Background This study assessed the feasibility of near‐infrared fluorescence imaging with indocyanine green (ICG) to identify the parathyroid glands (PGs) intraoperatively and to assess their perfusion after thyroid resection. Methods Patients undergoing elective thyroidectomy were enrolled in this prospective study. An intravenous bolus of 7.5 mg ICG was administered twice: the first bolus to identify the PGs before resection of the thyroid and the second to assess vascularization of the PGs after resection. Results A total of 30 operations in 26 patients were included. In 17 surgeries (56.7%), fluorescence imaging was of added value, especially to confirm the presence of a suspected PG. No intraoperative or postoperative complications occurred because of the use of ICG. Conclusion Near‐infrared fluorescence imaging with the use of ICG for intraoperative identification of the PGs and the assessment of its vascularization is feasible and safe and can provide more certainty about the location of the PGs.

Introduction. This pilot study evaluates if an electronic nose (eNose) can distinguish patients at risk for recurrent hernia formation and aortic aneurysm patients from healthy controls based on volatile organic compound analysis in exhaled air. Both hernia recurrence and aortic aneurysm are linked to impaired collagen metabolism. If patients at risk for hernia recurrence and aortic aneurysms can be identified in a reliable, low-cost, noninvasive manner, it would greatly enhance preventive options such as prophylactic mesh placement after abdominal surgery. Methods. From February to July 2017, a 3-armed proof-of-concept study was conducted at 3 hospitals including 3 groups of patients (recurrent ventral hernia, aortic aneurysm, and healthy controls). Patients were measured once at the outpatient clinic using an eNose with 3 metal-oxide sensors. A total of 64 patients (hernia, n = 29; aneurysm, n = 35) and 37 controls were included. Data were analyzed by an automated neural network, a type of self-learning software to distinguish patients from controls. Results. Receiver operating curves showed that the automated neural network was able to differentiate between recurrent hernia patients and controls (area under the curve 0.74, sensitivity 0.79, and specificity 0.65) as well as between aortic aneurysm patients and healthy controls (area under the curve 0.84, sensitivity 0.83, and specificity of 0.81). Conclusion. This pilot study shows that the eNose can distinguish patients at risk for recurrent hernia and aortic aneurysm formation from healthy controls.

No abstract

Introduction: Bicycle spoke injuries (BSIs) in children are notorious for the presence of Salter Harris type 1 (SH1) fractures. Most patients are therefore treated with cast immobilization. However, the actual prevalence of SH1 following a BSI is unknown. In this study, we aimed to describe a cohort with radiograph-negative BSIs and to identify possible clinical predictors for SH1 which might be useful for adequate risk assessment. Methods: A retrospective cohort study was performed, including all children ≤12 years visiting our Emergency Department (ED) with a BSI. Patients without radiographic evidence of a fracture were classified as low or high level of suspicion of SH1. Multivariate logistic regression analysis was used to identify independent predictors of a high level of suspicion of SH1. Results: In total, 323 patients were included. Ninety-three patients (29%) had a proven fracture; 230 patients were radiograph-negative at first presentation. Of these, 166 patients (72%) were treated with cast immobilization. At follow-up, 32 patients (13.9%) were classified as high level of suspicion of SH1. No clinical variables were found to be predictive for SH1. Local tenderness at the lateral malleolus was associated with a high level of suspicion of SH1, however, this was not statistically significant (OR 2.89, p-value 0.057). Conclusion: Although BSIs with radiograph-negative ankle injuries are generally treated with cast immobilization, in this cohort only 13.9% had a high level of suspicion of SH1. Lateral malleolus tenderness was associated with a high level of suspicion of SH1 injury, but none of the clinical variables had a significant predictive value.