Axillary Reverse Mapping Using Indocyanine Green in Breast Cancer: Standardization of the Technique.

Purpose: To validate the Axillary Reverse Mapping (ARM) technique with indocyanine green (ICG), focusing on the detection rate and the procedure's feasibility. The predictive factors for metastatic involvement of ARM nodes are also analyzed to define the target population for ARM indication.

Methods: This prospective, observational, non-randomized study of patients with breast cancer included patients with an indication for axillary lymph node dissection (ALND) performed between June 2021 and June 2023.

Long-term outcome of the Sauvé-Kapandji procedure in patients with post-traumatic distal radioulnar joint disorders.

The aims of this study were to retrospectively assess the occurrence of complications or need for secondary wrist procedures after the Sauvé-Kapandji procedure, and to prospectively assess patient-reported outcomes at long-term follow-up. All patients treated with the Sauvé-Kapandji procedure in our tertiary referral hospital between January 2008 and September 2021 were identified and contacted to complete the Quick Disabilities of the Arm, Shoulder, and Hand and the Patient-Rated Wrist/Hand Evaluation outcome measures. In total, 30 patients, with a median follow-up of 82 months, were included in this study.

How a broken vertebra can lead to a fatal hemorrhage: a case report.

Background: Unintentional falls are common among the elderly and given the expected increase of the aging population, these falls contribute to a high number of admissions to the emergency department. Relatively low-energy trauma mechanisms can lead to serious injuries in the elderly, with contributing factors being comorbidities, medication use and degenerative abnormalities.

Case Presentation: A 94-year-old female suffered an unintentional fall at home.

AI Algorithm to Predict Acute Coronary Syndrome in Prehospital Cardiac Care: Retrospective Cohort Study.

Background: Overcrowding of hospitals and emergency departments (EDs) is a growing problem. However, not all ED consultations are necessary. For example, 80% of patients in the ED with chest pain do not have an acute coronary syndrome (ACS).

[Prehospital triage of undifferentiated syndromes in the ambulance].

Increasing complexity due to an ageing population, a shortage of healthcare professionals and the rising costs are major concerns for the acute care in the coming years. Innovative triage methods in the ambulance could improve appropriate care for patients with subacute undifferentiated syndromes. A proportion of these patients should not be transferred to an emergency department.

Serum metabolomics analysis for quantification of muscle loss in critically ill patients: An explorative study.

Background: During Intensive Care Unit (ICU) admission, patients demonstrate up to 15% muscle loss per week, contributing to neuromuscular weakness, complicating recovery and delaying return to daily life. Biomarkers for muscle loss could aid in early detection of patients at risk and help guide resources to mitigate muscle loss, e.g.

Comparison of Prehospital Assessment by Paramedics and In-Hospital Assessment by Physicians in Suspected Stroke Patients: Results From 2 Prospective Cohort Studies.

Background: It is unknown if ambulance paramedics adequately assess neurological deficits used for prehospital stroke scales to detect anterior large-vessel occlusions. We aimed to compare prehospital assessment of these stroke-related deficits by paramedics with in-hospital assessment by physicians.

Methods: We used data from 2 prospective cohort studies: the LPSS (Leiden Prehospital Stroke Study) and PRESTO study (Prehospital Triage of Patients With Suspected Stroke).

Prehospital Stroke Triage: A Modeling Study on the Impact of Triage Tools in Different Regions.

Background And Purpose: Direct transportation to a thrombectomy-capable intervention center is beneficial for patients with ischemic stroke due to large vessel occlusion (LVO), but can delay intravenous thrombolytics (IVT). The aim of this modeling study was to estimate the effect of prehospital triage strategies on treatment delays and overtriage in different regions.

Methods: We used data from two prospective cohort studies in the Netherlands: the Leiden Prehospital Stroke Study and the PRESTO study.

Improved prehospital triage for acute cardiac care: results from HART-c, a multicentre prospective study.

Background: Cardiac symptoms are one of the most prevalent reasons for emergency department visits. However, over 80% of patients with such symptoms are sent home after acute cardiovascular disease has been ruled out.

Objective: The Hollands-Midden Acute Regional Triage-cardiology (HART-c) study aimed to investigate whether a novel prehospital triage method, combining prehospital and hospital data with expert consultation, could increase the number of patients who could safely stay at home after emergency medical service (EMS) consultation.

Long-term results of distal oblique bundle reinforcement for treatment of chronic bidirectional instability of the distal radioulnar joint.

Distal oblique bundle (DOB) reinforcement for treatment of post-traumatic bidirectional instability of the distal radioulnar joint (DRUJ) has previously been reported. The objective of the current study was to assess the incidence of symptomatic graft failure and the need for secondary wrist procedures at a longer follow-up in an updated patient cohort of 27 patients with 28 DOB reinforcement procedures. Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and patient-rated wrist/hand evaluation (PRWHE) outcome measures were also evaluated.

The prevalence of non-accidental trauma among children with polytrauma: A nationwide level-I trauma centre study.

Objective: We aimed to investigate the prevalence and characteristics of non-accidental trauma (NAT) in children with polytrauma treated at level-I trauma centres (TC).

Summary Of Background: Data 6-10% Of children who present at the emergency department with injuries, sustain polytrauma. Polytrauma may result from either accidental (AT) or NAT, i.

