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J Dalsgaard

Publications and source records attributed to J Dalsgaard.

17 recordsLinked to original sources
PubMed2005

Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up.

OBJECTIVES: To compare the effect of graded physiotherapeutic training of the rotator cuff versus arthroscopic subacromial decompression in patients with subacromial impingement. METHODS: Randomised controlled trial with 12 months' follow up in a hospital setting. Ninety consecutive patients aged 18 to 55 years were enrolled. Symptom duration was between six months and three years. All fulfilled a set of diagnostic criteria for rotator cuff disease, including a positive impingement sign. Patients were randomised either to arthroscopic subacromial decompression, or to physiotherapy with exercises aiming at strengthening the stabilisers and decompressors of the shoulder. Outcome was shoulder function as measured by the Constant score and a pain and dysfunction score. "Intention to treat" analysis was used, with comparison of means and control of confounding variables by general equation estimation analysis. RESULTS: Of 90 patients enrolled, 84 completed follow up (41 in the surgery group, 43 in the training group). The mean Constant score at baseline was 34.8 in the training group and 33.7 in the surgery group. After 12 months the mean scores improved to 57.0 and 52.7, respectively, the difference being non-significant. No group differences in mean pain and dysfunction score improvement were found. CONCLUSIONS: Surgical treatment of rotator cuff syndrome with subacromial impingement was not superior to physiotherapy with training. Further studies are needed to qualify treatment choice decisions, and it is recommended that samples are stratified according to disability level.

Adolescent↗
PubMed1998

Fishing down marine food webs

The mean trophic level of the species groups reported in Food and Agricultural Organization global fisheries statistics declined from 1950 to 1994. This reflects a gradual transition in landings from long-lived, high trophic level, piscivorous bottom fish toward short-lived, low trophic level invertebrates and planktivorous pelagic fish. This effect, also found to be occurring in inland fisheries, is most pronounced in the Northern Hemisphere. Fishing down food webs (that is, at lower trophic levels) leads at first to increasing catches, then to a phase transition associated with stagnating or declining catches. These results indicate that present exploitation patterns are unsustainable.

Journal Article↗
PubMed1998

Perioperative myocardial ischaemia in patients undergoing surgery for fractured hip randomized to incremental spinal, single-dose spinal or general anaesthesia.

Quantitative assessment of myocardial ischaemia during incremental spinal, single-dose spinal and general anaesthesia may provide guidelines for the choice of anaesthetic technique for osteosynthesis of hip fractures in the elderly atherosclerotic individual. Forty-three patients with coronary artery disease were allocated to receive either incremental spinal anaesthesia (bupivacaine 0.5% plain) (A), single-dose spinal anaesthesia (2.5 mL of bupivacaine 0.5% plain) (B) or general anaesthesia (fentanyl, thiopentone, atracurium, enflurane, N2O/O2) (C) for hip surgery. ST segment monitoring was performed from the induction of anaesthesia and for the following 48 h, and perioperative hypotension, blood loss and fluid therapy were recorded. ST depression developed in two out of 14 (A), seven out of 15 (B) and six out of 14 (C) patients (P = 0.14). In (A), a total of seven ST depressions occurred in the observation period as opposed to 125 in (B) and 16 in (C) (P < 0.05). Intra-operative ST depression only occurred in (B). Three (A), 33 (B) and 40 (C) hypotensive events were recorded (P < 0.002). Altogether, 56% of hypotensive patients developed ST depression compared with 10% of normotensive patients (P < 0.003). In (A), 1.6 mL of 0.5% bupivacaine were used as opposed to the fixed 2.5 mL dose in (B) (P < 0.001). In the first post-operative week, mortality was higher in (B) (P < 0.05) but, after 1 month, there was no significant difference in mortality between the three groups. The incidence of hypotension and myocardial ischaemia was lowest in the group receiving incremental spinal anaesthesia.

Aged↗
PubMed1993

[Analgesic effect of low-dose intra-articular morphine after ambulatory knee arthroscopy].

