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Reinier W.A. Spek Diederik P.J. Smeeing Linda van den Heuvel Marike C. Kokke Abhiram R. Bhashyam Johannes C. Kelder Egbert J.M.M. Verleisdonk Roderick M. Houwert Detlef van der Velde 《The Journal of foot and ankle surgery》2021,60(4):712-717
The incidence of geriatric ankle fractures is rising and the potential for complications is high in this population. Little is known about factors associated with increased postoperative complications after surgical fixation of ankle fractures in older-age patients. The purpose of this retrospective cohort study was to assess the epidemiology and risk factors for complications after surgically treated ankle fractures in geriatric patients. All patients who were 65 years or older and had a surgically treated ankle fracture were included. Pilon fractures, patients who were initially treated conservatively or who had less than 1 month of follow-up were excluded. Postoperative complications, demographic-, fracture- and surgical data of 282 patients were recorded from two level 2 trauma centers between 2012 and 2017. A total of 87 (30.9%) patients developed a complication, of which wound related complications were most frequently reported. Superficial and deep wound infections were observed in 27 (9.6%) and 18 (6.4%) patients, respectively. Multivariate regression analysis demonstrated increased age to be an independent predictive variable for the occurrence of postoperative complications (odds ratio 1.04; 95% confidence interval 1.00-1.09), while cast immobilization for more than 2 weeks was a protective factor for the development of wound related complications (odds ratio 0.34; 95% confidence interval 0.17-0.66). In conclusion, the incidence of postoperative complications among geriatric patients after surgical treatment of ankle fractures is high and patients should be informed accordingly. 相似文献
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Bram?Fioole Marike?Kokke Richard?van Hillegersberg Inne?HM?Borel RinkesEmail author 《BMC surgery》2005,5(1):7
Background
The purpose of this study was to evaluate the long-term results of partial liver resection for benign liver lesions. 相似文献3.
de Moor JM Brons E Kokke FT Vos H Tolboom JJ 《Nederlands tijdschrift voor geneeskunde》2004,148(16):791-794
In a 5.1-year-old girl who had been treated by surgical correction of biliary atresia and total orthotopic liver transplantation, extreme dietary selectivity was noted; this was treated by behaviour therapy. On entry in the rehabilitation centre, she manifested malnutrition along with a variety of gastro-enterologic complaints. The treatment consisted of a set of behavioural procedures such as stepwise expansion of the diet, verbal prompting, intermittent contingent attention and a list of agreements with a system of rewards; this led to the elimination of the dietary selectivity and to the consumption of a varied diet in a normal tempo. 相似文献
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de Ridder L Rings EH Damen GM Kneepkens CM Schweizer JJ Kokke FT Benninga MA Norbruis OF Hoekstra JH Gijsbers CF Escher JC 《Inflammatory bowel diseases》2008,14(3):353-358
BACKGROUND: Infliximab is effective for induction and maintenance of remission in Crohn's disease. It is unknown how long patients should be kept on infliximab therapy. The primary aim of this study was to assess duration of effective maintenance therapy and infliximab dependency in pediatric CD patients initially responding to infliximab therapy. METHODS: All pediatric patients treated with infliximab by pediatric gastroenterologists in the Netherlands because of severe luminal or fistulizing CD with initial response to infliximab therapy were reviewed. Duration of therapy, clinical response and adverse events were recorded. RESULTS: Sixty-six CD patients (37 boys) in 10 hospitals were initially responding to infliximab therapy. Mean age at the start of infliximab therapy was 14.5 years (range, 8.1-18.5 years). Mean follow-up since infliximab was started was 41.3 months (range 12-165). In total, 991 infusions were administered. Analysis demonstrates that 15.2% of patients had prolonged response, while 56.1% were infliximab dependent and 28.8% lost response. In total, 10 patients (15.2%) developed an infection during infliximab therapy and 8 (12.1%) had an immediate allergic reaction. CONCLUSIONS: Good clinical response to maintenance infliximab therapy was seen in 70% of patients. Infliximab maintenance therapy seems very effective and safe in pediatric CD. However, more than half of the patients in this cohort is dependent on repeated infliximab infusions. The number of infliximab infusions received when patients lost response to infliximab was diverse. There was no statistical difference regarding response to infliximab therapy when started early as compared to later in the course of Crohn's disease. 相似文献
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Chantal Kerkhofs Servi J. C. Stevens Saul N. Faust William Rae Anthony P. Williams Peter Wurm Rune
stern Paul Fockens Christiane Würfel Martin Laass Freddy Kokke Alexander P. A. Stegmann Han G. Brunner 《Human mutation》2020,41(1):196-202
Idiopathic intestinal varicosis is a developmental disorder defined by dilated and convoluted submucosal veins in the colon or small bowel. A limited number of families with idiopathic intestinal varices has been reported, but the genetic cause has not yet been identified. We performed whole‐exome and targeted Sanger sequencing of candidate genes in five intestinal varicosis families. In four families, mutations in the RPSA gene were found, a gene previously linked to congenital asplenia. Individuals in these pedigrees had intestinal varicose veins and angiodysplasia, often in combination with asplenia. In a further four‐generation pedigree that only showed intestinal varicosities, the RPSA gene was normal. Instead, a nonsense mutation in the homeobox gene NKX2‐3 was detected which cosegregated with the disease in this large family with a LOD (logarithm of the odds) score of 3.3. NKX2‐3 is a component of a molecular pathway underlying spleen and gut vasculature development in mice. Our results provide a molecular basis for familial idiopathic intestinal varices. We provide evidence for a relationship between the molecular pathways underlying the development of the spleen and intestinal mucosal vasculature that is conserved between humans and mice. We propose that clinical management of intestinal varices, should include assessment of a functional spleen. 相似文献
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van der Doef HP Kokke FT van der Ent CK Houwen RH 《Current gastroenterology reports》2011,13(3):265-270
Meconium ileus at birth, distal intestinal obstruction syndrome (DIOS), and constipation are an interrelated group of intestinal
obstruction syndromes with a variable severity of obstruction that occurs in cystic fibrosis patients. Long-term follow-up
studies show that today meconium ileus is not a risk factor for impaired nutritional status, pulmonary function, or survival.
DIOS and constipation are frequently seen in cystic fibrosis patients, especially later in life; genetic, dietary, and other
associations have been explored. Diagnosis of DIOS is based on suggestive symptoms, with a right lower quadrant mass confirmed
on abdominal radiography, whereas symptoms of constipation are milder and of longer standing. In DIOS, early aggressive laxative
treatment with oral laxatives (polyethylene glycol) or intestinal lavage with balanced osmotic electrolyte solution and rehydration
is required, which now makes the need for surgical interventions rare. Constipation can generally be well controlled with
polyethylene glycol maintenance treatment. 相似文献
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Gobardhan PD Elias SG Madsen EV van Wely B van den Wildenberg F Theunissen EB Ernst MF Kokke MC van der Pol C Borel Rinkes IH Wijsman JH Bongers V van Gorp J van Dalen T 《Annals of surgical oncology》2011,18(6):1657-1664