Maturitas
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Publicly organized population breast cancer screening is presently hotly debated. Indeed, population screening is poorly effective, induces harms in a healthy population and is costly. ⋯ The latter could be a more efficient strategy. The principles of individualized screening are (a) to start from the age at which the breast cancer risk is equal to that for an average women aged 50 years, (b) to stop when the risk of co-mortality exceeds the risk of breast cancer mortality, (c) to adapt the exams frequency and the imaging modalities to the individual risk and to the breast density, (d) to reassess regularly and individually the screening strategy, and (e) to discuss honestly with each woman in order to help her to decide if she participates or not.
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Celiac disease is a genetically-based and immunologically-mediated systemic disorder, affecting primarily the small intestine in adults. About 0.5-1% of most populations studied are affected, with up to 2% in Finland. In families, specifically first-degree relatives, up to 20% may have the disease. ⋯ Finally, another associated disease causing similar clinical and biopsy features or, alternatively, a complicating disorder may develop, such as a lymphoma. Some with biopsy features suggestive of celiac disease may not respond to a gluten-free diet. These may not have celiac disease at all, but instead, a sprue-like intestinal disease, or so-called unclassified sprue.
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Randomized Controlled Trial Comparative Study
Efficacy and safety of high dose intramuscular or oral cholecalciferol in vitamin D deficient/insufficient elderly.
To evaluate and compare the effects and safety of high dose intramuscular (IM) or oral cholecalciferol on 25-hydroxyvitamin D [25(OH)D] levels, muscle strength and physical performance in vitamin D deficient/insufficient elderly. ⋯ In vitamin D deficient/insufficient elderly, a single megadose of cholecalciferol increased vitamin D levels significantly and the majority of the patients reached optimal levels. Although both administration routes are effective and appear to be safe, IM application is more effective in increasing 25(OH)D levels and balance performance.
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Although sleep disturbances are common during female mid-life, few studies have described in detail the prevalence of this problem and related risk factors. ⋯ Insomnia and poor sleep quality were highly prevalent in this mid-aged female sample in which the influence of age and the menopause was only modest and rather linked to menopausal symptoms already occurring since the premenopause.
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Review Meta Analysis
The effect of whole body vibration on balance, mobility and falls in older adults: a systematic review and meta-analysis.
This systematic review aimed to examine the effect of WBV on balance, mobility and falls among older adults. The databases used included MEDLINE, the Excerpta Medica database, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library Databases of Systematic Reviews, Physiotherapy Evidence Database (PEDro), PubMed, and Science Citation Index (last search in October 2011). Randomized controlled trials that investigated the effect of WBV on balance, mobility or falls in older adults were included in this review. ⋯ The effect of WBV on other balance/mobility outcomes and fall rate remains inconclusive. To conclude, WBV may be effective in improving relatively basic balance ability and mobility among older adults, particularly frailer ones. More good-quality WBV trials are required.