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Biomedical subjects

M Martens

Publications and source records attributed to M Martens.

At least 19 recordsLinked to original sources

A case of systemic strongyloidiasis in an ex-coal miner with idiopathic colitis.

An ex-coal miner was diagnosed with an idiopathic sigmoiditis compatible with colitis ulcerosa. He was treated with corticosteroids because of his deteriorating clinical condition, but his condition continued to worsen. He revealed to have a systemic Strongyloides stercoralis hyperinfection and Strongyloides colitis. A short time after diagnosis he died from septic shock despite therapy with thiabendazole and antibiotics. S. stercoralis is an opportunistic infection that is not uncommon and has high mortality in hyperinfection. It is prevalent in (sub)tropical areas, and also in coal mines because of the specific microclimate. However, the parasite is difficult to detect because eosinophilia can appear normal in chronic infection. Several stool examinations, duodenal aspiration or biopsies are necessary for a high diagnostic sensitivity. Serological diagnosis is the most sensitive and specific but is not always available.

Animals

A right lower quadrant mass in cystic fibrosis: a diagnostic challenge.

In a cystic fibrosis (CF) patient a right lower quadrant (RLQ) mass may be a difficult diagnostic problem. Most frequently it is due to a distal intestinal obstruction syndrome also called meconium ileus equivalent, but the possibility of intussusception and appendiceal abscess should also be considered. We describe three CF patients with an appendiceal abscess seen in a 4-year period. All three patients had a palpable RLQ mass. Chronicity and obliteration of the appendiceal lumen with abnormally viscid mucus may lead to concealed perforation and be responsible for the atypical presentation.

Abscess

Subacromial impingement: open versus arthroscopic decompression.

An analysis of the follow-up results of 53 patients treated by an arthroscopic decompression (AD) and 53 patients treated by an open decompression (OD) is presented. Patients were evaluated pre- and postoperatively with the UCLA Shoulder Rating Scale, which includes an assessment of pain, function, range of motion, strength, and patient satisfaction. After an average of 20.1 months for the AD group and 27.3 months for the OD group, good or excellent results were found in 83.1% in the AD group and in 81.1% in the OD group. Patient satisfaction was 88.3% (AD) compared with 94.3% (OD). Results of decompression in both groups were not influenced by associated pathologies (acromioclavicular degeneration, frozen shoulder, calcified tendinitis, rotator cuff lesions).

Acromion

Osteoid osteoma as a cause of knee pain. A review of 10 cases.

Osteoid osteoma is a benign tumor frequently situated around the knee. It should therefore be considered as a possible cause of atraumatic knee pain in young adults. The mean interval from onset of symptoms to diagnosis is 14 months. Clinical symptoms are the most reliable diagnostic factors. Block resection is the treatment of choice. A retrospective study of 10 patients is presented.

Adolescent

Chronic compartment syndrome: diagnosis and management.

Young people active in sports, especially cyclists, runners and soccer players, may develop a chronic compartment syndrome, typically after a few years of athletic involvement. Complaints frequently appear when the intensity or frequency of training is increased. It is remarkable that runners develop mainly an anterior compartment syndrome, whereas soccer players and cyclists suffer mostly from a deep posterior compartment syndrome. The chief complaint is a cramp-like pain and weakness in the lower leg during effort. A compartmental tissue-pressure measurement must be performed to evaluate the severity of the compartment syndrome and to determine which compartments are involved. A clear clinical history and abnormal values of tissue-pressure measurements are indicative for a fascial release of the involved compartments and help assure a satisfactory result after surgery.

Adult

Correlation between magnetic resonance imaging and arthroscopy in the diagnosis of anterior cruciate ligament and meniscus lesions.

In both radiological and orthopedic journals the value of MRI for diagnosing internal derangement of the knee has been assessed recently. However, results vary widely and no study reports on the differentiation among types of ACL tears. As far as meniscal pathology is concerned, attention has been drawn by Reicher et al. (11) and Glashow et al. (5) upon the false positive tears of the posterior horn of the medial meniscus. Where most authors consider signal inversion in the posterior horn of the meniscus as a normal finding in children--due to the higher water content--the same fact in adults can be interpreted as a false positive image or a missed tear at arthroscopy (5).

Adolescent

Bacteriologic findings with ectopic pregnancy.

The fallopian tubes and peritoneum of 27 patients were cultured at the time of salpingotomy/salpingectomy to determine if active tubal infection was the cause of post-operative temperature elevations. Infection was documented in six patients (22%). Previous exposure to Chlamydia trachomatis was documented with 2 endocervical cultures and 17 serum specimens positive for IgG antibody. The culture results, however, did not correlate with the postoperative febrile morbidity.

