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Biomedical subjects

M P Heijboer

Publications and source records attributed to M P Heijboer.

9 recordsLinked to original sources
PubMed2006

Successful endoscopic treatment of chronic groin pain in athletes.

BACKGROUND: Chronic groin pain, especially in professional sportsmen, is a difficult clinical problem. METHODS: From January 1999 to August 2005, 55 professional and semiprofessional sportsmen (53 males; mean age, 25 +/- 4.5 years; range, 17-36 years) with undiagnosed chronic groin pain were followed prospectively. All the patients underwent an endoscopic total extraperitoneal (TEP) mesh placement. RESULTS: Incipient hernia was diagnosed in the study athletes: 15 on the right side (27%), 12 on the left side (22%), and 9 bilaterally (16%). In 20 patients (36%), an inguinal hernia was found: 3 direct inguinal hernias (5%) and 17 indirect hernias (31%). All the athletes returned to their normal sports level within 3 months after the operation. CONCLUSIONS: A TEP repair must be proposed to patients with prolonged groin pain unresponsive to conservative treatment. If no clear pathology is identified, reinforcement of the wall using a mesh offers good clinical results for athletes with idiopathic groin pain.

Adolescent↗
PubMed2005

Diagnostic value of blind synovial biopsy in clinical practice.

OBJECTIVE: To assess the diagnostic value of blindly performed synovial biopsies in carefully selected patients with unclassified arthritis. METHODS: Synovial tissue was obtained blindly under local anaesthesia. The Arthroforce III take-apart 3.5 mm needle and 1.5 mm grasping forceps were used for this purpose. RESULTS: Four patients with unclassified arthritis could be diagnosed properly based upon examination of synovial tissue of the knee obtained by an easy-to-perform blind biopsy. The arthritis of the four patients was diagnosed as being part of Erdheim-Chester disease, sarcoidosis, multicentric reticulohistiocytosis and arthritis caused by foreign-body material, respectively. CONCLUSIONS: Analysis of synovial tissue obtained during a blind biopsy procedure has diagnostic potential in carefully selected patients with unclassified arthritis. The common denominator in all the cases presented was a differential diagnosis consisting of a rheumatological disease with characteristic histological features.

Adult↗
PubMed2005

[Health care in sports by a team physician, especially in soccer].

The aim of health care in sports is to promote, to secure, and to recover general health of sportsmen, taking into consideration the sport's specific loads. In general, a (professional) sports club has a private (para)medical team consisting of a team physician, a physiotherapist, and an attendant or masseur. The team physician organizes the arrangements and the preventive, diagnostic, and curative tasks of the (para)medical team. In sports, sometimes medical emergencies occur, such as tongue bite, cardiac problems, hypoglycaemia in diabetes, anaphylactic shock, and hypo- as well hyperthermia. Sports injuries are caused by acute physical forces, chronic overload or repeated micro-traumas. High-incidence injuries in all sports are injuries of joints, bones, head, neck, back and abdomen. In case of medical emergencies, the team physician has to take action quickly and professionally. If sports injuries occur, the team physician has to provide first aid and to arrange a treatment and rehabilitation plan in consultation with the paramedical members of the team. During the treatment and rehabilitation, the team physician has to be of assistance to sportsmen. In arranging some of his tasks, a team physician can ask for assistance or help from a dentist or an oral and maxillofacial surgeon.

Athletic Injuries↗
PubMed2005

[Development, physiology, and cell activity of bone].

Bones are of crucial importance for the human body, providing skeletal support, serving as a home for the formation of haematopoietic cells, and reservoiring calcium and phosphate. Long bones develop by endochondral ossification. Flat bones develop by intramembranous ossification. Bone tissue contains hydroxyapatite and various extracellular proteins, producing bone matrix. Two biological mechanisms, determining the strength of bone, are modelling and remodelling. Modelling can change bone shape and size through bone formation by osteoblasts at some sites and through bone destruction by osteoclasts at other sites. Remodelling is bone turnover, also performed by osteoclasts and osteoblasts. The processes of modelling and remodelling are induced by mechanical loads, predominantly muscle loads. Osteoblasts develop from mesenchymal stem cells. Many stimulating factors are known to activate the differentiation. Mature osteoblasts synthesize bone matrix and may further differentiate into osteocytes. Osteocytes maintain structural bone integrity and allow bone to adapt to any mechanical and chemical stimulus. Osteoclasts derive from haematopoietic stem cells. A number of transcription and growth factors have been identified essential for osteoclast differentiation and function. Finally, there is a complex interaction between osteoblasts and osteoclasts. Bone destruction starts by attachment of osteoclasts to the bone surface. Following this, osteoclasts undergo specific morphological changes. The process of bone destruction starts by acid dissolution of hydroxyapatite. After that osteoclasts start to destruct the organic matrix.

