Summary Background Medical abortion with mifepristone and prostaglandins is well established. We compared clinical assessment with self-assessment of abortion outcome. Methods This randomised, ...controlled, non-inferiority trial was done in four clinics in Austria, Finland, Norway, and Sweden, between Aug 16, 2011, and Jan 31, 2013. Women aged 18 years and older who had requested medical termination of a pregnancy up to 63 days of gestation were eligible. Computer-generated block randomisation (block size ten) assigned women in a 1:1 ratio to attend routine clinical follow-up or to self-assess outcome at home with a semiquantitative urine human chorionic gonadotropin (hCG) test 1–3 weeks after abortion. The primary outcome was the percentage of women with complete abortion not requiring further medical or surgical intervention within 3 months. Analysis was per protocol and by intention to treat. The non-inferiority margin was five percentage points. This trial is registered with ClinicalTrials.gov , number NCT01487213. Findings 924 women were assigned routine follow-up (n=466) or self-assessment (n=458) and included in the intention-to-treat analysis. 901 were included in the per-protocol analysis (n=446 and n=455, respectively). Complete abortion was reported in 432 (95%) of 455 in the routine follow-up group and 419 (94%) of 446 women in the self-assessment group (crude difference −1·0, 95% CI −4·0 to 2·0). 20 (4%) women in the routine follow-up group and 17 (4%) in the self-assessment group required surgery. No women in the routine follow-up group versus three in the self-assessment group had undetected continuing pregnancies. Eight (1·8%) and one (0·2%) women, respectively, had infections (p=0·038). Interpretation Self-assessment was non-inferior to routine follow-up and could save resources. Funding Nordic Federation of Obstetrics and Gynaecology, European Society of Contraception, Helsinki University Central Hospital, Helse Finnmark, Swedish Research Council, and Stockholm County Council and Karolinska University Hospital.
Abstract Objectives The study sought to compare the prevalence, clinical correlates and prognostic impact of diabetes in Southeast Asian versus white patients with heart failure (HF) with preserved ...or reduced ejection fraction. Background Diabetes mellitus is common in HF and is associated with impaired prognosis. Asia is home to the majority of the world’s diabetic population, yet data on the prevalence and clinical significance of diabetes in Asian patients with HF are sparse, and no studies have directly compared Asian and white patients. Methods Two contemporary population-based HF cohorts were combined: from Singapore (n = 1,002, median 25th to 75th percentile age 62 54 to 70 years, 76% men, 19.5% obesity) and Sweden (n = 19,537, 77 68 to 84 years, 60% men, 24.8% obesity). The modifying effect of ethnicity on the relationship between diabetes and clinical correlates or prognosis (HF hospitalization and all-cause mortality) was examined using interaction terms. Results Diabetes was present in 569 (57%) Asian patients versus 4,680 (24%) white patients (p < 0.001). Adjusting for clinical covariates, obesity was more strongly associated with diabetes in white patients (odds ratio OR: 3.45; 95% confidence interval CI: 2.86 to 4.17) than in Asian patients (OR: 1.82; 95% CI: 1.13 to 2.96; pinteraction = 0.026). Diabetes was more strongly associated with increased HF hospitalization and all-cause mortality in Asian patients (hazard ratio: 1.50; 95% CI: 1.21 to 1.87) than in white patients (hazard ratio: 1.29; 95% CI: 1.22 to 1.36; pinteraction = 0.045). Conclusions Diabetes was 3-fold more common in Southeast Asian compared to white patients with HF, despite younger age and less obesity, and more strongly associated with poor outcomes in Asian patients than white patients. These results underscore the importance of ethnicity-tailored aggressive strategies to prevent diabetes and its complications.
...delayed washing of the newborn's whole body (after 7 days of age) was associated with a reduced risk of allergen sensitization, whereas an increased risk was seen for children who had a mother who ...worked during pregnancy. ...our findings suggest that the reduced prevalence of allergen sensitization seen among children of families with an anthroposophic lifestyle was largely explained by a low incidence of food sensitization before 1 year of age.
Highlights IGF-1 IGFBP-1 Ulrika Ljung Faxén • HFpEF and HFrEF differ regarding IGF-1, with higher concentrations in HFpEF • HFpEF and HFrEF phenotypes were similar regarding increased IGFBP-1 ...concentrations • IGFBP-1 was associated with NT-proBNP in both HFpEF and HFrEF • Higher IGF-1 levels were associated with better prognosis in HFrEF but not in HFpEF
Allergen specific IgE (cut-off level >=0.35 kUA/L ) against food- (hen's egg, cow's milk and peanut), animal- (cat and dog) and pollen (birch and timothy) allergens was analyzed in blood samples at ...6, 12, 24 and 60 months of age.
PDF
