ANZ journal of surgery
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ANZ journal of surgery · Apr 2007
Surgical repair followed by functional rehabilitation for acute and chronic achilles tendon injuries: excellent functional results, patient satisfaction and no reruptures.
We evaluated 46 patients who underwent surgical repair of the Achilles tendon at our institution during a 4.5-year period, followed by early weight bearing, aiming to assess their return to activities, rerupture rate and satisfaction. ⋯ We believe that surgical repair using this technique associated with an early return to protected full weight-bearing ambulation and an active early rehabilitation programme provides not only excellent functional results, patient satisfaction and a zero rerupture rate, but also much less morbidity in the first 3 months and a quicker overall recovery compared with non-operative treatment.
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ANZ journal of surgery · Apr 2007
Australian Endocrine Surgeons Guidelines AES06/01. Postoperative parathyroid hormone measurement and early discharge after total thyroidectomy: analysis of Australian data and management recommendations.
The risk of hypocalcaemia after thyroidectomy has traditionally mandated inpatient monitoring for signs and symptoms as well as frequent measurement of serum calcium levels. In recent years there has been much interest in the published work about the use of intact parathyroid hormone (PTH) to better predict hypocalcaemia after thyroidectomy. Although generally accurate, the use of intact parathyroid hormone in Australia has not become widespread. On behalf of the Australian Endocrine Surgeons an analysis of Australian data on the use of PTH levels to predict hypocalcaemia after thyroidectomy was carried out. The data were analysed with a view to making recommendations about the use of this test in clinical practice and the feasibility of achieving safe early discharge for patients. ⋯ Normal postoperative PTH levels accurately predict normocalcaemia after total or completion thyroidectomy. PTH levels should ideally be drawn 4 h postoperatively and patients with PTH in the normal range can be safely discharged on the first postoperative day. Use of oral calcium supplements, either as needed or routinely, will avoid mild symptoms that may develop in 7% without treatment.