Unilateral posterior scleral defect was not associated with altered ocular biomechanics.

Technologies that describe the biomechanics of the eye are of emerging importance in glaucoma and keratoconus. A defect in the wall of the eye would be expected to affect biomechanics, resulting in the dispersion of mechanical energy and more viscous rather than elastic behaviour. Here, a mildly myopic man in his 50s was noted to have a deep conduit beside the right optic disc which appeared to pass posteriorly to the optic nerve sheath or orbit.

Neuro-ophthalmic complications of modern anti-cancer drugs.

Purpose: Targeted cancer therapies have been responsible for a dramatic shift in treatment strategies for cancer, and the number of drugs, classes, and indications are continually growing. Neuro-ophthalmic complications of these medications are an uncommon but important subset of adverse events which profoundly impact vision. This review aims to collate studies and reports of known neuro-ophthalmic complications of targeted therapies and describe their management.

[Conservative treatment options for unguis incarnatus].

Unguis incarnatus (ingrown toenail) is a common problem in daily practice. Persons with unguis incarnatus stage two and three are often referred for surgical partial nail excision, however conservative treatment or minimal-invasive alternatives exist. In the latest Dutch guideline for ingrown toenails, there is minimal attention to these alternatives.

Lower Extremity Amputation Rates in People With Diabetes Mellitus: A Retrospective Population Based Cohort Study in Zwolle Region, The Netherlands.

Objective: Lower extremity amputations are a major complication of diabetes mellitus (DM). In a previous Dutch study, the incident rate of major amputations was 89.2 per 100 000 person years.

Evaluation of a multilevel implementation program for timeout and shared decision making in breast cancer care: a mixed methods study among 11 hospital teams.

Objective: Evaluation of a multilevel implementation program on shared decision making (SDM) for breast cancer clinicians.

Methods: The program was based on the 'Measurement Instrument for Determinants of Innovations-model' (MIDI). Key factors for effective implementation were included.

Highly Sensitive Flow Cytometric Detection of Residual B-Cells After Rituximab in Anti-Neutrophil Cytoplasmic Antibodies-Associated Vasculitis Patients.

Background: B-cell depletion with rituximab (RTX) is an effective treatment for anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) patients. Nevertheless, relapses are frequent after RTX, often preceded by B-cell repopulation suggesting that residual autoreactive B-cells persist despite therapy. Therefore, this study aimed to identify minimal residual autoimmunity (MRA) in the B-cell compartment of AAV patients treated with RTX.

Editor's Choice - Nationwide Analysis of Patients Undergoing Iliac Artery Aneurysm Repair in the Netherlands.

Objective: The new 2019 guideline of the European Society for Vascular Surgery (ESVS) recommends consideration for elective iliac artery aneurysm (eIAA) repair when the iliac diameter exceeds 3.5 cm, as opposed to 3.0 cm previously.

Examining stimuli paired with alternative reinforcement to mitigate resurgence in children diagnosed with autism spectrum disorder and pigeons.

In two laboratory experiments, we examined whether stimuli paired with alternative reinforcers could mitigate resurgence of a previously reinforced target response with pigeons (Experiment 1) and children diagnosed with Autism Spectrum Disorder (Experiment 2). In Phase 1, we arranged food reinforcement according to a variable-ratio schedule for engaging in a target response. In Phase 2, we arranged extinction for target responding and differentially reinforced alternative responding according to a fixed-ratio schedule, with every alternative-reinforcer delivery paired with a change in keylight color (Experiment 1) or automated verbal (praise) statement (Experiment 2).

Glucocorticoids inhibit macrophage differentiation towards a pro-inflammatory phenotype upon wounding without affecting their migration.

Glucocorticoid drugs are widely used to treat immune-related diseases, but their use is limited by side effects and by resistance, which especially occurs in macrophage-dominated diseases. In order to improve glucocorticoid therapies, more research is required into the mechanisms of glucocorticoid action. In the present study, we have used a zebrafish model for inflammation to study glucocorticoid effects on the innate immune response.

CADASIL: Treatment and Management Options.

CADASIL is a life-threatening and disabling disease. Despite the progress achieved so far, no therapies able to limit the disease progression have been found and only empiric treatments can be employed to relieve the main disease symptoms. Further in vivo studies as well as data aggregation and multi-centre controlled clinical trials are needed to confirm the emerging findings in order to identify evidence-based therapies for CADASIL.

Microbial biofilms and wound healing: an ecological hypothesis.

Man has lived together with microbes for so long that we have become completely dependent on their presence. Most microbes reside in biofilms; structured communities encased in a protective matrix of biopolymers. Under healthy conditions, the microbial biofilm is in balance with itself (endo-balance) and with the host (exo-balance).

Cyanoacrylate skin microsealant for preventing surgical site infection after vascular surgery: a discontinued randomized clinical trial.

Background: Surgical site infections (SSI) after vascular surgery are related to substantial morbidity. Restriction of bacterial access to the site of surgery with a cyanoacrylate sealant is a new concept. We performed a randomized clinical trial to assess the effect of the sealing of skin with a cyanoacrylate preparation at the site of surgery on the incidence of SSI after arterial reconstruction.

Use of autologous platelet-rich fibrin on hard-to-heal wounds.

This retrospective study found that use of autologous platelet-rich fibrin on a range of hard-to-heal wounds achieved full healing or a significant reduction in wound diameter with no adverse effects. Prospective studies are now needed

Maggot debridement therapy of infected ulcers: patient and wound factors influencing outcome - a study on 101 patients with 117 wounds.

Introduction: It has been known for centuries that maggots are potent debriding agents capable of removing necrotic tissue and slough. In January 2004, the US Food and Drug Administration decided to regulate maggot debridement therapy (MDT). As it is still not clear which wounds are likely or unlikely to benefit from MDT, we performed a prospective study to gain more insight in patient and wound characteristics influencing outcome.

Extracellular matrix prevents split-skin grafting in selected cases.

Surgeons at a Dutch wound clinic close open wounds with split-skin grafts. Concerns about the risk of postoperative complications in some patients led them to find an alternative option. Use of an extracellular matrix dressing was effective.

Extracellular Wound Matrix (OASIS®): Exploring the Contraindications. Results of Its Use in 32 Consecutive Outpatient Clinic Cases.

Unlabelled: Background. In the authors' experience re-epithelialization after successful debridement and granulation can be the most difficult part of the wound closure process. Extracellular matrix products represent a possible solution.

Maggot debridement therapy in the palliative setting.

Success rates of Maggot Debridement Therapy (MDT) differ, but range from 70% to 80%. In this article it is argued that wound closure is not always feasible and is not always the aim of the treatment. A patient is described in whom the intent of MDT was not wound closure, but infection removal, reduction of odor, and eventually prevention of a below knee amputation.

A Non-healing Sinus of the Lower Leg 5 Years After Vacuum-assisted Closure Therapy Due To a Gossypiboma.

Since its introduction, vacuum-assisted closure (V.A.C.