PubMed · 15359519
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J Kelley Avery. 2004. Constipation not always benign.. https://pubmed.ncbi.nlm.nih.gov/15359519/
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AIM: To study if data on lower limb amputations and vascular operations in the National Hospital Discharge Register can be used for comparison of diabetes care between hospital districts. METHODS: We identified diabetic persons from the National Hospital Discharge Register (1988-2002), the National Social Security Institute (since 1964) and pharmacies (since 1994). A search for lower limb amputations and vascular operations was made through the Hospital Discharge Register. An analysis of the correlation of the age and gender adjusted incidence of first major amputations and the age and gender adjusted incidence of first vascular operations for diabetics was made between 14 hospitals districts with the largest diabetic population. RESULTS: A total of 308,447 diabetics were identified. There were 11,070 diabetics who had a lower extremity amputation and 9530 diabetics who had a vascular operation in Finland in 1988-2002. The annual number of first amputations decreased from 924 to 387 per 100,000 diabetics during the study period. There were up to three-fold differences in age and gender adjusted indexed numbers of first amputations between different hospital districts during the last follow-up period from year 2000 to 2002. There was a clear inverse correlation between the incidence of first major amputations and first vascular operations and particularly between incidence of first major amputations and infrapopliteal reconstructions. CONCLUSION: The incidence of major amputation is declining in the diabetic population. This positive development can be explained by more active vascular operative treatment. Regional differences are wider than acceptable.
Between 2000 and 2003, 99 cattle with limb fractures were treated. Over 50 per cent were tibial fractures, with the femur and os calcis being the second and third most frequently affected bones. Eight of the cattle were slaughtered because of their poor prognosis, 10 were treated by stall confinement, 76 were treated by external coaptation with a Thomas splint-cast combination and three were treated with a simple or reinforced half limb cast; these 79 cattle were usually discharged immediately. One calf was treated with internal fixation, and another by amputation. Follow-up information was obtained by telephone, and the treatments were classified as either completely successful (return to previous production level), partially successful (return to lower production level) or failure. Forty (52.6 per cent) of the cattle treated with the Thomas splint-cast combination were classified as a complete success and 14 (18.4 per cent) as a partial success; the treatment failed in 19 of the cattle and three were lost to follow-up. The animals' bodyweight, age and sex, and whether the fracture was open or closed, had no significant influence on the outcome. Among the 10 cattle treated for proximal fractures by stall confinement, there were five survivors, four non-survivors and one was lost to follow-up.