Treatment of traumatic rib fractures: an overview of current evidence and future perspectives.

Operative management of rib fractures has gained significant popularity over the last years, however, it remains a controversial topic, due to the substantial heterogeneity among rib fracture patients with considerable differences in epidemiology. Hence, the present narrative review aims to provide an overview of the treatment and (long-term) outcomes of rib fractures, with an emphasis on the surgical treatment. Nowadays, computed tomography (CT) has been shown to be most practical and sensitive for detecting rib fractures, of which up to 50% is missed on other imaging modalities.

Feasibility and complications after transoral endoscopic thyroidectomy via vestibular approach (TOETVA) - a single-center first experience case series.

Background: This paper reports on the first experience after implementation of a transoral endoscopic thyroidectomy via vestibular approach (TOETVA) as an alternative to (partial) thyroidectomy or isthmusectomy in a single center. Feasibility, implementation and specific complications are addressed.

Methods: All patients who underwent a TOETVA procedure in our center between November 2019 and March 2023 were included.

VATS-assisted surgical stabilization of rib fractures in flail chest: 1-year follow-up of 105 cases.

Objectives: Early surgical stabilization of flail chest has been shown to improve chest wall stability and diminish respiratory complications. The addition of video‑assisted thoracoscopic surgery (VATS) can diagnose and manage intrathoracic injuries and evacuate hemothorax. This study analyzed the outcome of our 7-year experience with VATS-assisted surgical stabilization of rib fractures (SSRF) for flail chest.

Surgical treatment of acromioclavicular dislocation associated with midshaft fracture of the ipsilateral clavicle.

Acromioclavicular dislocation combined with a midshaft clavicle fracture is a rare traumatic shoulder problem. Various treatment options have been described in literature. We describe a new technique using a hook plate and coracoclavicular sling to replace the ruptured coracoclavicular ligaments in combination with plate osteosynthesis of the clavicle fracture.

Pain and Cognition in Multiple Sclerosis.

Objective: The goal of the present study was to examine the relationship between pain and cognition in patients with multiple sclerosis.

Design: Cross-sectional.

Setting: Nursing home and personal environment of the investigators.

[Chronic traumatic encephalopathy: an old acquaintance in athletes].

- Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease caused by repetitive head injuries like those seen in sports such as boxing, American football and soccer.- The clinical features of CTE are a range of cognitive, psychiatric and motor symptoms, and histopathology involves deposits of hyperphosphorylated tau protein and the presence of TAR DNA-binding protein (TDP-43) with relatively little beta-amyloid.- CTE is difficult to differentiate clinically from Alzheimer's disease, frontotemporal dementia and psychiatric disorders because of the major symptom overlap between these conditions.

Addition of Video-Assisted Thoracoscopic Surgery to the Treatment of Flail Chest.

Background: Video-assisted thoracoscopic surgery (VATS) is increasingly used in chest trauma for diagnostic and therapeutic purposes. In this report we describe our single-institutional experience with VATS in the surgical treatment of patients with flail chest after high-energy trauma.

Methods: From January 2013 to July 2014, 15 patients with flail chest after high-energy trauma were treated in our hospital.

Intracytoplasmic sperm injection in partial globozoospermia.

Objective: To compare the outcome of intracytoplasmic sperm injection (ICSI) in patient couples where the male partner has partial globozoospermia with the outcome in a general ICSI population.

Design: Case-control study.

Setting: Center for Reproductive Medicine, Radboud University Nijmegen Medical Center, the Netherlands, a tertiary referral center.

Operative and functional treatment of rupture of the lateral ligament of the ankle. A randomised, prospective trial.

Consecutive patients with a confirmed rupture of at least one of the lateral ligaments of the ankle were randomly assigned to receive either operative or functional treatment. They were evaluated at a median of 8 years (6 to 11). In total, 370 patients were included.

Radiography in acute ankle injuries: the Ottawa Ankle Rules versus local diagnostic decision rules.

Study Objective: We validate the Ottawa Ankle Rules and 2 Dutch ankle rules in distinguishing clinically significant fractures from insignificant fractures and other injuries in patients with a painful ankle presenting to the emergency department.

Methods: This prospective comparison of 3 ankle rules was conducted in the ED of a 580-bed community teaching hospital in Amsterdam from January 1998 to April 1999. Participants included 647 consecutive patients aged 18 years or older presenting with a painful ankle after trauma.

Treatment of ruptures of the lateral ankle ligaments: a meta-analysis.

Background: Ruptures of the lateral ankle ligaments are very common; however, treatment remains controversial. The aim of the current study was to perform a meta-analysis of randomized, controlled clinical trials of existing treatment strategies for acute ruptures of the lateral ankle ligaments.

Methods: Randomized, controlled trials reported between 1966 and 1998 were included if they involved acute ruptures of the lateral ankle ligaments.

