Increased incidence of traumatic spinal injury in patients aged 65 years and older in the Netherlands.

PURPOSE: The global population is ageing rapidly. As a result, an increasing number of older patients with traumatic spine injuries are seen in hospitals worldwide. However, it is unknown how the incidence of traumatic spinal injury has developed over the past decade. Therefore, this study aimed to determine the incidence and characteristics of traumatic spinal injury in patients aged under and above 65 years. METHODS: During three time periods: 2009-2010, 2014-2015 and 2019-2020, all adult patients with traumatic spinal injury in the Netherlands were identified from the Dutch National Trauma Registry. Patient-related characteristics and 1-year mortality were collected from a subgroup of patients treated at a level-1 trauma centre, and patients aged ≥ 65 years were compared to patients aged < 65 years. RESULTS: In the Dutch National Trauma Registry 25,737 patients with traumatic spinal injury were identified. The incidence of spine injury in patients > 65 years was 49.5/100,000/yr in 2009-2010, 68.8 in 2014-2015 and 65.9 in 2019-2020. The percentage of patients ≥ 65 years increased from 37% in 2009-2010, to 43% in 2014-2015, and to 47% in 2019-2020. In the subgroup of 1054 patients treated in a level-1 trauma centre, a similar increasing incidence was seen in patients aged ≥ 65 years. In these patients low energy falls were the most common trauma mechanism and the cervical spine was the most commonly injured region. Moreover, patients ≥ 65 years had significantly higher 1-year mortality compared with patients aged < 65 years, 22.7% versus 9.2%. CONCLUSION: The incidence of traumatic spinal injury in older patients in the Netherlands has increased over the last 12 years. Almost half of the patients with traumatic spinal injury are currently aged ≥ 65 years. The increasing incidence and the high 1-year mortality highlight the need to modify existing treatment protocols for these patients.

Cubital tunnel release with Wide Awake Local Anaesthesia No Tourniquet (WALANT) technique in an outpatient setting is safe and effective.

Ulnar nerve release is often performed under general anaesthesia. Wide Awake Local Anaesthesia No Tourniquet (WALANT) is a new anaesthetic method increasingly used by hand surgeons in an outpatient setting. It has advantages such as the possibility to shift surgical interventions out of the regular surgical theatre settings into an outpatient clinical setting, no risk of complications or side effects resulting from regional and general anesthesia and decreased costs. The use of WALANT has not been investigated extensively in elbow surgery. This study aims to evaluate clinical outcomes after ulnar nerve release under WALANT 27 patients with ulnar nerve release for cubital tunnel syndrome were included. The primary outcome was the presence of (remaining) symptoms after ulnar nerve release. Data was extracted from medical records. 13 out of 27 patients had (mild) remaining symptoms after ulnar nerve release, and 1 complication (superficial wound infection) was seen. Ulnar nerve release under WALANT is safe and effective in patients with primary ulnar nerve entrapment that have failed conservative therapy.

Glycan labeling strategies and their use in identification and quantification.

Most methods for the analysis of oligosaccharides from biological sources require a glycan derivatization step: glycans may be derivatized to introduce a chromophore or fluorophore, facilitating detection after chromatographic or electrophoretic separation. Derivatization can also be applied to link charged or hydrophobic groups at the reducing end to enhance glycan separation and mass-spectrometric detection. Moreover, derivatization steps such as permethylation aim at stabilizing sialic acid residues, enhancing mass-spectrometric sensitivity, and supporting detailed structural characterization by (tandem) mass spectrometry. Finally, many glycan labels serve as a linker for oligosaccharide attachment to surfaces or carrier proteins, thereby allowing interaction studies with carbohydrate-binding proteins. In this review, various aspects of glycan labeling, separation, and detection strategies are discussed.

Analysis of glyphosate, AMPA, Glufosinate and MPPA with ION chromatography tandem mass spectrometry using A membrane suppressor in the ammonium form application to surface water of low to moderate salinity.

This paper describes a simple and reliable method for the sensitive and selective determination of the pesticides Glyphosate and Glufosinate and their main metabolites aminomethylphosphonic acid (AMPA) and 3-[hydroxy(methyl)phosphinoyl]propionic acid (MPPA) in surface water. The developed method is based on ion chromatography hyphenated to electrospray tandem mass spectrometry and does not require derivatization. A membrane suppressor, regenerated at pH 9, has been used in this work to strongly improve the peak shape of AMPA, which suffered from huge tailing due to the interaction of this compound with acidic membrane suppressors. With this modified suppressor the sensitivity for AMPA improved about 100 times. Moreover, addition of 40% methanol to the hydroxy eluent improved MS sensitivity for all compounds by 1.3-2.8 times. The separation is performed on a strong anion exchange column. Glyphosate and AMPA are detected in the negative ion ESI mode, whereas Glufosinate and MPPA show much better sensitivity in the positive ion ESI mode. Surface water samples were spiked with the labelled parent compounds. Sample preparation comprised a filtering step over coupled solid phase extraction Ba, Ag and Na cartridges to remove chloride and sulphate ions. The performance characteristics of the method were determined with real surface water samples. Samples containing 12.6 g L-1 chloride were also used in the validation process and showed no problem. Nitrate is not removed from the samples and may give ion-suppression for Glyphosate. Linearity of the method was established over at least three orders of magnitude in the measuring range 10-2000 ng L-1 for surface water. The reliability of the results was ensured by the application of the criteria from the Dutch Technical Agreement (NTA 8379) concerning "identification", "indication", and "absence" of substances. The limit of quantitation with regard to identification was 10 ng L-1 for all compounds and the limits of detection with regard to indication were 6.5-9.6 ng L-1. The recovery (94-104%) and reproducibility variance (5.5-6.2%) were excellent. The suitability of the developed method was demonstrated by the analysis of 172 surface water samples of low to moderate salinity from different parts of The Netherlands. AMPA was identified in 99% of the samples and always exceeded the maximum allowable concentration of 100 ng L-1. The maximal concentration found in surface water was 9900 ng L-1. Glyphosate was identified in 82% of the samples and in only 6% Glyphosate exceeded the maximum allowable concentration of 100 ng L-1. MPPA was identified in about 75% of the samples whereas Glufosinate was rarely detected and never exceeded the limit of quantitation.