Biomedical subjects
Publications and source records attributed to E De Groof.
A patient with bleeding from the lateral circumflex artery following total hip replacement was successfully treated by embolization. The mechanism of injury and treatment modalities are discussed.
Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases. We report the case of a 67-year-old man with bilateral ruptures of the patellar tendons caused by minor trauma and with a good functional end result.
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In 17 Belgian surgical centers, 324 operations have been performed for acute cholecystitis in patients 80 years of age or older. In this group of patients: 1. The incidence of acute cholecystitis is hardly higher in women than in men. 2. The patients were operated within 24 hours of admission in 38% of cases. The main bile duct was surgically explored in 1/3 of patients. Cholecystostomy or simple drainage were used in 1/10 of cases only. 3. Operative mortality was 19%. It was higher for patients operated as emergencies than for delayed operations and higher also when the cholecystectomy was associated with an exploration of the bile duct. The ideal treatment for such patients should thus be a cholecystectomy with an endoscopic sphincterotomy.
The influence of malaria on the hemoglobin A2 (Hb A2) level in humans was studied in a series of 94 imported cases in Belgium. Sixty-nine of the patients were natives of Western European countries, their results are reported separately since their origin and the results of their hematological examination made it unlikely that they carried the beta-thalassemia trait. The Hb A2 level of the 94 malaria patients (mean 2.76%; S.D. 0.51%) was not statistically different from that found in 60 healthy controls (mean 2.70%; S.D. 0.38%; P greater than 40). Likewise the level of the 65 Western European patients was not statistically different from that of the same controls (mean 2.81%; S.D. 0.42%; P greater than 0.10). There was also no significant difference between the level in patients infected with a particular species of Plasmodium and that of the controls. No correlation was found between the Hb A2 level and the intensity of the parasitemia or the concentration of total hemoglobin in the blood. These results are discussed in comparison with the divergent ones obtained by others and it is suggested that malaria has no significant influence on the results of surveys for the prevalence of beta-thalassemia in regions of malaria endemicity.
The use of enteral feeding systems in patients with enterocutaneous fistulae is reviewed. The following problems are discussed: methods of administration, effects of enteral nutrition on patients with a gastro-intestinal fistula, clinical results (nutritional schemes, timing of nutritional support and caloric input). It is concluded that an enteral feeding system is the first choice in cases of distal GIT-fistulae, and in low-output fistulae. In other cases, it may be used in combination with TPN. The need for fistula-registration is thought to be of importance in view of prospective studies in this field.
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Conservative management of a traumatic biliopleural fistula. A female patient, 13 years of age, developed a right-sided haemothorax after a stab wound in the right para-vertebral region. Pleural effusion reoccurred after thoracic drainage was stopped. Ten days after the injury, thoracic puncture enabled a diagnosis of biliopleural fistula to be made, confirmed by ERCP and CT-scan. The fistula closed after repeat thoracic drainage combined with prophylactic antibiotic therapy.