Preliminary notes on parasites found in ruminants at Municipal Abattoir, Baton Rouge, Louisiana

Cover title.Bibliography: p. 7.Mode of access: Internet

Recovery after total hip or knee arthroplasty: physical and mental functioning

Musculoskeletal complaints are extremely common and have important consequences for the individual and society. The most prevalent chronic musculoskeletal disease is osteoarthritis (OA). OA is a disease of the articular joint and can lead to severe disability. In Western adult populations it is one of the most frequent causes of pain and stiffness, loss of function and disability. With regard to the major joints, OA is most prevalent in the knee and hip joint. In the Netherlands, in 2007 about 312,000 persons had knee OA and 238,000 persons had hip OA. Based on demographic development it is expected that the absolute number of persons with OA will increase by about 52% between 2007 and 2040. If the expected increase of patients with obesity is also taken into account, the prevalence of OA will become even greater. The initial treatment of OA consists of pain medication, physical therapy, and lifestyle recommendations. These treatments aim to suppress the symptoms and to improve or maintain functioning. When conservative treatment fails to alleviate pain and dysfunction caused by knee or hip OA, total knee arthroplasty (TKA) and total hip arthroplasty (THA) are cost-effective surgical options that can provide significant pain relief and improvement in physical functioning. The number of TKA and THA procedures performed in the Netherlands has increased substantially in the last decades. Between 1996 and 2008 the annual number of TKAs placed in the Netherlands in patients with a primary diagnosis of OA increased from 4,046 to 11,881, an increase of almost 300%. During this same period, the number of THAs placed in the Netherlands increased from 16,803 to 17,401 procedures. Because of the aging of the Western population, together with the increasing number of people with overweight and the improvements in surgical techniques, these numbers are expected to increase even further

Ikfstajezotuuknie: Half uitgesproken woorden in alledaagse gesprekken

Amsterdam klinkt in informele gesprekken vaak als Amsdam en Rotterdam als Rodam, zonder dat de meeste moedertaalsprekers zich daar bewust van zijn. In alledaagse situaties valt een aanzienlijk deel van de klanken weg. Daarnaast worden veel klanken zwakker gearticuleerd (bijvoorbeeld een d als een j, als de mond niet helemaal afgesloten wordt). Het lijkt waarschijnlijk dat deze half uitgesproken woorden een probleem vormen voor tweedetaalleerders. Gereduceerde vormen kunnen immers sterk afwijken van de vormen die deze leerders geleerd hebben. Of dit werkelijk zo is, hebben de auteurs onderzocht in twee studies. Voordat ze deze twee studies bespreken, vertellen ze eerst kort iets over de verschillende typen reducties die voorkomen

Body satisfaction and physical appearance in gender dysphoria

Gender dysphoria (GD) is often accompanied by dissatisfaction with physical appearance and body image problems. The aim of this study was to compare body satisfaction with perceived appearance by others in various GD subgroups. Data collection was part of the European Network for the Investigation of Gender Incongruence. Between 2007 and 2012, 660 adults who fulfilled the criteria of the DSM-IV gender identity disorder diagnosis (1.31:1 male-to-female [MtF]:female-to-male [FtM] ratio) were included into the study. Data were collected before the start of clinical gender-confirming interventions. Sexual orientation was measured via a semi-structured interview whereas onset age was based on clinician report. Body satisfaction was assessed using the Body Image Scale. Congruence of appearance with the experienced gender was measured by means of a clinician rating. Overall, FtMs had a more positive body image than MtFs. Besides genital dissatisfaction, problem areas for MtFs included posture, face, and hair, whereas FtMs were mainly dissatisfied with hip and chest regions. Clinicians evaluated the physical appearance to be more congruent with the experienced gender in FtMs than in MtFs. Within the MtF group, those with early onset GD and an androphilic sexual orientation had appearances more in line with their gender identity. In conclusion, body image problems in GD go beyond sex characteristics only. An incongruent physical appearance may result in more difficult psychological adaptation and in more exposure to discrimination and stigmatization

