Understanding the mechanism of injury and fracture pattern of paediatric triplane ankle fractures versus adult trimalleolar fractures.

Aims: Paediatric triplane fractures and adult trimalleolar ankle fractures both arise from a supination external rotation injury. By relating the experience of adult to paediatric fractures, clarification has been sought on the sequence of injury, ligament involvement, and fracture pattern of triplane fractures. This study explores the similarities between triplane and trimalleolar fractures for each stage of the Lauge-Hansen classification, with the aim of aiding reduction and fixation techniques.

Functional recovery after reduced pediatric fractures of the forearm with respect to perceived limitations, common post-traumatic symptoms, range of motion, and dexterity: a prospective study.

Purpose: Studies on functional recovery after pediatric forearm fractures are scarce. Outcome measures are usually (retrospectively) incorporated to compare treatments. How these parameters recover has only rarely fallen within the scope.

A Two-Step Approach for 3D-Guided Patient-Specific Corrective Limb Osteotomies.

Corrective osteotomy surgery for long bone anomalies can be very challenging since deformation of the bone is often present in three dimensions. We developed a two-step approach for 3D-planned corrective osteotomies which consists of a cutting and reposition guide in combination with a conventional osteosynthesis plate. This study aimed to assess accuracy of the achieved corrections using this two-step technique.

Detection of foot contact in treadmill running with inertial and optical measurement systems.

In running assessments, biomechanics of the stance phase are often measured to understand external loads applied to the body. Identifying time of initial foot contact can be challenging in runners with different strike patterns. Peak downward velocity of the pelvis (PDVP) has been validated in a laboratory setting to detect initial contact.

The Effect of Grazing Intensity and Sward Heterogeneity on the Movement Behavior of Suckler Cows on Semi-natural Grassland.

Extensively grazed semi-natural grasslands contribute to a wide range of ecosystem services, including the preservation of biodiversity and provision of livestock feed. Depending on the grazing intensity, cattle are set in motion to fulfill their nutritional needs. In this way, they influence the vegetation composition, while at the same time the foraging behavior is affected by the vegetation.

Recovery of strength after reduced pediatric fractures of the forearm, wrist or hand; A prospective study.

Introduction: The way strength recovers after reduction of pediatric fractures of the upper extremity has not previously been the specific scope of research. This is remarkable, since strength measurements are often used as an outcome measure in studies on trauma of the upper extremity. The aim of this study was to evaluate how strength recovers after sustainment of fractures of the forearm, wrist or hand treated by closed or open reduction in children and adolescents in the first 6 months after trauma.

High delayed and missed injury rate after inter-hospital transfer of severely injured trauma patients.

Purpose: Missed injuries are reported in 1.3-65% of all admitted trauma patients. The severely injured patient that needs a higher level of care which requires an inter-hospital transfer has an increased risk for missed injuries.

Gradual tapering TNF inhibitors versus conventional synthetic DMARDs after achieving controlled disease in patients with rheumatoid arthritis: first-year results of the randomised controlled TARA study.

Objectives: The aim of this study is to evaluate the effectiveness of two tapering strategies after achieving controlled disease in patients with rheumatoid arthritis (RA), during 1 year of follow-up.

Methods: In this multicentre single-blinded (research nurses) randomised controlled trial, patients with RA were included who achieved controlled disease, defined as a Disease Activity Score (DAS) ≤ 2.4 and a Swollen Joint Count (SJC) ≤ 1, treated with both a conventional synthetic disease-modifying antirheumatic drugs (csDMARD) and a TNF inhibitor.

Dissemination of localized Mycobacterium malmoense infection in an immunocompromised patient.

A 75-year-old woman with a history of immunosuppressive treatment for rheumatoid arthritis and non-Hodgkin lymphoma, was referred to our reference centre for treatment of tenosynovitis caused by Mycobacterium malmoense, which had disseminated due to immunosuppressive therapy. This rare diagnosis was made after years of treatment for supposed rheumatoid arthritis. The patient presented with relapsing tenosynovitis with wounds on her right middle finger and wounds on her left lower leg, despite 3 months of adequate therapy (rifampicin+ethambutol+clarithromycin).

[E-bikers are more often seriously injured in bicycle accidents: results from the Groningen bicycle accident database].

Objective: Analysing injury types, injury severity and mortality in victims of accidents with electric bicycles in comparison with conventional bicycles.

Design: Prospective cohort study.

Method: Data of patients treated at the Accident & Emergency Department of the University Medical Center Groningen after a bicycle accident are being entered in a database since 2014.

Predictive factors of radiological progression after 2 years of remission-steered treatment in early arthritis patients: a post hoc analysis of the IMPROVED study.

Objectives: To identify predictive factors of radiological progression in early arthritis patients treated by remission-steered treatment.

Methods: In the IMPROVED study, 610 patients with early rheumatoid arthritis (RA) or undifferentiated arthritis (UA) were treated with methotrexate (MTX) and a tapered high dose of prednisone. Patients in early remission (disease activity score (DAS) <1.

Health-related quality of life and functional ability in patients with early arthritis during remission steered treatment: results of the IMPROVED study.

Introduction: The aim of this study was to investigate patient reported outcomes (PROs) of functional ability and health related quality of life (HRQoL) in patients with early (rheumatoid) arthritis during one year of remission steered treatment.

