Abstract:
INTRODUCTION:There is no definitive cure for Dupuytren disease (DD), and recurrence of finger contractures after treatment is common. Surgical fasciectomy is considered the standard treatment method for recurrence, although associated with a high incidence of complications. Collagenase injection, a non-surgical treatment option, has been shown to be a safe and effective method; however, most studies regarding collagenase have involved first-time treatment. Collagenase efficacy in patients with recurrent DD beyond the immediate effect has not yet been determined. The aim of our study is to compare surgical fasciectomy and collagenase injection in treating recurrent DD. METHODS AND ANALYSIS:The study is a single-centre randomised controlled trial. Inclusion criteria are recurrence of DD in one or more fingers after previous treatment with fasciectomy or collagenase injection, a passive extension deficit ≥30° in the metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joint, and a palpable cord causing the recurrent contracture. A total of 56 patients will be randomised to either surgical fasciectomy or collagenase injection. A hand therapist blinded to patients' group allocation will measure range of motion at baseline, 3 months, 12 months, 24 months and 60 months. The primary outcomes are the total active extension deficit (MCP plus PIP) at 3 months and the proportion of patients with contracture worsening ≥20° in the treated finger joint at 2 years compared with 3 months. The secondary outcomes include changes in total active motion, active and passive extension deficit from baseline up to 5 years, scores on patient-reported outcome measures, adverse events and costs of treatment. ETHICS AND DISSEMINATION:Ethical approval has been obtained from the Regional Ethical Review Board, Lund University, Sweden(2017/623). The trial will be conducted according to the Helsinki Declaration of 1975, revised in 2000. The results of the trial will be disseminated as published articles in peer-reviewed journals. TRIAL REGISTRATION:NCT03406338; Pre-results.
journal_name
BMJ Openjournal_title
BMJ openauthors
Nordenskjöld J,Lauritzson A,Waldén M,Kopylov P,Atroshi Idoi
10.1136/bmjopen-2018-024424subject
Has Abstractpub_date
2019-02-25 00:00:00pages
e024424issue
2issn
2044-6055pii
bmjopen-2018-024424journal_volume
9pub_type
杂志文章,随机对照试验相关文献
BMJ Open文献大全abstract:INTRODUCTION:Osteoarthritis of the knee has been identified as the most common disability in Pakistan. Total knee replacement (TKR) surgery is the curative treatment for advanced osteoarthritis of the knee; however, cost remains one of the barriers to effective and timely service delivery. OBJECTIVE:We conducted a tim...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025258
更新日期:2019-05-28 00:00:00
abstract:OBJECTIVES:To explore feedback on tailored SMS reminders to encourage medication adherence and outpatient treatment among patients taking antipsychotic medication, and associations related to the feedback. DESIGN:A cross-sectional survey nested within a nationwide randomised clinical trial ("Mobile.Net" ISRCTN27704027...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2015-008574
更新日期:2015-11-09 00:00:00
abstract:OBJECTIVES:Amid a political agenda for integrated, high-value care, the UK is implementing its Low Back and Radicular Pain Pathway. To align care with need, it is imperative to understand the patients' perspective. The purpose of this study was, therefore, to explore how people experience being managed for sciatica wit...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037157
更新日期:2020-06-11 00:00:00
abstract:INTRODUCTION:Low vision and blindness adversely affect education and independence of children and young people. New 'assistive' technologies such as tablet computers can display text in enlarged font, read text out to the user, allow speech input and conversion into typed text, offer document and spreadsheet processing...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-015939
更新日期:2017-06-21 00:00:00
abstract:OBJECTIVE:To explore healthcare providers' views on barriers to and facilitators of use of the national family planning (FP) guideline for FP services in Amhara Region, Ethiopia. DESIGN:Qualitative study. SETTING:Nine health facilities including two hospitals, five health centres and two health posts in Amhara Region...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-023403
更新日期:2019-02-20 00:00:00
abstract:OBJECTIVE:Chronic obstructive pulmonary disease (COPD) is among the leading causes of morbidity and mortality worldwide, but longitudinal studies of the economic consequences of COPD are scarce. This Danish study evaluated for the first time ever the economic consequences of COPD of an entire nation before and after th...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-004069
更新日期:2014-01-06 00:00:00
abstract:INTRODUCTION:Systematic reviews of high-quality randomised controlled trials are necessary to identify effective interventions to impact burn wound infection (BWI) outcomes. Evidence synthesis requires that BWI is reported in a consistent manner. Cochrane reviews investigating interventions for burns report that the in...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-026056
