ABSTRACT
In Norway as a whole, an average of six percent of all patients who had been guaranteed treatment within six months had not received treatment as promised. A survey of 917 orthopaedic "guarantee patients" who had waited longer than five months for treatment showed that 486 patients had waited longer than six months. 28% of the patients were suffering from hip or back problems, and the majority were suffering from problems in the extremities. In the case of 11% treatment was, in their own view, no longer relevant, and 2/3 were not interested in receiving treatment at another hospital, if this were to be offered. In the case of 33% of the patients the referring doctor thought it reasonable that the waiting time had exceeded six months.
Subject(s)
Orthopedics/legislation & jurisprudence , Waiting Lists , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , NorwaySubject(s)
Down Syndrome/blood , Thyroid Hormones/blood , Adult , Down Syndrome/complications , Humans , Hypothyroidism/etiology , Middle AgedABSTRACT
Between 1951 and 1973, 138 patients aged 0 to 12 years were operated on for coarctation of the aorta. Ten of 18 infants died early. There were 3 late deaths, 2 occurred suddenly and 1 after reoperation. Three of the 125 late survivors had severe, 19 had slight symptoms, while 103 had no complaints, 3 of whom refused examination. The remaining 122 cases were examined between 2 and 24 years (mean 10.9 years) after the operation. Two patients had sequelae from an operative spinal cord injury and 2 had late hemipareses (traumatic in one). Recoarctation, defined as arm/leg pressure gradient exceeding mmHg, totally occurred in 18.7%, and in 4 of 7 cases operated on in infancy. Hypertension without recoarctation was observed in 17.2% and associated cardiovascular anomalies in 18% of the late survivors. It is suggested that the optimal age for surgical repair of coarctation of the aorta is between 4 and 6 years of age. A long-term follow-up is recommended in all patients.
Subject(s)
Aortic Coarctation/surgery , Adolescent , Adult , Age Factors , Aortic Coarctation/complications , Aortic Coarctation/mortality , Aortic Coarctation/physiopathology , Blood Pressure , Child , Female , Follow-Up Studies , Heart Diseases/complications , Humans , Male , Paralysis/complications , Postoperative Complications/mortality , Prognosis , RecurrenceABSTRACT
Intranasal administration of DDAVP (1-deamino-8-D-arginine vasopressin), a synthetic analogue of vasopressin, followed by measurement of urine osmolaity 6 h afterwards, represents a convenient, reliable and simple method for the estimation of renal concentrating capacity in children. The DDAVP-test is as accurate and reproducible as the water deprivation test, irrespective of the degree of concentrating capacity. Mean urine osmolality after DDAVP in children without renal disease was found to be 984 +/- 218 mosmol/kg water (m +/- 2 SD). In children with recurrent pyelonephritis, urine osmolality after DDAVP was decreased. The values were significantly lower with bilateral changes than with unilateral changes of chronic pyelonephritis in the i.v. urograms. In chronic pyelonephritis the concentrating capacity appears to be earlier impaired than other parameters of renal function.
