Chest wall perforator flap reconstruction in breast conserving surgery: quality of life and limited complications in outpatient treatment.

Background: Breast conserving surgery (BCS) with partial breast reconstruction (PBR) results in less morbidity, better cosmetic outcomes, and improved patient satisfaction compared to mastectomy. Perforator flap reconstruction can attenuate defects prone to breast deformity after BCS. Usually, postoperative drains and inpatient admission are part of this treatment.

[Neurological side-effects associated with immune checkpoint inhibitors].

The use of checkpoint inhibitors has shown significant clinical benefit in various cancer types but also carries a risk of immune-related adverse events (irAEs). As the use of checkpoint inhibitors continues to rise, so does the incidence of irAEs. Among these, neurological adverse events (neuro-irAEs) are particularly challenging to detect since they can manifest with a wide range of symptoms, often mimicking disease progression.

[Residency attrition in orthopaedic surgery; an explanatory model based on qualitative research].

Objective: Many factors can lead to residency attrition. The underlying process however and how these factors interact remains unclear. Understanding this process can provide background to put the available evidence into perspective.

Investigating the impact of acceptance and commitment therapy for mental healthcare professionals: the effect on patients´ self-stigmatization, a pilot study.

Background: A significant proportion of mental health care professionals (MHCPs) hold stigmatizing attitudes about their patients. When patients perceive and internalize these beliefs, self-stigmatization can increase. Acceptance and Commitment Therapy (ACT) may decrease stigmatizing attitudes by changing the 'us' versus 'them' thinking into continuum beliefs.

Diagnostic accuracy of 99Tc-HDP SPECT/CT and MRI for foot and ankle osteoarthritis (ProSPECT-trial): Study protocol.

Background: Accurate localisation of symptomatic osteoarthritic (OA) lesions in the midfoot, hindfoot and ankle remains challenging due to their complex anatomy. Conventional radiographs have limitations in complex areas or overlapping structures. SPECT/CT has shown promising results in detecting symptomatic OA lesions, yet its superiority over MRI, the current standard for soft tissue pathology, remains uncertain.

Outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support - a systematic review and meta-analysis.

Background: Postcardiotomy cardiogenic shock (PCCS) in cardiac surgery is associated with a high rate of morbidity and mortality. Beside other therapeutic measures (e.g.

Preferences of pregnant women and obstetric healthcare professionals on using noninvasive prenatal testing to predict adverse pregnancy outcomes: a discrete choice experiment.

Objectives: Noninvasive prenatal testing (NIPT) to screen for fetal aneuploidies by analysing cell-free DNA in maternal plasma is available to pregnant women worldwide. In the future, the scope of NIPT could potentially be expanded to the prediction of adverse pregnancy outcomes. The objective of this study was to assess and compare the preferences of pregnant women and obstetric healthcare professionals on this new test purpose of NIPT.

Newborn With Refractory Seizures Due To Hemimegalencephaly And Tuberous Sclerosis Complex: Case Report and Literature Review.

Background Hemimegalencephaly (HME) is a rare congenital disorder that is initiated during embryonic development with abnormal growth of one hemisphere. Tuberous sclerosis complex (TSC), a genetic disorder, is rarely associated with HME. Methods We present a case of a newborn with HME with a confirmed mutation in the TSC-1 gene and describe the clinical course, findings on (amplitude integrated) electroencephalography (aEEG), cranial ultrasound (CUS), MRI, and the postmortem evaluation.

DIAMACC: protocol of a prospective diagnostic accuracy study of the maximal systolic acceleration to detect peripheral arterial disease in patients with diabetes-related foot ulceration in the Netherlands.

Introduction: Foot ulcers are one of the most serious complications of diabetes, leading to significant risks on amputation and mortality. Peripheral arterial disease (PAD) is an important factor for the development and the outcome of diabetic foot ulcers (DFU). Although prompt and accurate detection of PAD is critical to reduce complications, its diagnosis can be challenging with currently used bedside tests (such as ankle-brachial index and toe pressure) due to medial arterial calcification.

Improving the accUracy of Referrals to the emerGency departmEnt of patieNts with chesT pain using the modified HEART score in Emergency Medical Transport (URGENT 2.0): protocol for a multicentre randomised controlled trial.

Introduction: Ischaemic heart disease is the single most common cause of death worldwide. Traditionally, distinguishing patients with cardiac ischaemia from patients with less alarming disease, in prehospital triage of chest pain, is challenging for both general practitioners and ambulance paramedics. Less than 20% of patients with chest pain, transferred to the emergency department (ED), have an acute coronary syndrome (ACS) and the transportation and analysis at the ED of non-ACS patients result in substantial healthcare costs and a great patient burden.

Cell-derived Newcastle disease virus variant with two amino acid substitutions near cleavage site of F shows favorable traits as oncolytic virus.

Newcastle disease virus (NDV) has shown encouraging effectiveness in , , and in early clinical trials as a viro-immunotherapy for pancreatic cancer. Previously, NDV used in clinical trials was produced in embryonated chicken eggs; however, egg-produced viruses are known to be partly neutralized by the human complement system when administered intravenously. Here, an NDV variant (NDV F0) was generated for production in mammalian cells, without passage in eggs.