更新日期:2019-05-14 00:00:00
abstract:OBJECTIVE:To assess scientific publication and map research gaps on access to medicines (ATM) in Latin American and the Caribbean low-income and middle-income countries (LMIC). DESIGN:Scoping review. Two independent reviewers assessed studies for inclusion and extracted data from each study. INFORMATION SOURCES:Searc...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-002224
更新日期:2013-05-03 00:00:00
abstract:INTRODUCTION:Previous studies have showed association between smoking and central fat distribution. However, the impact of smoking on whole body fat distribution, particularly peripheral fat distribution remains unclear. METHODS:Nicotine dependence was assessed in a total of 1264 male adults aged 18-80 years using the...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-022465
更新日期:2019-03-12 00:00:00
abstract::Background Mini-sternotomy for isolated aortic valve replacement aims to reduce operative trauma hastening recovery and improving the cosmetic outcome of cardiac surgery. The short-term clinical benefits from the mini-sternotomy are presumed to arise because the incision is less extensive and the lower half of the che...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2011-000266
更新日期:2011-11-24 00:00:00
abstract:OBJECTIVES:To use wrist-actrigrphy to collect objective measures of sleep and to characterise actigraphy-measured sleep patterns among children with disabilities. We also assessed the extent to which, if at all, caregivers' education is associated with children's sleep disturbances. DESIGN:Cross-sectional study. SETT...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008589
更新日期:2015-12-07 00:00:00
abstract:INTRODUCTION:Diabetic macular oedema (DMO) and proliferative diabetic retinopathy (PDR) are the major causes of sight loss in people with diabetes. Due to the increased prevalence of diabetes, the workload related to these complications is increasing making it difficult for Hospital Eye Services (HSE) to meet demands. ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027795
更新日期:2019-06-28 00:00:00
abstract:OBJECTIVES:The objective of this study was to explore whether reducing the material supplied to external experts during peer review and decreasing the burden of response would maintain review quality into prioritising research questions for a major research funder. METHODS AND ANALYSIS:Clinical experts who agreed to r...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-016104
更新日期:2017-08-21 00:00:00
abstract:OBJECTIVE:To evaluate the impact of a model of rural community health service (CHS) on the use and acceptability of primary healthcare services. DESIGN:Quasi-experimental. SETTING:Two adjacent rural counties in China. PARTICIPANTS:5842 residents in 2009 and 3807 in 2010 from 980 households in 7 intervention township...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-004148
更新日期:2014-02-28 00:00:00
abstract:INTRODUCTION:Excessive prescribing after surgery has contributed to a public health crisis of opioid addiction and overdose in North America. However, the value of prescribing opioids to manage postoperative pain after surgical discharge remains unclear. We propose a systematic review and meta-analysis to assess the ex...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-035443
更新日期:2020-02-02 00:00:00
abstract:OBJECTIVES:To better model underlying trends in cervical cancer incidence so as to model past trends, to estimate the impact of cervical screening on cervical cancer rates at different ages and to obtain a counterfactual baseline under a no-screening scenario. DESIGN:Trend analysis of cancer registry data recorded bet...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-026292
更新日期:2019-01-24 00:00:00
abstract:INTRODUCTION:North America is amid an opioid use epidemic. Opioid agonist treatment (OAT) effectively reduces extramedical opioid use and related harms. As with all pharmacological treatments, there are risks associated with OAT, including fatal overdose. There is a need to better understand risk for adverse outcomes d...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025204
更新日期:2018-08-05 00:00:00
abstract:INTRODUCTION:Delirium is very common in patients admitted to intensive care unit (ICU), and may worsen survival in these patients. Several meta-analyses have evaluated the antidelirium effects of dexmedetomidine in ICU patients, but their findings were inconsistent. Recently, several large multicentre randomised clinic...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025850
更新日期:2019-04-03 00:00:00
abstract:OBJECTIVES:To summarise treatment success rate (TSR) among adult bacteriologically confirmed pulmonary tuberculosis (BC-PTB) patients in sub-Saharan Africa (SSA). DESIGN:We searched MEDLINE, EMBASE, Google Scholar and Web of Science electronic databases for eligible studies published in the decade between 1 July 2008 ...
