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Biomedical subjects

F Petitjeans

Publications and source records attributed to F Petitjeans.

12 recordsLinked to original sources
PubMed2004

Acid aspiration prophylaxis in obstetrics in France: a comparative survey of 1998 vs. 1988 French practice.

BACKGROUND AND OBJECTIVE: To survey French anaesthetic practice regarding acid aspiration prophylaxis and compare it with an earlier survey. METHODS: A confidential questionnaire was sent to all 800 maternity units in France to assess three major topics: (a) drugs used for pharmacological prophylaxis; (b) regional anaesthesia for labour and Caesarean section and (c) techniques used for general anaesthesia and endotracheal intubation. RESULTS: Two-hundred-and-two units responded. Pharmacological prophylaxis was regularly used for labouring women in 78% of the responding units in 1998 (compared with 63% in 1988, P < 0.05). Antacid drug use before Caesarean section had increased from 75% in 1988 to 97% in 1998 (P < 0.05). General anaesthesia was used for Caesarean section by less than 2% of responding units (vs. 21% in 1988, P < 0.05). In contrast, there was little change in the use of endotracheal intubation for instrumental delivery (53% vs. 50%) or manual removal of the placenta (15% vs. 16%) between 1988 and 1998. The use of cricoid pressure increased significantly during the 10 yr period (50% vs. 88%, P < 0.05) and the technique was correctly described by 80% of the responding units (vs. 50%, P < 0.05). Similarly, the use of succinylcholine increased significantly from 25% (1988) to 479 (1998) (P < 0.05). CONCLUSIONS: There was a significant overall improvement of French practice regarding acid aspiration prophylaxis in obstetrics. However, the complete prophylaxis strategy is still not used in every patient emphasizing the need for continuing medical education.

Anesthesia, Conduction↗
PubMed2002

[Early rupture of a cryopreserved arterial allograft].

Cryopreserved arterial allografts are used in vascular surgery to treat infected arterial prosthesis. This treatment reduces mortality and morbidity compared to conventional surgery. We observed a case of early rupture of the allograft with the death of the patient due to a misdiagnosis. Recent findings show that cases of rupture have been described, and that current cryopreservation protocols may be the cause of degeneration. To avoid a sudden death for the patient, this complication must be known to diagnose quickly and treat surgically before a final haemorrhagic shock.

Arteries↗
PubMed2002

Tachycardia and convulsions induced by accidental intravascular ropivacaine injection during sciatic block.

Ropivacaine, a recently introduced local anesthetic of the amide family (1), seems to show less toxicity than bupivacaine (2-4). Nevertheless, both neurologic and cardiovascular toxicities are possible. Six cases of ropivacaine-induced convulsions have previously been reported (5-10), of which three cases also showed cardiovascular toxicity. In three cases, total plasma concentrations were measured (Table 1).

Adult↗
PubMed2001

[Obesity, diabetes mellitus, and gas gangrene: a major therapeutic challenge].

Soft tissue infections are uncommon but prognosis is severe (20 to 50%). Management consists in surgical debridement, antibiotic therapy against anaerobic and aerobic bacteria, and appropriate intensive care. When available, hyperbaric oxygen therapy is an integral part of the treatment. We report the case of 56-year-old female patient with diabetes (150 kg) was hospitalized in our unit a few days after surgical treatment of a buttocks abscess for clinical signs of peripheral gas gangrene. Surgical exploration showed necrotizing soft tissue infection with fasciitis. Adequate therapy using antibiotics, surgery daily and hyperbaric oxygen was given. Therapy had to be adapted to the patient's obesity. Outcome was good with recovery and few sequelae, allowing transfer to a medical ward.

Abscess↗
PubMedDate not supplied

[Severe hypofibrinegenemia after rattlesnake envenomation in France].

A 22-year-old man, who maintains illegally numerous exotic snakes at home (suburbs of Paris), was bitten by one of his Bresilian rattlesnakes, the lance-headed viper Bothrops moojeni, with grade III envenomation. The fibrinogen was less than 0,5 g/L, the prothombin time was 22%, the activated partial thromboplastin time was 94 seconds. The authors discuss the biological and clinical management of this defibrination, due to defibrinogenating proteases (thrombin-like enzymes), present in Bothrops moojeni venom. The patient received 7 vials of an antivenom directed to another crotal, Bothrops lanceolatus. Despite the importance of defibrinogenation, there was only a few clinical evidence of bleeding, according to the literature. The normalization of coagulation studies occured only after day 11. This case-report outlines the danger of the increase of exotic snakes maintained as pet in France and the difficulties to obtain specific antivenoms.

Adult↗