PubMed Health⌕ Search

Biomedical subjects

L R Hölmich

Publications and source records attributed to L R Hölmich.

8 recordsLinked to original sources
PubMed2004

Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study.

BACKGROUND: Groin pain is a diagnostic and therapeutic challenge to sports medicine. The literature provides no consensus on definitions of or diagnostic criteria for groin pain in athletes. To compare the results of research and treatments, the methods used to diagnose and evaluate the degree of groin pain must be clearly defined and reproducible. OBJECTIVES: To describe clinical examination techniques for groin pain in athletes and evaluate the intraobserver and interobserver reliability of these. METHODS: Eighteen athletes, nine with sports related groin pain and nine without groin pain, were examined by two doctors and two physiotherapists. The examiners were trained in the examination techniques before the study. The examiners were blinded to the symptoms and identity of the subjects. The subjects were examined twice by each examiner in random order. The examinations included evaluation of adductor muscle related pain and strength, iliopsoas muscle related pain, strength, and flexibility, abdominal muscle related pain, and strength and pain at the symphysis joint. Kappa statistics and percentage of agreement were used to evaluate the data. RESULTS: Overall, the kappa values and percentage of agreement were in accordance and showed good reliability of the examinations. The kappa values for the intraobserver agreement were above 0.60 in 11 of 14 tests, and those for the interobserver agreement of the pain tests were above 0.60 in eight of 10 tests. The only test without acceptable interobserver reliability was the strength test for iliopsoas muscle. CONCLUSION: All but one of the tests investigated were reproducible and subject only to limited intraobserver and interobserver variation.

Adult↗
PubMed2003

Stage of breast cancer at diagnosis among women with cosmetic breast implants.

Concern has been raised about the potential delay in breast cancer diagnosis in the augmented breast. We linked a cohort of 2955 women, who received cosmetic breast implants in Denmark during the period 1973-1997 with the Danish Cancer Registry and the Danish Breast Cancer Cooperative Group register. We identified 23 incident cases of invasive breast cancer diagnosed subsequent to breast implantation. We randomly selected 11 controls for each case from the Danish Breast Cancer Cooperative Group's register, and obtained detailed information on all study subjects about surgery, histopathology and stage of breast cancer at diagnosis, intended adjuvant treatment according to trial protocols and overall survival. We found that women with breast implants on average were diagnosed with breast cancer at the same stage as controls. Significantly more women with breast implants had tumour cells in the surgical margins according to the Danish Breast Cancer Cooperative Group's data. There was no significant difference in overall survival between the two groups after an average of 6.4 years of follow-up. Based on this limited number of women with breast cancer subsequent to breast augmentation, breast implants do not appear to delay the diagnosis of breast cancer, and no evidence of impaired survival after breast cancer diagnosis in augmented women was found.

Adult↗
PubMed2001

Prevalence of silicone breast implant rupture among Danish women.

The durability of silicone gel-filled breast implants is of concern, but there are few epidemiological studies on this issue. To date, most of the relevant findings are derived from studies of explantation, which suffer from bias by including women with symptoms or concerns about their implants. As part of a long-term magnetic resonance imaging study of the incidence of rupture, this study involved 271 women with 533 cosmetic breast implants who were randomly selected from among women who underwent cosmetic breast implantation from 1973 through 1997 at one public and three private plastic-surgery clinics in Denmark. The prevalence of rupture was determined from the first magnetic resonance screening. The images were evaluated by four independent readers, using a standardized, validated form. The outcomes under study were rupture, possible rupture, and intact implant. Ruptures were categorized as intracapsular or extracapsular. Overall, 26 percent of implants in 36 percent of the women examined were found to be ruptured, and an additional 6 percent were possibly ruptured. Of the ruptured implants, 22 percent were extracapsular. In multiple regression analyses, age of implant was significantly associated with rupture among second- and third-generation implants, with a 12-fold increased prevalence odds ratio for rupture of implants that were between 16 and 20 years of age, compared with implants between 3 and 5 years of age. Surgitek implants (Medical Engineering Corporation, Racine, Wis.) had a significantly increased prevalence odds ratio of 2.6 for rupture, compared with the reference implants. No significant association was found with the position (subglandular or submuscular) or the type of implant (single- or double-lumen). Extracapsular ruptures were significantly associated with a history of closed capsulotomy (p = 0.001). In the future, the authors plan to examine the women in their cohort with a second magnetic resonance imaging scan to establish the incidence of rupture, a parameter unknown to date in the literature, and to further characterize those factors associated with the actual risk of rupture.

