Publications by authors named "B van Dijk"

271 Publications

One-year infection control rates of a DAIR (debridement, antibiotics and implant retention) procedure after primary and prosthetic-joint-infection-related revision arthroplasty - a retrospective cohort study.

J Bone Jt Infect 2021 27;6(4):91-97. Epub 2021 Jan 27.

Department of Orthopedics, University Medical Center Utrecht, Utrecht, the Netherlands.

: Debridement, antibiotics and implant retention (DAIR) procedures are effective treatments for acute postoperative or acute hematogenous periprosthetic joint infections. However, literature reporting on the effectiveness of DAIR procedures performed after a one- or two-stage revision because of a prosthetic joint infection (PJI) (PJI-related revision arthroplasty) is scarce. The aim of this study is to retrospectively evaluate the infection control after 1 year of a DAIR procedure in the case of an early postoperative infection either after primary arthroplasty or after PJI-related revision arthroplasty. : All patients treated with a DAIR procedure within 3 months after onset of PJI between 2009 and 2017 were retrospectively included. Data were collected on patient and infection characteristics. All infections were confirmed by applying the Musculoskeletal Infection Society (MSIS) 2014 criteria. The primary outcome was successful control of infection at 1 year after a DAIR procedure, which was defined as the absence of clinical signs, such as pain, swelling, and erythema; radiological signs, such as protheses loosening; or laboratory signs, such as C-reactive protein (CRP) ( ) with no use of antibiotic therapy. : Sixty-seven patients were treated with a DAIR procedure (41 hips and 26 knees). Successful infection control rates of a DAIR procedure after primary arthroplasty ( ) and after prior PJI-related revision arthroplasty ( ) were 69 % and 56 %, respectively ( ). The successful infection control rates of a DAIR procedure after an early acute infection ( ) and after a hematogenous infection ( ) following primary arthroplasty were both 69 % ( ). : In this limited study population, no statistically significant difference is found in infection control after 1 year between DAIR procedures after primary arthroplasty and PJI-related revision arthroplasty.
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http://dx.doi.org/10.5194/jbji-6-91-2021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129908PMC
January 2021

Incidental findings during the diagnostic work-up in the head and neck cancer pathway: Effects on treatment delay and survival.

Oral Oncol 2021 May 23;118:105350. Epub 2021 May 23.

University of Groningen, University Medical Center Groningen, Department of Otorhinolaryngology, Head and Neck Surgery, Groningen, the Netherlands.

Objectives: As a result of the increasing number of diagnostic scans, incidental findings (IFs) are more frequently encountered during oncological work-up in patients with head and neck squamous cell carcinomas (HNSCC). IFs are unintentional discoveries found on diagnostic imaging. Relevant IFs implicate clinical consequences, resulting in delay in oncologic treatment initiation, which is associated with unfavorable outcomes. This study is the first to investigate the incidence and nature of IFs over the years and establish the effect of relevant IFs on delay.

Material And Methods: This retrospective study compared two time periods (2010-2011 and 2016-2017), described associations between relevant IFs and delay in carepathway interval (days between first visit and treatment initiation) and assessed the effect of relevant IFs on overall two-year survival.

Results: In total, 592 patients were included. At least one IF was found in 61.5% of the patients, most frequently on chest-CT. In 128 patients (21.6%) a relevant IF was identified, resulting for the majority in radiologist recommendations (e.g. additional scanning). Presence of a relevant IF was an independent significant factor associated with delay in treatment initiation. The risk of dying was higher for patients with a relevant IF, although not significant in the multivariable model (HR: 1.46, p = 0.079).

Conclusion: In diagnostic work-up for HNSCC patients, relevant IFs are frequently encountered. As the frequency of additional imaging rises over the years, the number of IFs increased simultaneously. These relevant IFs yield clinical implications and this study described that relevant IFs result in significant delay in treatment initiation.
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http://dx.doi.org/10.1016/j.oraloncology.2021.105350DOI Listing
May 2021

Cortactin expression assessment improves patient selection for a watchful waiting strategy in pT1cN0-staged oral squamous cell carcinomas with a tumor infiltration depth below 4 mm.

Head Neck 2021 May 19. Epub 2021 May 19.

Department of Pathology & Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Background: In this feasibility study we aimed to evaluate the value of previously reported molecular tumor biomarkers associated with lymph node metastasis in oral squamous cell carcinoma (OSCC) to optimize neck strategy selection criteria.

Methods: The association between expression of cortactin, cyclin D1, FADD, RAB25, and S100A9 and sentinel lymph node status was evaluated in a series of 87 (cT1-2N0) patients with OSCC treated with primary resection and SLNB procedure.

Results: Tumor infiltration depth and tumor pattern of invasion were independent prognostic markers for SLN status, while none of the tumor makers showed a better prognostic value to replace SLNB as neck staging technique in the total cohort. However, in the subgroup of patients with pT1N0 OSCC, cortactin expression (OR 16.0, 95%CI 2.0-127.9) was associated with SLN classification.

