[E-bikers are more often seriously injured in bicycle accidents: results from the Groningen bicycle accident database]. / E-bikers raken vaker ernstig gewond na fietsongeval.

OBJECTIVE: Analysing injury types, injury severity and mortality in victims of accidents with electric bicycles in comparison with conventional bicycles. DESIGN: Prospective cohort study. METHOD: Data of patients treated at the Accident & Emergency Department of the University Medical Center Groningen after a bicycle accident are being entered in a database since 2014. We have analysed this database for accidents with electric bicycles (e-bikes) and conventional bicycles occurring among adult patients for the period of July 2014 to May 2016. 'Propensity score matching' was used to match e-bikers to conventional cyclists, based on age, gender and the presence of comorbidities. RESULTS: 107 of the 475 included victims were riding an e-bike. Average age of e-bikers and conventional cyclists was 65 years and 39 years respectively. Comorbidity was more common in e-bikers. E-bikers were injured significantly more severely than conventional cyclists. They had more severe injuries of the head and face, and upper and lower extremities. E-bikers were also admitted to the hospital more often, and for longer periods, and they underwent surgery more often. Mortality was the same. Propensity score matching revealed that e-bikers had multiple severe injuries (ISS > 15) twice as often as conventional cyclists, that they had more severe head injuries and were admitted for longer periods than conventional cyclists. CONCLUSION: E-bikers who had a bicycle accident had more severe injuries, more frequently had multiple injuries and had more severe head injuries than conventional cyclists. This resulted in a greater need for care. Preventive measures such as riding lessons and helmet use should be encouraged. Care providers should pay extra attention to the possibility of severe injuries when a patient had a bicycle accident with an e-bike.

Function of pediatric Nissen-Rossetti fundoplication followed up into adolescence and adulthood.

BACKGROUND: We analyzed the very long-term results of the Nissen-Rossetti fundoplication performed in young children. Little has been reported about follow-up longer than 5 years in homogeneous populations. This study concerns a homogeneous group with a minimum follow-up of 10 years; these former patients, therefore, are now adolescents or adults. STUDY DESIGN: In 24 consecutive patients without other congenital or acquired anomalies of the esophagus or stomach, we evaluated the primary postoperative diagnoses, symptoms of recurrent reflux, and their state of health in 1994. RESULTS: After a median follow-up of 16 years, the result was excellent in 18 patients, good in 5, and poor in I (graded according to Visick). Patients with recurring reflux symptoms had evidence of failure of the fundoplication. All but 1 had been given a diagnosis of recurrent reflux within 2 years after the operation. The situation after 2 years seems predictive for the later outcome. CONCLUSIONS: In almost all cases, the Nissen-Rossetti fundoplication is a long-lasting, effective treatment for young children with symptomatic gastroesophageal reflux.

[Limited value of routine preoperative laboratory studies in children]. / Beperkte waarde van routinematig preoperatief laboratoriumonderzoek bij kinderen.

In order to determine whether in routine preoperative laboratory testing of children abnormal results were reported which influenced the course of the anesthesia or of the operation, a retrospective survey of charts was carried out at the University Children's Hospital, Groningen. The patients involved were 143 low risk children, admitted for ENT surgery. The main outcome measures were abnormalities and perioperative complications. There were 1.4% laboratory abnormalities (including five children with a haemoglobin concentration less than 7.1 mmol/l, one with a calcium concentration less than 2.2 mmol/l, one with an albumin concentration less than 30 g/l), and seven complications (bradycardia during intubation, bronchial obstruction, bleeding, excessive vomiting (three times), and leakage of perilymphatic fluid). There were no correlations between the abnormal test results and the complications. Routine laboratory testing in children scheduled for surgery might be reduced to measurement of haemoglobin, especially in non-white children.