Large-scale, methodologically sound trials indicate that the symptomatic benefit of chondroitin is minimal or nonexistent. Use of chondroitin in routine clinical practice should therefore be discouraged.

Objective To examine whether excluding patients from the analysis of randomised trials are associated with biased estimates of treatment effects and higher heterogeneity between trials. Design Meta-epidemiological study based on a collection of meta-analyses of randomised trials. Data sources 14 meta-analyses including 167 trials that compared therapeutic interventions with placebo or nonintervention control in patients with osteoarthritis of the hip or knee and used patient reported pain as an outcome. Methods Effect sizes were calculated from differences in means of pain intensity between groups at the end of follow-up, divided by the pooled standard deviation. Trials were combined by using random effects metaanalysis. Estimates of treatment effects were compared between trials with and trials without exclusions from the analysis, and the impact of restricting meta-analyses to trials without exclusions was assessed. Results 39 trials (23%) had included all patients in the analysis. In 128 trials (77%) some patients were excluded from the analysis. Effect sizes from trials with exclusions tended to be more beneficial than those from trials without exclusions (difference −0.13, 95% confidence interval −0.29 to 0.04). However, estimates of bias between individual meta-analyses varied considerably (τ 2 =0.07). Tests of interaction between exclusions from the analysis and estimates of treatment effects were positive in five meta-analyses. Stratified analyses indicated that differences in effect sizes between trials with and trials without exclusions were more pronounced in meta-analyses with high between trial heterogeneity, in meta-analyses with large estimated treatment benefits, and in meta-analyses of complementary medicine. Restriction of meta-analyses to trials without exclusions resulted in smaller estimated treatment benefits, larger P values, and considerable decreases in between trial heterogeneity.

Objective: Because of known significant seasonal fluctuations of iodine concentration in cow's milk (ICM) in Switzerland (winter=summer (w=s) ICM ratio averages 5.6), we looked for seasonal variations and familial aspects in urinary iodine and sodium concentrations (UIC, UNaC). Design: Prospective sequential cohort investigation. Setting: University hospital. Subjects: Thirteen children (six girls, seven boys) aged 3 -10 y and their parents (n ¼ 9) aged 30 -47 y. Interventions: The volunteers collected 1729 spot urine samples (5.1996 -5.1998). UIC data from winter (UIC w : DecemberFebruary) and summer seasons (UIC s : July -September) were compared with UNaC and average milk consumption. Iodine intakes from milk and salt were modelized. Results: Highest seasonal fluctuations of UIC were found in six pre-school children (w=s UIC group average ¼ 1.56, significant), followed by seven school children (w=s UIC group average ¼ 1.24, N.S.); none existed in adults. UIC=UNaC showed corresponding seasonal fluctuations in children, but not in adults. Winter milk was an important iodine source for children, as proven indirectly by similar seasonal fluctuations of ICM, UIC, UIC=UNaC and an important part within UIC due to milk. Conclusions: Contribution to UIC from milk intake during winter was high in children (40 -50%) and lower in adults (about 20%). Compared with children, dietary habits of adults are more complex and their iodine supply depends mainly on iodized salt and not on milk, so the effect of seasonal ICM variations on UIC is less marked. Because of significant seasonal UIC fluctuations in consumers of fresh milk products in Switzerland, results of future UIC studies conducted during summer and winter seasons should be compared cautiously, especially in young children. Furthermore, consumption of milk is to be promoted, since, besides calcium and vitamins, it is an essential source of iodine. UNaC determination should be included in epidemiologic studies if the dietary source of iodine is questioned. Sponsorship: This work was supported by grants from the University Hospital in Bern, the Swiss Federal Office of Public Health, the 'Swiss National Foundation for Scientific Research' (32-49424.96), the 'Fondation Genevoise de Bienfaisance V Rossi di Montelera', the 'Schweizerische Lebensversicherungs-und Rentenanstalt' and the 'Schüpbach Foundation of the University of Bern'. European Journal of Clinical Nutrition (2003) 57, 636 -646. doi:10.1038=sj.ejcn.1601590 Keywords: iodine; season; milk; child; diet; salt *Correspondence: C Als, Division of Clinical Chemistry, Inselspital, University of Bern, CH-3010 Bern, Switzerland. E-mail: claudine.als@insel.ch Guarantors: C Als, B Zimmerli and M Haldimann. Contributors: CA had the initial idea, wrote and coordinated the project over several years. CA and BZ wrote the manuscript. MH and BZ did the calculations and the statistical evaluations. MH did the analyses of urinary iodine in his laboratory. All contributors helped in planning the study, evaluating the results a...

In a representative cross-sectional study during 12 months of the years 2008/2009 in four abattoirs in Switzerland, lung and pleura lesions as well as lesions of slaughter carcasses and organs of 34 706 pigs were studied for frequency and type of macroscopic lesions. Of the 24276 examined pigs, 91.2% of the lungs, 94.4% of the heart and 95.5% of the livers showed no macroscopically visible lesions. Pigs that were produced for a label program had significantly less bronchopneumonia and pneumonia residuals, pleuritis and liver lesions due to echinococcosis. Pigs supervised by the Swiss Pig Health Service (SGD), showed significantly less bronchopneumonia and pneumonia residuals, diffuse pleuritis, pleuritis/pericarditis and milkspots compared to the non-SGD supervised farms. Thanks to the national eradication program for enzootic pneumonia (EP) and actinobacillosis, the health-status of lungs has been considerably improved and the prevalence of pleurisy decreased considerably. The results of this study indicate a good herd health in Swiss pig production.

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