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1643 records – page 1 of 165.

5-aminosalicylic acid dependency in Crohn's disease: a Danish Crohn Colitis Database study.

https://arctichealth.org/en/permalink/ahliterature138932
Source
J Crohns Colitis. 2010 Nov;4(5):575-81
Publication Type
Article
Date
Nov-2010
Author
Dana Duricova
Natalia Pedersen
Margarita Elkjaer
Jens K Slott Jensen
Pia Munkholm
Author Affiliation
Clinical and Research Center for Inflammatory Bowel Disease, ISCARE a.s. and Charles University in Prague, Czech Republic. dana.duricova@seznam.cz
Source
J Crohns Colitis. 2010 Nov;4(5):575-81
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Crohn Disease - drug therapy
Denmark
Drug Utilization
Female
Hospitals, University
Humans
Male
Mesalamine - therapeutic use
Middle Aged
Phenotype
Retrospective Studies
Sex Factors
Time Factors
Treatment Outcome
Young Adult
Abstract
The role of 5-aminosalicylic acid (5-ASA) in Crohn's disease is unclear. The outcome of the first course of 5-ASA monotherapy with emphasis on 5-ASA dependency was retrospectively assessed in consecutive cohort of 537 Crohn's disease patients diagnosed 1953-2007.
Following outcome definitions were used: Immediate outcome (30 days after 5-ASA start) defined as complete/partial response (total regression/improvement of symptoms) and no response (no regression of symptoms with a need of corticosteroids, immunomodulator or surgery). Long-term outcome defined as prolonged response (still in complete/partial response 1 year after induction of response); 5-ASA dependency (relapse on stable/reduced dose of 5-ASA requiring dose escalation to regain response or relapse =1 year after 5-ASA cessation regaining response after 5-ASA re-introduction).
One hundred sixty-five (31%) patients had monotherapy with 5-ASA. In 50% 5-ASA monotherapy was initiated =1 year after diagnosis (range 0-49 years). Complete/partial response was obtained in 75% and no response in 25% of patients. Thirty-six percent had prolonged response, 23% developed 5-ASA dependency and 38% were non-responders in long-term outcome. Female gender had higher probability to develop prolonged response or 5-ASA dependency (OR 2.89, 95%CI: 1.08-7.75, p=0.04). The median duration (range) of 5-ASA monotherapy was 34 months (1-304) in prolonged responders, 63 (6-336) in 5-ASA dependent and 2 (0-10) in non-responders.
A selected phenotype of Crohn's disease patients may profit from 5-ASA. Fifty-nine percent of patients obtained long-term benefit with 23% becoming 5-ASA dependent. Prospective studies are warranted to assess the role of 5-ASA in Crohn's disease.
PubMed ID
21122562 View in PubMed
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The 24-hour urine collection: gold standard or historical practice?

https://arctichealth.org/en/permalink/ahliterature155561
Source
Am J Obstet Gynecol. 2008 Dec;199(6):625.e1-6
Publication Type
Article
Date
Dec-2008
Author
Anne-Marie Côté
Tabassum Firoz
André Mattman
Elaine M Lam
Peter von Dadelszen
Laura A Magee
Author Affiliation
Department of Nephrology, University of Sherbrooke, Sherbrooke, PQ, Canada.
Source
Am J Obstet Gynecol. 2008 Dec;199(6):625.e1-6
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Adult
Biological Markers - urine
British Columbia
Cohort Studies
Creatinine - urine
Female
Gynecology - standards
Hospitals, University
Humans
Hypertension - diagnosis - urine
Pre-Eclampsia - diagnosis - urine
Pregnancy
Pregnancy Complications, Cardiovascular - diagnosis - urine
Pregnancy outcome
Prenatal Care - standards
Reference Standards
Retrospective Studies
Sensitivity and specificity
Time Factors
Urinalysis - standards
Young Adult
Abstract
The objective of the study was to determine completeness of 24-hour urine collection in pregnancy.
This was a retrospective laboratory/chart review of 24-hour urine collections at British Columbia Women's Hospital. Completeness was assessed by 24-hour urinary creatinine excretion (UcreatV): expected according to maternal weight for single collections and between-measurement difference for serial collections.
For 198 randomly selected pregnant women with a hypertensive disorder (63% preeclampsia), 24-hour urine collections were frequently inaccurate (13-54%) on the basis of UcreatV of 97-220 micromol/kg per day (11.0-25.0 mg/kg per day) or 133-177 micromol/kg per day (15.1-20.1 mg/kg per day) of prepregnancy weight (respectively). Lean body weight resulted in more inaccurate collections (24-68%). The current weight was frequently unavailable (28%) and thus not used. For 161 women (81% proteinuric) with serial 24-hour urine levels, a median [interquartile range] of 11 [5-31] days apart, between-measurement difference in UcreatV was 14.4% [6.0-24.9]; 40 women (24.8%) had values 25% or greater, exceeding analytic and biologic variation.
Twenty-four hour urine collection is frequently inaccurate and not a precise measure of proteinuria or creatinine clearance.
PubMed ID
18718568 View in PubMed
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Academic vascular unit collaboration with advertising agency yields higher compliance in screening for abdominal aortic aneurysm.

