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Biomedical subjects

L Merckx

Publications and source records attributed to L Merckx.

15 recordsLinked to original sources
PubMed1998

[Early enteral feeding in cranial trauma].

Until some years ago, patients suffering from head injury were poorly fed and nutrition was not a primary concern in the medical treatment of these patients. To date, six studies on head-injury patients have examined the effect of nutritional support on their outcome. All showed that lack of adequate nutrition contributed to increased mortality and morbidity. Head-injured patients on conventional enteral nutrition receive significantly less calories and proteins, resulting in an increased morbidity and mortality rate. Most of the severely head injured patients receiving enteral nutrition do not tolerate enteral feedings because of abnormal gastric emptying. The mechanisms of altered gastric function remain obscure. Increased intracranial pressure, cytokines, corticotropin-releasing factor, opiates, and other agents may all play a role. Impaired gastric motility has led to increasing use of small bowel feeding in head-injured patients. Jejunal feeding enables a higher caloric input and a better nitrogen balance. Moreover, it enables early enteral administration of nutrients in a safe and efficient way. Early administration of nutrients may be extremely important as it seems to decrease the hypermetabolic response to traumatic injury. Therefore, early jejunal enteral feeding may become an important cornerstone in the medical management of head-injured patients.

Craniocerebral Trauma↗
PubMed1997

[Contact allergy to cosmetics].

This article gives the results of contact allergic reactions to cosmetics seen between 1985 and 1990 (462 patients investigated) and between 1991 and 1996 (486 patients investigated). Perfume components remain the most frequently occurring allergens in cosmetics. They are followed by preservative agents, a class within which important shifts have occurred over time (e.g. as with the isothiazolinone mixture). Excipients and certainly emulsifiers (e.g. cocamidopropylbetaine) are potentially not only irritants but also allergens. Among the "active" or category-specific ingredients, oxidative hair dyes, based on paraphenylenediamine and derivatives, and nail care products, based on (meth)acrylates are particularly apt to cause professional dermatoses. Finally, the share of sunscreens as cosmetic allergens remains limited, which may well be because a contact or photocontactallergy is often not recognized since the differential diagnosis with a primary sun intolerance is not always obvious.

Allergens↗
PubMed1996

A consensus on the normal characteristics of corpus cavernosum EMG.

Corpus cavernosum EMG (CC-EMG) has raised much controversy since its introduction. The first workshop on CC-EMG has resulted in acceptance of a standardized technique of recording. Using this technique 110 normal potent volunteers have been examined in different centres. One year later there is an agreement among participants that an analogous recording of CC-EMG during flaccidity in normal subject results in reproducible findings. CC-EMG is characterized by highly reproducible waveforms (potentials) within the individual subject and mostly of comparable shape interindividually. Maximum peak to peak amplitude lies between 75 and > 500 microV and potentials have a mean duration of 12 s.

Adolescent↗
PubMed1995

Endoscopic submucosal Teflon injection (STING): an alternative treatment of vesicoureteric reflux in children.

The authors present their results in treating vesicoureteric reflux with an endoscopic submucosal teflon injection (STING) of the refluxing ureter. One hundred refluxing units in 68 children were treated with a maximum follow-up of five years. Indications were high grade reflux (III-V), persistence or progression of reflux despite conservative therapy, breakthrough urinary infections despite antibiotic prophylaxis and finally bad antibiotic compliance. Treatment was performed on an outpatient basis and appeared to be free of complications. Reflux was cured with a success rate of 75% after a single injection and 96% after two injections. With respect to the grade of reflux, best results were obtained in low grade reflux (Grade I-II). A 60-70% success rate was obtained in high grade reflux (III-V). The main advantage over open reimplantations lies in its non invasiveness, simplicity and possibility of being repeated in case of failure.

Child↗
PubMed1994

Penile electromyography in the diagnosis of impotence.

Cavernous electromyography of the flaccid penis was done in 93 impotent patients that were evaluated with several types of electrodes. We found that the potentials are generated by the cavernous tissue and are not the reflections of distant electromyographic events. Using monopolar needle electrodes, accurate interpretation of the electromyographic tracings seems possible. Our results confirm the value of penile electromyography as a way to objectivate penile smooth muscle atrophy as well as pelvic autonomic neuropathy with subsequent penile smooth muscle desynchronization. A neuromuscular dysfunction may be the causative factor in 39% of our impotent patients.

