Maturitas
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Despite the well-known association of obesity with increased mortality and the development of chronic diseases, an "obesity paradox" has been reported in several patient categories; i.e., overweight and obese patients have a better prognosis than normal or low-weight individuals. The present review aims to identify potential factors lying beneath the beneficial effect of overweight and obesity. In particular, the role of nutritional status, malnutrition and catabolic state, as well as intentional vs. unintentional weight loss and the possibility of a U-shape relationship between body mass index and survival will be examined. Furthermore, methodological considerations framing the obesity paradox will be presented and discussed.
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Treating anaemia in older patients who have undergone hip fracture surgery is to enhance functional recovery. The relationship between peri-operative haemoglobin levels and outcome after hip fracture surgery are controversial. We assessed whether higher haemoglobin levels predict length of hospital stay after hip fracture surgery in elderly subjects. ⋯ Higher postoperative haemoglobin levels predict shorter length of hospital stay after hip fracture surgery in the elderly. A definitive randomized clinical trial has to demonstrate whether this association is causal.
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Institutions and journals both have important duties relating to research and publication misconduct. Institutions are responsible for the conduct of their researchers and for encouraging a healthy research environment. Journals are responsible for the conduct of their editors, for safeguarding the research record, and for ensuring the reliability of everything they publish. ⋯ To achieve this, we make the following recommendations. Institutions should: • have a research integrity officer (or office) and publish their contact details prominently; • inform journals about cases of proven misconduct that affect the reliability or attribution of work that they have published; • respond to journals if they request information about issues, such as disputed authorship, misleading reporting, competing interests, or other factors, including honest errors, that could affect the reliability of published work; • initiate inquiries into allegations of research misconduct or unacceptable publication practice raised by journals; • have policies supporting responsible research conduct and systems in place for investigating suspected research misconduct. Journals should: • publish the contact details of their editor-in-chief who should act as the point of contact for questions relating to research and publication integrity; • inform institutions if they suspect misconduct by their researchers, and provide evidence to support these concerns; • cooperate with investigations and respond to institutions' questions about misconduct allegations; • be prepared to issue retractions or corrections (according to the COPE guidelines on retractions) when provided with findings of misconduct arising from investigations; • have policies for responding to institutions and other organizations that investigate cases of research misconduct.
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Review Comparative Study
Vertebroplasty and kyphoplasty--a systematic review of cement augmentation techniques for osteoporotic vertebral compression fractures compared to standard medical therapy.
After more than two decades the treatment effect of cement augmentation of osteoporotic vertebral compression fractures (VCF) has now been questioned by two blinded randomised placebo-controlled trials. Thus many practitioners are uncertain on the recommendation for cement augmentation techniques in elderly patients with osteoporotic VCF. This systematic review analyses randomised controlled trials on vertebroplasty and kyphoplasty to provide an overview on the current evidence. ⋯ Kyphoplasty is probably not cost-effective (evidence level IIb), and vertebroplasty has not more than short-term cost-effectiveness (evidence level IV). Vertebroplasty and kyphoplasty cannot be recommended as standard treatment for osteoporotic VCF. Ongoing sham-controlled trials may provide further evidence in this regard.