https://arctichealth.org/en/permalink/ahliterature263583
Source
J Med Screen. 2014 Dec;21(4):216-8
Publication Type
Article
Date
Dec-2014
Author
Moncef Zarrouk
Anders Gottsäter
Martin Malina
Jan Holst
Source
J Med Screen. 2014 Dec;21(4):216-8
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Advertising as Topic - economics
Aortic Aneurysm, Abdominal - ultrasonography
Cooperative Behavior
Hospitals, University
Humans
Odds Ratio
Patient compliance
Sweden
Abstract
To improve compliance with abdominal aortic aneurysm (AAA) screening in low compliance areas, individually tailored invitations were developed in collaboration with a professional advertising agency. Compliance increased in two intervention municipalities from 71.4% in 2010-2012 to 78.1% in 2013 (p?=?0.025), and was then higher [odds ratio 1.7; 95% confidence interval 1.1-2.6; p?=?0.013] than in two control municipalities in which compliance was unchanged (417/552 [75.5%] in 2010-12 and 122/180 [67.8%] in 2013). Compliance with AAA-screening can be increased by collaboration with a professional advertising agency, albeit at a comparably high cost.
PubMed ID
25118161 View in PubMed
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Acceptability and profile of the clinical drug trials underway in Finnish university hospitals in the 1990s: applications reviewed by ethics committees.

https://arctichealth.org/en/permalink/ahliterature192044
Source
Methods Find Exp Clin Pharmacol. 2001 Sep;23(7):415-23
Publication Type
Article
Date
Sep-2001
Author
T. Keinonen
S. Nieminen
V. Saareks
V. Saano
P. Ylitalo
Author Affiliation
Department of Pharmacology and Toxicology, University of Kuopio, Finland. tuija.keinonen@medfiles.fi
Source
Methods Find Exp Clin Pharmacol. 2001 Sep;23(7):415-23
Date
Sep-2001
Language
English
Publication Type
Article
Keywords
Clinical Protocols - standards
Clinical Trials Data Monitoring Committees - statistics & numerical data
Clinical Trials as Topic - standards - statistics & numerical data
Ethics Committees, Research - statistics & numerical data
Finland
Hospitals, University - statistics & numerical data
Humans
Informed Consent - statistics & numerical data
Multicenter Studies as Topic - statistics & numerical data
Patient Selection
Practice Guidelines as Topic
Research Design - standards - statistics & numerical data
Retrospective Studies
Abstract
There is scarce information in literature about the decisions made by ethics committees concerning the clinical studies they have reviewed. A retrospective, detailed review of 666 applications, their amendments and the ethics committees' statements was undertaken. All protrocols of clinical studies on medicinal products submitted to and reviewed by the ethics committees of two university hospitals during the years 1992, 1994, 1996 and 1998 were investigated. Most of the studies were international (50%), multicenter (71%), phase III trials (41%) on a new clinical entity, (38%). Validity of the clinical drug study applications was acceptable in more than half of the cases (364; 55%), while 91 (14%) were approved with advisory comments, 153 (23%) had to be amended, 35 (5%) were left pending and 23 (3%) were rejected. Most of the questions pertained to informed consent and the study protcol. In accordance with precious results, our findings support the opinion that the submitted documents need to be improved, especially with regard to informed consent and study protocols, in order to gain better Good Clinical Practice (GCP) compliance. Well-defined, documented operating procedures of the ethics committees would have facilitated the practical issues in the review process.
PubMed ID
11771857 View in PubMed
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Accuracy and quality in the nursing documentation of pressure ulcers: a comparison of record content and patient examination.

