Prevalence of post-traumatic neuropathic pain after digital nerve repair and finger amputation

Introduction: Post-traumatic neuropathic pain is a major factor affecting the quality of life after finger trauma and is reported with considerable variance in the literature. This can partially be attributed to the different methods of determining neuropathic pain. The Douleur Neuropathique 4 (DN4) has been validated to be a reliable and non-invasive tool to assess the presence of neuropathic pain. This study investigated the prevalence of neuropathic pain after finger amputation or digital nerve repair using the DN4 questionnaire. Methods: Patients with finger amputation or digital nerve repair were identified between 2011 and 2018 at our institution. After a minimal follow-up of 12 months, the short form DN4 (S-DN4) was used to assess neuropathic pain. Results: A total of 120 patients were included: 50 patients with 91 digital amputations and 70 patients with 87 fingers with digital nerve repair. In the amputation group, 32% of the patients had pain, and 18% had neuropathic pain. In the digital nerve repair group, 38% of the patients had pain, and 14% had neuropathic pain. Secondly, of patient-, trauma-, and treatment-specific factors, only the time between trauma and surgery had a significant negative influence on the prevalence of neuropathic pain in patients with digital nerve repair. Conclusion: This study shows that persistent pain and neuropathic pain are common after finger trauma with nerve damage. One of the significant prognostic factors in developing neuropathic pain is treatment delay between trauma and time of digital nerve repair, which is of major clinical relevance for surgical planning of these injuries.</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

Relict periglacial soils on Quaternary terraces in the central Ebro Basin (NE Spain)

Pedofeatures associated with ancient cold climatic conditions have been recognized in soils on terraces in the Monegros area (central Ebro Basin, Spain), at a latitude of 41°49′N and an altitude of 300 m a.s.l. Eleven soil profiles were described on fluvial deposits corresponding to the most extensive terrace (T5) of the Alcanadre River, Middle Pleistocene in age (MIS8–MIS7). Each soil horizon was sampled for physical, chemical, mineralogical and micromorphological analyses. Macromorphological features related to pedocryogenic processes were described: involutions, jacked stones, shattered stones, detached and vertically oriented carbonatic pendents, fragmented carbonatic crusts, laminar microstructures, succitic fabric, silt cappings on rock fragments and aggregates, and irregular, broken, discontinuous and deformed gravel and sandy pockets. Accumulations of Fe–Mn oxides, dissolution features on the surface of carbonatic stones, and calcitic accumulations were identified related to vadose–phreatic conditions. The observed periglacial features developed under cold environmental conditions in exceptional geomorphic and hydrological conditions. This soil information may have potential implications in studies of paleoclimate in the Ebro Valley as well as in other Mediterranean areas

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

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

Patient-Reported Outcomes and Function after Surgical Repair of the Ulnar Collateral Ligament of the Thumb

Purpose: The purpose of this study was to report prospectively collected patient-reported outcomes of patients who underwent open thumb ulnar collateral ligament (UCL) repair and to find risk factors associated with poor patient-reported outcomes. Methods: Patients undergoing open surgical repair for a complete thumb UCL rupture were included between December 2011 and February 2021. Michigan Hand Outcomes Questionnaire (MHQ) total scores at baseline were compared to MHQ total scores at three and 12 months after surgery. Associations between the 12-month MHQ total score and several variables (i.e., sex, injury to surgery time, K-wire immobilization) were analyzed. Results: Seventy-six patients were included. From baseline to three and 12 months after surgery, patients improved significantly with a mean MHQ total score of 65 (standard deviation [SD] 15) to 78 (SD 14) and 87 (SD 12), respectively. We did not find any differences in outcomes between patients who underwent surgery in the acute (&lt;3 weeks) setting compared to a delayed setting (&lt;6 months). Conclusions: We found that patient-reported outcomes improve significantly at three and 12 months after open surgical repair of the thumb UCL compared to baseline. We did not find an association between injury to surgery time and lower MHQ total scores. This suggests that acute repair for full-thickness UCL tears might not always be necessary. Type of study/level of evidence: Therapeutic II.</p

Zorg in beeld; een scriptie naar de inzetbaarheid van de UMCG-zorggids

Inleiding De huidige ontwikkelingen in het zorglandschap leiden tot een steeds grotere druk onder zorginstellingen om zich te onderscheiden van concurrenten. De overheid stimuleert zorgverzekeraars om selectief in te kopen, wat ziekenhuizen aanzet tot het bieden van kwalitatief goede zorg tegenover betaalbare prijzen. Deze en andere ontwikkelingen waren voor het UMCG aanleiding om na te denken over hoe zij zich effectief kan profileren naar verschillende doelgroepen. Methode Grotendeels exploratief onderzoek met interviews onder verschillende doelgroepen. Tijdens deze gesprekken werd door gebruik van een topiclijst getracht (latente) wensen, behoeften en beweegredenen naar boven te krijgen. Resultaten Op basis van de onderzoeksresultaten is een advies geschreven over het effectief profileren. Dit advies is aangevuld met een implementatieplan ter ondersteuning van het UMCG in het proces van profilering. Conclusie Het UMCG kan door gebruik van het advies uniek en effectief zijn in de profilering richting verschillende doelgroepen. De inhoud van deze scriptie is vertrouwelijk. Wilt u de volledige scriptie inzien, dan kunt u een verzoek mailen aan: [email protected]