Forearm muscle dynamometry was performed in the non-dominant arm in 61 patients undergoing major abdominal and limb vascular surgery, before operation and then 1, 3, 5, and 7 days after surgery. Six patients died in the postoperative period and seven patients developed major postoperative complications (bronchopneumonia, two; wound infection, four; myocardial infarction, one). The preoperative grip strength, measured in kilograms, of the patients who died after major vascular surgery was not significantly lower than that of patients who had an uncomplicated postoperative course. Of the 55 surviving patients, seven developed complications after surgery. These patients had significantly reduced grip strength, expressed as a percentage of the individual preoperative value (P less than 0.05), from the first to the seventh postoperative day when compared with patients without complications. The delayed recovery of grip strength preceded the clinical manifestation of complications. These data suggest that delayed recovery of voluntary muscle performance may be used to detect patients developing postoperative complications and so allow their early treatment.
Summary:Three hundred and fifty women complaining of breast pain symptoms of sufficient severity to interfere with their normal lifestyle were reviewed in a special breast pain clinic over a 5 year period.Seventy-two patients (21%) had spontaneous resolution of breast pain and they required reassurance only before discharge. Of the remaining 278 patients, accurate classification ofbreast pain syndromes was achieved in 89%, the commonest syndrome being cyclical breast pain which accounted for 54% of the women followed up. The remaining womens' breast pain was classified as trigger zone (14%), continuous (8%), Tietze's disease (5%), spinal root (4%), duct ectasia (4%) and psychological depression (2%). In the remaining 25 patients (9%) the breast pain could not be classified.The experience from this clinic is that a majority of women complaining ofsevere breast pain symptoms can be accurately classified and appropriate therapy instituted.
With an adenoma pick-up rate of 8 to 12 percent for screening flexible sigmoidoscopy, retroflexion increases adenoma detection by approximately 1 percent without adverse effects and should be an integral part of flexible sigmoidoscopy.
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