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Menu labels displaying food energy in physical activity calorie equivalents (PACE) is a possible strategy to encourage ordering meals with fewer calories and promoting physical activity. Potential effects of such labeling for children have never been examined.

Nerve injuries, wound complications and especially poor cosmetic results still have an important impact on the carotid endarterectomy (CEA) morbidity. Introduction of the mini skin incision in clinical practice seems to be safe with reduction in postoperative pain and superficial and cranial nerves lesions, and better aesthetics outcomes. The objective of this retrospective study was to compare the results between the short longitudinal with the short transverse cervical incision and to evaluate their impact on cranial and cervical nerves and aesthetic outcomes.From January 2007 to December 2009 266 patients underwent 300 consecutive primary CEA procedures. Two-hundred nineteen patients were submitted to short longitudinal cervical incision (group A), in eighty one a short transverse cervical skin incision (group B) was performed. The average of skin incision was about 4-5.5 cm. In all cases a preoperative CEA duplex ultrasounds (US) assisted skin marking was carried out. All patients were submitted to the general anesthesia with Remifentanyl conserved consciousness. Routinely synthetic patch and selective policy intraluminal shunts were used. Incisions were extended when shunts were required or in case of high carotid bifurcation. Preoperative and postoperative cranial nerves evaluation was always performed and a questionnaire about the satisfaction of the aesthetic outcome was proposed to all patients to the discharge and six months follow-up. Stroke/TIA, death, wound complications, cranial and cervical nerves injuries and restenosis rate were reported and analyzed through statistical analysis (χ2 and Student's t test).The 30 days mortality was 0.3% (1/300). The TIA rate was 0.91% in group A and 1.2 % in group B (P0.9). Wound complications were 1.8% and 1.2 % respectively (P0.1). No statistically differences were reported in the incidence of cranial and cervical nerves injuries between the two groups (P0.9). No difference in restenosis rate was detected (P0.9). In case of lengthening of the incision for high internal carotid (ICA) stenosis and especially to the need of shunt deployment, the longitudinal approach showed unequivocally to be easier and safer.No differences were achieved between short longitudinal and transverse incision in term of stroke, wound complications or nerves impairment. A good cosmetic outcome was gained in both groups. The Duplex US skin markings pre-CEA permitted localization and limits of the plaque with appropriate short incision. A longitudinal cervical approach is to prefer as can lead to an easier proximal and distal lengthening in cases of atherosclerotic extension of the plaque and shunt deployment.

Objective To identify prognostic indicators for geriatric patients discharged from an acute care hospital. Design Prospective observational study. Setting Base line assessment at discharge from an acute care hospital; reassessment after 1 year at home. Patients One hundred-seventy-eight consecutive patients over 70 years of age (mean age ± SD = 75.6 ± 13.1 years, range 70–95 years, 52% males); 56% were dependent in one or more Activities of Daily Living, 21% had abnormal Mini Mental State Scores. Main Outcome Measures mortality, increasing physical dependence, health care utilization. Results Mortality was directly related to a low ADL score at hospital discharge (Odds Ratio = 3.31, Confidence Limits = 1.91–5.75), neoplastic diseases (OR = 3.59, CL = 2.01–6.43), cardiovascular diseases (OR = 2.47, CL = 1.40–4.36), and drug use, expressed as the total number of individual preparations prescribed at discharge (OR = 1.72, CL = 1.05–2.83). Low ADL score, cardiovascular and neoplastic diseases were also predictive of increasing physical dependency. The use of health care services, quantified by an appropriately designed score, did not correlate with any of the baseline variables, with the implication that the use of the health care services was not proportional to the need for care. Conclusions: Elderly subjects at major risk of death and disability can be easily identified at discharge by a simple assessment of their medical and functional state.

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