Objectives: To evaluate the clinical effectiveness of soft tissue injury management by emergency nurse practitioners (ENPs) and extended scope physiotherapists (ESPs) compared to the routine care provided by doctors in a UK emergency department (ED).
Design: Randomised, pragmatic trial of equivalence.
Setting: One adult ED in England.
Participants: 372 patients were randomised; 126 to the ESP group, 123 to the ENP group and 123 to the doctor group. Participants were adults (older than 16 years) presenting to the ED with a peripheral soft tissue injury eligible for management by any of the three professional groups. Patients were excluded if they had any of the following: injury greater than 72 hours old; systemic disease; dislocated joints; recent surgery; unable to give informed consent (eg, dementia), open wounds; major deformities; opiate analgesia required; concurrent chest/rib injury; neurovascular deficits and associated fracture.
Interventions: Patients were randomised to treatment by ESPs, ENPs or routine care provided by doctors (of all grades).
Main Outcome Measures: Upper-limb and lower-limb functional scores, quality of life, physical well-being, preference-based health measures and the number of days off work.
Results: The clinical outcomes of soft tissue injury treated by ESPs and ENPs in the ED were equivalent to routine care provided by doctors.
Conclusions: As all groups were clinically equivalent it is other factors such as cost, workforce sustainability, service provision and skill mix that become important. This result validates the role of the ENP, which is becoming established as an integral part of minor injuries care, and demonstrates that the ESP should be considered as part of the clinical skill mix without detriment to outcomes. ISRCTN-ISRCTN TRIALS REGISTER NUMBER: 70891354.
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http://dx.doi.org/10.1136/bmjopen-2012-001092 | DOI Listing |
Langenbecks Arch Surg
January 2025
Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Purpose: Optimal management of retroperitoneal soft tissue sarcoma (RPS) often requires extensive tumor resections, frequently involving gastrointestinal organs. The impact of these procedures on the nutritional status and hemoglobin (Hb) levels of RPS patients remain unexplored. In this study, we aimed to evaluate preoperative nutritional status as well as the prevalence of anemia in RPS patients, and to investigate longitudinal changes throughout the disease course in order to identify potential strategies for prehabilitation.
View Article and Find Full Text PDFOrthod Fr
January 2025
Nantes Université, Université Angers, CHU Nantes, INSERM, CNRS, CRCI2NA, 44000 Nantes, France
Introduction: The aim of this article is to present the diagnostic and therapeutic approach to unilateral posterior vertical insufficiency.
Material And Methods: The authors describe the management protocol.
Results: Posterior vertical insufficiency (PVI) manifests clinically as obliquity of the maxillo-mandibular occlusal plane and bicommissural line, and deviation of the chin.
Turk Neurosurg
February 2024
SBÜ Gaziosmanpaşa Eğitim ve Araştırma Hastanesi.
Aim: Minimally-invasive spinal surgery is increasingly being adopted worldwide. In this study, we evaluated the postoperative magnetic resonance imaging (MRI) findings and clinical outcomes of patients who underwent full endoscopic lumbar disk surgery.
Methods: Preoperative and postoperative 3rd and 6th month MRI features, visual analog scale (VAS) score, Oswestry Disability Index (ODI), and clinical features of patients who underwent percutaneous endoscopic lumbar discectomy between August 2009 and January 2012 were retrospectively analyzed.
J Oral Rehabil
January 2025
Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, Gangneung, Republic of Korea.
Background: For restorative demands, increased vertical dimension of occlusion (VDO) is sometimes necessary, as facial changes can be perceptible.
Objectives: This study aimed to evaluate the perception of facial change due to increased VDO and associated soft tissue changes using 3D-scanned facial images.
Methods: Forty participants with healthy dentition and no loss of VDO were recruited.
Cureus
December 2024
Biomedical Sciences, University of Chicago, Chicago, USA.
Pediatric-type follicular lymphoma (PTFL) is an extremely rare B-cell lymphoma that primarily affects children and young adults, typically in individuals under 25 years old, with a median age of 15 years. Here, we report a rare case of PTFL in a 27-year-old adult male who presented with a slow-growing mass near his left ear. Initial CT scans of the neck revealed two oval-shaped, smooth, well-defined, homogeneously enhancing soft tissue density lesions in the superficial lobe of the left parotid gland.
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