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Biomedical subjects

U Fredberg

Publications and source records attributed to U Fredberg.

At least 19 recordsLinked to original sources
PubMed2004

Ultrasonography as a tool for diagnosis, guidance of local steroid injection and, together with pressure algometry, monitoring of the treatment of athletes with chronic jumper's knee and Achilles tendinitis: a randomized, double-blind, placebo-controlled study.

BACKGROUND: The diagnosis of Achilles and patella tendinitis has until recently been based on clinical examination, and treatment with local steroid injection has been given blindly. This is the first randomized, double blind, placebo-controlled study of local steroid injection in athletes with chronic tendinitis, which used ultrasonography to increase diagnostic accuracy, to guide the correct placement of local steroid and, conjunctively with pressure algometry, to objectify and monitor the results of treatment. METHOD: Forty-eight athletes each with severe symptomatic tendinitis of a patellar (24) or Achilles tendon (24) for more than 6 months, whose conditions were confirmed ultrasonographically, and who all failed conservative treatment (rehabilitation) were included in this double-blind, placebo-controlled study and treated with three ultrasonographically guided peritendinous injections of steroid or placebo. RESULTS: The conditions of only one-third of the referred athletes with clinically suspected tendinitis were confirmed by ultrasonographic examination. The ultrasonographically guided peritendinous injection of steroid had a significant effect in reducing pain and thickening of tendons. CONCLUSION: Ultrasonography should be used in the future to assure precise diagnosis and to guide the peritendinous injection of steroid in chronic Achilles and patella tendinitis. Ultrasonography and pressure algometry are recommended as objective methods for monitoring the effect of treatment. Ultrasonographically guided injection of long-acting steroid can normalize the ultrasonographic pathological lesions in the Achilles and patellar tendons, and has a dramatic clinical effect but when combined with aggressive rehabilitation with running after a few days, many will have relapse of symptoms within 6 months.

Achilles Tendon↗
PubMed2001

Traumatic arthritis in sport.

After the introduction of ultrasonography in sports medicine, traumatic arthritis is recognized relatively frequently among athletes. In this case study, the ultrasonographic findings and the prompt effect of ultrasonographically guided intra-articular injection of long-acting steroid are demonstrated in two patients.

Ankle Joint↗
PubMed1999

Jumper's knee. Review of the literature.

Jumper's knee is an overuse disease. The initial subjective complaints are well-localized pain, usually occurring after physical activities and often at the lower pole of the patella. The diagnosis of jumper's knee is usually easily established after acquiring a detailed history and a carefully performed physical examination, but the lesion can be mistaken for other disorders or injuries, such as bursitis, meniscal injuries or chondromalacia (1) or other causes of the patellofemoral pain syndrome. Today ultrasonography is the method of choice for the evaluation of jumper's knee as it is both time and cost saving, non-invasive, repeatable, accurate and allows a dynamic image of the tendon, guided injections and control of treatment. Conservative therapy is the treatment of choice in the early stages and includes adequate warm-up, stretching of the quadriceps muscle and physical activity with respect to the pain, and ice pack application after activity. When the pain disappears, the training intensity can be increased. NSAID (Non-Steroidal Anti-Inflammatory Drugs) and local peritendinous injections with long-acting steroids can be a helpful and safe adjuvant to the conservative treatment and should be tried before surgery. Surgical treatment is indicated only if a prolonged and well-supervised conservative treatment program fails in chronic jumper's knee (including local injection with steroid) or in acute total rupture. Review papers concerning jumper's knee are already published (2-5), but in this review the importance of ultrasonography to make the diagnosis, to plan therapy and control the treatment and the safety of peritendinous injection with steroid is pointed out. The scientific documentation for the recommanded treatment (conservative, steroid injection and operation) is, however, insufficient. Many more controlled studies are needed. Ultrasonography and placebo-controlled, double-blinded, cross-over studies for treatment with local injection of steroid are ongoing (6, 7).

Adrenal Cortex Hormones↗
PubMed1998

Home treatment with recombinant activated factor VII: results from one centre.

Haemophilia patients developing an inhibitor against factor VIII (FVIII) or FIX require alternative treatment for the management of their bleeding, rather than standard procedures. In patients with low titre inhibitors, increased doses of FVIII or FIX may improve haemostasis. If a higher titre is present, a porcine FVIII concentrate may be efficacious in selected cases. 'Bypassing' agents, such as low purity FIX concentrates, or activated or unactivated concentrates of prothrombin complex may also be useful in inhibitor patients. An activated factor VII molecule (rFVIIa; NovoSeven, Novo Nordisk, Bagsvaerd, Denmark), has been produced by recombinant DNA cell technology. In June 1994, we established a home treatment programme with rFVIIa for five inhibitor patients to study its efficacy in the early intervention of bleeding episodes; our results from the first 3 years are presented. Self-treatment in the home took place in 50 instances of acute minor bleeding. A mean of 2.02 doses of rFVIIa (each dose of about 90 microg/kg bodyweight) was required to arrest bleeding (range 1-4 doses). Four bleeding episodes required in-hospital management either because the acute condition was caused by severe trauma, or because treatment had not been instituted in the early phase of bleeding. Here, the range of rFVIIa doses was 4-37. For comparison, we also report 36 minor bleeding episodes managed in-hospital in three of these five patients who participated in the Compassionate Use Study where home treatment was not permitted. These bleeding episodes required considerably more administrations of rFVIIa with a mean consumption of 8 doses in joint bleeds and 9.5 doses in muscle and soft tissue bleeds. In conclusion, we feel that our home treatment results strongly suggest that early intervention by home treatment with rFVIIa in acute minor bleeding is efficacious and cost effective.

