379 results match your criteria: "Alrijne Medical Centre Leiderdorp & Leiden University Medical Centre[Affiliation]"

Background And Importance: Traumatic intracranial hemorrhage (tICH) after mild traumatic brain injury (mTBI) is not uncommon in the elderly. Often, these patients are admitted to the hospital for observation. The necessity of admission in the absence of clinically important intracranial injuries is however unclear.

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Purpose: This observational pilot study investigated (1) carpal positioning in the neutral wrist pose, (2) the scapholunate (SL) rotation axis, (3) physiological SL motion, and (4) the SL distance after combined palmar and dorsal SL ligament reconstruction using quantitative four-dimensional computed tomography (4D-CT) imaging.

Methods: Six subjects were included, and 4D-CT images of both wrists were obtained. Kinematic parameters of the treated side were compared to those of the healthy contralateral side, which was used as the normal reference.

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Risk prediction of implant loss following implant-based breast reconstruction: a population-based study.

Plast Reconstr Surg

December 2024

Department of Plastic and Reconstructive surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Introduction: Implant loss following implant-based breast reconstruction (IBBR) is a serious complication, resulting in re-operations, patient suffering, and a significant decrease in quality of life. This study aimed to create a validated risk prediction model for implant loss after IBBR using perioperative risk factors.

Methods: Patients who had undergone either a two-stage or a direct-to-implant postmastectomy IBBR were identified from the Dutch Breast Implant Registry (DBIR).

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Economic analysis of hyperbaric oxygen therapy for the treatment of ischaemic diabetic foot ulcers.

Diving Hyperb Med

December 2024

Department of Surgery, Amsterdam UMC, Location AMC, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.

Introduction: The aim was to determine the cost-effectiveness and cost-utility of additional hyperbaric oxygen therapy (HBOT) compared to standard care (SC) for ischaemic diabetic foot ulcers (DFUs) regarding limb salvage and health status.

Methods: An economic analysis was conducted, comprising cost-effectiveness and cost-utility analyses, with a 12-month time horizon, using data from the DAMO₂CLES multicentre randomised clinical trial. Cost-effectiveness was defined as cost per limb saved and cost-utility as cost per quality-adjusted life year (QALY).

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Background: There is considerable practice variation in labelling, diagnosis and treatment of adults with sterile bone inflammation. We developed a expert consensus recommendations on the disease definition, diagnosis and treatment of this rare condition.

Methods: Systematic literature review and Grading of Recommendations, Assessment, Development and Evaluations-based appraisal of evidence, two Delphi surveys and three digital and in-person consensus meetings with a multidisciplinary expert panel and patient representatives.

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Platelet to erythrocyte ratio and mortality in massively transfused trauma patients.

Injury

January 2025

Department of Surgery, Alrijne Medical Centre, 2353 GA Leiderdorp, the Netherlands; Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, 3000 CA Rotterdam, the Netherlands; Defence Healthcare Organization, Ministry of Defence, 3584 AB Utrecht, the Netherlands; Department of Surgery, Leiden University Medical Centre, 2333 ZA Leiden, the Netherlands. Electronic address:

Article Synopsis
  • The study investigates the impact of platelet transfusions on mortality in trauma patients experiencing massive bleeding.
  • Data collected from Dutch trauma centers showed that patients receiving a higher platelet to red blood cell (RBC) ratio had significantly lower mortality rates within 6 and 12 hours compared to those receiving lower ratios or no platelets.
  • The findings suggest that higher platelet ratios, along with better plasma:RBC ratios, may lead to improved survival outcomes in these patients, though the ideal transfusion strategy is still uncertain.
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Background And Purpose: There has been a concerted move in recent times to shift from an exclusionary to a positive diagnosis of functional movement disorders (FMDs). To date, most of the focus has been on defining positive physical signs. Here the focus was on the diagnostic specificity of specific symptoms and patient characteristics.

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Targeted antimicrobial regimens for Gram-negative prosthetic joint infections: a prospective multicenter study.

Antimicrob Agents Chemother

December 2024

Leiden University Center for Infectious Diseases (LU-CID), Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands.

Fluoroquinolones (FQs) are considered the most effective antimicrobial treatment for Gram-negative prosthetic joint infection (GN-PJI). Alternatives are needed due to increasing FQ resistance and side effects. We aimed to compare different targeted antimicrobial strategies for GN-PJI managed by debridement, antibiotics, and implant retention (DAIR) or one-stage revision surgery (1SR) and to review the literature of oral treatment options for GN-PJI.

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Article Synopsis
  • This study assesses the effectiveness of prone SPECT imaging with [Tc]Tc-sestamibi compared to Molecular Breast Imaging (MBI) in predicting treatment response in women with locally advanced breast cancer (LABC).
  • It involved 18 patients who underwent SPECT scans shortly after and 90 minutes post-injection, along with MBI, to analyze tumor characteristics like wash-out rates and standardized uptake values.
  • Results indicated that early SPECT provided useful semi-quantitative data comparable to MBI, though further research with broader clinical parameters is necessary to determine the clinical implications of these findings.
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Background: In metastatic castration-resistant prostate cancer (mCRPC), using serum prostate-specific antigen (PSA) levels to evaluate treatment response is not always accurate. This study aimed to assess the efficacy of PSMA PET/CT at specific time points for evaluating treatment response and predicting survival in mCRPC patients, compared to PSA.

Methods: Sixty mCRPC patients underwent [F]PSMA-1007 PET/CT at baseline and for treatment response evaluation of either androgen receptor-targeted agents (after 3 months) or chemotherapy (after completion), and were retrospectively analysed.