Methods: In this study, 610 patients with early rheumatoid arthritis (RA) or undifferentiated arthritis (UA) were treated with methotrexate (MTX) and tapered high dose of prednisone. Patients in early remission (Disease Activity Score (DAS) <1.

Four-month metacarpal bone mineral density loss predicts radiological joint damage progression after 1 year in patients with early rheumatoid arthritis: exploratory analyses from the IMPROVED study.

Aim: To assess whether in early (rheumatoid) arthritis (RA) patients, metacarpal bone mineral density (BMD) loss after 4 months predicts radiological progression after 1 year of antirheumatic treatment.

Methods: Metacarpal BMD was measured 4 monthly during the first year by digital X-ray radiogrammetry (DXR-BMD) in patients participating in the IMPROVED study, a clinical trial in 610 patients with recent onset RA (2010 criteria) or undifferentiated arthritis, treated according to a remission (disease activity score<1.6) steered strategy.

A two-step treatment strategy trial in patients with early arthritis aimed at achieving remission: the IMPROVED study.

Objectives: To assess which treatment strategy is most effective in inducing remission in early (rheumatoid) arthritis.

Methods: 610 patients with early rheumatoid arthritis (RA 2010 criteria) or undifferentiated arthritis (UA) started treatment with methotrexate (MTX) and a tapered high dose of prednisone. Patients in early remission (Disease Activity Score <1.

Outbreak of severe sepsis due to contaminated propofol: lessons to learn.

Nosocomial infections are a frequent concern in healthcare. Despite the available knowledge on nosocomial infections and preventive measures, outbreaks of infections continue to occur. An outbreak of severe sepsis in patients who underwent minor procedures in an operating theatre during two consecutive days is described and analysed in this study.

Medication reconciliation performed by pharmacy technicians at the time of preoperative screening.

Background: Medication errors occur regularly in surgical patients, especially due to transfer problems at the time of hospital admission. A method for decreasing the error rate is medication reconciliation by hospital pharmacists as part of a preoperative clinic. The role of pharmacy technicians in this process has not been studied.

Empirical evaluation of spatial and non-spatial European-scale multimedia fate models: results and implications for chemical risk assessment.

Multimedia environmental fate models are commonly-applied tools for assessing the fate and distribution of contaminants in the environment. Owing to the large number of chemicals in use and the paucity of monitoring data, such models are often adopted as part of decision-support systems for chemical risk assessment. The purpose of this study was to evaluate the performance of three multimedia environmental fate models (spatially- and non-spatially-explicit) at a European scale.

Uncertainty in msPAF-based ecotoxicological effect factors for freshwater ecosystems in life cycle impact assessment.

Ecotoxicological effect factors are part of the analysis of relative impacts by chemical contaminants on ecosystems. Uncertainty distributions, represented by the 90% confidence interval, belonging to ecotoxicological effect factors for freshwater ecosystems were determined. This study includes 869 high production volume chemicals, related to 7 nonspecific toxic modes of action (TMoAs).

Estimating the impact of high-production-volume chemicals on remote ecosystems by toxic pressure calculation.

Although many chemicals are in use, the environmental impacts of only a few have been established, usually on per-chemical basis. Uncertainty remains about the overall impact of chemicals. This paper estimates combined toxic pressure on coastal North Sea ecosystems from 343 high-production-volume chemicals used within the catchment of rivers Rhine, Meuse, and Scheldt.

Evaluation of the electroencephalographic bispectral index during fentanyl-midazolam anaesthesia for cardiac surgery. Does it predict haemodynamic responses during endotracheal intubation and sternotomy?

The bispectral index, a value derived from the electroencephalogram, has been proposed as a measure of anaesthetic effect. The aim of the present study was to evaluate the bispectral index during midazolam-fentanyl anaesthesia for cardiac surgery for its possible role as a predictor of increases in systolic blood pressure during endotracheal intubation and sternotomy. After institutional approval 15 consenting patients, scheduled for elective cardiac surgery, were selected for the study.

Function of pediatric Nissen-Rossetti fundoplication followed up into adolescence and adulthood.

Background: We analyzed the very long-term results of the Nissen-Rossetti fundoplication performed in young children. Little has been reported about follow-up longer than 5 years in homogeneous populations. This study concerns a homogeneous group with a minimum follow-up of 10 years; these former patients, therefore, are now adolescents or adults.

A double blind comparison of lidocaine 2% with or without glucose for spinal anesthesia.

The aim of the study was to compare lidocaine 2% plain to lidocaine 2% with glucose 8% for spinal anesthesia. Forty male patients scheduled for urologic surgery participated. The patients were randomly divided into two groups: the plain (P) group received 4 ml of glucose-free lidocaine 2%, the heavy (H) group received 4 ml of lidocaine 2% containing 8% glucose.

Thoracic epidural bupivacaine plus sufentanil: high concentration/low volume versus low concentration/high volume.

Background And Objectives: To compare the postoperative analgesic and side effects of a continuous epidural infusion of bupivacaine with sufentanil: high concentration/low volume versus low concentration/high volume.

Methods: In a prospective study, 30 patients scheduled for thoracic surgery had a thoracic epidural catheter inserted. Postoperative analgesia was provided by a continuous epidural infusion for 3 days.