The INTERSALT Study, an international, collaborative, cross-sectional investigation of the relation between blood pressure and dietary and other factors, used quality-controlled, standardized procedures and assessment of multiple possible confounding factors to study 10,079 men and women in 52 population-based samples in 32 countries. In this study 24-h urinary excretion data were used as biochemical markers of intakes of sodium, potassium, and protein, with repeat examinations done in a randomly selected 8% of participants to asses reliability and correct for regression-dilution bias. INTERSALT showed that high salt intake, low potassium intake, excess alcohol consumption, and energy imbalance resulting in overweight are critically involved in the origins of the high blood pressure prevalent among a majority of adult populations. The findings also show that obtaining accurate estimates of associations between dietary intake and blood pressure requires large population-based samples, high-quality dietary information, control for multiple confounding variables, and modern multivariate methods of data analyses, including correction of observed associations for within-person variation in intake.

Background: Laboratory and some epidemiological reported an inverse association with vitamin C intake. studies suggest that antioxidants, such as vitamin C,The two non-randomised and four randomised conare protective for cardiovascular disease. This protectrolled trials were all small. Of the randomised trials one tive effect may be mediated through blood pressure reported a significant decrease in BP, one a non-(BP). This is the first systematic review of epidemiologsignificant decrease and two were uninterpretable. ical studies of vitamin C and BP.Conclusions: We found a consistent cross-sectional Method: Published cross-sectional studies, prospective association between higher vitamin C intake or status studies and trials in humans were identified that examand lower BP, though no study controlled adequately ined the association between vitamin C intake or plasma for confounding by other dietary factors. Further crossvitamin C levels and BP. Relevant references were sectional studies are required to establish whether an located by MEDLINE search 1966-1996, EMBASE search independent association exists. If this is shown to be 1980-1996, by searching personal bibliographies, books the case larger and longer term trials will be needed to and reviews and from citations in located articles.confirm the association is causal. Potentially the impact Results: Cross-sectional data were available from 18 on cardiovascular disease of a modest change in mean populations. Ten of 14 reported an inverse association population vitamin C intake is large. between plasma vitamin C and BP and three of four

Background: With the recent publication of the International Conference on Harmonisation E17 guideline and major reforms in China underway, the platform for clinical trial conduct is expected to change. This study aims to assess the strategic inclusion of regions in clinical trials and its change in trends over the past decade. Methods: The ClinicalTrials.gov registry was searched for clinical trials registered by the top 10 pharmaceutical companies between 1 January 2008 and 31 December 2017. Extracted data included phase, disease type, intervention, study start year, and region. Trial type was classified as either a local study or a multiregional clinical trial as per the International Conference on Harmonisation E17 guideline. Results: Of 2488 phase I, 1855 phase II, and 1999 phase III trials included, the majority of phase I trials were local studies (76.8%), while the majority of phase II (66.0%) and phase III (72.2%) trials were multiregional clinical trials. The proportion of multiregional clinical trials showed an increasing trend for all phases (p \ 0.01). Although North America and Europe remained the main locations, increasing trends of inclusion of other regions, such as East Asia, were noted. Conclusion: Globalization of drug development is evident with the increasing trend of multiregional clinical trial. Regulatory authorities as well as the pharmaceutical industry should prepare for the evolving setting of clinical research and problems that can arise from these changes.

The case records of 12 patients with late onset anorexia nervosa (onset after age 25) were examined and compared with two control groups. Life events as rated according to the Bedford Life Events Schedule were more common prior to the onset of the anorexia in the late onset group than in either control group. The older patients were also more likely to experience a concurrent depressive illness. The significance of these findings is discussed.Anorexia nervosa is predominantly a disorder of adolescent females. Indeed the disorder has been conceptualized as a means of preventing or reversing biological and psychological maturity (Crisp, 1980). Despite its predominance in the young there have been reports since the illness was first described of it occurring in older women. Lasegue (1874) reports a case occurring in a woman of 32. Janet (1927) reports on a new case occurring in a woman of 38 and a reoccurrence in a woman of 40. In Ryle's (1936) study of 51 cases, 13 were over the age of 30, and 8 were over 40, the oldest being 59. More recently there have been case reports of anorexia nervosa in older patients diagnosed according to modern criteria (Kellet, Trimble, & Thorley, 1975; Launer, 1978;Hsu & Zimmer, 1988). Dally (1984) described a series of women with onset of anorexia after marriage. Exact age of onset is not described but there is a group of 11 women with onset at or after menopause. He felt that there were enough differences in the clinical picture of these older onset cases to coin the term anorexia tardive.Many of these papers have discussed predisposing factors. Ryle (1936) re-Laurence Mynors-Wallis, M.A., M.R.C.P., M.R.C.Psych., is Wellcome Trust Training Fellow in Mental Health, University of Oxford Department of Psychiatry. Janet Treasure, Ph.D., M.R.C.P., M.R.C.Psych., is Senior Lecturer at the institute of Psychiatry, and Deborah Chee, M.R.C.P., M.R.C.Psych., is Registrar in Psychiatry, Maudsley Hospital, London.

Ever since its first introduction seven decades ago, there has been continuous advancement of the concept and technique of Interproximal enamel reduction (IPR). It's demonstrated that with correct case selection and clinical performance, IPR is safe and effective for alleviating crowding, improving dental and gingival aesthetics as well as facilitating post-treatment stability. The fulfilment of treatment outcomes depends on careful pre-treatment examination and planning, appropriate clinical procedures and effective post-treatment protection. This review aims to provide a general introduction to IPR in terms of its history background, risks and benefits and clinical performance.