Dan Med Bull
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To determine the value of "Low Back Pain Rating Scale" as a postal questionnaire, a retrospective study was undertaken of patients who had undergone first-time lumbar disc surgery 14-72 months previously. Rate of response was 86% (261/304). ⋯ Thirty-seven patients were receiving pensions in the postoperative period due to continued back pain. "Low Back Pain Rating Scale" used as a postal questionnaire was found to be useful in determining general overall assessment status in patients who had undergone lumbar surgery. This evaluation method could be used as a quality control in future studies regarding this patient group.
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Comparative Study
Doctor and patient characteristics as modifiers of the effect of a changing remuneration system in general practice.
The objectives of the study was to investigate the effects on general practitioners' activities of a change in their remuneration system from a capitation-based system to a mixed fee-per-item and capitation-based system. It was our hypothesis that the effect of the change in remuneration varied between subgroups of doctors and patients as a result of the modifying effect of the doctors' age, sex, practice facilities, assistance, side jobs, and size of practice as well as patients' age, sex, and diagnostic group. The study was carried out as a follow-up with data collected from contact sheets completed by general practitioners in one period before a change in remuneration and two periods after. ⋯ The general increases in diagnostic and curative activities and reductions in referrals by general practitioners as a result of the change were found to be quite similar across subgroups of doctors and patients. While, total contact rates changed little, the sex of doctors showed a modifying effect: male doctors tended to increase their contact rates compared to female doctors. This tendency was most prominent among female patients with non-infectious diseases.
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Randomized Controlled Trial Clinical Trial
Surgical wound dressing in outpatient paediatric surgery. A randomised study.
A comparison of two different wound dressings was carried out in a series of 88 paediatric patients. The patients were randomised to either Steristrip plus Cutiplast, a conventional absorbent wound dressing, or to DuoDERM, an occlusive adhesive dressing. The study, set up to show which was the most convenient dressing for minor outpatient surgery, focused on the psychological aspects of operative treatment of infants and children. ⋯ Significantly less pain was experienced on removal of the wound dressing in the DuoDERM group. When dressed with DuoDERM, children could be bathed in the immediate postoperative period without complication. In conclusion, an occlusive wound dressing (DuoDERM) seems to minimize the physical and psychological trauma to the infant or child and reduce the disruption to the child's and the parents' daily routines.
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Review Comparative Study
Hypothermic patients admitted to an intensive care unit: a fifteen year survey.
In the period 1975-1989, 620 (4.5%) of 13,645 patients admitted to the intensive care unit of a Danish university hospital were diagnosed as suffering from hypothermia. The aim of the retrospective survey carried out is to describe this group of patients and to evaluate the methods used for rewarming. The degree of hypothermia was mild in 554 of the patients, moderate in 60, and severe in six. ⋯ The mortality rate showed no relationship to the hypothermia. With the exception of extracorporal circulation, the rewarming and mortality rates did not differ from the results shown in studies carried out using active and invasive rewarming procedures. In conclusion, with the exception of extracorporal circulation, rewarming of hypothermic patients by preservation of the endogenous heat production seems as effective as active and invasive rewarming methods.
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Activation and inhibition of the haemostatic system was reviewed including the interaction between the four biological systems involved in haemostasis: the vessel wall, the platelets, the coagulation system and the fibrinolytic system. The haemostatic mechanism is initiated at the site of injury through local activation of surfaces and release of tissue thromboplastin, resulting in formation and deposition of fibrin. The coagulation process is regulated by physiological anticoagulants. ⋯ Haemorrhagic complications to oral surgery in patients without known defects of the coagulation system is reviewed. It is concluded that the investigations conducted to the present day do not permit final conclusions with respect to the pathophysiological role of defects in the coagulation and the fibrinolytic systems for the development of bleeding after oral surgery. Further investigations are necessary in order to clarify these aspects, and should include extensive laboratory analyses to reveal rare congenital defects such as factor XIII- and alpha 2-antiplasmin deficiencies.(ABSTRACT TRUNCATED AT 400 WORDS)