control mechanism which may automatically prevent excessive FSH stimulation of the ovaries. It should also be possible to produce synthetic LH-RH fairly cheaply. Nevertheless, many more clinical studies must be performed before we can define the proper place for LH-RH in the treatment of anovulatory infertility. Our studies in patients with anorexia nervosa prove that LH-RH can be used alone or in combination with HCG to induce follicular growth and maturation, ovulation, and pregnancy in such amenorrhoeic women, who have no evidence of endogenous ovarian activity. It remains to be seen if LH-RH is equally effective in other women with amenorrhoea.

PurposeThe aim of this study was to investigate feasibility of exercise-based rehabilitation delivered after hospital discharge in patients with intensive care unit–acquired weakness (ICU-AW).Materials and methodsTwenty adult patients, mechanically ventilated for more than 48 hours, with ICU-AW diagnosis at ICU discharge were included in a pilot feasibility randomized controlled trial receiving a 16-session exercise-based rehabilitation program. Twenty-one patients without ICU-AW participated in a nested observational cohort study. Feasibility, clinical, and patient-centered outcomes were measured at hospital discharge and at 3 months.ResultsIntervention feasibility was demonstrated by high adherence and patient acceptability, and absence of adverse events, but this must be offset by the low proportion of enrolment for those screened. The study was underpowered to detect effectiveness of the intervention. The use of manual muscle testing for the diagnosis of ICU-AW lacked robustness as an eligibility criterion and lacked discrimination for identifying rehabilitation requirements. Process evaluation of the trial identified methodological factors, categorized by “population,” “intervention,” “control group,” and “outcome.”ConclusionsImportant data detailing the design, conduct, and implementation of a multicenter randomized controlled trial of exercise-based rehabilitation for survivors of critical illness after hospital discharge have been reported.RegistrationClinical Trials Identifier NCT00976807

During the period between 1965 and 1983, 101 pharyngolaryngoesophagectomies with primary pharyngogastric anastomosis were carried out for primary hypopharyngeal cancer at The Royal National Throat, Nose and Ear Hospital, London, England. The Hospital mortality rate was 11%; postoperative complications such as pleural effusion and regurgitation of bile occurred in all patients. Successful swallowing occurred in all patients before they left the hospital‐usually within 2 wk of surgery. An actuarial survival rate of 58% was obtained for the entire group.