Intraventricular catheter placement by electromagnetic navigation safely applied in a paediatric major head injury patient

Introduction: In the management of severe head injuries, the use of intraventricular catheters for intracranial pressure (ICP) monitoring and the option of cerebrospinal fluid drainage is gold standard. In children and adolescents, the insertion of a cannula in a compressed ventricle in case of elevated intracranial pressure is difficult; therefore, a pressure sensor is placed more often intraparenchymal as an alternative option. Discussion: In cases of persistent elevated ICP despite maximal brain pressure management, the use of an intraventricular monitoring device with the possibility of cerebrospinal fluid drainage is favourable. We present the method of intracranial catheter placement by means of an electromagnetic navigation techniqu

Association of Subchondral Changes With Age and Clinical Outcome in Patients With Osteochondral Fractures in the Knee: MRI Analysis at 1 to 10 Years Postoperatively

Background Predictive factors influencing outcomes after surgical fixation of osteochondral fractures (OCFs) in the knee, particularly time between injury and surgery, have not been determined. Purpose To report imaging and clinical outcomes after OCF fixation and to assess the association between clinical scores and patient characteristics, lesion morphology, and appearance on magnetic resonance imaging (MRI) scans. Study Design Case series; Level of evidence, 4. Methods We assessed the clinical and imaging outcomes of 19 patients after screw fixation for OCFs in the knee at a minimum follow-up of 1 year. Patient characteristics, lesion morphology, and time from trauma to surgery were reviewed for each patient. At final follow-up, patients completed a 100-point visual analog scale (VAS) for pain, Tegner activity scale, Knee injury and Osteoarthritis Outcome Score (KOOS), and patient satisfaction survey. Postoperative MRI scans were assessed using the MOCART (magnetic resonance observation of cartilage repair tissue), Osteochondral Allograft MRI Scoring System, and bone marrow edema (BME) size. Results The mean patient age at surgery was 21.3 ± 11.4 years, and the median time from trauma to surgery was 10 days (range, 0-143 days). The refixed OCF fragment failed in 1 (5.3%) patient on the lateral condyle at 15 months postoperatively. The mean follow-up for the remaining 18 patients was 4.7 ± 3.2 years, and postoperative outcomes were as follows: VAS pain score, 9.5 ± 17.9; Tegner score, 4.8 ± 2.3; KOOS-Pain, 85.9 ± 17.6, KOOS-Symptoms, 76.4 ± 16.1; KOOS-Activities of Daily Living, 90.3 ± 19.0; KOOS-Sport, 74.4 ± 25.4; and KOOS-Quality of Life, 55.9 ± 24.7. Overall, 84.2% were satisfied or very satisfied with outcomes. Patient age was significantly associated with KOOS subscale scores and subchondral imaging parameters including BME and presence of subchondral cysts, which in turn were the only imaging variables linked to clinical outcomes (P < .05). Time from injury to surgery was not correlated with clinical or imaging outcomes. Conclusion Fixation of OCFs yielded acceptable clinical and imaging outcomes at a mean 5-year follow-up with seemingly little influence of delayed surgical treatment. Postoperative subchondral changes were significantly associated with clinical outcomes and were linked to patient age at surgery

Use of a novel pressure distribution system for severely ill neonates: a clinical pilot study carried out by the PREPICare consortium

Background: Pressure Injuries are not exclusively an adult phenomenon; various risk factors contribute to a high prevalence rate of 43% in the neonatal and pediatric intensive care population. Effective preventive measures in this population are limited. Methods: We performed a pilot study to analyze the distribution and localization of support surface interface pressures in neonates in a pediatric intensive care unit (PICU). The hypothesis was that pressure redistribution by a novel air mattress would reduce pressure peaks in critical neonates. The measurements were conducted in a 27-bed level III PICU between November and December 2020. This included measuring pressure distribution and pressure peaks for five neonates positioned on either a state-of-the-art foam mattress or a new prototype air mattress. Results: We confirmed that the pressure peaks were significantly reduced using the prototype air mattress, compared with the state-of-the-art foam mattress. The reduction of mean pressure values was 9-29%, while the reduction of the highest 10% of pressure values was 23-41%. Conclusions: The journey to an effective, optimal, and approved product for severely ill neonates to reduce Pressure Injuries is challenging. However, a crucial step was completed by this pilot study with the first pressure measurements in a real-world setting and the successful realization of a decrease in pressure peaks obtained using a prototype air mattress

