***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Undernutrition and weight loss are important determinants of clinical outcome in older patients after hip fracture but the effectiveness of nutritional support programs in routine clinical practice remains controversial . AIMS OF THE PROJECT : To determine if oral nutritional supplements given daily for 28 days after hip fracture surgery could prevent weight loss and /or lead to improved clinical outcomes ( mortality rates , discharge destination , activities of daily living or length of hospital stay ) in non-malnourished community-dwelling older women with hip fracture . METHODS One hundred and nine women with BMI range 20 - 30 kg/m(2 ) were allocated to either nutritional supplements ( 352 kcal/day ) or usual hospital nutrition using a quasi-r and omisation technique . Body weight changes were monitored at 4 and 8 weeks and clinical outcomes were recorded at discharge and at 6 months . RESULTS No significant differences in weight change or clinical outcomes were seen between the two groups . Compliance with consuming the nutritional supplements was quite variable and there was a significant negative correlation between the amount of supplement consumed and subsequent weight change ( r=-0.36 , P=0.019 ) . CONCLUSIONS Poor compliance with oral nutritional supplements is an important determinant of the effectiveness of oral nutritional interventions in preventing weight loss after hip fracture . Whilst this may explain the lack of clinical improvements seen , our data do not support the routine use of oral nutritional supplements in non-malnourished hip fracture patients To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results AIMS To investigate whether a nutritional intervention in older women and men with femoral neck fracture had an effect on postoperative complications during hospitalization and on nutritional status at a four-month follow-up . METHODS The design was a r and omized controlled trial . The present study sample consisted of 157 patients aged 70 years and above with femoral neck fracture . The nutritional intervention included , among other things , a nutritional journal to detect nutrition deficiencies and protein-enriched meals for at least four days postoperatively . Further , at least two nutritional and protein drinks were served each day during the whole hospitalization and other factors that would influence the patient 's nutrition were also considered and dealt with . Postoperative complications were registered and patients were assessed using the Mini Nutritional Assessment ( MNA ) scale , including body mass index ( BMI ) , on admission and at a four-month follow-up . RESULTS Malnutrition was common and low MNA scores were associated with postoperative complications such as delirium and decubitus ulcers . There were significantly fewer days of delirium in the intervention group , seven patients in the intervention group developed decubitus ulcers vs. 14 patients in the control group and the total length of hospitalization was shorter . There were no detectable significant improvements regarding nutritional parameters between the intervention and the control group at the four-month follow-up but men improved their mean BMI , body weight and MNA scores in both the intervention and the control groups while women deteriorated in both groups . CONCLUSIONS Malnutrition was common among older people with hip fractures admitted to hospital . The nutritional intervention might have contributed to the patients suffering fewer days with delirium , fewer decubitus ulcers and shorter hospitalization but did not improve the long-term nutritional status , at least not in women . RELEVANCE TO CLINICAL PRACTICE This nutritional intervention , which was included in a multifactorial multidisciplinary intervention , is inexpensive and relatively easy to implement . It has significant effects on complications but no long-term effect on nutritional parameters , at least not in women AIM To evaluate the effects of a protein-rich liquid supplementation , alone or in combination with the anabolic steroid n and rolone decanoate , on body composition , activities of daily living ( ADL ) status and the health-related quality of life ( HRQoL ) after a femoral neck fracture . METHODS Sixty women , aged 83 + /- 5 years ( mean + /- SD ) , BMI < 24 kg/m2 ( 20.4 + /- 2 kg/m2 ) and capable of co-operating , with a femoral neck fracture treated with internal fixation , were r and omised to open treatment during 6 months with a protein-rich liquid formula alone ( PR , Fortimel , 200 ml/day , 20 g protein/day ) or in combination with n and rolone decanoate ( PR/N , Deca-Durabol 25 mg i.m./3 weeks ) or to a control group ( C ) . The patients were re-examined after 6 and 12 months regarding body weight ( BW ) , lean body mass ( LBM , DXA ) , ADL status according to Katz , HRQoL according to EQ 5-D and fracture healing . RESULTS LBM decreased in the C ( -1.2 + /- 2 kg ) and PR groups ( -1.2 + /- 1 kg ) but remained the same in the PR/N group ( 0.3 + /- 1 kg ) ( P < 0.05 between groups ) . ADL remained at a high level in the two intervention groups but declined significantly in the C group ( P < 0.005 between groups ) . The decline in HRQoL was least pronounced in the PR/N group at 6 months ( P < 0.05 between groups ) . Patients with fracture healing complications lost more BW ( P < 0.05 ) and LBM ( P < 0.01 ) than patients with uneventful fracture healing . CONCLUSION Protein-rich liquid supplementation in combination with n and rolone given for 6 months to lean elderly women after a femoral neck fracture may positively affect LBM , ADL and A double-blind comparative study of 1 alpha-OHD3 and placebo was performed on 37 patients with osteoporotic hip fracture without clinical osteomalacia .  