Danish medical journal
-
Danish medical journal · Jul 2012
ReviewClavicle fractures may be conservatively treated with acceptable results - a systematic review.
The optimal treatment of acute, displaced midshaft clavicle fractures is controversial. Despite lack of compelling evidence towards superior results after primary surgery, it seems that more and more patients are treated surgically. The aim of this study was to investigate which treatment modality should be preferred in this population according to current literature. ⋯ Surgical treatment of acute, displaced midshaft clavicle fractures with a plate yields a better functional outcome and lower mal- and nonunion rates than conservative treatment. However, the clinical relevance of the observed functional benefits are questionable as is the use of the shoulder outcome scores frequently employed to assess the functional outcome of clavicle fracture treatment. When operative treatment is preferred, the number needed to treat to avoid a nonunion is high.
-
Danish medical journal · Jul 2012
ReviewStaging of women with breast cancer after introduction of sentinel node guided axillary dissection.
Today, sentinel lymph node dissection (SLND) has replaced axillary lymph node dissection (ALND) as standard procedure for staging of the axilla in the treatment of breast cancer. SLND can accurately stage the axilla by removing on average only two lymph nodes. Only in case of metastatic spread to sentinel nodes an ALND is offered. ⋯ Accordingly, there is a trend towards omission of ALND in breast cancer patients with minimal metastatic disease in sentinel node. As a result, a tool is needed to identify a group of patients with high risk of recurrence, where ALND should still be offered. In our model a small group of patients with micrometastases had a high risk of NSN metastases on nearly 40%, comparable to patients with macrometastases, indicating that ALND may still be recommended in this subgroup in the future.
-
Danish medical journal · Jul 2012
Cumulated Ambulation Score to evaluate mobility is feasible in geriatric patients and in patients with hip fracture.
Regaining basic mobility independence is considered important for elderly hospitalised patients. The Cumulated Ambulation Score (CAS) is a valid tool for evaluating these patients' basic mobility (getting in and out of bed, sit-to-stand from a chair and walking) in orthopaedic wards, and its use is recommended in Denmark for patients with hip fracture. The aims of the present study were to evaluate the feasibility of the CAS in a geriatric ward and to describe its use after hip fracture in Denmark. ⋯ In geriatric wards, the CAS is a feasible tool for evaluating all patients' basic mobility, and we recommend that it be used in other settings and at all hospitals treating patients with hip fracture.
-
Danish medical journal · Jul 2012
There is room for improvement in the prevention and treatment of headache after lumbar puncture.
The incidence of post dural puncture headache (PDPH) after lumbar puncture (LP) can be reduced from 36% to 0-9% by use of an atraumatic needle size 24 gauge (G)/0.56 mm rather than a traumatic needle size 22 G/0.7 mm. The evidence supporting some of the prophylactic and therapeutically treatments of PDPH is sparse. The objective of this study was to clarify which needles doctors at neurological departments in Denmark use for LP and how they treat and prevent PDPH. ⋯ Atraumatic needles for LP have not become standard in Danish neurological departments. Knowledge about the treatment and prevention of PDPH seems insufficient.
-
Danish medical journal · Jul 2012
Periodic fever associated with aphthous stomatitis, pharyngitis and cervical adenitis.
The periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is a non-hereditary idiopathic febrile syndrome belonging to the group of autoinflammatory diseases. PFAPA does not cause long-lasting sequelae. An early diagnosis provides treatment possibilities for the patient and comfort to the family. ⋯ not relevant.