https://arctichealth.org/en/permalink/ahliterature77064
Source
J Wound Ostomy Continence Nurs. 2004 Nov-Dec;31(6):328-35
Publication Type
Article
Author
Gunningberg Lena
Ehrenberg Anna
Author Affiliation
Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden. lena.gunningberg@akademiska.se
Source
J Wound Ostomy Continence Nurs. 2004 Nov-Dec;31(6):328-35
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Documentation - standards
Female
Health services needs and demand
Hospitals, University
Humans
Male
Middle Aged
Nursing Assessment - standards
Nursing Audit
Nursing Evaluation Research
Nursing Records - standards
Observer Variation
Physical Examination - nursing - standards
Practice Guidelines
Pressure Ulcer - diagnosis - epidemiology - nursing
Prevalence
Retrospective Studies
Risk assessment
Severity of Illness Index
Sweden - epidemiology
Abstract
OBJECTIVE: To determine the accuracy and describe the quality of nursing documentation of pressure ulcers in a hospital care setting. DESIGN: A cross-sectional survey was used comparing retrospective audits of nursing documentation of pressure ulcers to previous physical examinations of patients. SETTING AND SUBJECTS: All inpatient records (n = 413) from February 5, 2002, at the surgical/orthopedic (n = 144), medical (n = 182), and geriatric (n = 87) departments of one Swedish University hospital. INSTRUMENTS: The European Pressure Ulcer Advisory Panel data collection form and the Comprehensiveness In Nursing Documentation. METHODS: All 413 records were reviewed for presence of notes on pressure ulcers; the findings were compared with the previous examination of patients' skin condition. Records with notes on pressure ulcers (n = 59) were audited using the European Pressure Ulcer Advisory Panel and Comprehensiveness In Nursing Documentation instruments. RESULTS: The overall prevalence of pressure ulcers obtained by audit of patient records was 14.3% compared to 33.3% when the patients' skin was examined. The lack of accuracy was most evident in the documentation of grade 1 pressure ulcers. The quality of the nursing documentation of pressure ulcer (n = 59) was generally poor. CONCLUSIONS: Patient records did not present valid and reliable data about pressure ulcers. There is a need for guidelines to support the care planning process and facilitate the use of research-based knowledge in clinical practice. More attention must be focused on the quality of clinical data to make proper use of electronic patient records in the future.
PubMed ID
15867708 View in PubMed
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Accuracy, completeness and comprehensiveness of information on pressure ulcers recorded in the patient record.

