The decision between imputing the domains or the EQ-5D-3L index scores depends on the observed missing data pattern and the sample size available for analysis. Analysts conducting this type of exercises should also evaluate the sensitivity of the analysis to the MAR assumption and whether the imputation model is correctly specified.

TURBT and/or RC specimens to a group of controls who did not have LVI on TURBT (34) or RC (32). RESULTSPatients with LVI present in their TURBT specimen had a shorter disease-specific survival than those without LVI, with a 5-year survival of 33.6% vs 62.9% (log-rank test P = 0.027; hazard ratio 2.21). LVI at TURBT varied with clinical stage ( P = 0.049). Patients with LVI and who were clinical stage I or II had lower survival than those without LVI ( P = 0.049; hazard ratio 2.68). LVI did not affect survival among those with clinical stage III or IV ( P = 0.29). There was a trend for patients with LVI at TURBT to be clinically understaged compared to those without LVI (75% vs 46%) but the difference was not significant ( P = 0.086). Patients with LVI detected in their RC specimen were significantly more likely to have cancer recurrence than were those with no evidence of LVI (48% vs 19%, P = 0.006). For the RC group there was also a significant difference in survival distribution between patients with evidence of LVI vs those without (5-year survival 45.5% vs 78.4%, P = 0.017). Those with LVI were significantly more likely to die from the disease than those without LVI ( P = 0.017; hazard ratio 2.92). CONCLUSIONSOur findings suggest that LVI is a histological feature that might be associated with a poorer prognosis in patients with urothelial carcinoma of the bladder. The presence of LVI in TURBT specimens predicts shorter survival for patients with stage I or II disease. The presence of LVI in RC specimens predicts recurrence of disease and shorter survival. Further studies are needed to determine whether this group of patients would benefit from early RC and/or perioperative chemotherapy to improve clinical outcomes. KEYWORDSbladder cancer, lymphatic metastasis, neoplasm staging, cystectomy Study Type -Prognosis (case series) Level of Evidence 4 OBJECTIVETo test the hypothesis that patients with bladder cancer who had evidence of lymphovascular invasion (LVI) in their transurethral resection of bladder tumour (TURBT) and radical cystectomy (RC) specimens would have a worse prognosis and higher likelihood of clinical understaging, and to assess the effect of LVI discovered at RC on subsequent diseaserelated mortality, as the prognostic significance of LVI in TURBT or RC specimens of patients treated for urothelial carcinoma of the bladder is not completely established. PATIENTS AND METHODSWe retrospectively reviewed the records of 163 patients with urothelial carcinoma of the bladder seen at our institution, and who had TURBT (69) or RC (94) between 1995 and 2005. We compared patients with LVI on

The purpose of this study was to determine the effects of sodium bicarbonate (NaHCO3) ingestion on intermittent running and subsequent performance. Eight healthy men volunteered to take part in the study. One hour after the ingestion of either NaHCO(3) or placebo (sodium chloride; NaCl) participants undertook 20 x 24-second runs on a motorized treadmill at the velocity eliciting maximal oxygen uptake (100% v-VO(2)max). After sprint 20 participants performed a run to volitional exhaustion at 120% v-VO(2)max. Capillary blood samples for blood pH, bicarbonate ([HCO(3)]), and lactate ([Bla]) concentration were taken pre and postingestion, every fifth sprint and after the performance run. After ingestion of NaHCO(3), blood [HCO(3)] increased from resting values (p < 0.05), and the increase in pH approached significance. Blood [HCO(3)(-)] continually decreased throughout intermittent exercise (p < 0.05) and decreased further after performance in both trials (p < 0.05). [Bla] was similar in both trials throughout intermittent exercise but was greater at exhaustion for NaHCO(3) (main effect for trial; p < 0.05). There was no significant difference in performance of the group between trials (78 +/- 22 and 75 +/- 22 seconds for NaHCO(3) and NaCl, respectively). The intercept of the relationships between [Bla] and [HCO(3)(-)] and between [Bla] and pH was greater during NaHCO(3) (p < 0.05), whereas the relationship between pH and [HCO(3)(-)] was unchanged (p > 0.05). The results of this study suggest that the ingestion of NaHCO(3) before intermittent type exercise was sufficient to induce metabolic alkalosis but did not significantly affect performance. However, because significant individual variations in performance were observed, an individual approach to bicarbonate ingestion is recommended based on the intensity and duration of the required performance.

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