Conclusions: Expression of cortactin is a promising immunohistochemical tumor marker to identify patients at low risk that may not benefit from SLNB or END.
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http://dx.doi.org/10.1002/hed.26746DOI Listing
May 2021

Cochlear implantation for tinnitus in adults with bilateral hearing loss: protocol of a randomised controlled trial.

BMJ Open 2021 05 18;11(5):e043288. Epub 2021 May 18.

Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.

Introduction: Tinnitus is the perception of sound without an external stimulus, often experienced as a ringing or buzzing sound. Subjective tinnitus is assumed to origin from changes in neural activity caused by reduced or lack of auditory input, for instance due to hearing loss. Since auditory deprivation is thought to be one of the causes of tinnitus, increasing the auditory input by cochlear implantation might be a possible treatment. In studies assessing cochlear implantation for patients with hearing loss, tinnitus relief was seen as a secondary outcome. Therefore, we will assess the effect of cochlear implantation in patients with primarily tinnitus complaints.

Method And Analysis: In this randomised controlled trial starting in January 2021 at the ENT department of the UMC Utrecht (the Netherlands), patients with a primary complaint of tinnitus will be included. Fifty patients (Tinnitus Functional Index (TFI) 32, Beck's Depression Index <19, pure tone average at 0.5, 1, 2 and 4 kHz: bilateral threshold between 50 and ≤75 dB) will be randomised towards cochlear implantation or no intervention. Primary outcome of the study is tinnitus burden as measured by the TFI. Outcomes of interest are tinnitus severity, hearing performances (tinnitus pitch and loudness, speech perception), quality of life, depression and patient-related changes. Outcomes will be evaluated prior to implantation and at 3 and 6 months after the surgery. The control group will receive questionnaires at 3 and 6 months after randomisation. We expect a significant difference between the cochlear implant recipients and the control group for tinnitus burden.

Ethics And Dissemination: This research protocol was approved by the Institutional Review Board of the University Medical Center (UMC) Utrecht (NL70319.041.19, V5.0, January 2021). The trial results will be made accessible to the public in a peer-review journal.

Trial Registration Number: NL8693; Pre-results.
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http://dx.doi.org/10.1136/bmjopen-2020-043288DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130732PMC
May 2021

Intermetatarsal bursitis, a novel feature of juxta-articular inflammation in early rheumatoid arthritis that is related to clinical signs: results of a longitudinal MRI-study.

Arthritis Care Res (Hoboken) 2021 May 10. Epub 2021 May 10.

Department of Rheumatology, Leiden University Medical Centre, Leiden, the Netherlands.

Objective: Intermetatarsal bursae in the forefeet possess a synovial lining, similarly to joints and tendon-sheaths. Inflammation of these bursae (intermetatarsal bursitis; IMB) was recently identified as specific for early RA. We hypothesised that if IMB is indeed an RA-feature, then it associates with 1) other local inflammatory measures (synovitis/tenosynovitis/osteitis), 2) clinical signs and 3) responds to DMARD-therapy similarly as other local inflammatory measures.

Methods: 157 consecutive early RA-patients underwent unilateral contrast-enhanced 1.5T forefoot-MRI at diagnosis. MRIs were evaluated for IMB-presence, and for synovitis/tenosynovitis/osteitis in line with the RA MRI scoring-system (summed as RAMRIS-inflammation). MRIs at 4/12/24 months were evaluated for IMB-presence and -size in patients who had IMB at baseline and received early DMARD-therapy. Logistic regression and generalised estimating equations were used. ACPA-stratification was performed.

Results: 69% of RA-patients had ≥1 IMB. In multivariable analysis on bursa-level, presence of IMB was independently associated with local presence of synovitis and tenosynovitis (OR 1.69(95%CI 1.12-2.57) and 2.83(1.80-4.44), respectively), but not osteitis. On patient-level, IMB-presence was most strongly associated with tenosynovitis (2.92(1.62-5.24)). IMB-presence associated with local joint-swelling (2.7(1.3-5.3)) and tenderness (1.7(1.04-2.9)) independent of RAMRIS-inflammation. During treatment, IMB-size decreased between 0-12 months. This decrease associated with decrease in RAMRIS-inflammation; which was driven by synovitis-decrease. Within ACPA-positive and ACPA-negative RA similar results were obtained.

Conclusion: IMB particularly accompanies inflammation of the synovial lining of joints and tendon-sheaths, showed a similar treatment response after DMARD-initiation and associates with typical clinical signs. These findings suggest that IMB represents a frequently present novel RA-feature of juxta-articular synovial inflammation.
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http://dx.doi.org/10.1002/acr.24640DOI Listing
May 2021