The Diagnostic Value of Ultrasound of the Rectus Femoris for the diagnosis of Sarcopenia in adults: A systematic review.

Background & Aim: Sarcopenia is defined as a loss of muscle mass and function, which can be caused by normal ageing or factors such as physical inactivity. Severe health consequences caused by sarcopenia highlight the need for early identification. Computed Tomography (CT) imaging, often mentioned as the gold standard due to its accuracy, is costly and not routinely performed in daily clinical care.

Clinical evaluation of automated segmentation for body composition analysis on abdominal L3 CT slices in polytrauma patients.

Introduction: Sarcopenia is a muscle disease that involves loss of muscle strength and physical function and is associated with adverse health effects. Even though sarcopenia has attracted increasing attention in the literature, many research findings have not yet been translated into clinical practice. In this article, we aim to validate a deep learning neural network for automated segmentation of L3 CT slices and aim to explore the potential for clinical utilization of such a tool for clinical practice.

Prevalence of inflicted and neglectful femur shaft fractures in young children in national level I trauma centers.

Background: The prevalence of inflicted femur fractures in young children varies (1.5-35.2%), but these data are based on small retrospective studies with high heterogeneity.

Screening, diagnosis and monitoring of sarcopenia: When to use which tool?

Background & Aims: Sarcopenia is a muscle disorder associated with loss of muscle mass, strength and function. Early screening, diagnosis and treatment may improve outcome in different disease conditions. A wide variety of tools for estimation of muscle mass is available and each tool has specific technical requirements.

High prevalence of non-accidental trauma among deceased children presenting at Level I trauma centers in the Netherlands.

Purpose: Between 0.1-3% of injured children who present at a hospital emergency department ultimately die as a result of their injuries. These events are typically reported as unnatural causes of death and may result from either accidental or non-accidental trauma (NAT).

MAS: Standalone Microwave Resonator to Assess Muscle Quality.

Microwave-based sensing for tissue analysis is recently gaining interest due to advantages such as non-ionizing radiation and non-invasiveness. We have developed a set of transmission sensors for microwave-based real-time sensing to quantify muscle mass and quality. In connection, we verified the sensors by 3D simulations, tested them in a laboratory on a homogeneous three-layer tissue model, and collected pilot clinical data in 20 patients and 25 healthy volunteers.

Ambulance deceleration causes increased intra cranial pressure in supine position: a prospective observational prove of principle study.

Background: Ambulance drivers in the Netherlands are trained to drive as fluent as possible when transporting a head injured patient to the hospital. Acceleration and deceleration have the potential to create pressure changes in the head that may worsen outcome. Although the idea of fluid shift during braking causing intra cranial pressure (ICP) to rise is widely accepted, it lacks any scientific evidence.

Deep Learning Automated Segmentation for Muscle and Adipose Tissue from Abdominal Computed Tomography in Polytrauma Patients.

Manual segmentation of muscle and adipose compartments from computed tomography (CT) axial images is a potential bottleneck in early rapid detection and quantification of sarcopenia. A prototype deep learning neural network was trained on a multi-center collection of 3413 abdominal cancer surgery subjects to automatically segment truncal muscle, subcutaneous adipose tissue and visceral adipose tissue at the L3 lumbar vertebral level. Segmentations were externally tested on 233 polytrauma subjects.

Prehospital triage of patients with acute cardiac complaints: study protocol of HART-c, a multicentre prospective study.

Introduction: Emergency department (ED) overcrowding is a major healthcare problem associated with worse patient outcomes and increased costs. Attempts to reduce ED overcrowding of patients with cardiac complaints have so far focused on in-hospital triage and rapid risk stratification of patients with chest pain at the ED. The Hollands-Midden Acute Regional Triage-Cardiology (HART-c) study aimed to assess the amount of patients left at home in usual ambulance care as compared with the new prehospital triage method.

Comparison of Prehospital Scales for Predicting Large Anterior Vessel Occlusion in the Ambulance Setting.

Importance: The efficacy of endovascular thrombectomy (EVT) for symptomatic large anterior vessel occlusion (sLAVO) sharply decreases with time. Because EVT is restricted to comprehensive stroke centers, prehospital triage of patients with acute stroke codes for sLAVO is crucial, and although several prediction scales are already in use, external validation, head-to-head comparison, and feasibility data are lacking.

Objective: To conduct external validation and head-to-head comparisons of 7 sLAVO prediction scales in the emergency medical service (EMS) setting and to assess scale feasibility by EMS paramedics.

Mid-term outcome of volar plate fixation for scaphoid nonunion.

Aims: Fixation of scaphoid nonunion with a volar locking plate and cancellous bone grafting has been shown to be a successful technique in small series. Few mid- or long-term follow-up studies have been reported. The aim of this study was to report the mid-term radiological and functional outcome of plate fixation for scaphoid nonunion.

High Prevalence of Sarcopenia in Older Trauma Patients: A Pilot Study.

Sarcopenia is related to adverse outcomes in various populations. However, little is known about the prevalence of sarcopenia in polytrauma patients. Identifying the number of patients at risk of adverse outcome will increase awareness to prevent further loss of muscle mass.