Effectiveness of behavioral interventions and behavior change techniques for reducing soft drink intake in disadvantaged adolescents: A systematic review and meta-analysis.

Reducing sugar-sweetened beverage (SSB) intake is an important dietary target, especially among socioeconomically disadvantaged ethnic minority adolescents. This review and meta-analysis evaluated the effectiveness of behavioural interventions aiming to reduce SSB intake in socioeconomically disadvantaged ethnic minority adolescents and examined which behaviour change techniques (BCTs) were most effective. A systematic search was conducted using the PRISMA criteria. Quality assessments were done using the Cochrane criteria. In a narrative synthesis, studies were divided into effective and non-effective, and relative effectiveness ratios of individual BCTs were calculated. Pooled standardized mean differences (SMDs) and their 95% confidence intervals were estimated with random-effects models using cluster robust methods. Twenty-two studies were included in the qualitative synthesis. A meta-analysis (n = 19) revealed no significant between-group differences in reduction of SSB intake. Five self-regulatory BCTs had an effectiveness ratio >50%: feedback, goal-setting, action planning, self-monitoring and problem-solving/barrier identification. The risk of bias assessments were judged to be moderate to high risk for randomized controlled trials (RCTs) studies and low to moderate for pre-post studies. There was no indication of publication bias. In conclusion, self-regulatory BCTs may be effective components to change SSB behaviour. However, high-quality research is needed to evaluate the effectiveness of behavioural interventions and identify BCTs effective for reducing SSB intake among disadvantaged adolescents with ethnic minority backgrounds.

Digital image analysis agrees with visual estimates of adult bone marrow trephine biopsy cellularity.

INTRODUCTION: Evaluation of cellularity is an essential component of bone marrow trephine biopsy examination. The standard practice is to report the results as visual estimates (VE). Digital image analysis (DIA) offers the promise of more objective measurements of cellularity. METHODS: Adult bone marrow trephine biopsy sections were assessed for cellularity by VE. Sections were scanned using an Aperio AT2 Scanscope and analyzed using a Cytonuclear (version 1.4) algorithm on halo software. Intraclass correlation (ICC) was used to assess relatedness between VE and DIA, and between MRI and DIA for a separate subset of patients. Trephine biopsy sections from a subset of patients with bone marrow biopsies uninvolved by malignancy were assessed for age-related changes. RESULTS: Interobserver VE agreement was good to excellent. The ICC value was 0.81 for VE and DIA, and 0.50 for MRI and DIA. Linearity studies showed no statistically significant trend for age-related changes in cellularity in our cohort (r = -.29, P = .06). CONCLUSIONS: Agreement was good between VE and DIA. It may be possible to use DIA or VE to measure cellularity in the appropriate clinical scenario. The limited sample size precludes similar determinations for MRI calculations. Further studies examining healthy donors are necessary before making definitive conclusions regarding age and cellularity.

Total laparoscopic radical hysterectomy: a change in practice for the management of early stage cervical cancer in a U.K. cancer center.

In order to evaluate the safety, surgical, and oncological outcomes of the introduction of a total laparoscopic radical hysterectomy (TLRH) service, the authors conducted a retrospective review of all TLRHs performed in the present centre from the beginning of the service in August 2010. TLRH appears in this series to be safe. Complication rates were comparable to National Institute for Health and Clinical Excellence (NICE) and literature standards. Oncological outcomes, despite the short follow up period, appear acceptable. TLRH is a valuable alternative to open surgery for the treatment of early cervical cancer.

Centralized Pan-Middle East Survey on the Under-Treatment of Hypercholesterolemia: Results from the CEPHEUS Study in Egypt.

BACKGROUND: Cardiovascular disease is a major cause of morbidity and mortality; however, the risks associated with this disease can be reduced by targeting circulating low-density lipoprotein cholesterol (LDL-C) with lipid-lowering drugs, as recommended in many treatment guidelines. Their effectiveness for hypercholesterolemia management depends on appropriate use in at-risk patients. Observational studies have shown varying adherence to national and international guidelines on reaching LDL-C treatment goals. METHODS: The Centralized Pan-Middle East Survey on the under-treatment of hypercholesterolemia (CEPHEUS) study observed the current management of hypercholesterolemia in patients on lipid-lowering drugs in seven Middle Eastern countries, and results from 1,043 patients in Egypt are presented here. RESULTS: Overall, less than 50% of patients achieved their LDL-C treatment goal, with patients at higher risk of a cardiovascular event being less likely to attain their target. Nearly, three-quarters of patients in this study were considered high or very high risk, with only 10% of high-risk patients reaching their treatment goal. CONCLUSIONS: Management of hypercholesterolemia in Egypt is comparatively worse than the average for similar countries in the region, and many patients with high risk of CVD are not being effectively treated. Initiatives to improve physicians' management of these patients and patient compliance to treatment are urgently needed. FUNDING: AstraZeneca, Cairo, Egypt.