Adult↗
PubMed1997

[Injury pattern in a sports club with its own sports physician].

As the first Danish athletic association, TST-79 in 1995 appointed a permanent sports doctor for use by all its members. We publish the results of the first year. Seventeen percent of all handball players and 11% of all football players were seen in the consultation. The athletes were between 10 and 69 years old. Seventy-eight percent of the injured athletes could be diagnosed, instructed and, if necessary, treated after one consultation. Eight percent were sent for further examination at a hospital. Ultrasound examinations were necessary for establishing the diagnosis in 10% of the injured athletes. Some of the injuries were serious, and would probably not have been seen if the athletes did not have the possibility of consulting a sports doctor. This would increase the risk of chronic injury. It is suggested that a permanent arrangement with a sports doctor is an economically reasonable investment.

Adolescent↗
PubMed1997

Local corticosteroid injection in sport: review of literature and guidelines for treatment.

The risks and benefits of local injection therapy of overuse sports injuries with corticosteroids are reviewed here. Injection of corticosteroid inside the tendon has a deleterious effect on the tendon tissue and should be unanimously condemned. No reliable proof exists of the deleterious effects of peritendinous injections. Too many conclusions in the literature are based on poor scientific evidence and it is just the reiteration of a dogma if all steroid injections are abandoned. The corticosteroids represent an adjuvant treatment in the overall management of sports injuries: basic treatment is 'active' rest and graduated rehabilitation within the limits of pain. With proper indications there are only few and trivial complications that may occur with corticosteroid injections. Guidelines for proper local injection therapy with corticosteroids are given.

Adrenal Cortex Hormones↗
PubMed1996

The sportsman's hernia--fact or fiction?

This review is based on the results of 308 operations for unexplained, chronic groin pain suspected to be caused by an imminent, but not demonstrable, inguinal hernia: the 'sportsman's hernia' (SH). No differences in perioperative findings between cured and non-cured athletes were found. However, there was a remarkable difference between the various perioperative findings in the studies. It was characteristic that further clinical investigation of the noncured, operated athletes gave an alternative and treatable diagnosis in more than 80% of cases. Herniography was used consistently in the diagnostic process in all the studies on SH. However, in 49% of cases hernias were also demonstrated on the opposite, asymptomatic groin side. In conclusion, the final diagnosis (and treatment) often reflects the speciality of the doctor and the present literature does not supply proper evidence to the theory that SH constitutes a credible explanation for chronic groin pain.

Athletic Injuries↗
PubMed1995

[Iliopsoas tendinitis in athletes. Diagnosis and treatment].

Iliopsoas tendinitis is a common injury in sport. Despite of this there are only a few articles in the literature that deal with these injuries. The changes in the inflamed tendons and muscles have been difficult to determine objectively. The modernization of ultrasound devices has improved the methods of examination and made it possible to diagnose objective changes in the tendons and muscles. Recommendations for the treatment of acute and chronic iliopsoas tendinitis are given.

Adult↗
PubMed1995

Ultrasound in the diagnosis and treatment of iliopsoas tendinitis: a case report.

Ultrasound examination is a recognized advanced tool in the diagnosis of many sport-related overuse injuries. This article illustrates a new indication for ultrasound examination: the diagnosis of iliopsoas tendinitis and its treatment by ultrasound-guided local injection of long-acting corticosteroid.

Adrenal Cortex Hormones↗
PubMed1993

[Lateral ligament ruptures of the ankle joint in young athletes].

Treatment of lateral ligament rupture of the ankle has previously been primarily surgical. Immobilisation in a plaster cast has recently become more usual, and gradually this treatment is partially being replaced by immobilisation in adhesive elastic bandage. Operation of younger, athletic patients with large ruptures is, however, still recommended. It is inexpedient to operate these patients. They will be delayed for several weeks in their return to sport.

Adult↗
PubMed1988

Acute neurogenic pulmonary oedema following generalized tonic clonic seizure. A case report and a review of the literature.

A case of acute neurogenic pulmonary oedema following a generalized tonic clonic seizure is presented. The condition is rare and the exact pathophysiology is unknown. Pulmonary oedema is a serious complication of epileptic seizures, however, and the importance of awareness of this condition and its treatment is emphasized by a high mortality rate in older epileptics and by the demonstration of pulmonary oedema in recent series of young epileptics who died suddenly.

Acute Disease↗
PubMed1985

The contaminated skin-knife--fact or fiction.

Three hundred and fifty-eight patients undergoing clean orthopaedic surgery were included in this prospective study. The knives used during surgery, i.e. the knife used for skin incision (the skin-knife) and the knife used to finish the operation were bacteriologically examined. We found no evidence that the practise of discarding the knife after skin incision reduced the incidence of wound infection after clean orthopaedic surgery. Laminar air flow significantly reduced the rate of knife contamination.

Equipment Contamination↗