Dan Med Bull
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Randomized Controlled Trial
No effect of steroids on seroma formation after mastectomy.
Seroma formation is a common problem after breast surgery. Studies indicate that seroma formation is a result of the postoperative inflammatory process. Glucocorticoid inhibits the inflammatory response. ⋯ Injection of a bolus of 125 mg of methylprednisolone sodium succinate before mastectomy did not reduce drainage volume or seroma formation. If intravenous glucocorticoid did have an effect, the case material was too small to prove it.
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The positive outcomes of coordination of healthcare services are to an increasing extent becoming clear. However the complexity of the field is an inhibiting factor for vigorously designed trial studies. Conceptual clarity and a consistent theoretical frame-work are thus needed. ⋯ However caution must be advised before making concrete conclusions due to the complexity of the matter and until more studies have been conducted. With this thesis an initial step has been taken into a new research field. Ongoing research will make it possible to deliver the evidence needed by decision makers, planners and managers - ultimately to benefit the patients.
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Practice Guideline
Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults.
The nationwide Danish Hernia Database, recording more than 10,000 inguinal and 400 femoral hernia repairs annually, provides a unique opportunity to present valid recommendations in the management of Danish patients with groin hernia. The cumulated data have been discussed at biannual meetings and guidelines have been approved by the Danish Surgical Society. Diagnosis of groin hernia is based on clinical examination. ⋯ In the early convalescence period there are no physical restrictions. These guidelines will also be available at the website for the Danish Hernia Database (www.herniedatabasen.dk). The guidelines will be updated when new substantial evidence becomes available.