The effectiveness of eHealth interventions on physical activity and measures of obesity among working-age women: a systematic review and meta-analysis.

Physical inactivity and obesity are modifiable risk factors for cardiovascular disease, particularly in women. eHealth interventions may increase physical activity and improve obesity-related outcomes among women. The objective of this study was to review the evidence of the effectiveness of eHealth interventions to increase moderate-to-vigorous physical activity among working-age women. The secondary objective was to examine their effectiveness on improving obesity-related outcomes. A comprehensive search strategy was developed for eight electronic databases; through July 2016. All studies consisting of >80% women of working-age (18-65 years) in high income countries were included. Multiple unblinded reviewers determined study eligibility and extracted data. Risk of bias was evaluated using the Cochrane Risk of Bias Tool and data quality using the Grading of Recommendations Assessment, Development and Evaluation approach. Data were pooled using a random-effects model. Sixty studies were included in the review of which 20 were in the meta-analysis. The meta-analysis demonstrated eHealth interventions improved moderate-to-vigorous physical activity (standard mean difference = 1.13, 95% confidence interval: 0.58, 1.68, P < 0.0001); an increase of ~25 min week-1 . No changes were observed in obesity-related outcomes; waist circumference (P = 0.06), body mass (P = 0.05) and body mass index (P = 0.35). eHealth interventions are effective at increasing min week-1 of moderate-to-vigorous physical activity among working-age women from high income countries.

Lateral venous ulcer and short saphenous vein insufficiency.

PURPOSE: The objective of this report is to emphasize the importance of saphenopopliteal junction (SPJ) reflux in the genesis of lateral leg ulcers and to suggest a proper diagnostic and therapeutic approach. METHODS: Twenty legs with isolated lateral perimalleolar ulcers from the basis for this report. None had medial ankle ulcers, and most showed no hyperpigmentation or lipodermatosclerosis. Fifteen had been treated with a nonvenous diagnosis. Reflux at the SPJ was detected by handheld continuous wave Doppler and was confirmed with duplex scans. No other abnormalities were found. Brief conservative treatment and duplex localization of the SPJ preceded its ligation and division. RESULTS: All ulcers healed within 12 weeks, but one in a radiated leg recurred at 9 months. Other complications included two hematomas and one each of ankle edema, superficial wound infection, and sural neuropathy. CONCLUSIONS: Even isolated lateral leg and ankle ulcers with minimal accessory venous stigmata can be of venous reflux origin. Detection with the continuous wave Doppler and confirmation of reflux and localization of the SPJ allow surgical correction to proceed swiftly with an expectation of satisfactory results.