Scand J Surg
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Multicenter Study
Intraoperative Complications and Mid-Term Follow-Up of Large-Diameter Head Metal-on-Metal Total Hip Arthroplasty and Hip Resurfacing Arthroplasty.
Large-diameter head total hip arthroplasty and hip resurfacing arthroplasty were popular in Finland from 2000 to 2012 for the treatment of hip osteoarthritis. The aim of this retrospective study was to investigate the mid-term survival of large-diameter head total hip arthroplasty patients operated on in three university hospitals and to compare these results to the survival of hip resurfacing arthroplasty patients. ⋯ The mid-term survival of both of these devices was poor, and revisions due to adverse reactions to metal debris will most likely rise at longer follow-up. There were more intraoperative complications in the large-diameter head total hip arthroplasty group than in the hip resurfacing arthroplasty group.
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Randomized Controlled Trial Multicenter Study Comparative Study
The Accuracy of the Computed Tomography Diagnosis of Acute Appendicitis: Does the Experience of the Radiologist Matter?
To assess the accuracy of computed tomography in diagnosing acute appendicitis with a special reference to radiologist experience. ⋯ The accuracy of computed tomography in diagnosing acute appendicitis was high. The experience of the radiologist did not improve the diagnostic accuracy. The results emphasize the role of computed tomography as an accurate modality in daily routine diagnostics for acute appendicitis in all clinical emergency settings.
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Randomized Controlled Trial Multicenter Study
Clinical Assessment of Fluid Balance is Incomplete for Colorectal Surgical Patients.
Fluid balance for the surgical patient has been proven very important for the postoperative outcome and development of complications. The aim of this study was to evaluate, for the first time in modern times, the accordance between nurse-based fluid charting (cumulated fluid balance) and body weight change for general surgical patients. ⋯ The accordance between cumulated fluid balance and body weight change for colorectal surgical patients is relatively good for the first four postoperative days, however, with large uncertainty, whereas on the fifth and sixth postoperative day, the discrepancy is statistically and clinically significant. The fluid chart cannot stand alone in interpretation of the patient's fluid balance; body weight and clinical judgment is indispensable.
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Multicenter Study
Intraoperative motive for performing a laparoscopic appendectomy on a postoperative histological proven normal appendix.
Diagnostic laparoscopy is the ultimate tool to evaluate the appendix. However, the intraoperative evaluation of the appendix is difficult, as the negative appendectomy rate remains 12%-18%. The aim of this study is to analyze the intraoperative motive for performing a laparoscopic appendectomy of an appendix that was proven to be noninflamed after histological examination. ⋯ In more than half of the microscopic healthy appendices, the surgeon was convinced of the diagnosis appendicitis during surgery. Intraoperative laparoscopic assessment of the appendix can be difficult.
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Multicenter Study
An 8-year follow-up study of 221 consecutive hip fracture patients in Finland: analysis of reoperations and their direct medical costs.
Some hip fracture patients need one or more reoperations because of complications following initial operative treatment. ⋯ Almost 10% of hip fracture patients required reoperations, and these reoperations caused significant direct costs to health care. However, direct costs account for only approximately 25% of the first year's total costs. These costs should be taken into account when evaluating the economics of hip fractures and the burden of health care.