https://arctichealth.org/en/permalink/ahliterature124061
Source
Scand J Caring Sci. 2013 Mar;27(1):84-91
Publication Type
Article
Date
Mar-2013
Author
Asta Thoroddsen
Guðrún Sigurjónsdóttir
Margareta Ehnfors
Anna Ehrenberg
Author Affiliation
School of Health and Medical Sciences, Örebro University, Örebro, Sweden. astat@hi.is
Source
Scand J Caring Sci. 2013 Mar;27(1):84-91
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Cross-Sectional Studies
Hospitals, University
Humans
Iceland
Information Services
Medical Records
Pilot Projects
Pressure Ulcer
Abstract
To describe the accuracy, completeness and comprehensiveness of information on pressure ulcers documented in patient records.
A cross-sectional descriptive study performed in 29 wards at a university hospital in Iceland. The study included skin assessment of patients and retrospective audits of records of patients identified with pressure ulcers.
A sample of 219 patients was inspected for signs of pressure ulcers on 1 day in 2008. Records of patients identified with pressure ulcers were audited (n = 45) retrospectively.
The prevalence of pressure ulcers was 21%. Information in patient records lacked accuracy, completeness and comprehensiveness. Only 60% of the identified pressure ulcers were documented in the patient records. The lack of accuracy was most prevalent for stage I pressure ulcers.
The purpose of documentation to record, communicate and support the flow of information in the patient record was not met. The patient records lacked accuracy, completeness and comprehensiveness, which can jeopardise patient safety, continuity and quality of care. The information on pressure ulcers in patient records was found not to be a reliable source for the evaluation of quality in health care. To improve accuracy, completeness and comprehensiveness of data in the patient record, a systematic risk assessment for pressure ulcers and assessment and treatment of existing pressure ulcers based on evidence-based guidelines need to be implemented and recorded in clinical practice. Health information technology, including the electronic health record with decision support, has shown promising results to facilitate and improve documentation of pressure ulcers.
PubMed ID
22630335 View in PubMed
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Accuracy in the recording of pressure ulcers and prevention after implementing an electronic health record in hospital care.

https://arctichealth.org/en/permalink/ahliterature155835
Source
Qual Saf Health Care. 2008 Aug;17(4):281-5
Publication Type
Article
Date
Aug-2008
Author
L. Gunningberg
M Fogelberg Dahm
A. Ehrenberg
Author Affiliation
Surgery Division, Uppsala University Hospital, Uppsala, Sweden. lena.gunningberg@akademiska.se
Source
Qual Saf Health Care. 2008 Aug;17(4):281-5
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Data Collection - methods - standards
Hospitals, University
Humans
Medical Records Systems, Computerized
Pressure Ulcer - epidemiology - prevention & control
Prevalence
Retrospective Studies
Sweden
Abstract
To compare the accuracy in recording of pressure-ulcer prevalence and prevention before and after implementing an electronic health record (EHR) with templates for pressure-ulcer assessment.
All inpatients at the departments of surgery, medicine and geriatrics were inspected for the presence of pressure ulcers, according to the European Pressure Ulcer Advisory Panel-methodology, during 1 day in 2002 (n = 357) and repeated in 2006 (n = 343). The corresponding patient records were audited retrospectively for the presence of documentation on pressure ulcers.
In 2002, the prevalence of pressure ulcers obtained by auditing paper-based patient records (n = 413) was 14.3%, compared with 33.3% in physical inspection (n = 357). The largest difference was seen in the geriatric department, where records revealed 22.9% pressure ulcers and skin inspection 59.3%. Four years later, after the implementation of the EHR, there were 20.7% recorded pressure ulcers and 30.0% found by physical examination of patients. The accuracy of the prevalence data had improved most in the geriatric department, where the EHR showed 48.1% and physical examination 43.2% pressure ulcers. Corresponding figures in the surgical department were 22.2% and 14.1%, and in the medical department 29.9% and 10.2%, respectively. The patients received pressure-reducing equipment to a higher degree (51.6%) than documented in the patient record (7.9%) in 2006.
The accuracy in pressure-ulcer recording improved in the EHR compared with the paper-based health record. However, there were still deficiencies, which mean that patient records did not serve as a valid source of information on pressure-ulcer prevalence and prevention.
PubMed ID
18678726 View in PubMed
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Accuracy of coding for possible warfarin complications in hospital discharge abstracts.