Electrodes↗
PubMed1991

The use of prostaglandins for diagnosis and treatment of erectile impotence.

The authors present their experience in using PGE-1 for the assessment of 77 impotent patients. This drug can be safely used as a screening test for vasculogenic impotence but is also useful in more invasive diagnostic tests. PGE-1 is probably the only natural product that can be used commonly for the treatment of erectile impotence, because it is a safe and effective drug.

Alprostadil↗
PubMed1990

[Echographic anatomy of the male urethra].

Sonographic urethrography is used as a new tool in understanding urethral pathology. Although a prospective study is necessary to demonstrate it, this examination seems to be complementary to retrograde Urethrography.

Humans↗
PubMed1990

[Total intravenous anesthesia using propofol and alfentanil in comparison with balanced anesthesia in neurosurgery].

Anaesthesia for neurosurgical patients should provide haemodynamic stability, reduce cerebral metabolism, preserve cerebral autoregulation, avoid increases of intracranial pressure and guarantee rapid recovery without respiratory depression. A commonly used Balanced Anaesthesia (BA, n = 20) (thiopental and fentanyl bolus induction and maintenance with repetition boluses of fentanyl and droperidol, thiopental infusion, and isoflurane in N2O/O2) was compared to Total Intravenous Anaesthesia (TIVA, n = 20) with propofol and alfentanil infusion. Pancuronium was employed for muscle relaxation in both groups. The TIVA evinced more haemodynamic stability during induction; notably, there was no increase in blood pressure after intubation, as seen in the BA group. Another advantage of TIVA is that it obviates the use of N2O. Quality of recovery after the procedure was determined by standardised psychometric tests. The time span between awakening of patients to orientation and concentration was significantly shorter in the TIVA group compared to the BA group. There was also a smaller deviation of these parameters in the TIVA group indicating a more predictable recovery.

Adult↗
PubMedDate not supplied

Anesthesia for craniotomy: total intravenous anesthesia with propofol and alfentanil compared to anesthesia with thiopental sodium, isoflurane, fentanyl, and nitrous oxide.

STUDY OBJECTIVE: To compare a total intravenous (IV) anesthetic technique based on propofol and alfentanil with a commonly used anesthetic technique for craniotomy. DESIGN: Open-label, randomized, clinical study. SETTING: Neurosurgical clinic at a university hospital. PATIENTS: Forty patients, aged 18 to 55 years, scheduled for brain tumor surgery. INTERVENTIONS: In 20 patients, anesthesia was induced with fentanyl and thiopental sodium and maintained with fentanyl, dehydrobenzperidol, isoflurane, nitrous oxide (N2O), and a thiopental sodium infusion. Twenty patients were anesthetized with a propofol loading infusion followed by a maintenance infusion at a fixed rate. In addition, alfentanil was administered as a loading bolus, followed by a variable-rate infusion, with additional doses as necessary to maintain hemodynamic stability. MEASUREMENTS AND MAIN RESULTS: A decrease in blood pressure (BP) after induction with thiopental sodium was followed by a significant increase in BP and heart rate (HR) during intubation. BP and HR did not change during the propofol loading infusion. However, the administration of alfentanil was followed by a similar decrease in BP with a return to baseline values during the intubation period. Return of normal orientation (7 +/- 5 minutes vs 27 +/- 23 minutes) and concentration (12 +/- 12 minutes vs 35 +/- 37 minutes) was shorter and more predictable for the propofol-alfentanil-treated patients than for the thiopental sodium patients. Maintenance propofol concentration (nine patients) was between 3 +/- 0.69 micrograms/ml and 3.36 +/- 1.17 micrograms/ml, while the concentration at awakening was 1.09 microgram/ml. Alfentanil concentration at extubation (nine patients) was 79 +/- 34 ng/ml. CONCLUSION: A total IV anesthetic technique with propofol and alfentanil is a valuable alternative to a more commonly used technique based on thiopental sodium, N2O, fentanyl, and isoflurane.

Adult↗