journal_title:BMJ open
pub_type: 杂志文章,meta分析
doi:10.1136/bmjopen-2019-029400
更新日期:2019-09-06 00:00:00
abstract:OBJECTIVE:To investigate social inequalities underlying low birthweight (LBW) outcomes in Sri Lanka. DESIGN:Cross-sectional study. SETTING:This study used the Sri Lanka Demographic and Health Survey 2016, the first such survey to cover the entire country since the Civil War ended in 2001. PARTICIPANTS:Birthweight da...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037223
更新日期:2020-05-25 00:00:00
abstract:OBJECTIVE:Township hospitals (THs) are important components of the three-tier rural healthcare system of China. However, the efficiency and productivity of THs have been questioned since the healthcare reform was implemented in 2009. The objective of this study is to analyse the efficiency and productivity changes in T...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011911
更新日期:2016-11-11 00:00:00
abstract:OBJECTIVES:This review aims to understand what elements of psychosocial interventions are associated with improved outcomes for people with dementia to inform implementation in care homes. DESIGN:A systematic review of qualitative and quantitative intervention studies was undertaken. ELIGIBILITY CRITERIA FOR INCLUDED...
journal_title:BMJ open
pub_type: 杂志文章,评审
doi:10.1136/bmjopen-2016-014177
更新日期:2017-02-09 00:00:00
abstract:OBJECTIVES:To compare the risk profile of women giving birth in private and public hospitals and the rate of obstetric intervention during birth compared with previous published rates from a decade ago. DESIGN:Population-based descriptive study. SETTING:New South Wales, Australia. PARTICIPANTS:691 738 women giving b...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001723
更新日期:2012-09-10 00:00:00
abstract:OBJECTIVE:To investigate timely access to palliative medicines/drugs (PMs) from community pharmacies to inform palliative care service delivery. DESIGN:Mixed methods in two sequential phases: (1) prospective audit of prescriptions and concurrent survey of patients/representatives collecting PMs from pharmacy and (2) i...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029016
更新日期:2019-11-24 00:00:00
abstract:INTRODUCTION:After a diagnosis of localised breast cancer, overweight, obesity and weight gain are negatively associated with prognosis. In contrast, maintaining an optimal weight through a balanced diet combined with regular physical activity appears to be effective protective behaviour against comorbidity or mortalit...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003855
更新日期:2013-10-28 00:00:00
abstract:OBJECTIVES:To assess which osmolarity equation best predicts directly measured serum/plasma osmolality and whether its use could add value to routine blood test results through screening for dehydration in older people. DESIGN:Diagnostic accuracy study. PARTICIPANTS:Older people (≥65 years) in 5 cohorts: Dietary Stra...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008846
更新日期:2015-10-21 00:00:00
abstract:OBJECTIVE:Multiple rib fractures (RFs) and pulmonary contusions (PCs), with resulting systemic lung inflammation, are the most common injuries caused by blunt chest trauma (BCT) in motor vehicle accidents. This study examined levels of the inflammation marker interleukin (IL)-6 and those of the acute-phase reactant sur...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011797
更新日期:2016-10-12 00:00:00
abstract:OBJECTIVES:This study aimed to investigate whether violent and non-violent offending were related to elevated risk of suicide. We also investigated whether the risk was higher among those with repeated offences and how experiences of substance misuse and suicide attempt modified the relationship. DESIGN:A nationwide p...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003497
更新日期:2014-02-03 00:00:00
abstract:OBJECTIVES:To improve the experiences of people from diverse cultural backgrounds, there has been an increased emphasis on strengthening cultural awareness and competence in healthcare contexts. The aim of this focus-group based study was to explore how professionals in cancer care experience their encounters with migr...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-025956
更新日期:2019-03-23 00:00:00
abstract:OBJECTIVES:Patients with atrial fibrillation (AF) are at increased risk of many adverse events, notably stroke. To prevent all adverse outcomes, integrated AF care is advocated though the potential domain for such multidisciplinary management is still unclear. Therefore, insight in the systemic nature of AF and identif...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-021681
更新日期:2018-08-23 00:00:00