pump inhibitors has not been specifically evaluated in obese subjects .

The aim of this study was to compare the antisecretory response to a single oral dose of 20 mg rabeprazole , 20 mg omeprazole and placebo in obese subjects .

Gastric pH was monitored for 24 hours on three separate occasions in eighteen H. pylori-negative , asymptomatic obese subjects .

Subjects were given omeprazole , rabeprazole or placebo in a randomized order and in a double-blind fashion .

The main analysis criterion was 24-h percent of time post dose with intragastric pH above 3 ; secondary criteria were percentage of time above pH 4 , median pH , [ H + ] concentrations and nocturnal acid breakthrough ( NAB ) .

Results were analyzed using linear mixed models and Wilks test comparing variances .

24-h median [ IQ ] percentages of time with gastric pH above 3 and 4 were higher with rabeprazole than omeprazole ( 46 [ 37-55 ] vs. 30 [ 15-55 ] % , 9 [ 5-11 ] % for placebo ) but the differences did not reach statistical significance ( p = 0.11 and 0.24 , respectively ) .

Median acid concentrations were significantly lower with rabeprazole than with omeprazole and placebo ( 22 [ 14-53 ] vs. 54 [ 19-130 ] and 95 [ 73-170 ] mmoles/l , p < 0.01 ) for all periods .

The number of NAB was significantly lower with rabeprazole than with omeprazole ( median 1 [ 1,2 ] vs. 2 [ 1-3 ] , p = 0.04 ) .

Variances of 24-h data ( pH above 3 and 4 , median pH , [ H + ] concentrations ) were significantly lower with rabeprazole than with omeprazole ( p < 0.0001 ) .

In asymptomatic obese subjects the gastric antisecretory response to a single dose of rabeprazole and omeprazole was strong and not significantly different between drugs despite a significantly more homogeneous response with rabeprazole .

ClinicalTrial.gov : NCT01136317 .

To study the effect of growth hormone ( GH ) treatment on ovarian and uterine morphology and function in short , prepubertal small-for-gestational-age ( SGA ) girls .

A multinational , randomized controlled trial on safety and efficacy of GH therapy in short , prepubertal children born SGA .

Not applicable .

A subgroup of 18 Danish girls born SGA included in North European SGA Study ( NESGAS ) .

One year of GH treatment ( 67 g/kg/day ) followed by 2 years of randomized GH treatment ( 67 g/kg/day , 35 g/kg/day , or IGF-I titrated ) .

Data on anthropometrics , reproductive hormones , and ultrasonographic examination of the internal genitalia were collected during 36 months of GH treatment .

Uterine and ovarian volume increased significantly during 3 years of treatment ( 64 % and 110 % , respectively ) but remained low within normal reference ranges .

Ovarian follicles became visible in 58 % after 1 year compared with 28 % before GH therapy .

Anti-Mllerian hormone increased significantly during the 3 years of GH therapy but remained within the normal range .

Precocious puberty was observed in one girl ; another girl developed multicystic ovaries .

GH treatment was associated with statistically significant growth of the internal genitalia , but remained within the normal range .