1 alpha-OHD3 , in a dose of 1 microgram/day together with 2.5 g CaCO3 , did not heal osteoporosis as judged from determinations of bone mineral density and histomorphometric analyses during four months of treatment . However , 1 alpha-OHD3 seemed to have an effect on fracture healing as concluded from the posttreatment alkaline phosphatase level . Hypercalcemia was common , occurring in six out of 19 patients treated with 1 alpha-OHD3 . It is concluded that treatment of osteoporosis with 1 alpha-OHD3 and calcium is ineffective and potentially dangerous because it frequently causes hypercalcemia Twenty patients underwent simultaneous bilateral medial unicompartmental knee arthroplasty . Pre-operative hip-knee-ankle alignment and valgus stress radiographs were used to plan the desired post-operative alignment of the limb in accordance with established principles for unicompartmental arthroplasty . In each patient the planned alignment was the same for both knees . Overall , the mean planned post-operative alignment was to 2.3 degrees of varus ( 0 degrees to 5 degrees ) . The side and starting order of surgery were r and omised , using conventional instrumentation for one knee and computer-assisted surgery for the opposite side . The mean variation between the pre-operative plan and the achieved correction in the navigated and the non-navigated limb was 0.9 degrees ( sd 1.1 ; 0 degrees to 4 degrees ) and 2.8 degrees ( sd 1.4 ; 1 degrees to 7 degrees ) , respectively . Using the Wilcoxon signed rank test , we found the difference in variation statistically significant ( p < 0.001 ) . Assessment of lower limb alignment in the non-navigated group revealed that 12 ( 60 % ) were within + /- 2 degrees of the pre-operative plan , compared to 17 ( 87 % ) of the navigated cases . Computer-assisted surgery significantly improves the post-operative alignment of medial unicompartmental knee arthroplasty compared to conventional techniques in patients undergoing bilateral simultaneous arthroplasty . Improved alignment after arthroplasty is associated with better function and increased longevity In a double-blind trial , 194 ambulatory elderly patients ( mean age , 74 + /- 8 years ) recovering from acute illnesses were r and omly assigned to receive either ornithine oxoglutarate ( OGO ) or a placebo .  Nine subjects withdrew during the study , six in the OGO group and three in the placebo group .  OGO and the placebo were administered once daily at a dose of 10 g after lunch for 2 months ; the patients were monitored for a total of 4 months . Efficacy was evaluated in terms of nutritional variables , quality of life and total cost of medical treatment . The analysis involved a total of 185 patients ( 93 in the placebo group and 92 in the OGO group ) . The two groups were comparable at inclusion . After 30 and 60 days of treatment , there was a significant improvement in the following variables in the OGO group relative to the placebo group : appetite ( p < 0.001 ) , body weight ( p < 0.001 ) and independence ( p < 0.01 ) . Two months after the end of treatment , there was still a significant improvement in the quality -of-life index ( p < 0.001 ) and the medical-cost index ( p < 0.03 ) in the OGO group , with an overall cost saving of 37 % . We conclude that OGO seems to be a cost-effective nutritional supplement for elderly convalescent patients OBJECTIVE To investigate the short- and long-term effects of a multidisciplinary postoperative rehabilitation programme in patients with femoral neck fracture . DESIGN AND SUBJECTS A r and omized controlled trial in patients ( n = 199 ) with femoral neck fracture , aged > or= 70 years . METHODS The primary outcomes were : living conditions , walking ability and activities of daily living performance on discharge , 4 and 12 months postoperatively . The intervention consisted of staff education , individualized care planning and rehabilitation , active prevention , detection and treatment of postoperative complications . The staff worked in teams to apply comprehensive geriatric assessment , management and rehabilitation . A geriatric team assessed those in the intervention group 4 months postoperatively , in order to detect and treat any complications . The control group followed conventional postoperative routines . RESULTS Despite shorter hospitalization , significantly more people from the intervention group had regained independence in personal activities of daily living performance at the 4- and 12-month follow-ups ; odds ratios ( 95 % confidence interval ( CI ) ) 2.51 ( 1.00 - 6.30 ) and 3.49 ( 1.31 - 9.23 ) , respectively . More patients in the intervention group had also regained the ability to walk independently indoors without walking aids by the end of the study period , odds ratio ( 95 % confidence interval ) 3.01 ( 1.18 - 7.61 ) . CONCLUSION A multidisciplinary postoperative intervention programme enhances activities of daily living performance and mobility after hip fracture , from both a short-term and long-term perspective BACKGROUND Low-energy fractures of the hip , forearm , shoulder , and spine are known consequences of osteoporosis . OBJECTIVE We evaluated the effect of 1 y of treatment with calcium and vitamin D on bone mineral density ( BMD ) and bone markers in patients with a recent low-energy fracture . DESIGN In a double-blinded design , patients with fracture of the hip ( lower-extremity fracture , or LEF ) or upper extremity ( UEF ) were r and omly assigned to receive 3000 mg calcium carbonate + 1400 IU cholecalciferol or placebo ( 200 IU cholecalciferol ) . BMD of the hip ( HBMD ) and lumbar spine ( LBMD ) were evaluated by dual-energy X-ray absorptiometry , and physical performance was assessed by the timed Up & Go test . Serum concentrations of 25-hydroxycholecalciferol , parathyroid hormone ( PTH ) , telepeptide of type I collagen ( ICTP ) , osteocalcin , and N-terminal propeptide of collagen type I were measured . RESULTS A total of 122 patients were included ( 84 % women ; x + /- SD age : 70 + /- 11 y ) ; 68 % completed the study . In an intention-to-treat analysis , 
    Output:
    
Protein supplementation may have reduced the number of long term complications and days spent in rehabilitation wards .
While some evidence exists for the effectiveness of oral protein and energy feeds , overall the evidence for the effectiveness of nutritional supplementation remains weak .