Partial Remodeling after Conservative Treatment of Trampoline Fractures in Children

(1) Background: Trampoline fractures (proximal tibia fracture with positive anterior tilt) are increasing. This study represents the first attempt to determine the extent of remodeling in these fractures after conservative treatment (2) Methods: This Swiss prospective multicenter study included children aged 2 to 5 years with a trampoline fracture who were radiologically examined on the day of the accident and after one year. In addition, the anterior tilt angle was compared between the injured and unaffected tibia. Remodeling was defined as complete (final anterior tilt angle ≤ 0°), incomplete (smaller but still >0°), or no remodeling. (3) Results: The mean extent of remodeling was −3.5° (95% CI: −4.29°, −2.66°, p p 1 year after the trauma showed advanced remodeling, suggesting that one year is too short to observe complete remodeling

Paternal Body Mass Index (BMI) Is Associated with Offspring Intrauterine Growth in a Gender Dependent Manner

Background: Environmental alternations leading to fetal programming of cardiovascular diseases in later life have been attributed to maternal factors. However, animal studies showed that paternal obesity may program cardio-metabolic diseases in the offspring. In the current study we tested the hypothesis that paternal BMI may be associated with fetal growth. Methods and Results: We analyzed the relationship between paternal body mass index (BMI) and birth weight, ultrasound parameters describing the newborn’s body shape as well as parameters describing the newborns endocrine system such as cortisol, aldosterone, renin activity and fetal glycated serum protein in a birth cohort of 899 father/mother/child triplets. Since fetal programming is an offspring sex specific process, male and female offspring were analyzed separately. Multivariable regression analyses considering maternal BMI, paternal and maternal age, hypertension during pregnancy, maternal total glycated serum protein, parity and either gestational age (for birth weight) or time of ultrasound investigation (for ultrasound parameters) as confounding showed that paternal BMI is associated with growth of the male but not female offspring. Paternal BMI correlated with birth parameters of male offspring only: birth weight; biparietal diameter, head circumference; abdominal diameter, abdominal circumference; and pectoral diameter. Cortisol was likewise significantly correlated with paternal BMI in male newborns only

Die diagnostische Testgenauigkeit von manuellen Schultertests des Subacromialen Impingement Syndroms (SIS): eine systematische Literaturübersischt und Meta-Anaylse

Le but de notre revue systématique est d'examiner la fiabilité diagnostique des différents examens cliniques pour le diagnostic physiothérapeutique du conflit sous-acromial (SIS), afin d'offrir un aperçu et une aide au praticien lors de son investigation. Une recherche systématique d‟articles a été effectuée sur les bases de données Pubmed, CINAHL, Web of Science, Cochrane Library et dans les archives du réseau bibliothécaire de l‟université de Bern, Bâle et de l‟ ETH Zurich. Neuf études ont été incluses puis évaluées sur leurs qualités méthodologiques à travers l'outil QUADAS. Les données ont été extraites, partiellement regroupées et présentées graphiquement au moyen des programmes informatiques "Review Manager 5.1" et "Disque Méta".Das Ziel unserer systematischen Übersichtsarbeit ist es, die diagnostische Testgenauigkeit verschiedener Tests zur Befunderhebung des SIS zu untersuchen, um den Praktikern einen Überblick zu verschaffen. Die systematische Literatursuche wurde in den Datenbanken Pubmed, Cinahl, Web of Science, Cochrane und den Bibliotheken der Uni Bern, Basel und der ETH Zürich getätigt. Es wurden neun Studien eingeschlossen und anschliessend mit dem QUADAS-Tool auf ihre Qualität untersucht. Die Daten haben wir mit „Review Manager 5.1“ und „Meta Disc“ extrahiert, teilweise gepoolt und grafisch dargestellt. Wir geben die gepoolten Sensitivitäten und Spezifitäten, sowie die Likelihood Ratios, die wir mit den gepoolten Sensitivitäten und Spezifitäten berechnet haben, an