https://arctichealth.org/en/permalink/ahliterature173437
Source
Thromb Res. 2006;118(2):253-62
Publication Type
Article
Date
2006
Author
T. Arnason
P S Wells
C. van Walraven
A J Forster
Author Affiliation
Ottawa Health Research Institute-Clinical Epidemiology Program, Canada.
Source
Thromb Res. 2006;118(2):253-62
Date
2006
Language
English
Publication Type
Article
Keywords
Anticoagulants - therapeutic use
Canada
Hemorrhage - complications
Hospitals, University
Humans
International Classification of Diseases
Medical Records
Reproducibility of Results
Retrospective Studies
Thromboembolism - complications
Warfarin - therapeutic use
Abstract
Hospital discharge abstracts could be used to identify complications of warfarin if coding for bleeding and thromboembolic events are accurate.
To measure the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9CM) codes for bleeding and thromboembolic diagnoses.
University affiliated, tertiary care hospital in Ottawa, Canada.
A random sample of patients discharged between September 1999 and September 2000 with an ICD-9-CM code indicating a bleeding or thromboembolic diagnosis.
Gold-standard coding was determined by a trained chart abstractor using explicit standard diagnostic criteria for bleeding, major bleeding, and acute thromboembolism. The abstractor was blinded to the original coding. We calculated the sensitivity, specificity, positive, and negative predictive values of the original ICD-9CM codes for bleeding or thromboembolism diagnoses.
We reviewed 616 medical records. 361 patients (59%) had a code indicating a bleeding diagnosis, 291 patients (47%) had a code indicating a thromboembolic diagnosis and 36 patients (6%) had a code indicating both. According to the gold standard criteria, 352 patients experienced bleeding, 333 experienced major bleeding, and 188 experienced an acute thromboembolism. For bleeding, the ICD-9CM codes had the following sensitivity, specificity, positive and negative predictive values [95% CI]: 93% [90-96], 88% [83-91], 91% [88-94], and 91% [87-94], respectively. For major bleeding, the ICD-9CM codes had the following sensitivity, specificity, positive and negative predictive values: 94% [91-96], 83% [78-87], 87% [83-90], and 92% [88-95], respectively. For thromboembolism, the ICD-9CM codes had the following sensitivity, specificity, positive and negative predictive values: 97% [94-99], 74% [70-79], 62% [57-68], and 98% [96-99], respectively. By selecting a sub-group of ICD-9CM codes for thromboembolism, the positive predictive value increased to 87%.
In our centre, the discharge abstract could be used to identify and exclude patients hospitalized with a major bleed or thromboembolism. If coding quality for bleeding is similar in other hospitals, these ICD-9-CM diagnostic codes could be used to study population-based warfarin-associated hemorrhagic complications using administrative databases.
PubMed ID
16081144 View in PubMed
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Achieving therapeutic clarity in assisted personal body care: professional challenges in interactions with severely ill COPD patients.

https://arctichealth.org/en/permalink/ahliterature155622
Source
J Clin Nurs. 2008 Aug;17(16):2155-63
Publication Type
Article
Date
Aug-2008
Author
Kirsten Lomborg
Marit Kirkevold
Author Affiliation
Department of Nursing Science, Institute of Public Health, Aarhus University, Aarhus, Denmark. kl@nursingscience.au.dk
Source
J Clin Nurs. 2008 Aug;17(16):2155-63
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Adaptation, Psychological
Adult
Attitude of Health Personnel
Baths - nursing - psychology
Clinical Competence
Communication
Denmark
Dyspnea - etiology
Helping Behavior
Hospitals, University
Humans
Middle Aged
Negotiating - psychology
Nurse's Role - psychology
Nurse-Patient Relations
Nursing Methodology Research
Nursing Staff, Hospital - education - organization & administration - psychology
Patient Care Planning - organization & administration
Patient Participation - methods - psychology
Pulmonary Disease, Chronic Obstructive - nursing - psychology
Qualitative Research
Questionnaires
Severity of Illness Index
Abstract
This paper aims to present a theoretical account of professional nursing challenges involved in providing care to patients suffering from chronic obstructive pulmonary disease. The study objectives are patients' and nurses' expectations, goals and approaches to assisted personal body care.
The provision of help with body care may have therapeutic qualities but there is only limited knowledge about the particularities and variations in specific groups of patients and the nurse-patient interactions required to facilitate patient functioning and well-being. For patients with severe chronic obstructive pulmonary disease, breathlessness represents a particular challenge in the performance of body care sessions.
We investigated nurse-patient interactions during assisted personal body care, using grounded theory with a symbolic interaction perspective and a constant comparative method.
Twelve cases of nurse-patient interactions were analysed. Data were based on participant observation, individual interviews with patients and nurses and a standardized questionnaire on patients' breathlessness.
Nurses and patients seemed to put effort into the interaction and wanted to find an appropriate way of conducting the body care session according to the patients' specific needs. Achieving therapeutic clarity in nurse-patient interactions appeared to be an important concern, mainly depending on interactions characterized by: (i) reaching a common understanding of the patient's current conditions and stage of illness trajectory, (ii) negotiating a common scope and structuring body care sessions and (iii) clarifying roles.
It cannot be taken for granted that therapeutic qualities are achieved when nurses provide assistance with body care. If body care should have healing strength, the actual body care activities and the achievement of therapeutic clarity in nurses' interaction with patients' appear to be crucial.
The paper proposes that patients' integrity and comfort in the body care session should be given first priority and raises attention to details that nurses should take into account when assisting severely ill patients.
PubMed ID
18710375 View in PubMed
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Acute Achilles tendon rupture: a questionnaire follow-up of 487 patients.