The purpose of this study was to demonstrate the effect of intra-articular morphine following knee arthroscopy performed in infiltration analgesia. Fifty-two healthy patients were randomized to receive either morphine 1 mg or placebo. The pain was assessed two, five, eight and 24 hours after the procedure by 1) a VAS scale and 2) the amount of acetaminophen consumed. Demographic data in the two groups were similar. The pain scores at eight and 24 hours and the acetaminophen consumption after eight hours were lower in the morphine group (p < 0.05). Our results confirm the hypothesis of peripherally distributed opioid receptors. Stratifying data in therapeutic vs. diagnostic arthroscopy suggests an additional effect of morphine in patients undergoing therapy (0.05 < p < 0.10), an aspect which supports the hypothesis of peripherally administered morphine acting as a potential suppressor of the substance P mediated cytokine cascade. Intraarticular morphine 1 mg after knee arthroscopy offers efficient analgesia lasting more than 24 hours. The method is devoid of side effects and deserves wider recognition.

Adolescent↗
PubMed1993

[Analgesic effect of 2 different doses of intra-articular morphine after ambulatory knee arthroscopy. A randomized, prospective, double-blind study].

The effect of intra-articular morphine following knee arthroscopy has been verified in several studies, but the optimal dose has not been established. An earlier study by the authors showed significant effect of one mg morphine versus placebo. In this study, fifty patients were randomized to receive either two or four mg of intra-articular morphine following day-case knee arthroscopy in infiltration analgesia. The injected volume in both groups was five ml. The pain was assessed preoperatively, two, four, eight, 24, 36 and 48 hours after the procedure by 1) a VAS scale and 2) amount of acetaminophen consumed. Forty-seven patients completed the study. Demographic data in the two groups were similar. The results showed no significant difference in VAS score between the two dose regimes at any time. Onset of pain after cessation of the local analgesia was not influenced by the morphine dose. On this basis it is recommended to limit the dose of intraarticular morphine, as local adverse reactions to morphine cannot be ruled out.

Adolescent↗
PubMed1993

[Displaced proximal humeral fracture--conservative treatment].

The results of 42 patients with displaced proximal humeral fractures treated by conservative methods were reviewed. Follow-up evaluation included clinical and radiographic examination median two years after the trauma. The results were assessed using Neer's protocol. The patients were asked to assess the results. The patients assessed the results better than the Neer score (p < 0.001). The patients' response to non-operative treatment was satisfactory. It is concluded that the Neer classification of the results underestimates the degree of satisfaction achieved by the patients. It is concluded that displaced proximal humeral fractures can be treated satisfactorily by non-operative methods.

Adult↗
PubMed1992

Displaced proximal humeral fractures: results of conservative treatment.

The results of 42 patients with displaced proximal humeral fractures treated by conservative means were reviewed. The system advocated by Neer was used to classify the fractures. Of the patients, 16 had two-fragment fractures, 17 three-fragment fractures and 9 four-fragment fractures. In 21 patients, fractures were treated with a sling for 1 week, and in 21 with a hanging cast for 1 week. All patients received physiotherapy after immobilization. Follow-up evaluation included clinical and radiographic examination at a median of 2 years after the trauma. The results were assessed using Neer's protocol. The patients were asked to assess the results. The patients assessed the results better than the Neer score (P less than 0.001). The patients with two-fragment fractures assessed the results as excellent or satisfactory and better than the three- and four-fragment ones (P less than 0.01). The patient response to non-operative treatment was satisfactory. It is concluded that the Neer classification of the results underestimates the degree of satisfaction achieved by the patients. It is concluded that displaced proximal humeral fractures can be treated satisfactorily by non-operative methods.

Adult↗
PubMed1991

[Unicompartmental knee alloplasty by the St. Georg method. A follow-up of 42 knees after 5-10 years].

The results are presented of 42 arthroplasties by the St. Georg method in 37 patients who could be followed-up clinically and radiologically after median periods of observation of 66 months. The HSS-scoring method (Hospital for Special Surgery Score) was employed to assess the results. Good or excellent results (HSS score greater than 69 points) were obtained in 79% of the arthroplasties and 86% were relieved of pain on weightbearing. In selected patients, the St. Georg hemiarthroplasty is found to be a usable alternative to total condylar arthroplasty in the treatment of unicompartmental osteoarthritis of the knee.