Adolescent↗
PubMed2001

Capsular contracture after cosmetic breast implant surgery in Denmark.

The authors investigated the association between the occurrence of capsular contracture and implant and patient characteristics. All women with breast implants from 1977 to 1997 were identified from the files of two private plastic surgery clinics in Denmark. Information on implant and patient characteristics, surgical procedure, and complications was obtained through medical records and self-administered questionnaires. Of 754 women (1,572 implants), average age at implantation was 32 years. Implant types were silicone double lumen, textured, 31.2%; silicone single lumen, textured, 27.8%; silicone single lumen, smooth, 24.5%; silicone double lumen, smooth, 0.8%; and other or missing, 15.7%. Placement was submuscular for more than 90% of implants. Capsular contracture occurred in 7.9% of implanted breasts, on an average of 621 days postoperatively, with 51.6% being bilateral. Overall, 66.1% of capsular contractures were recorded within the first 12 months postoperatively, and 79.0% were recorded within 24 months. Double-lumen implants were associated with a significantly (p < 0.01) reduced occurrence of capsular contracture. In summary, capsular contracture typically occurs within the first 2 years of implantation. Host factors may be important because more than half the capsular contractures in the current study were bilateral. Occurrence of capsular contracture did not appear to be associated with implant surface or placement, occurrence of local complications, or patient characteristics, although these findings should be interpreted cautiously.

Adult↗
PubMed1995

[Eye injuries during hobby-work using machine tools].

Data from the EU-project EHLASS (European Home and Leisure Accident Surveillance System) collected from five Danish hospitals during the period 1989-1991 contained 185,551 accidents occurring at home and during leisure time. The population in the catchment area is approximately 700,000. Of these accidents, 9900 involved eye-injury, 2940 of these occurred during hobby-activities, and 1460 of these while the subject was using either drilling-, welding- or grinding-equipment. The incidence of eye-injuries occurring during the use of these machines has risen from 0.6/1000/year in 1989 to 0.7/1000/year in 1990 and to 0.8/1000/year in 1991. In 98% of the cases the patients were men, 30% were between 20 and 29 years of age. A common activity at the time of the accident was "car-repairing". Foreign-body-lesions were seen in 60% of the cases, and actinic conjunctivitis in 30%. None of the injuries were serious, but they were often very painful and demanding of resources. All the injuries could have been avoided by the use of proper eye protection.

Accidents, Home↗
PubMed1995

Collagen with gentamicin for prophylaxis of postoperative infection. Staphylococcus aureus osteomyelitis studied in rabbits.

In 34 rabbits, both tibiae were inoculated with Staphylococcus aureus. 14 legs received no treatment and served as controls. In 12 legs, the wound was treated with pure collagen and in 18 legs, collagen with gentamicin (Gentacoll) in a dose of 10 mg/kg body weight was applied to the wound before closure. Postoperatively 12 received 10 mg/kg body weight gentamicin intravenously and no local treatment. The animals were killed 7 days after inoculation and evaluated macroscopically and microbiologically for infection. 6 rabbits (12 legs) were used for pharmacokinetic studies only and they were killed after 2, 4, and 18 hours, respectively. 11/14 untreated legs developed a macroscopically acute osteomyelitis. No infection was found in the 18 legs treated with Gentacoll and 1/12 treated with gentamicin systemically had growth of the inoculated bacteria in tissue biopsies. The concentrations of gentamicin in the serum as well as locally reached peak values were well above the MIC value in all groups, with a maximum after 1-2 hours. No gentamicin could be detected after 18 hours, independently of the mode of administration.

Animals↗
PubMed1994

Congenital hereditary paresis of ramus marginalis nervus facialis in five generations.

We report a case of familial congenital paresis of ramus marginalis nervus facialis in 5 generations. The paresis varied in location, i.e., 2 right-sided and 3 left-sided, 1 side unknown. The primary patient, a 33-year-old female, presented with a complete right-sided congenital lower lip palsy. Electromyographic examination showed absent voluntary activity of the right depressor labii inferior muscle. There was no evidence of denervation of the paretic muscle. These findings may suggest either absence of the depressor labii inferior muscle or possibly absent voluntary activation due to a defect at brainstem level.

Adult↗