Biomedical subjects

M De Muynck

Publications and source records attributed to M De Muynck.

13 recordsLinked to original sources

PubMed2007

Free radical scavengers are more effective than indomethacin in the prevention of experimentally induced heterotopic ossification.

The pathogenesis of heterotopic ossification is still unclear and the preventive therapies are usually insufficient. The present study was designed to investigate the possible preventive effect of free radical scavengers on the development of experimentally induced heterotopic ossification in a rabbit model and to compare free radical scavengers with indomethacin to determine whether they act synergistically. A standard immobilization-manipulation model was used to induce heterotopic ossification in the hind legs of 40 1-year-old female New Zealand albino rabbits. The animals were divided into four groups and received daily either placebo, a free radical scavenger cocktail [allopurinol and N-acetylcysteine (A/A)], indomethacin or the combination of A/A and indomethacin in a randomized double-blind fashion. Every 4 days an X-ray was taken and the thickness and length of new bone formation was measured at the thigh. A marked statistically significant difference was found between the four groups. In the groups that received A/A, either alone or combined with indomethacin, an inhibition of bone growth, both in thickness and in length was demonstrated. In this experimental model free radical scavengers had a superior inhibitory effect on heterotopic ossification than indomethacin. Free radicals could play an important role in the pathogenesis of heterotopic ossification.

Acetylcysteine↗

PubMed2003

Urinary retention after hysterectomy for benign disease: extended diagnostic evaluation and treatment with sacral nerve stimulation.

OBJECTIVE: To detect prospectively neurogenic damage in patients with urinary retention responding to sacral nerve stimulation (SNS) after hysterectomy for benign disease. PATIENTS AND METHODS: From August 1995 to February 2002, 13 of 15 patients (mean age 43 years, sd 7) with urine retention for a mean (sd, range) of 25 (22, 6-240) months after hysterectomy for benign disease, were prospectively evaluated and treated with SNS. They were assessed using urodynamics at baseline and during the test stimulation. Sensory evoked potentials (SEPs), electrical sensory threshold (EST) measurements of the pudendal nerve, bladder neck and the bladder (2 Hz, 0-300 V), and needle electromyography of the external urethral sphincter (EUS) were undertaken in all patients. RESULTS: De-afferentiation (EST >/= 200 V) was limited to the bladder in four of the 13 patients and extended to the bladder neck in one other, and was matched by no response at the SEP. Relative ESTs of the bladder neck correlated inversely with residual urine (r = - 0.76, P = 0.01, x = 546, fx = 1.22) and bladder capacity (r = - 0.77, P = 0.01, x = 611, fx = 1.26) at diagnosis. Complex repetitive discharges and decelerating bursts of the EUS were seen in these five patients. Unilateral SNS was applied in 10 patients (bilateral in three). A revision was needed in six patients. Uroflowmetry at the last follow-up showed a mean (sd) maximum urinary flow rate of 22 (18) mL/s (not significantly different from during trial stimulation) with residual urine of 50-100 mL in two and 200-400 mL in three patients. Intermittent catheterization was needed in four patients. CONCLUSION: Urinary retention after hysterectomy for benign disease is associated with de-afferentiation of the bladder wall in some patients and is correlated inversely with the relative EST of the bladder neck. A Fowler syndrome was detected in five patients. For residual urine, about half the patients have a good and a third a partial long-term effect; we now offer SNS as a further treatment option.

Adult↗

PubMed2001

The pain cycle: implications for the diagnosis and treatment of pelvic pain syndromes.

The aim of the study was to report our results of sacral nerve stimulation in patients with pelvic pain after failed conservative treatment. From 1992 to August 1998 we treated 111 patients (40 males, 71 females, ages 46 +/- 16 years) with chronic pelvic pain. All patients with causal treatment were excluded from this study. Pelvic floor training, transcutaneous electrical nerve stimulation (TENS) and intrarectal or intravaginal electrostimulation were applied and sacral nerve stimulation was used for therapy-resistant pain. The outcome of conservative treatment and sacral nerve stimulation (VAS <3/10; >50% pain relief) was related to symptoms of voiding dysfunction and dyschezia, and urodynamic proof of dysfunctional voiding, not to the pain localization or treatment modality. Outcome was inversely related to neuropathic pain. When conservative treatment failed, a test stimulation of the S3 root was effective in 16/26 patients, and 11 patients were implanted successfully with a follow-up of 36 +/- 8 months. So far no late failures have been seen. A longer test stimulation is needed in patients with pelvic pain because of a higher incidence of initial false positive tests. Our conclusion is that sacral nerve stimulation is effective in the treatment of therapy-resistant pelvic pain syndromes linked to pelvic floor dysfunction.

