I finally found something exciting to write about, the suture button/tightrope. I must admit that I’ve been “suture button curious” for a while now and seeing Andersen et al’s exciting RCT with almost 100 patients was truly interesting. The suture button outperformed the 4-cortical syndesmotic screws in all measurements, both patient reported and radiographic. The study is simply almost too good to be true. Continue reading
Category Archives: General
Unstable ankle fractures – a British multi-center study provides a neat alternative to surgery
The Brits have done it again: an amazing, multi-center study on ankle surgery. They looked at 620 unstable ankle fractures and compared close contact casting (CCC) with surgery. Like so many orthopaedic interventions it seems that both methods are equivalent regarding patient reported outcome although 15% had malunion vs 3% in in the surgical group. Likewise there was a higher non-union in the CCC group, 10% vs 3%. Furthermore about 1 in 5 in the CCC group required later surgery. Continue reading
Chochrane supports restrictive transfusions
I’ve previously written a two posts on blood transfusions from a surgeons perspective (End of the blood reign and A bloody mess) and I was therefore thrilled when I stumbled upon this [Cochrane review](https://www.ncbi.nlm.nih.gov/pubmed/27731885) that concludes:
The findings provide good evidence that transfusions with allogeneic RBCs can be avoided in most patients with haemoglobin thresholds above 7 g/dL to 8 g/dL.
Setting up a multilabel classification network with torch-dataframe
A common situation is that you have an image that can represent more than one class, e.g. a image may both have an oil tanker and an oil platform. You also may have missing data for some of these that you don’t want to evaluate. In my research this problem occurs and my solution so far has been a my own [criterion_ignore](https://github.com/gforge/criterion_ignore) that sets the errors for ignore labels to zero. This post will be a quick look at how to combine the torch-dataframe with the criterion_ignore. Continue reading
Canakinumab – difficult to pronounce but useful for treating gout?
Gout can be incredibly painful where the main treatment option are nonsteroidal anti-inflammatory drugs (NSAID). Unfortunately NSAIDs are not the best alternative for elderly patients as it may induce heart & kidney failure. I was therefore thrilled to see that canakinumab recently was approved by Läkemedelsverket as a treatment alternative. Continue reading
End of the blood reign?
As I have a weakness for studies that challenge the dogma, I was ecstatic when I stumbled upon Carson et al.’s bold study on blood transfusions. In their study they selected 2000 patients with cardiovascular disease that were undergoing surgery due to hip fracture. Interestingly, there was no difference in 3-year mortality when randomizing between transfusion Hemoglobin thresholds of 100 g/L or 80 g/L! Continue reading
Financial incentives in health-care – a podcast recommendation
I recently e-mailed Freakonomics asking them to look into the economic incentives that govern health-care. Guess if I was thrilled when I found these two recent gems (although I can’t take any credit):
- How Do We Know What Really Works in Healthcare?
- How Many Doctors Does It Take to Start a Healthcare Revolution?
Freakonomics delivers as always with a fresh, interesting scientific perspective. As a supporter since a few years I want to recommend these to anyone interested in the topic. As I have written earlier, I find it perplexing that so many arthroscopies are being performed while so much evidence is pointing against this. There is probably a vast combination of incentives that result in this, these podcasts provide some nice insights.
Drawing a directed acyclic graph (DAG) for blood transfusions after surgery
I recently wrote about blood transfusions and their inherent risk of postoperative infections. This post is a tutorial on some of the basics of drawing a directed acyclic graph (DAG). Blood transfusions and infections is a great topic as most are familiar with risk factors for infections. Continue reading
Fast-track publishing using knitr: intro (part I)
Fast-track publishing using knitr is a short series on how I use knitr to get my articles faster published. By fast-track publishing I mean eliminating as many of the obstacles as possible during the manuscript phase, and not the fast-track some journals offer. In this first introductory article I will try to (1) define the main groups of obstacles I have experienced motivating knitr, (2) options I’ve used for extracting knitted results into MS Word. The emphasis will be on general principles and what have worked for me. Continue reading
Compartment syndrome occurs most commonly after trauma to the lower leg. It causes excruciating pain and may result in muscle death and in some sever cases even death. Detecting these is therefore of uttermost importance and McQueen et al’s recent study on the subject is very welcome. They show that continuous intracompartmental pressure measurement in a clinical setting is feasible and has a high sensitivity and specificity. Continue reading