Overweight and obesity among children who are deaf: Quantitative and qualitative findings

The current study examined rates of overweight and obesity among children attending schools for the deaf, including factors associated with greater prevalence of overweight. Further, interviews were conducted with school staff to assess school perceptions of overweight and weight management. Although prevalence of overweight and obesity was high (approximately 28%), this rate was not greater than that of youth in the general population, and body mass index was higher among females. Several themes regarding factors contributing to overweight among deaf children, barriers for weight management, and possible components for weight management interventions emerged in interviews with school staff.     

An Alternative Approach to Selecting Patients for High‐risk Screening with Breast MRI

Current guidelines for adding breast MRI to annual screening mammography are based entirely upon stratification of risk, with a heavy focus on lifetime calculations. This approach is fraught with difficulty due to the reliance on mathematical models that vary widely in their calculations, the inherent age discrimination of using lifetime risks rather than short‐term incidence, and the failure to incorporate mammographic density, the latter being an independent risk as well as the greatest predictor of mammographic failure. By utilizing a system of patient selection similar to what was used in the American College of Radiology Imaging Network (ACRIN) 6666 trial for multi‐modality imaging, 33 women without a prior diagnosis of breast cancer were found to harbor mammographically occult carcinoma through MRI screening. These 33 patients represent a 2% yield, closely approximating the yields seen in prospective MRI screening trials of women at very high risk of breast cancer. Using the “~20–25%” minimum established by the American Cancer Society and later the National Comprehensive Cancer Network, the Gail model would have prompted the use of MRI in only 9 of 33 (27.3%) patients, the Claus model 1 of 33 (3%), and the Tyrer–Cuzick model 12 of 33 (36.4%). Using all three models and opting for the highest calculated risk, then including BRCA‐positivity, still would have identified only 16 of 33 (48.5%) patients with occult breast cancer discovered by MRI. Only one patient was BRCA‐positive, and none had lobular carcinoma in situ, while 6 of 33 patients (18.2%) had atypical ductal hyperplasia (ADH). Measures are proposed to refine patient selection for MRI screening through the use of short‐term or categorical risks, mammographic density, while maintaining cost‐effectiveness through longer MRI screening intervals.     

Patient‐reported outcomes from SYNERGY,a randomized,double‐blind,multicenter study evaluating combinations of mirabegron and solifenacin compared with monotherapy and placebo in OAB patients

Aims

To evaluate patient‐reported outcomes (PROs) of combinations of solifenacin and mirabegron compared with solifenacin and mirabegron monotherapy and with placebo in patients with overactive bladder (OAB) from the SYNERGY trial.

Methods

Following a 4‐week placebo run‐in, period patients (≥18 years) with OAB were randomized 2:2:1:1:1:1 to receive solifenacin 5 mg + mirabegron 25 mg (combination 5 + 25 mg), solifenacin 5 mg + mirabegron 50 mg, (combination 5 + 50 mg), solifenacin 5 mg, mirabegron 25 mg, mirabegron 50 mg or placebo for 12 weeks, followed by a 2‐week washout period. At each visit, PROs related to quality of life, symptom bother, and treatment satisfaction were assessed, including OAB‐q Symptom Bother score, health‐related quality of life (HRQOL) Total score, treatment satisfaction‐visual analogue scale (TS‐VAS), and patient perception of bladder condition (PPBC) questionnaires.

Results

Overall, 3527 patients were randomized into the study, with 3494 receiving double‐blind treatment. At end of treatment (EoT), both combination groups showed greater improvements in OAB‐q Symptom Bother score compared with the monotherapy groups (nominal P < 0.001). Statistically significant improvements in HRQOL Total scores were observed in the combination groups versus monotherapy groups (P ≤ 0.002). For both combination groups, the OAB‐q Symptom Bother score responder rates at EoT were statistically significantly higher versus mirabegron monotherapy (P < 0.05). The mean adjusted changes from baseline to EoT for PPBC were greater in the combination groups compared with monotherapy groups.

Conclusions

PROs showed that combination therapy provided clear improvements and an additive effect for many HRQOL parameters, including OAB‐q Symptom Bother score, HRQOL Total score, and PPBC.     

Intraventricular CNS lesions: A pictorial essay

Intraventricular lesions of the central nervous system (CNS) can present a diagnostic challenge due to a range of differential diagnoses and radiological appearances. Both CT and MRI imaging findings, in combination with location and patient's age, can help limit the differentials. This pictorial essay presents the salient radiological features, location and demographics of the more common intraventricular lesions of the brain.     

Influence of training years on upper-body strength and power changes during the competitive season for professional Australian rules football players

ObjectivesTo determine if upper-body strength or power changes during the competitive season for elite Australian rules footballers and what influence the number of training years has on any changes.DesignRepeated measures.MethodsTwenty elite Australian rules footballers were assessed at preseason, in-season and postseason. Strength was assessed by the 1 Repetition Maximum bench press and power was assessed by bench press throws. Athletes’ results were analysed as a whole group as well as being divided into two groups according to training years: less than 3 years training and greater than 3 years training. All athletes performed the same resistance training program.ResultsThere were no significant differences in height, body mass, or skinfold measurements between the two age groups. As a whole group, there was no significant change in 1RM bench press. There was a small but significant decrease in mean bench throw power in-season (525 W) compared to preseason (542 W) and it then increased at postseason (541 W). Within group analysis revealed the in-season decrease in upper-body power was largely pertaining to the younger athletes. The older group maintained their upper body power levels while the younger group decreased power in-season (4%) before regaining it at season's end.ConclusionOlder footballers were able to maintain their upper body power while the younger footballers had a small but significant decrease in-season before regaining it by season's end. The overall volume of training and playing appears to have affected the younger athletes’ power more than older athletes. Both age groups maintained upper body strength.