Long-term mortality of Dutch COVID-19 patients admitted to the intensive care medicine: a retrospective analysis from a national quality registry.

Objective: To describe the 12-month mortality of Dutch COVID-19 intensive care unit patients, the total COVID-19 population and various subgroups on the basis of the number of comorbidities, age, sex, mechanical ventilation, and vasoactive medication use.

Methods: We included all patients admitted with COVID-19 between March 1, 2020, and March 29, 2022, from the Dutch National Intensive Care (NICE) database. The crude 12-month mortality rate is presented via Kaplan-Meier survival curves for each patient subgroup.

Reference intervals of work ability and productivity loss and their use in patients with inflammatory rheumatic and musculoskeletal diseases.

Objectives: To establish reference intervals (RIs) for work ability, at-work productivity loss and overall productivity loss in the general working population and to compare work ability and at-work productivity loss of patients with inflammatory rheumatic and musculoskeletal disease (iRMD) with this population.

Methods: Cross-sectional analysis among patients with iRMDs and population controls without iRMDs having paid work and participating in a Dutch cohort study. They reported on three work outcomes: work ability (0-10), at-work productivity loss and overall productivity loss (0%-100%).

Synovitis scoring in hand osteoarthritis with ultrasonography: the performance of the Global OMERACT/EULAR Ultrasound Synovitis Score (GLOESS) is comparable to synovial thickening alone.

Background: Inflammation is increasingly recognised as a treatment target in hand osteoarthritis, and therefore correct measurement of local inflammation is essential. This study aimed to assess ultrasound scoring of synovitis and the additional value of the Global OMERACT/EULAR Ultrasound Synovitis Score (GLOESS) in hand osteoarthritis.

Methods: Data from the randomised, double-blinded Hand Osteoarthritis Prednisolone Efficacy (HOPE) trial were used.

Differential impact of lifestyle factors on 2-hour glucose values in individuals with type 2 diabetes: potential for more personalized interventions.

Introduction: Lifestyle determinants of 2-hour glucose concentration in people with type 2 diabetes and interindividual differences need to be identified.

Research Design And Methods: 38 participants with type 2 diabetes, treated with lifestyle advice and/or metformin, tracked their physical activity, sleep and dietary intake, while continuously monitoring interstitial glucose concentrations for 11 periods of four consecutive days each. A linear mixed-effects model was used to quantify the effect of sleep, stress, current glucose, carbohydrate intake and exercise on glucose levels 2 hours later.

[Quick decisionmaking for acute pulmonary embolism patients].

Treatment options for patients with severe pulmonary embolism (PE) have increased substantially over the past decade. Although systemic thrombolysis is still the reperfusion therapy of choice for hemodynamically unstable PE patients, several new catheter guided reperfusion therapies have emerged as possibly safer alternatives. These therapies are increasingly implemented in clinical practice even though their efficacy and safety are yet to be proven by clinical outcome studies.

Metastatic conjunctival melanoma: a multicentre international study.

Background: To reveal clinical findings related to metastatic conjunctival melanoma.

Methods: 10 ophthalmic oncology centres (9 countries and 4 continents) shared data to create a large clinical case series. The main outcome measures were the incidence and cumulative risk of systemic metastasis, study mortality rates and Kaplan-Meier patient mortality after developing conjunctival melanoma metastasis.

GUIDANCE study: guided growth of the proximal femur to prevent further hip migration in patients with cerebral palsy-study protocol for a multicentre randomised controlled trial.

Introduction: Up to one-third of patients with cerebral palsy (CP) develop hip migration. Current standard care for early hip migration is bilateral adductor-psoas tenotomy; however, the failure rate is relatively high with 34%-74% of patients with CP requiring secondary hip surgery. Using temporary medial hemiepiphysiodesis of the proximal femur (TMH-PF), the morphology of the hip can be changed.

Patient experiences with person-centred and integrated chronic care, focussing on patients with low socioeconomic status: a qualitative study.

Background: effectiveness of single disease management programs (DMP) in general practice may be limited for patients with low socioeconomic status (SES), as DMPs insufficiently take into account the specific problems and needs of this population. A Person-Centred Integrated Care (PC-IC) approach focusing on patient's needs could address these problems.

Aim: to explore experiences of patients with (multiple) chronic diseases with regard to the acceptability of a general practice-based PC-IC approach, with a focus on patients with low SES, and to establish which modifications are needed to tailor the approach to this group.

Ethical challenges in conducting maternal-fetal surgery trials. A systematic review.

Objective: To present the ethical challenges embedded in published maternal-fetal surgery (MFS) trials and their potential solutions.

Method: Systematic review of normative and empirical literature. We selected articles based on predefined inclusion criteria.

[How to certify death and the cause of death].

In this article 10 important questions for physicians and other health care providers who are confronted with death during practice of their profession are answered. In the vast majority of cases, the attending physician can perform postmortem examination of those deceased. This article describes how an postmortem examination should be carried out correctly, what to do in unclear circumstances surrounding death and when an unnatural death should be considered.