Effects of 18-month low-magnitude high-frequency vibration on fall rate and fracture risks in 710 community elderly--a cluster-randomized controlled trial.

UNLABELLED: This study is a prospective cluster-randomized controlled clinical trial involving 710 elderly subjects to investigate the long-term effects of low-magnitude high-frequency vibration (LMHFV) on fall and fracture rates, muscle performance, and bone quality. The results confirmed that LMHFV is effective in reducing fall incidence and enhancing muscle performance in the elderly. INTRODUCTION: Falls are direct causes of fragility fracture in the elderly. LMHFV has been shown to improve muscle function and bone quality. This study is to investigate the efficacy of LMHFV in preventing fall and fractures among the elderly in the community. METHODS: A cluster-randomized controlled trial was conducted with 710 postmenopausal females over 60 years. A total of 364 participants received daily 20 min LMHFV (35 Hz, 0.3 g), 5 days/week for 18 months; 346 participants served as control. Fall or fracture rate was taken as the primary outcome. Also, quadriceps muscle strength, balancing abilities, bone mineral density (BMD), and quality of life (QoL) assessments were done at 0, 9, and 18 months. RESULTS: With an average of 66.0% compliance in the vibration group, 18.6% of 334 vibration group subjects reported fall or fracture incidences compared with 28.7% of 327 in the control (adjusted HR = 0.56, p = 0.001). The fracture rate of vibration and control groups were 1.1 and 2.3 % respectively (p = 0.171). Significant improvements were found in reaction time, movement velocity, and maximum excursion of balancing ability assessment, and also the quadriceps muscle strength (p < 0.001). No significant differences were found in the overall change of BMD. Minimal adverse effects were documented. CONCLUSION: LMHFV is effective in fall prevention with improved muscle strength and balancing ability in the elderly. We recommend its use in the community as an effective fall prevention program and to decrease related injuries.

Potentiation of radiotherapy by cis-dichlorodiammine platinum (II) in advanced cervical carcinoma.

Forty-five patients with Stages II and III cervical carcinoma were randomized to receive either radiation or cis-dichlorodiammine platinum (II) (cis-DPP) with radiation. Cis-DPP was administered in bolus injections of 25 mg/m2 at weekly intervals until completion of radium application. Complete response was noted in 11/20 (55%) patients in the radiochemotherapy group compared to 5/25 (20%) patients in the radiation group (P less than 0.025). No enhanced toxicities were observed with the addition of cis-DPP to radiation. The combined use of cis-DPP and radiotherapy offers promising potential in improving local-regional control of advanced cervical carcinoma.

Concurrent radiochemotherapy in the treatment of gynaecologic neoplasms.

Chemotherapy with adriamycin and/or cisplatinum in standard dosages concurrent with full radiation produced an accelerated local-regional tumour control leading to complete response in 12 of 14 patients who had advanced primary or recurrent gynaecologic neoplasms. The continuation of chemotherapy thereafter did not however prevent the development nor arrest progression of metastases outside the irradiated field. Epidermitis and myelosupression were the enhanced side effects but were tolerable and manageable. Radiochemotherapy can be applicable in situations where rapid shrinkage of the tumour bulk is required. Its other useful potentials deserve further evaluation.

Fine needle aspiration in gynaecologic oncology.

One hundred and ten fine needle aspirations were performed on 73 patients with primary and recurrent gynaecological cancers. The sampling sites included superficial and retroperitoneal lymph nodes, soft tissue masses, liver, lungs, abdominal and pelvic masses, parametrium, thyroid and breast nodules. This relatively simple, safe and yet reliable technique can obviate the need for biopsies in most situations, and a more liberal use of aspiration cytology in gynaecological malignancies is advocated.