Adult↗

PubMed2000

Urodynamic assessment of voiding dysfunction and dysfunctional voiding in girls and women.

Voiding dysfunction is defined as impaired bladder emptying, and presents with a mixture of lower urinary tract symptoms. Dysfunctional voiding is a condition in which there is a lack of coordination between the sphincter and detrusor during emptying in a patient without overt uropathy or neuropathy. Assessment of voiding dysfunction is important in women and girls in the prevention and treatment of urinary incontinence, retention, urinary tract infection and subsequent kidney damage. Accurate diagnosis is essential in order to select the correct treatment. Screening can be done by history-taking: symptom scores can help to guide the screening. More objective measures are uroflowmetry, ultrasonography and video-urodynamics. The latter is the gold standard for the diagnosis of voiding dysfunction and consists of simultaneous registration of pressure in the bladder and rectum and external sphincter behavior, either by electromyographic recording of pelvic floor activity or by pressure recording at the external sphincter, during the whole bladder cycle of filling and emptying. On fluoroscopy the bladder can be visualized throughout the filling and emptying phase. In dysfunctional voiding, hypertonicity and instability of the external urethral sphincter during filling cystometry and impaired external sphincter relaxation during emptying are pathognomonic findings. Pressure-flow analysis reveals no obstruction and the detrusor contractility is low.

Adolescent↗

PubMed1999

Jumper's knee: postoperative assessment. A retrospective clinical study.

Jumper's knee or infrapatellar insertional tendinopathy is a condition primarily found in athletes between 18 and 25 years of age who are engaged in explosive running and jumping sports. It is caused by microtears or partial macrotears through the patellar tendon. Conservative treatment is used as the primary approach. If conservative measures are insufficient or fail to relieve the symptoms, surgery is indicated. The patellar tendon is incised and the hyaline inflammatory tissue is removed. Twenty-six patients have been studied retrospectively, with specific attention to postoperative resumption of sports and residual subjective and objective findings. They all completed a detailed questionnaire and subsequently underwent a physical and ultrasound examination.

Adult↗

PubMed1998

Constipation and other chronic gastrointestinal problems in spinal cord injury patients.

From a questionnaire sent to 90 spinal cord injury (SCI) patients it is concluded that 58% of patients with a complete SCI above L2 suffer from constipation, defined as two or fewer bowel movements per week, or the use of aids such as laxatives, manual evacuation or enemas. Tetraplegic patients had the highest prevalence of constipation, while patients with low paraplegia were less prone to constipation. The use of anticholinergic drugs was found to predispose to constipation. Preserved rectal sensation did not influence the presence of constipation. Faecal incontinence was rare. Regular abdominal pain was present in one third of SCI patients and might be caused by an irritable bowel syndrome in 62% of these.

Abdominal Pain↗

PubMed1995

Association between muscle trauma and heterotopic ossification in spinal cord injured patients: reflections on their causal relationship and the diagnostic value of ultrasonography.

Paraplegic patients presenting with a subacute limitation of hip joint mobility were subjected to serial sonographic examinations. In four patients the initial sonographic study disclosed discontinuity with fluid collection in the psoas muscle, which was diagnostic of a traumatic muscle rupture. All four patients subsequently developed sonographic and radiographic evidence of heterotopic ossification. Our findings confirm that ultrasonography is an easy and inexpensive screening method for the early diagnosis of heterotopic ossification. The sonographic results obtained in these four paraplegic patients are indicative of a possible traumatic origin of heterotopic ossification around the hip.

Adult↗

PubMed1991

The neurophysiologic examination in organophosphate ester poisoning. Case report and review of the literature.

A 65-year-old woman who has been admitted after organophosphate-induced poisoning (Fenthion), develops pareses as a result of neuromuscular junctional dysfunction 7 days post-exposure. These findings are consistent with an intermediate syndrome, which may appear within 24 to 96 hours of exposure and subsides after 5 to 18 days. Delayed polyneuropathy develops within 1 to 3 weeks and abates after 6 to 12 months. A distal axonopathy can be demonstrated. Several authors have attempted EMG monitoring of pesticide-workers in agricultural and industrial settings. The electrophysiologic examination is an important diagnostic adjunct in the development and course of muscle paresis following organophosphate-ester poising.

Aged↗

PubMed1986