Deep venous thrombosis (DVT) is common after lower limb injury, but the effect of prophylactic treatment has not been documented in large randomised trials or meta-analyses. As a result, evidence-based recommendations have not been established. The purpose of this study was to evaluate the incidence of venous thromboembolism in patients with Achilles tendon rupture. A total of 100 consecutive patients with an acute Achilles tendon rupture were included in a prospective study and randomised to either surgical or non-surgical treatment. At 8 weeks after the initiation of treatment, 95/100 patients were screened for DVT using colour duplex sonography (CDS) with blinded interpretation by two experienced examiners and adjudication in cases of disagreement by a third person. A total of 95 patients (79 male and 16 female) with a median (range) age of 41 (24-63) years were screened for CDS at 8 weeks. Of the 95 patients, 32 had a CDS-verified thrombosis, 5 proximal and 27 distal, whereas 3 had non-fatal pulmonary embolism. Surgical treatment was performed in 49 patients, non-surgical in 46. There were no significant differences in DVT frequency between the two treatment groups. The incidence of asymptomatic and symptomatic deep venous thrombosis is high after Achilles tendon rupture and there is a need to define the possible benefit of thromboprophylaxis.

AimsTo study if retinopathy increases the risk of stroke recurrence in stroke patients with type 2 diabetes. Also, to study if stroke patients with type 2 diabetes have an increased risk of stroke recurrence compared to non-diabetics and if stroke patients with type 2 diabetes, regardless of retinopathy, have a higher incidence of carotid stenosis. Also, to study if stroke patients with type 2 diabetes retinopathy have increased incidence of carotid stenosis.MethodsWe included 445 patients with type 2 diabetes mellitus and a matched control group of 445 patients without diabetes, who had all suffered their first stroke or TIA. Information on retinopathy, risk factors and stroke recurrence were obtained from registers and medical records.ResultsRetinopathy did not increase the risk of stroke recurrence in diabetes patients, HR 0.89 (0.51–1.53), p = 0.67. The risk of stroke recurrence was not increased in diabetics compared to non-diabetes. Diabetes patients had an increased prevalence of carotid stenosis compared to non-diabetics, 1.69 (1.15–2.48), p = 0.008. The prevalence of carotid stenosis in diabetics with retinopathy was not increased compared to diabetics without retinopathy.ConclusionRetinopathy is not a predictor of stroke recurrence or carotid stenosis in type 2 diabetes patients.

Most veins of the upper (forearm) and lower extremity (popliteal vein) were competent even after a maneuver that induced venodilation and an increase in blood flow (exercise hyperemia or postocclusion reactive hyperemia). Veins with an inherent valvular weakness can be identified by a hyperemia test with duplex flow analysis.

RA larger than LA, independently of LVEF, is associated with all-cause mortality in elderly patients hospitalized due to HF.

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Lack of an agreed infrastructure for terminology is identified as one of the major barriers to interchange of knowledge modules and integration of knowledge bases with other clinical information systems. The goal of the GALEN project is to bridge this gap between different terminology systems through the construction of a terminology server, which is based on a rich conceptual model with mapping facilities to natural language expressions and coding schemas. The long term goal is to support communication between medical information systems. Arden Syntax is a standard format for the creation of knowledge modules, with sharability as one of the main objectives. Since Arden Syntax is based on a data-driven approach, the data items used need to be adapted to locally available terminology. The GALEN approach appears to be complementary to Arden Syntax and to the development of sharable knowledge modules. The major theme of this paper is utilization of the GALEN terminology server for knowledge module authoring. Two systems are presented, a knowledge base manager and a client to the terminology server, allowing the user to navigate in the semantic network and to import concept definitions and terms into the knowledge modules. The benefit of the terminology server, allowing the user to navigate in the semantic network and to import concept definitions and terms into the knowledge modules. The benefit of the terminology services is discussed.

Patient measurements to characterize pathophysiological phenomena are often difficult to describe. A controlled terminology for this domain is needed, to describe methods, appropriate reference values and to report results. This is a proposal for a categorial structure for such a terminology

Objective: To determine the incidence and characteristics of extravascular masses (EVM) giving rise to symptoms and signs of deep venous thrombosis (DVT). Design and technique: Routine ultrasound colour duplex scanning during a 6-month period. Patients: Three hundred and two inpatients and outpatients investigated on suspicion of DVT. Setting: Department of Clinical Physiology, which is the central non-invasive diagnostic unit of the county. Results: A diagnostis of DVT was made in 33%. EVM were detected in 14 patients (5%). In most cases the characteristic appearance on scanning was spindle-shaped (like a ‘mouse’) and mostly confined to the upper calf. These EVM were regarded as intramuscular haematoma or ruptured popliteal cysts. Conclusion: EVM of the leg are (1) a frequent cause of ‘pseudothrombosis' and can positively be identified by duplex ultrasound scanning: (2) most frequently found in the medial aspect of the right calf; and (3) often detected in patients with rheumatoid arthritis or patients on anticoagulant therapy and may give rise to signs and symptoms identical to DVT.