Ligament reconstruction in thumb carpometacarpal joint instability:A systematic review

In thumb carpometacarpal (CMC) instability, laxity of the ligaments surrounding the joint leads to pain and weakness in grip and pinch strength, which predisposes the patient to developing CMC joint arthritis. Recent advancements in joint anatomy and kinematics have led to the development of various surgical reconstructive procedures. This systematic review outlines the available ligament reconstruction techniques and their efficacy in treating nontraumatic and nonarthritic CMC instability. Additionally, we aimed to provide evidence which specific ligament reconstruction technique demonstrates the best results. Four databases (Embase, MEDLINE, Web of Science, and Cochrane Central) were searched for studies that reported on surgical techniques and their clinical outcomes in patients with nontraumatic and nonarthritic CMC instability. Twelve studies were analyzed for qualitative review, including nine different surgical ligament reconstruction techniques involving two hundred and thirty thumbs. All but one of the reported techniques improved postoperative pain scores and showed substantial improvement in pinch and grip strength. Complication rates varied between 0% and 25%. The included studies showed that ligament reconstruction effectively alleviated the patients’ complaints regarding pain and instability, resulting in overall high patient satisfaction. Nevertheless, drawing definitive conclusions regarding the superiority of any ligament reconstruction technique remains challenging owing to the limited availability of homogeneous data in the current literature.</p

Ligament reconstruction in thumb carpometacarpal joint instability:A systematic review

In thumb carpometacarpal (CMC) instability, laxity of the ligaments surrounding the joint leads to pain and weakness in grip and pinch strength, which predisposes the patient to developing CMC joint arthritis. Recent advancements in joint anatomy and kinematics have led to the development of various surgical reconstructive procedures. This systematic review outlines the available ligament reconstruction techniques and their efficacy in treating nontraumatic and nonarthritic CMC instability. Additionally, we aimed to provide evidence which specific ligament reconstruction technique demonstrates the best results. Four databases (Embase, MEDLINE, Web of Science, and Cochrane Central) were searched for studies that reported on surgical techniques and their clinical outcomes in patients with nontraumatic and nonarthritic CMC instability. Twelve studies were analyzed for qualitative review, including nine different surgical ligament reconstruction techniques involving two hundred and thirty thumbs. All but one of the reported techniques improved postoperative pain scores and showed substantial improvement in pinch and grip strength. Complication rates varied between 0% and 25%. The included studies showed that ligament reconstruction effectively alleviated the patients’ complaints regarding pain and instability, resulting in overall high patient satisfaction. Nevertheless, drawing definitive conclusions regarding the superiority of any ligament reconstruction technique remains challenging owing to the limited availability of homogeneous data in the current literature.</p

Groene groei: Investeren in biodiversiteit en natuurlijke hulpbronnen

Dit is het eindrapport van de Taskforce Biodiversiteit en Natuurlijke Hulpbronnen. Onder de titel Groene Groei, investeren in biodiversiteit en natuurlijke hulpbronnen pleit de Taskforce voor een omslag naar een economie die gebaseerd is op de draagkracht van de aarde. Daarvoor moet in 2020 biodiversiteitverlies tot staan gebracht zijn en in 2030 onze ecologische voetafdruk zijn gehalveerd. Uiteindelijk doel voor de Taskforce Biodiversiteit en Natuurlijke hulpbronnen is een wereld met veerkrachtige ecosystemen waarin voldoende voedsel, water, energie en bescherming is voor iedereen

Small Angle Scattering and Zeta Potential of Liposomes Loaded with Octa(carboranyl)porphyrazine

In this work the physicochemical characterization of liposomes loaded with a newly synthesised carboranyl porphyrazine (H2HECASPz) is described. This molecule represents a potential drug for different anticancer therapies, such as Boron Neutron Capture Therapy, Photodynamic Therapy and Photothermal Therapy. Different loading methods and different lipid mixtures were tested. The corresponding loaded vectors were studied by Small Angle Scattering (SANS and SAXS), light scattering and zeta potential. The combined analysis of structural data at various length scales and the measurement of the surface charge allowed to obtain a detailed characterization of the investigated systems. The mechanisms underlying the onset of differences in relevant physicochemical parameters (size, polydispersity and charge) were also critically discussed

Shadow Places: Patterns of Spatial Concentration and Incorporation of Irregular Immigrants in the Netherlands

Summary: In Western countries, irregular immigrants constitute a sizeable segment of the population. By combining quantitative and qualitative research methods, this article describes and explains irregular immigrants’ patterns of spatial concentration and incorporation in the Netherlands. So far these spatial patterns have not been described and explained systematically, neither in the Netherlands nor elsewhere. The article shows that illegal residence is selectively embedded in the (urban) social structure in various ways. The authors argue that irregular immigrants are likely to be spatially concentrated and incorporated in similar ways in other Western countries; now and in the foreseeable future

Forearm rotation improves after corrective osteotomy in patients with symptomatic distal radius malunion

Objectives: Distal radius malunion can result in pain and functional complaints. One of the functional problems that can affect daily life is impaired forearm rotation. The primary aim of this study was to investigate the effect of corrective osteotomy for distal radius malunion on forearm rotation at 12 months after surgery. We secondarily studied the effect on grip strength, radiological measurements, and patient-reported outcome measurements (PROMs). Patients and methods: This cohort study analysed prospectively collected data of adult patients with symptomatic distal radius malunion. All patients underwent corrective osteotomy for malunion and were followed for 1 year. We measured forearm rotation (pronation and supination) and grip strength and analysed radiographs. PROMs consisted of the Patient-Rated Hand/Wrist Evaluation (PRWHE) questionnaire, Visual Analogue Scale for pain, and satisfaction with hand function. Results:Preoperative total forearm rotation was 112° (SD: 34°), of which supination of 49° (SD: 25°) was more impaired than pronation of 63° (SD: 17°). Twelve months after surgery, an unpaired Student's t-test showed a significant improvement of total forearm rotation to 142° (SD: 17°) (p &lt; 0.05). Pronation improved to 72° (SD: 10°), and supination to 69° (SD: 13°) (p &lt; 0.05). Grip strength, PROMs, as well as inclination and volar tilt on radiographs improved significantly during the first year after surgery (p &lt; 0.05). Conclusion: In patients with reduced forearm rotation due to distal radius malunion, corrective osteotomy is an effective treatment that significantly improves forearm rotation. In addition, this intervention improves grip strength, the PRWHE-score, pain, and satisfaction with hand function.</p