Bone Development↗
PubMed2005

[Osteopetrosis. Classification, etiology, treatment options and implications for oral health].

Bone is continuously remodelled to maintain its strength and structural integrity. Remodelling is the result of an equilibrium between bone formation performed by osteoblasts and bone resorption performed by osteoclasts. In osteopetrosis this equilibrium is disturbed by a defect in the osteoclastogenesis or by disfunction of osteoclasts. Osteopetrosis is divided into four types: malignant infantile osteopetrosis, intermediate osteopetrosis, and two types of autosomal osteopetrosis. Malignant infantile osteopetrosis is usually diagnosed within the first year of birth by bone sclerosis and bone marrow obliteration. This type is very severe and usually results in death within a few years. The intermediate type usually appears before the age of ten and leads to recurrent pathologic fractures and cranial nerve compression. Autosomal dominant osteopetrosis is usually mild and consists of two sybtypes. Type I involves marked thickening of the cranial vault. Type II patients have predominantly sclerosis of the pelvis, the vertebrae and the base of the skull. Type I and II patients may often be long-lasting asymptomatic, but will eventually present with pathologic fractures, bone pain, and the effects of cranial nerve compression. Oral problems of osteopetrosis are delayed tooth eruption, absence of some teeth, malformed teeth, enamel hypoplasia, disturbed dentinogenesis, hypomineralisation of enamel and dentin, propensity for tooth decay, defects of the periodontal membrane, thickened lamina dura, mandibular protrusion, and the presence of odontomas. Tooth removal should be limited as it may induce bone fractures and osteomyelitis.

Bone Resorption↗
PubMed2000

Medial instability of the elbow: findings on valgus load radiography and MRI in 16 athletes.

Medial discomfort of the elbow in athletes can be due to valgus instability after acute ligament rupture or attenuation of the medial collateral ligament caused by repetitive microtrauma during overhead throwing. We studied 16 athletes with medial instability of the elbow due to insufficiency of the medial collateral ligament. 4 patients had sensory ulnar nerve symptoms, of whom 2 had abnormalities of the ulnar nerve on electromyography. 13 showed an increase in the ulno-humeral joint space on dynamic radiography under valgus load. MRI of 10 of these 13 elbows revealed rupture of the medial collateral ligament or avulsion of the medial collateral ligament. Dynamic radiography under valgus load seems to be of value for the diagnosis of chronic medial collateral ligament insufficiency.

Adult↗
PubMed1998

[One hundred years of orthopedics in the Netherlands. X. Sports injuries].

Sports injuries result from frequently repeated similar movements performed with submaximal force. In practice the term is also used, incorrectly, for many other injuries sustained during, or even outside, the practising of sports. Running may lead to injuries of muscles (rupture, chronic compartment syndrome), of tendons (peritendinitis, tendinosis, partial rupture, insertion tendinitis), of bone (stress fracture) and of cartilage (athrosis). Jumping mostly puts the ankle at risk, especially of development of an anterior or posterior impingement syndrome. Throwing puts much strain on the shoulder muscles; possible problems are microruptures in the rotator cuff, avulsion of the glenoid rim, chronic tendinitis of the biceps tendon and entrapment of the suprascapular nerve. The main element of the treatment is rest. If symptoms persist, surgery may be considered. Previous diagnostic imaging may then be of value.

Ankle Injuries↗
PubMed1980

Gastric diverticula.

The cases of three patients with a gastric diverticulum are described and the symptoms, diagnosis and treatment are reviewed.

Adult↗