Aged↗
PubMed1990

Antibiotic prophylaxis in lower-extremity amputations due to ischemia. A prospective, randomized trial of cephalothin versus methicillin.

The efficiency of prophylactic antibiotic therapy in amputation surgery was studied in a prospective, randomized trial of a first-generation cephalosporin (cephalothin) compared with a narrow-spectrum beta-lactam stable penicillin (methicillin). Eighty-eight patients received cephalothin 2 g X 4 on the day of operation, while 86 patients received methicillin 1 g X 4. The patients were followed up for 21 days. Infected wounds occurred in 14.8% of the patients in the cephalothin group, compared with 14% in the methicillin group. The frequency of deep infections was 10.2% versus 4.7% (P = 0.1611). The reamputation frequency was 18.2% in the cephalothin group compared with 12.8% in the methicillin group; the frequency of below-knee reamputation was 18.4% versus 7.7% (P = 0.1469). No clostridial infections were found. The study did not demonstrate any significant difference between cephalothin and methicillin in the prophylaxis for lower-extremity amputations, although the latter drug tended to be the best choice.

Adult↗
PubMed1986

Is there need for both intravenous urography and voiding cystography in the evaluation of children with recurrent urinary tract infections?

In a prospective study 33 children (aged 6-14 years) consecutively referred for recurrent urinary tract infections (RUTI), underwent intravenous urography (IVU) as well as voiding cystography (VC). Seven children had unilateral and two children had bilateral renal scarring, while ten children had unilateral and six children had bilateral vesico-ureteral reflux (VUR). Following normal IVU VUR was demonstrated in 22% of the ureters, but in all cases of low grade. In abnormal IVU, i.e. renal scarring or dilatation of the ureters, VC showed high grade VUR in 54% of the ureters. Based on these results and the current theories on the significance of patient age and grade of VUR, we conclude that in case of a normal IVU in children with RUTI and age of at least 6 years, there is no reason to supplement the pre-treatment evaluation with VC.

Adolescent↗
PubMed1985

Uroflowmetry in neurologically normal children with voiding disorders.

A prospective study was undertaken to delineate the role of spontaneous uroflowmetry as screening procedure for functional infravesical obstruction (detrusor/sphincter dyssynergia). More than 70% of thirty-nine children referred for urinary tract infections and/or enuresis in the absence of neurological deficits underwent a complete diagnostic program including intravenous urography, voiding cystography and cystoscopy as well as spontaneous uroflowmetry, cystometry-emg and pressure-flow-emg study. The incidence of dyssynergia was 22%. However, neither the flow curve pattern nor single flow variables were able to identify children with dyssynergia. Consequently uroflowmetry seems inefficient in the screening for dyssynergia in neurological normal children with voiding disorders in the absence of anatomical bladder outlet obstruction.

Adolescent↗
PubMed1984

Glucagon and ureteric colic.

A randomised prospective double-blind study of the effect of 1 mg glucagon intravenously was done on 51 consecutive patients with acute uretic colic. No significant difference between glucagon and placebo could be demonstrated as to pain relief or passage of calculi.

Colic↗
PubMed1977

ADP-induced platelet aggregation in vitro in patients with ischemic heart disease and peripheral thromboatherosclerosis.

ADP-induced platelet aggregation in vitro has been studied in 90 normal controls and in 30 patients with ischemic heart disease (IHD) and 22 with peripheral thromboatherosclerosis (PTA). The sensitivity to ADP was defined by the threshold concentration which produced secondary aggregation with an amplitude corresponding to not less than 80% of the transmission obtained by platelet-poor plasma. In the normal controls the threshold concentration was significantly lower in women aged 50 or more than in women under that age. The geometric means were lower in the patients than in the controls. Significantly lower threshold concentrations than in the corresponding age groups of controls were found in the following age groups of patients: Men and women greater than or equal to 50 years with IHD (p less than 0.005 and p less than 0.001, respectively), men and women under 50 with IHD (p less than 0.05). Men and women greater than or equal to 50 years with PTA (p less than 0.002 and p less than 0.01, respectively), men and women under 50 with PTA (p less than 0.005).

Adenosine Diphosphate↗