Aesthetic Outcomes of Perineal Reconstruction with the Lotus Petal Flap

The lotus petal flap can be applied for reconstruction of extensive defects in the vulvoperineal area. Studies on aesthetic outcomes are lacking. This study aimed to fill this gap. METHODS: All patients who underwent lotus petal flap reconstruction between October 2011 and December 2015 were asked permission to have their photographs used. Two questionnaires were used: (1) the Strasser score to assess the overall aesthetic results (range 0–15) and (2) the Patient and Observer Scar Assessment Scale (POSAS; range 6–60). Six plastic surgeons and 6 laymen filled in the Strasser score and the Observer scale of the POSAS. Patients filled in the Strasser score, the Patient scale of the POSAS and scored their overall satisfaction with the aesthetic results on a Likert scale (0–10). RESULTS: The photographs of 11 patients were included. The median Strasser score of all observers of 11.9 (range 0.0–75.0) indicated a mediocre aesthetic result. The median total POSAS score of 15.6 (range 6.0–41.0) indicated an aesthetically acceptable scar. Strasser and POSAS scores of the plastic surgeons and laymen did not differ significantly from the patients’ scores. The patient satisfaction score with the aesthetic result was a median of 6.0 of 10. CONCLUSIONS: The findings indicate that, overall, patients were moderately satisfied with the aesthetic results of their lotus petal flap reconstructions, as were the plastic surgeons and laymen. For clinical practice, it is important that the plastic surgeon manages expectations carefully before surgery, as it is possible that patients might experience a rather low aesthetic outcome after perineal reconstruction

Predictors of women's sexual outcomes after implant-based breast reconstruction

Objective: Although breast reconstruction has become an important treatment modality following mastectomy, few studies assessed predictors of postoperative sexual outcomes after breast reconstruction. Therefore, we aimed to study three sexual outcomes following implant-based breast reconstruction (IBBR), and associate multiple biopsychosocial factors with these outcomes. Methods: Data collection was part of a multicenter prospective study on IBBR. A predictive model was tested including medical, background and psychological predictors, partner relationship factors and physical sexual function. Data collection included clinical and questionnaire data (preoperatively and 1 year following reconstruction) using the BREAST-Q Sexual well-being scale (BQ5), and questions regarding sexual dysfunction and sexual satisfaction questions (Female Sexual Function Index). Results: The study sample consisted of 88 women who underwent mastectomy and IBBR. Mean postoperative BQ5 scores were lower than before surgery (M = 58 [SD = 18] vs 65 [SD = 20]; P =.01, Wilks' Lamdba =.88). Sexual dysfunctions were related strongest to orgasm inability and vaginal lubrication issues. The tested models predicted 37%-46% of the sexual outcomes: sexual outcomes were mostly predicted by psychosocial well-being, physical sexual function and partner support. Preoperative sexual and psychosocial well-being were positively associated with postoperative sexual well-being (r = 0.45 and r = 0.47). Conclusions: Although moderately positive sexual outcomes were reported after IBBR, some women reported issues with vaginal lubrication, breast sensation and orgasm. Sexual dysfunctions were predicted by vaginal lubrication and medical treatments, while sexual well-being and satisfaction were more predicted by psychosocial well-being and partner support. We advocate supportive care that includes partners and psychosocial functioning to optimize sexual outcomes after IBBR

Sensing Hotterdam: Crowd sensing the Rotterdam urban heat island

Sensing Hotterdam recorded the temperature in 1,000 Rotterdam homes and at 300 public spaces in the summer of 2014 in order to outline the links between the urban heat island, the built environment and public health in the city of Rotterdam. The measured outdoor temperature readings point to a clear heat island effect in Rotterdam. Temperatures in homes are generally higher than those in the surrounding area, and also show a large degree of variation. Indoor temperatures are less affected by local outdoor temperatures than we had expected

The prepectoral, hybrid breast reconstruction : the synergy of lipofilling and breast implants

Background: Breast reconstruction modalities are based on autologous tissue transfer, implants, or a combination of both. The aim of an allogeneic breast reconstruction is to minimize the impact of the implant on surrounding tissues to achieve an aesthetically pleasing result. Accurate tissue coverage, proper implant selection, and implant location are the absolute concerns in planning an implant-based reconstruction. Methods: A single surgeon's experience with the ergonomic, hybrid approach in primary and secondary breast reconstructions is presented. The hybrid approach is based on tissue expansion followed by serial sessions of fat grafting to augment the residual autologous (subcutaneous) compartment. The last step included the insertion of a prepectoral, ergonomic implant to obtain central core projection and additional volume. Results: Fifty-six hybrid breast reconstructions were performed with a mean follow-up of 24.1 months. Aesthetic outcomes and patient satisfaction have been good with pleasing breast projection, natural breast motion, and optimal coverage of the prepectoral implants. Conclusions: The hybrid reconstructive approach is a reliable technique to improve the outcomes in implant-based breast reconstructions. The 2-step, prepectoral approach with expander-to-implant exchange allows better control of the final breast shape, and complications related to submuscular approaches are avoided. Fat grafting adds an autologous benefit to obtain natural results