Instruments for assessment of impairments and activity limitations in patients with hand conditions: A European Delphi study.

Objective: To reach multidisciplinary European consensus on the assessment tools for impairments and activity limitations in patients with hand conditions.

Design: Electronic Delphi method.

Subjects: Thirty experts from European societies for hand therapy, hand surgery, and physical and rehabilitation medicine.

Similar risk for hemangiomas after amniocentesis and transabdominal chorionic villus sampling.

Aim: In an earlier study we have shown that transcervical chorionic villus sampling in excess of 90 mg increases the risk for hemangiomas of infancy three- to four-fold compared to amniocentesis. In the present study we investigated whether transabdominal chorionic villus sampling (TA-CVS), in which the samples are smaller, carries the same risk.

Material And Methods: Retrospectively, data were analyzed from 200 consecutive TA-CVS procedures and 200 consecutive amniocentesis procedures.

Faster wound healing with topical negative pressure therapy in difficult-to-heal wounds: a prospective randomized controlled trial.

Objective: A randomized clinical trial was conducted to determine the effectiveness and safety of topical negative pressure therapy in patients with difficult-to-heal wounds.

Methods: A total of 24 patients were randomly assigned to either treatment with topical negative pressure therapy or treatment with conventional dressing therapy with sodium hypochlorite. The study end point was 50% reduction in wound volume.

Hemangioma in the newborn: increased incidence after chorionic villus sampling.

Objectives: This study was designed to compare the effects of transcervical chorionic villus sampling (CVS) and amniocentesis on the prevalence of hemangiomas of infancy.

Methods: This is a cohort study of 250 consecutive assessable transabdominal amniocentesis procedures and 250 consecutive assessable transcervical CVS procedures performed between January and September 2002. Parents were asked to fill out a questionnaire regarding the presence of any type of skin lesions.

A review of surgical informed consent: past, present, and future. A quest to help patients make better decisions.

Background: Informed consent (IC) is a process requiring a competent doctor, adequate transfer of information, and consent of the patient. It is not just a signature on a piece of paper. Current consent processes in surgery are probably outdated and may require major changes to adjust them to modern day legislation.

Torque test measurement in segmental bone defects using porous calcium phosphate cement implants.

This study was performed to assess the bone healing supporting characteristics of porous calcium phosphate (Ca-P) cement when implanted in a rabbit segmental defect model as well as to determine the reliability of torque testing as a method to verify bone healing. The middiaphyseal radius was chosen as the area to create bilaterally increasing defect sizes (5, 10, and 15 mm), which were either filled with porous Ca-P cement or left open as a control. After 12 weeks of implantation, torque test measurements as well as histological and radiographic evaluation were performed.

In vivo bone response and mechanical evaluation of electrosprayed CaP nanoparticle coatings using the iliac crest of goats as an implantation model.

Recent trends in clinical implantology include the use of endosseous dental implant surfaces embellished with nano-sized modifications. The current study was initiated to evaluate the mechanical properties, as well as the potential beneficial effects, of electrosprayed CaP nanoparticle-coated (nano-CaP) implants on the in vivo osteogenic response, compared with grit-blasted, acid-etched (GAE) implant surfaces as controls. For this purpose nano-CaP coatings were deposited on cylindrical screw-type (St) implants and implanted bilaterally into the iliac crest of goats for 6weeks.

Anteromedial thigh flaps: an anatomical study to localize and classify anteromedial thigh perforators.

Until now, research on flaps in the anteromedial thigh region has focused on flaps in specific regions. To elucidate the complete pattern of suitable anteromedial thigh perforators, an anatomical study was performed by dissecting nine thighs from different cadavers. The ideal perforator has maximum length and diameter and runs through a septum.

The effect of alkaline phosphatase coated onto titanium alloys on bone responses in rats.

The enzyme alkaline phosphatase (ALP) was recently proposed as an implant coating material in order to improve the biological performance of orthopedic and dental implants. The present study evaluated the in vivo bone response to electrosprayed coatings, consisting of ALP, calcium phosphate (CaP) or a combination thereof (composite coating: ALP+CaP) compared to non-coated controls (gritblasted and acid etched). A total of 80 implants (n=10) with a gap of 1.

The quantitative assessment of peri-implant bone responses using histomorphometry and micro-computed tomography.

In the present study, the effects of implant design and surface properties on peri-implant bone response were evaluated with both conventional histomorphometry and micro-computed tomography (micro-CT), using two geometrically different dental implants (Screw type, St; Push-in, Pi) either or not surface-modified (non-coated, CaP-coated, or CaP-coated+TGF-beta1). After 12 weeks of implantation in a goat femoral condyle model, peri-implant bone response was evaluated in three different zones (inner: 0-500 microm; middle: 500-1000 microm; and outer: 1000-1500 microm) around the implant. Results indicated superiority of conventional histomorphometry over micro-CT, as the latter is hampered by deficits in the discrimination at the implant/tissue interface.

Effect of polymer molecular weight on the bone biological activity of biodegradable polymer/calcium phosphate cement composites.

Previous studies demonstrated that the addition of biodegradable polymer microparticles to calcium phosphate (CaP) cement improves the cement's degradative behavior without affecting its handling characteristics, especially its injectability and moldability. We investigated the influence of molecular weight of polymeric microparticles included in CaP cement on implant degradation and bone formation in critical-sized defects. Forty rats received cranial defects filled with formulations of CaP cement and poly(DL-lactic-co-glycolic acid) (PLGA) microparticles.

In vivo bioactivity of DNA-based coatings: an experimental study in rats.