https://arctichealth.org/en/permalink/ahliterature122895
Source
J Bone Joint Surg Am. 2012 Jul 3;94(13):1229-33
Publication Type
Article
Date
Jul-3-2012
Author
Dan Bergkvist
Ingrid Åström
Per-Olof Josefsson
Leif E Dahlberg
Author Affiliation
Department of Orthopaedics, Malmö University Hospital, Lund University, Södra Förstadsgatan 101, 20502 Malmö, Sweden. dan.bergkvist@glocalnet.net
Source
J Bone Joint Surg Am. 2012 Jul 3;94(13):1229-33
Date
Jul-3-2012
Language
English
Publication Type
Article
Keywords
Achilles Tendon - injuries
Adult
Age Factors
Cohort Studies
Female
Follow-Up Studies
Hospitals, University
Humans
Injury Severity Score
Male
Middle Aged
Orthopedic Procedures - methods
Pain Measurement
Patient satisfaction
Physical Therapy Modalities
Questionnaires
Recovery of Function
Retrospective Studies
Risk assessment
Rupture - radiography - rehabilitation - surgery
Sex Factors
Statistics, nonparametric
Sweden
Tendon Injuries - radiography - rehabilitation - surgery
Time Factors
Treatment Outcome
Young Adult
Abstract
The optimum treatment of acute total Achilles tendon rupture remains controversial. In the present study, the outcomes of surgical and nonsurgical treatment in a large number of patients were compared on the basis of patient age and sex.
The records of all 487 patients with an acute total Achilles tendon rupture that had occurred between 2002 and 2006 and had been treated at one of two university hospitals in Sweden were manually reviewed. Surgical treatment was primarily used at Hospital 1, whereas nonoperative functional treatment was primarily used at Hospital 2. At one to seven years after the rupture, the majority of the patients were evaluated for complications, the Achilles Tendon Total Rupture Score was calculated, a heel-raise test was performed, and calf circumference was measured. The outcomes of surgical and nonsurgical treatment were compared on the basis of patient age and sex.
The mean age at the time of the injury was forty-five years. In the surgical treatment group at Hospital 1, six (3%) of 201 patients had a re-rupture and three (1.5%) had an infection. In the nonsurgical treatment group at Hospital 2, the rate of re-rupture rate was 6.6% (fifteen of 227). When the results for the surgical treatment group at Hospital 1 were compared with those for the nonsurgical treatment group at Hospital 2, there was no significant difference in terms of the mean Achilles Tendon Total Rupture Score (81.7 compared with 78.9; p = 0.1), but both the difference in the heel-raise test (p = 0.01) and the difference in calf circumference (1.4 compared with 2.0 cm; p = 0.01) reached significance in favor of surgery. Nonsurgically managed female patients showed significant worsening of the Achilles Tendon Total Rupture Score and heel-raise test with increasing age at the time of injury.
The good Achilles Tendon Total Rupture Score in the nonsurgically managed group, together with the relatively low rate of re-ruptures and other complications in these patients, makes this treatment a preferable option for most patients. However, the tendency for a lower re-rupture rate and better performance on the heel-raise test in surgically treated patients suggest surgery may be beneficial in selected patients.
PubMed ID
22760392 View in PubMed
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1643 records – page 1 of 165.