15 research outputs found
De Quervain's tenosynovitis
No full text De Quervain’s tenosynovitis is a common cause of wrist pain in adults. It is characterised by atraumatic pain or tenderness along the radial side of the wrist and is often associated with overuse or repetitive movements of the wrist or thumb. De Quervain’s tenosynovitis affects the first dorsal compartment of the wrist. Better understanding of this disease can help GPs and their patients manage its sequelae. In this article, the clinical assessment of patients with suspected de Quervain’s tenosynovitis and its conservative and surgical treatment options are discussed. </jats:p
Trigger finger
No full textTrigger finger is a common cause of hand pain. It is caused by stenosis at the level of the first annular (A1) pulley, which interrupts the smooth gliding of the underlying flexor tendons at the level of the metacarpophalangeal joint. Patients present with locking of the finger in flexion and clicking or snapping. It is important that GPs have an understanding of this condition, in order to help their patients deal with its sequelae. In this article the pathophysiology, clinical assessment and management of patients with suspected trigger finger are discussed.</jats:p
Inverse association between serum albumin and future risk of venous thromboembolism:interrelationship with high sensitivity C-reactive protein
No full textPurpose: We aimed to assess the prospective association of serum albumin with venous thromboembolism (VTE) risk and evaluate if the association is independent of or modified by inflammation, as measured by high sensitivity C-reactive protein (hsCRP). Design: We analysed data of 2176 men aged 42–61 years free from VTE in the Kuopio Ischemic Heart Disease study, with serum albumin concentrations measured at baseline using Coulter’s bromocresol purple colorimetric assays. Hazard ratios (HRs) (95% confidence intervals [CI]) were calculated for VTE. Results: There were 109 validated cases of VTE recorded during a median follow-up of 24.9 years. The risk of VTE increased linearly below a serum albumin concentration of ∼48 g/l. In Cox regression analysis adjusted for established risk factors and other potential confounders, the HR (95% CI) for VTE per 1 standard deviation lower serum albumin was 1.23 (1.02–1.47). The association remained persistent on further adjustment for hsCRP 1.22 (1.01–1.46). Furthermore, the association was not modified by hsCRP and persisted on exclusion of men with elevated hsCRP levels. Conclusions: In middle-aged Caucasian men, low serum albumin is associated with an increased risk of VTE, consistent with a linear dose-response relationship. The association is independent of and not modified by inflammation.Key messages •Serum albumin may be associated with future risk of venous thromboembolism (VTE); however, the shape, nature, magnitude and consistency of the association is uncertain. •In a population-based prospective cohort study, low serum albumin was associated with an increased risk of VTE in a linear dose-response manner and this association was independent of and not modified by inflammation. •Serum albumin concentrations may play a role in the development of VTE.</p
The Use of Opioid Analgesics following Common Upper Extremity Surgical Procedures: A National, Population-Based Study
No full text
Close and incomplete excision margins in non-melanoma skin cancer: A tertiary plastic surgery center experience
No full textDear Sir,
Non-melanoma skin cancers (NMSC) are the commonest skin cancers, treated by specialists. Previous national audit data have reported incomplete excision rates of around 2.3–3%.1 Nolan et al. published NMSC incomplete excision rates by operating specialty (dermatology, plastic surgery and general practitioners (GP)); the lowest incomplete excision rates were by dermatologists with 6.2% for basal cell carcinoma (BCC) and 4.7% for squamous cell carcinoma (SCC).1 In contrast, the highest incomplete excision rates were by GPs (20.4% for BCCs, 19.9% for SCCs). For plastic surgery, results were intermediate with rates of 9.4% for BCCs and 8.2% for SCCs. Our experience of treating NMSCs in our plastic surgery tertiary referral center during the recent pandemic is presented...</p
Inverse association between serum albumin and future risk of venous thromboembolism: interrelationship with high sensitivity C-reactive protein
No full textPurpose: We aimed to assess the prospective association of serum albumin with venous thromboembolism (VTE) risk and evaluate if the association is independent of or modified by inflammation, as measured by high sensitivity C-reactive protein (hsCRP). Design: We analysed data of 2176 men aged 42–61 years free from VTE in the Kuopio Ischemic Heart Disease study, with serum albumin concentrations measured at baseline using Coulter’s bromocresol purple colorimetric assays. Hazard ratios (HRs) (95% confidence intervals [CI]) were calculated for VTE. Results: There were 109 validated cases of VTE recorded during a median follow-up of 24.9 years. The risk of VTE increased linearly below a serum albumin concentration of ∼48 g/l. In Cox regression analysis adjusted for established risk factors and other potential confounders, the HR (95% CI) for VTE per 1 standard deviation lower serum albumin was 1.23 (1.02–1.47). The association remained persistent on further adjustment for hsCRP 1.22 (1.01–1.46). Furthermore, the association was not modified by hsCRP and persisted on exclusion of men with elevated hsCRP levels. Conclusions: In middle-aged Caucasian men, low serum albumin is associated with an increased risk of VTE, consistent with a linear dose-response relationship. The association is independent of and not modified by inflammation.Key messages • Serum albumin may be associated with future risk of venous thromboembolism (VTE); however, the shape, nature, magnitude and consistency of the association is uncertain. • In a population-based prospective cohort study, low serum albumin was associated with an increased risk of VTE in a linear dose-response manner and this association was independent of and not modified by inflammation. • Serum albumin concentrations may play a role in the development of VTE. • Serum albumin may be associated with future risk of venous thromboembolism (VTE); however, the shape, nature, magnitude and consistency of the association is uncertain. • In a population-based prospective cohort study, low serum albumin was associated with an increased risk of VTE in a linear dose-response manner and this association was independent of and not modified by inflammation. • Serum albumin concentrations may play a role in the development of VTE.</p