Metastasis in a benign duodenal stromal tumour.

Gastro-intestinal stromal tumour (GIST) is increasingly recognized as a distinct entity within the group of soft tissue tumours. Mostly, GIST arises from the muscular components of the stromal layer, but the tumour may also originate from the autonomic nerve system, recently designated as gastro-intestinal autonomic nerve tumour (GANT). The majority of GIST is located in the stomach and small intestine; only 4% of GIST is found in the duodenum.

Polybrominated biphenyl and diphenylether flame retardants: analysis, toxicity, and environmental occurrence.

Data on two classes of brominated polyaromatic flame retardants are reviewed with emphasis on analytical aspects, occurrence, fate, and toxicity in the environment. Concentrations of brominated fire retardants are quantified as equivalents of commercial mixtures. Because different congeners behave differently in the environment and show large differences in toxicity, future studies would benefit from the availability of analytical standards of individual congeners.

HPLC determination of chloramphenicol degradation in eye drops.

An HPLC-method is described for the simultaneous determination of chloramphenicol and its most important degradation products. A 15 cm long C-18 reversed phase column was used with a mobile phase consisting of boric acid solution-acetonitrile (60 + 45) adjusted to a pH of 3. The amount of degradation of chloramphenicol eye drop solutions containing boric acid and borax, at pH 4.

Placental transfer and metabolism of purines and nucleosides in the pregnant guinea pig.

The placental transfer and metabolism of several purines and nucleosides have been investigated using an artificially perfused guinea-pig placenta. A model describing transfer and metabolism in the uteroplacental unit is constructed and applied. Measurements of oxypurines and guanine have been performed in vivo in the blood of pregnant guinea pigs and their fetuses.

The nucleus accumbens of rats and dopaminergic mechanisms regulating locomotor behaviour.

Dopamine and (3,4-dihydroxyphenylamino)-2-imidazoline (DPI) were injected into the nucleus accumbens of rats locally pretreated with ergometrine. The results show that the ergometrine-induced locomotor activity is inhibited by both compounds suggesting that ergometrine inhibits certain types of dopamine receptors. The data are discussed in terms of distinct types of dopamine receptors.

Further investigations on the effects of ergometrine and other ergot derivatives following injection into the nucleus accumbens of the rat.

The influence of different pretreatments upon locomotor stimulation, induced by injection of ergometrine into the nucleus accumbens of rats, was investigated. The noradrenergic antagonists phenoxybenzamine and propranolol and the serotonin antagonist methysergide produced no clear changes. Reserpine, alone or in combination with alpha-MPT, considerably shortened the delay between injection of ergometrine and start of locomotor stimulation.

Effects of chemical stimulation of the mesolimbic dopamine system upon locomotor activity.

The effects of local injections of drugs into terminal areas of the mesolimbic dopamine system were investigated. Bilateral administration of dopamine, but not of noradrenaline and serotonin, into the nucleus accumbens of non-pretreated rats resulted in stimulation of locomotor activity. No clear or only minor effects were seen after injections of the dopamine metabolites 3-methoxytyramine, DOPAC and HVA and after injections of media with different pH and osmolality.

The effect of microinjections of amphetamine into the neostriatum and the nucleus accumbens on self-stimulation behaviour.

The effect of micro-injections of dexamphetamine chloride into the neostriatum, the nucleus accumbens, the anterior hypothalamus, and the ventricular system on self-stimulation with electrodes in the ventral tegmentum was studied. Unilateral injections of 10 mug into the anterior hypothalamus produced no effect. Injections into the neostriatum tended to depress the self-stimulation rate, whereas injections into the nucleus accumbens increased the rate markedly.

Effects of antagonists upon locomotor stimulation induced by injection of dopamine and Noradrenaline into the nucleus accumbens of nialamide-pretreated rats.

The effects of injections of monoamines, alone and in combination with different antagonists, bilaterally into the nucleus accumbens of nialamide-pretreated rats were investigated. Dopamine was found to produce a stronger stimulation of locomotor activity than noradrenaline, whereas serotonin was effective only in a small number of animals, in which the duration of locomotor stimulation was shorter than after dopamine or noradrenaline. The effects of both dopamine and noradrenaline were completely antagonized by administration of a small dose of the dopamine antagonist haloperidol, administered bilaterally 15 min after the catecholamines.

Inhibition of d-amphetamine-induced locomotor activity by injection of haloperidol into the nucleus accumbens of the rat.

The effect of intracerebral administraton of antagonists of dopamine and noradrenaline upon the locomotor stimulation induced by intraperitoneal injection of d-amphetamine sulfate in rats was investigated. Inj ection of low doses of the dopamine antagonist haloperidol (2.5 mug and 5 mug) bilaterally into the nucleus accumbens antagonized the locomotor stimulation following d-amphetamine.