Adolescent

Shoulder impingement syndrome.

An analysis of the results of 53 patients treated by an open Neer decompression for chronic impingement of the shoulder is presented. Patients were evaluated pre- and post-operatively on the UCLA Shoulder Rating Scale, which includes an assessment of pain, function, range of motion, strength and patient satisfaction. After an average period of 27.3 months, good or excellent results were found in 81.1%. Satisfactory results (according to Neer) were found in 94.3%. Differential diagnosis of acromioclavicular pathology and cervical syndromes is important.

Adult

Surgical treatment of Jones fractures.

A transverse fracture of the proximal part of the fifth metatarsal is rarely caused by direct trauma but is usually secondary to overload. These fractures, when treated conservatively, have a high recurrence rate and give rise to prolonged sporting inactivity. The clinical and radiographical difference between an acute versus a stress fracture will decide on further treatment. A reversed graft, by an asymmetrical trapezoid autograft, offers a simple and effective surgical solution for nonunion and delayed union of Jones fractures in sportsmen.

Athletic Injuries

Treatment of postpartum endometritis.

In this study, cefoxitin alone (2 gm, every 8 hours) was generally sufficient to cure postpartum endometritis, even when the patient had received prophylaxis with a beta-lactam antibiotic. When single-agent therapy fails, addition of ampicillin usually results in a prompt clinical response.

Cefoxitin

Facetectomy of the patella in patellofemoral osteoarthritis.

Patellofemoral osteoarthritis is a common disease which may occur alone or in association with tibiofemoral gonarthrosis. In cases of isolated symptomatic patello-femoral osteoarthritis with typical lateral malalignment and formation of osteophytes at the lateral border of the patello-femoral joint we perform a lateral facetectomy of the patella and associated lateral retinaculum release. The results of a prospective study of 20 cases with a mean follow-up of 2 years are presented. A good-to-moderate result was obtained in 90%. The average age was 60 years. We had 2 failures with a subjective rating of poor. The principal reason was tibiofemoral gonarthrosis too far advanced at the time of the operation, which then progressed in the postoperative course. On the other hand this technique results in marked improvement for many cases and carries only a small risk. Further reconstructive surgery of the knee is not excluded. Because of the minor surgery and quick recovery, this operation presents a valid alternative to more involved operations such as patellectomy, Bandi or Maquet reconstructive procedures, or a patellofemoral prosthesis.

Adult

Response of lower genital tract flora to external pelvic irradiation.

Endocervical and vaginal cultures were obtained every week from patients undergoing external pelvic irradiation for gynecologic malignancy. Gram-positive aerobes accounted for 52 to 56% of isolates, gram-negative aerobes accounted for 15 to 16%, and anaerobes accounted for 29 to 32% of all isolates prior to therapy. No significant changes occurred during or after completion of radiation for the group. In individual patients, however, over 50% of organisms found on initial culture were no longer present on completion of external therapy.

Bacteria

Patella alta in patellofemoral instability.

In a retrospective study of 90 realignment procedures for patellar instability, a high percentage of patella alta was diagnosed based upon the preoperative radiographs: 53% or 48 knees. The LP-LT index, described by Insall and Salvati, averaged 0.80 for this group of patients. Post-operative measurements of this index showed a definite correction of the craniocaudal position of the patella, with a mean increase of 0.10 (0.80 to 0.90). In evaluating the severity of the eliciting trauma, it is suggested that the alta position makes the patella more prone to instability: only 14.5% of the alta knees (n = 48) sustained a significant trauma versus 28.5% in the non-alta population (n = 42). The altaposition, however, had no influence on the final outcome, (at a mean follow-up time of 57 months), after a latero-medial realignment procedure, using a proximal or a combined proximal and distal procedure.

Adolescent

Ticarcillin/clavulanic acid versus clindamycin and gentamicin in the treatment of post-cesarean endometritis following antibiotic prophylaxis.

One hundred fifty-two women who received cefazolin prophylaxis and subsequently developed postpartum endometritis were randomized to treatment with either ticarcillin/clavulanic acid (75) or clindamycin-gentamicin (77). Bacteria isolated from the endometrium were predominantly facultative anaerobic bacteria. The ratio of facultative anaerobes to obligate anaerobes was 3:1. Nineteen percent of the women were bacteremic, with mycoplasma the organism most frequently isolated from venous blood specimens. Cure rates were similar for both groups: ticarcillin/clavulanic acid 85% and clindamycin-gentamicin 81%. The advantages of ticarcillin/clavulanic acid are an increased spectrum of activity against beta-lactamase-producing bacteria, less toxicity, and lower cost.

Adult