SUMMARYBackground: Nutcracker oesophagus is characterized by high-amplitude oesophageal contractions. Recent data have shown a high prevalence of gastro-oesophageal acid reflux in patients with nutcracker oesophagus and, in open-label trials, patients seemed to benefit from acid suppression. Therefore, it has been suggested that noncardiac chest pain in patients with nutcracker oesophagus may be related to reflux rather than to the motor abnormality itself. Aims: To investigate the effect of intensive acid-suppressive treatment on chest pain in patients with nutcracker oesophagus. Methods: Nineteen patients with nutcracker oesophagus received lansoprazole or placebo in a double-blind, randomized, cross-over study.

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Background Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross‐disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person‐centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies. Method In order to develop and test the roadmap, a COST Action project was initiated: COST−CARES, with 28 participating countries. This paper provides an overview of evidence about the effects of each of the identified enablers. Intersections between the drivers and the enablers are identified as critical for the success of future cost containment, in tandem with maintained or improved quality in healthcare. This will require further exploration through testing. Conclusion Cost containment of future healthcare, with maintained or improved quality, needs to be addressed through a concerted approach of testing key factors. We propose a framework for test lab design based on these drivers and enablers in different European countries.

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Esophageal reflux is common in patients with UA and established CAD. As reflux-related chest pain may imitate angina pectoris, it is clinically important that gastroesophageal examination in patients with UA seems to be feasible and well tolerated in the 'acute setting'.

10534 Background: There is insufficient evidence on the associations between cardiorespiratory fitness (CRF), body mass index (BMI), and site-specific cancer mortality. Methods: We collected data on all men who underwent military conscription 1968-2005 in Sweden at ages 16-25. CRF was assessed as maximal aerobic workload on a cycle ergometer test and classified as low, moderate, or high. BMI (kg/m2) was classified as underweight ( < 18.5), normal weight (18.5-24.9), overweight (25-29.9), or obesity (≥30). Data was cross-linked on individual level through the Swedish identification number with national registers with high validity for information on cancer mortality. Follow-up was from conscription until death, emigration, or end of follow-up (12/31/2019). Cox regression analyses included CRF and BMI as well as age, year, and site of conscription, parental education, and muscle strength. Primary analyses tested linear trends for CRF and BMI, with effect sizes for categorical comparisons for interpretation. Results: 1,083,738 men were included in the analyses and were followed for a mean of 33 years, during which 8,912 cancer-specific deaths occurred. Lower CRF and higher BMI were linearly associated with any cancer mortality as well as with several site-specific cancer mortalities (table). However, death in some major cancer sites (prostate, CNS) were not associated with CRF or BMI and higher CRF was associated with higher mortality from malignant skin cancer. Conclusions: Higher CRF and lower BMI was associated with lower cancer mortality for some, but not all cancer sites. These results could be used as a further incentive for working with modifiable risk factors in public health. [Table: see text]

Rationale: More research is needed to uncover the effectiveness of combined strength and foam-rolling interventions to prevent running-related injuries.Objectives: To evaluate effectiveness of an 18-week general strength and foamrolling intervention on the incidence of running-related injuries. Method: This is an 18-week observational comparative study. A total of 433 recreational runners participated (n = 203 female). The intervention group (n = 228) performed general strength and foam-rolling exercises twice weekly for 18 weeks, the control group (n = 205) maintained their regular training habits. Running volume and running-related pain were reported weekly. Secondary analyses were performed on the subgroups of the intervention group based on compliance; low compliance (n = 100), intermediate compliance (n = 63), and high compliance(n = 65). Cumulative incidence proportions were calculated and time-to-event statistics were performed to compare survival times between groups. Univariate cox proportional hazards ratio was calculated to estimate the risk of runningrelated injuries at 18 weeks.Results: A total of 100 running-related injuries were sustained. The cumulative incidence proportion for the control and intervention groups was 27.1% (95% CI: 21.4-33.9) and 23.0% (95% CI: 17.8-29.4), respectively. No statistically significant difference was found between the overall intervention group and control group (log-rank p = 0.31). A significant difference existed between the high-compliance subgroup and the control group (log-rank p = 0.00). Highly compliant runners were 85% less likely (hazard rate ratio = 0.15; 95% CI: 0.05-0.46) to sustain an injury during the study compared with controls. Conclusion:Recreational runners highly compliant with the intervention were 85% less likely and took on average 57 days longer to sustain a running-related injury when compared with controls, with a cumulative incidence proportion of 4.6% after 18 weeks.