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Capelle aan den IJssel, Netherlands

Eker H.H.,Erasmus University Rotterdam | Steyerberg E.S.,Erasmus University Rotterdam | De Jong D.,Isala Hospital | Pierik E.G.J.M.,Isalaklinieken | And 8 more authors.
Annals of Surgery | Year: 2015

Background: Incisional hernia is one of the most frequent postoperative complications after abdominal surgery. Patients with an abdominal aortic aneurysm and patients with a body mass index of 27 or higher have an increased risk to develop incisional hernia. Primary mesh augmentation is a method in which the abdominal wall is strengthened to reduce incisional hernia incidence. This study focused on the short-term results of the PRImary Mesh Closure of Abdominal MidlineWounds trial, a multicenter double blind randomized controlled trial. Methods: Between 2009 and 2012 patients were included if they were operated via midline laparotomy, and had an abdominal aortic aneurysm or a body mass index of 27 or higher. Patients were randomly assigned to either receive primary suture, onlay mesh augmentation (OMA), or sublay mesh augmentation. Results: Outcomes represent results after 1-month follow-up. A total of 480 patients were randomized. During analysis, significantly (P = 0.002) more seromas were detected after OMA (n = 34, 18.1%) compared with primary suture (n = 5, 4.7%) and sublay mesh augmentation (n = 13, 7%). No differences were discovered in any of the other outcomes such as surgical site infection, hematoma, reintervention, or readmission. Multivariable analysis revealed an increase in seroma formation after OMA with an odds ratio of 4.3 (P = 0.004) compared with primary suture and an odds ratio of 2.9 (P = 0.003) compared with sublay mesh augmentation. Conclusions: On the basis of these short-term results, primary mesh augmentation can be considered a safe procedure with only an increase in seroma formation after OMA, but without an increased risk of surgical site infection. Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved. Source


de Witte D.,IJsselland Ziekenhuis
Nederlands tijdschrift voor geneeskunde | Year: 2010

A young man visited the Emergency Department with a painful right hand after punching his fist against a wall. He suffered a luxation in the fifth carpometacarpal joint and a fracture at the base of the fourth metacarpal bone which were successfully treated by reposition and plaster bandage for 4 weeks. Source


Schol-Gelok S.,IJsselland Ziekenhuis
Nederlands tijdschrift voor geneeskunde | Year: 2012

A 47-year-old woman with a history of ulcerative colitis and rheumatoid arthritis presented with a large ulcer with an erythematous halo of the right lower leg. The clinical course and the histopathological results were indicative of pyoderma gangrenosum. Source


Takacs I.M.,IJsselland Ziekenhuis
Nederlands tijdschrift voor geneeskunde | Year: 2010

A 77-year-old woman presented with a large swelling of the knee caused by prepatellar bursitis. Source


Sint Nicolaas J.,Erasmus Medical Center | de Jonge V.,Erasmus Medical Center | Cahen D.L.,Amstelland Hospital | Ouwendijk R.J.T.,Ikazia Hospital | And 4 more authors.
Clinical Gastroenterology and Hepatology | Year: 2012

Background & Aims: The efficacy of colorectal cancer screening programs depends on the rate of attendance at surveillance colonoscopy examinations. Increasing patients' awareness about the importance of surveillance might improve attendance, but it is not clear how much they know about their follow-up recommendations. We assessed the awareness of patients with adenomas about their surveillance recommendations. Methods: Ten endoscopy departments provided access to their colonoscopy database for quality assurance; 2 datasets were obtained. We analyzed data from 4000 colonoscopies (400 per department) performed on patients with adenomas. All the patients were mailed a survey to determine how much information they had about their colonoscopy results and their follow-up recommendations. Data from 549 patients were included in the analysis. We also assessed surveillance attendance among 500 patients (50 per department) who had adenomas removed. Results: Of the patients analyzed, 85% recalled retrieval of polyps during their colonoscopy, and 85% recalled whether they needed surveillance or not. The indication for surveillance was recalled by 69% of patients (range between departments, 55%-83%; P < .01). Factors that were associated with awareness of recommendations were younger age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.06-1.09), treatment by a gastroenterologist (OR, 5.53; 95% CI, 3.28-9.32), and presence of 3 or more adenomas (OR, 2.97; 95% CI, 1.29-6.85). Attendance among patients with adenomas varied among departments, from 60% to 89% (P < .01), and was not associated with awareness of patients about their recommendations per department (P = .59). Conclusions: Not enough patients (only 85%) who receive colonoscopies are aware of their results or surveillance recommendations. Although awareness of findings and recommendations did not correlate with follow-up attendance, patients should be better informed about findings and their need for surveillance. © 2012 AGA Institute. Source

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