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Objectives: Iron deficiency anemia is a significant global health concern, diagnosed by measuring hemoglobin concentrations in combination with plasma ferritin concentration. This study investigated the variability in ferritin reference intervals among laboratories in the Netherlands and examined how this affects the identification of iron-related disorders.

Methods: Ferritin reference intervals from 52 Dutch ISO15189-certified medical laboratories were collected.

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Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly being used for temporary bleeding control in patients with trauma with non-compressible truncal hemorrhage (NCTH). In recent years, the technique is gaining popularity in postpartum hemorrhage and non-traumatic cardiac arrest, although still underutilized. In other surgical fields, however, there is not yet much awareness for the possible advantages of this technique.

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Chronic nonbacterial osteitis (CNO) is a rare auto-inflammatory bone disease affecting children and adults. Adult CNO is characterized by painful bone lesions, primarily of the anterior chest wall. There is no approved therapy for adult CNO.

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Background: Axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT combined with pathological axillary treatment response has been proposed to guide de-escalation of axillary treatment for clinically node-positive breast cancer patients treated with neoadjuvant systemic therapy. The aim of this study was to assess whether axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT and breast cancer molecular subtype are predictors of axillary pCR.

Methods: This study included clinically node-positive patients treated with neoadjuvant systemic therapy in the prospective Radioactive Iodine Seed placement in the Axilla with Sentinel lymph node biopsy ('RISAS') trial (NCT02800317) with baseline [18F]fluorodeoxyglucose PET/CT imaging available.

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Purpose: Breast cancer (BC) screening enables early detection of BC, which may lead to improved quality of life (QoL). We aim to compare QoL between women with a screen-detected and clinically detected BC in the Netherlands.

Methods: We used data from the 'Utrecht cohort for Multiple BREast cancer intervention studies and Long-term evaluation' (UMBRELLA) between October 2013 and March 2022.

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Winding Back the Clock on Advanced Therapies: It's Time to Get Smart.

J Parkinsons Dis

October 2024

Parkinson's Disease Research Clinic, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.

Our language affects patients' perceptions of therapies. In Parkinson's disease, emergent response fluctuations and dyskinesias typically trigger conversations around commencing an "Advanced Therapy" which carries notions of Advanced Disease. The patient, resolute in their commitment to fighting the disease, is misled.

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Article Synopsis
  • The study investigates the use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) to manage severe abdominal bleeding by finding standardized catheter insertion lengths, aimed at improving practices in emergencies without x-ray guidance.
  • By analyzing CT scans of 1354 non-trauma patients, researchers established that catheter insertion distances vary based on age and sex, with males generally needing longer insertions.
  • Results showed optimal catheter lengths of 430 mm for zone I and varied lengths (234-264 mm) for zone III, highlighting significant anatomical differences that could impact emergency interventions.*
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Indocyanine green near-infrared fluorescence bowel perfusion assessment to prevent anastomotic leakage in minimally invasive colorectal surgery (AVOID): a multicentre, randomised, controlled, phase 3 trial.

Lancet Gastroenterol Hepatol

October 2024

Department of Surgery, Leiden University Medical Center, Leiden, Netherlands; Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands. Electronic address:

Background: Anastomotic leakage is a severe postoperative complication in colorectal surgery and compromised bowel perfusion is considered a major contributing factor. Conventional methods to assess bowel perfusion have a low predictive value for anastomotic leakage. We therefore aimed to evaluate the efficacy of real-time assessment with near-infrared (NIR) fluorescence imaging with indocyanine green (ICG) in the prevention of anastomotic leakage.

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Background: Individuals with Parkinson's disease (PD) report a diminished perceived functional autonomy as their condition progresses. For those seeking emergency care, it is unknown whether the patient-physician relationship is instrumental in respecting patient autonomy. This study evaluated patient autonomy ideals in individuals with PD requiring emergency care and the perceived support for autonomy from emergency department physicians.

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Background: Several prehospital scales have been designed to aid paramedics in identifying stroke patients in the ambulance setting. However, external validation and comparison of these scales are largely lacking.

Aims: To compare all published prehospital stroke detection scales in a large cohort of unselected stroke code patients.

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Background And Objective: Upper tract urothelial carcinoma (UTUC) can be managed efficiently and safely through kidney-sparing surgery (KSS) in selected patient groups. However, the most effective and efficient postoperative surveillance strategy remains undetermined. We aimed to provide a comprehensive synopsis of the follow-up strategies and survival outcomes in patients diagnosed with UTUC treated by KSS.

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Introduction: Closed-loop spinal cord stimulation (CL-SCS) is a recently introduced system that records evoked compound action potentials (ECAPs) from the spinal cord elicited by each stimulation pulse and uses this information to automatically adjust the stimulation strength in real time, known as ECAP-controlled SCS. This innovative system compensates for fluctuations in the distance between the epidural leads and the spinal cord by maintaining the neural response (ECAP) at a predetermined target level. This data collection study was designed to assess the performance of the first CL-SCS system in a real-world setting under normal conditions of use in multiple European centers.

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Aims: It is not clear which type of casting provides the best initial treatment in adults with a distal radial fracture. Given that between 32% and 64% of adequately reduced fractures redisplace during immobilization in a cast, preventing redisplacement and a disabling malunion or secondary surgery is an aim of treatment. In this study, we investigated whether circumferential casting leads to fewer the redisplacement of fewer fractures and better one-year outcomes compared with plaster splinting.

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