DNA-based coatings possess beneficial properties useful for medical and dental implants. The present study evaluated the potential in vivo bioactivity of DNA-based coatings, either or not pretreated in simulated body fluid (SBF). DNA-based coatings were generated on titanium cylinders using layer-by-layer deposition, with bis-ureido-surfactant as the cationic component and DNA as the anionic component.

Clinimetric properties of instruments to assess activities in patients with hand injury: a systematic review of the literature.

Objective: To perform a systematic review of the literature to assess the clinimetric properties of instruments measuring limitations of activity.

Data Sources: The Medline, Cochrane Library, Picarta, Occupational Therapy-seeker, and CINAHL databases were searched for English or Dutch language articles published between 2001 and 2006.

Study Selection: Two reviewers independently reviewed the identified publications for eligibility (based on the title and abstract), methodologic criteria, and clinimetric properties.

Effect of infant orthopedics on facial appearance of toddlers with complete unilateral cleft lip and palate (Dutchcleft).

Objective: To evaluate the effect of infant orthopedics (IO) on facial appearance of 54 patients with unilateral cleft lip and palate (UCLP), aged 4 and 6 years.

Design: Prospective two-arm randomized controlled clinical trial in three Cleft Palate Centers in the Netherlands (Dutchcleft-trial).

Interventions: Patients were divided randomly into two groups.

Management of haemangiomas of infancy: a retrospective analysis and a treatment protocol.

Haemangiomas of infancy are common benign endothelial neoplasms that affect roughly 1:10 children. Treatment is indicated in complicated cases. We have evaluated treatment in a multidisciplinary setting.

No increased bone formation around alendronate or omeprazole loaded bioactive bone cements in a femoral defect.

Alendronate and omeprazole have been found to influence bone healing by interfering with osteoclastic activity, resulting in increased bone formation. The biological effect of these conventional drugs, incorporated into bioactive bone cement (G2B1), was investigated in a rabbit model. The 2 materials and a control were inserted in defects created in the femoral condyle of rabbits.

The kinetic and biological activity of different loaded rhBMP-2 calcium phosphate cement implants in rats.

The healing of large bone defects can be improved by osteogenic bone graft substitutes, due to growth factor inclusion. A sustained release of these growth factors provides more efficient bioactivity when compared with burst release and might reduce the dose required for bone regeneration, which is desirable for socioeconomical and safety reasons. In this study, we compared different rhBMP-2 loadings in a sustained release system of CaP cement and PLGA-microparticles and were able to couple kinetic to biological activity data.

Closing capacity of segmental radius defects in rabbits.

In the research of synthetic bone graft substitutes, the relevance for bone regeneration can be confirmed in a critical-sized model. In this study the rabbit radial defect was investigated as an ingenious model of critical size, due to its defect immobilizing intact ulna. In addition, the influence of poly(DL-lactic-co-glycolic acid) (PLGA) on bone regeneration was determined.

Postburn contracture treatment: a healthcare project in Bangladesh.

Over the last 6 years, a health care program aimed at the surgical correction of postburn contractures has taken place in Faridpur, Bangladesh. People in this rural region are very poor and often cannot afford medical treatment. Often secondary flexion contractures of the face and chin as well as the upper and lower extremity impede daily functioning and have an enormous psycho-social impact.

Can face-to-face patient education be replaced by computer-based patient education? A randomised trial.

Objective: Computer-based patient education is an effective (therapeutic) tool. More and more studies prove that it can be an effective additive for face-to-face education, but it is still unclear if it is possible to educate patients by only using a computer. Our objective was to compare knowledge levels and satisfaction scores after computer-based patient education versus doctor-based patient education.

Investigation as to the osteoinductivity of macroporous calcium phosphate cement in goats.

For bone formation in critical-sized or poor healing defects, osteoinductive behavior of synthetic bone grafts is crucial. Although the osteoconductive behavior of calcium phosphate (CaP) cement is generally accepted, its osteoinductive potential is less reported. In this study, osteoinduction of porous CaP cement was investigated.

Octyl-2-cyanoacrylate tissue glue (Dermabond) versus Monocryl 6 x 0 Sutures in lip closure.

Objective: To assess the value of octyl-2-cyanoacrylate tissue glue in lip closure versus Monocryl stitches.

Design: Closure of a cleft lip can be done using transcutaneous Monocryl 6 x 0 sutures or using octyl-2-cyanoacrylate tissue glue (Dermabond). In 15 consecutive patients, the cleft lip was closed with Monocryl 6 x 0 and in another 15 consecutive patients, Dermabond was applied.

Cytokeratin expression in palatal and marginal mucosa of cleft palate patients.

Objective: The margin of a palatal cleft is a unique anatomical site since the palatal mucosa is continuous with the nasal or nasopharyngeal mucosa. The aim of this study was to compare the expression patterns of cytokeratins and basal membrane components of the mucosa in the area of the cleft.

Design: Biopsies from the mucosa of the hard palate and from the cleft margin in the soft palate were obtained from five patients during the primary surgical closure of the cleft.

Porous poly(DL-lactic-co-glycolic acid)/calcium phosphate cement composite for reconstruction of bone defects.

Calcium phosphate (Ca-P) cements are injectable, self-setting ceramic pastes generally known for their favorable bone response. Ingrowth of bone and subsequent degradation rates can be enhanced by the inclusion of macropores. Initial porosity can be induced by CO(2) foaming during setting of the cement, whereas secondary porosity can develop after hydrolysis of incorporated poly(DL-lactic- co-glycolic acid) (PLGA) microparticles.

The pathogenesis of hemangiomas: a review.

Learning Objectives: After reading this article, the participant should be able to: 1. Differentiate between hemangiomas and vascular malformations. 2.