How many walking and cycling trips made by elderly are beyond commonly used buffer sizes: results from a GPS study.

In choosing appropriate buffer sizes to study environmental influences on physical activity, studies are hampered by insufficient insight into the distance elderly travel actively. This study aims at getting insight into the number of trips walked and cycled within various buffer sizes using GPS measures. Data were obtained from the Elderly And their Neighborhood study (Spijkenisse, the Netherlands (2011-2012)). Trip length and mode of transport were derived from the GPS data (N=120; total number of trips=337). Distance decay functions were fitted to estimate the percentage of trips to grocery stores within commonly used buffer sizes. Fifty percent of the trips walked had a distance of at least 729m; for trips cycled this was 1665m. Elderly aged under 75 years and those with functional limitations walked and cycled shorter distances than those over 75 years and those without functional limitations. Males cycled shorter distances than females. Distance decay functions may aid the selection of appropriate buffer sizes, which may be tailored to individual characteristics.

Effect of interferon alpha-2b on endometrioma cells in vitro.

OBJECTIVE: To examine the effect of interferon alpha-2b on the growth of endometrioma cells and its effect on the DNA synthesis. METHODS: Cells from four separate endometrioma cell lines were seeded into six-well plates in M199 medium containing increasing levels of interferon alpha-2b: 0 (control), 50, 100, 500, 1000, and 2000 U/mL. All cells were counted on days 0, 3, 6, and 9 in quadruplicate, and the counts were averaged for each condition. A second experiment was run to demonstrate the effect of short-term exposure of interferon alpha-2b on the growth of endometrioma cells in culture. In a separate experiment, cells from two endometriomas were plated in quadruplicate to evaluate the DNA synthesis. On day 3, 1000 and 4000 U/mL of interferon alpha-2b were added and run simultaneously with control (0 U/mL) wells. 3H-thymidine was added to each condition for 24 and 48 hours' incubation. Cells were then harvested and counted in a scintillation counter to study the 3H-thymidine uptake. RESULTS: Interferon alpha-2b suppressed endometrioma cell growth in vitro. This effect increased with increasing concentrations of interferon alpha-2b (50-2000 U/mL) compared with the control (0 U/mL). The suppression of cell growth was statistically significant, but when interferon alpha-2b was removed from the culture cell growth increased. 3H-thymidine uptake by endometrioma cells decreased compared with the control after 24 and 48 hours for interferon alpha-2b concentrations of 1000 and 4000 U/mL, respectively. CONCLUSION: Interferon alpha-2b inhibits the growth and DNA synthesis of endometrioma cells in culture. This finding may have prospects for the treatment of endometriosis.

Uterine artery embolization: the role in obstetrics and gynecology.

OBJECTIVE: Evaluation of the studies for the use of uterine artery embolization in various conditions in both obstetrics and gynecology. DESIGN: Literature review. RESULTS: Uterine artery embolization was successful in controlling postpartum hemorrhage in 94.9% of the cases. It was effective in controlling the bleeding in 96% of cases with uterine arteriovenous malformations and in 100% of the cases with abdominal and cervical pregnancies. Recently, it has been introduced as a line of treatment for uterine fibroids. It controlled bleeding in 82-92% of cases, and lead to 20-64% reduction in size of fibroids. CONCLUSIONS: Uterine artery embolization is of significant value in treating certain hemorrhagic conditions in obstetrics and gynecology including postpartum hemorrhage, ectopic pregnancy, and arteriovenous malformations. Its use in treatment of uterine fibroids is new and needs more collaborative studies by gynecologists and intervention radiologists to evaluate issues related to necrosis of the tumor, sepsis, and the long-term effect on size and recurrence rate.