[The effect of muscle training program for home care employees]. / Effekten af generel muskeltraening for ansatte inden for hjemmeplejen.

To assess the results of general muscle training for home helpers and home nurses we followed 40 women who completed a six month strength training program. All participants were employees at the home care district Skovgården Hjørring. The training program consisted of exercises for all parts of the body. It was a general rehabilitation program and consisted of a teeterboard, a rubberband and a weight bag adjustable from one to six kg. The duration of the program was one hour. All participants were instructed in the training program by author Ulla Willadsen. The period of training lasted six months and was performed twice a week.

Facilitation of pain sensitization in knee osteoarthritis and persistent post-operative pain: a cross-sectional study.

BACKGROUND: Around 20% of patients with osteoarthritis (OA) have chronic post-operative pain after total knee arthroplasty (TKA) and often undergo revision surgery with unfavourable pain outcome. This study compared sensitization in pain patients with knee OA and after revision TKA (re-TKA). METHODS: Median pressure pain thresholds (PPTs) assessed from the most affected knee (localized sensitization) were used to subgroup 53 patients with OA pain and 20 patients with pain after re-TKA: group 1: OA and high-knee PPT; group 2: OA and low-knee PPT; group 3: re-TKA and high-knee PPT; group 4: re-TKA and low-knee PPT. Clinical pain intensity was assessed using a visual analogue scale (VAS). Bilateral PPTs were measured from the lower leg and forearm (spreading sensitization). Furthermore, the pain intensities evoked by 10 repeated pressure pain stimuli (temporal summation) at the knee and lower leg were assessed on an electronic VAS. RESULTS: The mean clinical pain intensity was not significantly different between groups. The PPTs from both lower leg and forearm were significantly lower in group 4 compared to groups 1, 2, and 3 and in groups 2 and 3 compared to group 1 (p < 0.05). Temporal summations from the knee and lower leg were significantly facilitated in groups 3 and 4 compared to groups 1 and 2 (p < 0.05). CONCLUSIONS: Despite similar pain intensities, facilitated temporal summation is worse in re-TKA than in OA and patients with high local knee hyperalgesia show more prominent spreading sensitization. The study suggests that sensitization should be considered in knee OA especially before re-TKA.

Blood reinfusion combined with femoral nerve block in total knee replacement for patients with increased risk of bleeding.

PURPOSE: To compare patients with increased risk of bleeding who received combined blood reinfusion and femoral nerve block in total knee replacement (TKR) to regular patients treated routinely with respect to pain relief, blood loss, and knee function. METHODS: In a consecutive series of 67 patients who underwent unilateral TKR, 12 patients with increased risk of bleeding owing to cardiac disease or previous thromboembolic events received continuous femoral nerve block and blood reinfusion, without tranexamic acid (TA) injection. The remaining 55 patients were controls who received standard postoperative treatment (TA injection, local injection of analgesics, and suction drainage without reinfusion). The volume of blood loss (drained or reinfused), pain score (using a visual analogue scale) and knee function (using the Knee Society Score [KSS]) in the 2 groups were compared. RESULTS: In the study group, patients were 5 years older and tended to have a lower preoperative KSS function score (35 vs. 45, p=0.08) and a higher function-related pain score (6.5 vs. 6, p=0.10). The mean volume of drained blood wasted in the study group did not differ significantly from the mean total volume of drained blood in the control group (235 vs. 300 ml, p=0.14). Similarly, the mean decrease in postoperative haemoglobin concentration did not differ significantly between the respective groups (2.1 vs. 2.1 mmol/l, p=0.97). A significantly greater proportion of patients received allogenic blood transfusion in the study group than in controls (3/12 vs. 2/55, p<0.01). The study group exhibited significantly higher pain scores during training (1.7 vs. 1.4, p=0.03) and lower escape oxycodone consumption (5 vs. 15 mg/kg, p=0.06) on postoperative day 1 (but not other days). The duration of hospitalisation was also longer (5.5 vs. 4 days, p=0.04). CONCLUSION: In TKR patients with increased risk of bleeding, blood reinfusion combined with femoral nerve block is safe and comparable to standard methods of pain control (local injection of analgesics).

The clinical effect of naproxen sodium after arthroscopy of the knee: a randomized, double-blind, prospective study.

The aim of this study was to examine the clinical effect of naproxen sodium after knee arthroscopy. The design was randomized, prospective, and double-blind, with a placebo control group. Patients with preoperative synovial reaction were excluded. One hundred twenty consecutive arthroscopies were performed in 77 men and 43 women, median age 34 (range 18-65) years. General anesthesia was used. Ninety-one arthroscopies were operative, whereas 29 were diagnostic. Postoperatively the patients received either 550 mg naproxen sodium twice daily or placebo for 10 days. Patients were given 500 mg acetaminophen to use if needed. Clinical examinations were performed 10 and 20 days postoperation. The results were analyzed using the Mann-Whitney test and chi 2 test. No operative complications were registered. All but two patients completed the study. Six patients had slight gastrointestinal symptoms. At 10 days' follow-up, in patients who had undergone operative arthroscopy naproxen sodium demonstrated a statistically significant effect on synovial effusion (p < 0.01), range of motion (p < 0.001), quadriceps strength (p < 0.05), pain (p < 0.001), walking activity (p < 0.05), and use of crutches (p < 0.01). In patients who had undergone diagnostic arthroscopy naproxen sodium demonstrated a beneficial effect on pain (p < 0.01). At 20 days' follow-up, in the operative group naproxen sodium affected synovial effusion (p < 0.05), range of motion (p < 0.01) and pain (p < 0.05), and walking activity (p < 0.05). No effect was seen in the diagnostic group at 20 days' follow-up.

Gold in the ovary of rats exposed to sodium aurothiomalate.

The ultrastructural localization of gold in the ovary of rats injected intraperitoneally with sodium aurothiomalate has been demonstrated using a histochemical technique that visualizes minute traces of gold. Gold was visualized in the oocyte within the cortical granules and in lysosomes of theca interna cells and interstitial cells.

Significance of the extent of transurethral prostatic resection for postoperative complications.

The significance of the extent of transurethral prostatic resection for benign prostatic hypertrophy was evaluated as regards early and late postoperative complications in a prospective, randomized study. The two treatment groups were preoperatively comparable in age, incidence of urinary retention and estimated prostatic weight. In 83 cases the median weight of resected tissue was 18 (range 4-118) g, while in 84 cases the resection was less extensive--median weight 7 (1-40) g. No significant intergroup difference was found in incidence of bladder tamponade, bladder perforation, urinary tract infection or pneumonia. The blood transfusion need was greatest among the patients with complete transurethral adenomectomy of the prostate. Concerning late postoperative complications, the groups did not differ in incidence of urethral stricture, bladder neck contracture or reoperation for benign prostatic hypertrophy. Patients with preoperative urethral instrumentation had heightened risk of developing postoperative urethral stricture.

Sexual life following 'minimal' and 'total' transurethral prostatic resection.

81 otherwise healthy men with an average age of 67 years and verified prostatic hypertrophy were randomized into two groups for either 'minimal' or 'total' transurethral prostatic resection (TUR-P). Interviews on sexual life were made preoperatively and 6 and 12 months postoperatively. 58 men (72%) were prior to the operation sexually active. 18 (31%), mainly men of advanced age, discontinued sexual activity following TUR-P. 40 (69%) remained active. 19 had retrograde ejaculation. No significant difference was found between 'minimal' and 'total' TUR-P concerning the effect on sexual activity and the occurrence of retrograde ejaculation.