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Biomedical subjects

H Lambert

Publications and source records attributed to H Lambert.

At least 181 records · Page 10Linked to original sources
PubMed1976

[Acute consumption coagulopathies. 120 cases].

Consumption coagulopathy is frequently observed in a resuscitation department. 120 cases of various etiologies are reviewed: complications of pregnancy (61 cases), infections (23 cases) or various stresses: acute hemolysis, shock, severe hepatic failure, intoxications, acidosis, heat-stroke... Consumption coagulopathy is intricated with the general stress which induces it, and with the visceral lesions induced by the stress and which can be aggravated by the consumption coagulopathy. The state of shock is observed in 76% of the cases, the haemorrhagic syndrome in 73%. Acute hemolysis and the clinical signs evocative of disseminated intravascular coagulation (cutaneous signs) are more rare. Following the initial manifestations, visceral complications may develop: renal, hepatic, respiratory, neurological, digestive. The evolution of the biology must be carefully studied. The diagnosis is made on both clinical and biological data. Etiological and pathophysiological treatment should be carried out. In our series, controlled and adapted heparin therapy was given systematically.

Disseminated Intravascular Coagulation↗
PubMed1976

[Consumption coagulopathies and severe postpartum hemorrhage].

15 patients were referred to the Intensive Care Unit immediately after delivery for severe post-partum haemorrhage. In 7 cases complications followed retroplacental haemotoma formation and in the other 8 cases they were due to secondary haemorrhages from the placental site and/or from tears of the cervix or vagina. It is a clinical picture that is associated with a state of shock, with continuing massive bleeding associated with failure of the blood to clot and which persists and becomes worse with the transfusion of stored blood and of the coagulation factors. In all these cases severe coagulation pathology due to consumption defects is revealed. We must point out that tears of the cervix and vagina which have been neglected and failure to compensate for the original blood loss are among the aetiological factors. Treatment with Heparin giving a dose of 1 to 3 mg per kg of body weight per 24 hours and controlled by a strict biological check together with symptomatic resuscitation from the state of shock and from the coagulation factors is successful (9 cases) if it is undertaken early on. A fatal outcome, whether it is due to a persistent state of shock (1 case) or to visceral complications of diffuse intravascular coagulation (C.I.V.D.) (5 cases) can be found where treatment is delayed and when insufficient blood is replaced and when antifibrinolytics are prescribed. A preventive therapeutic plan as well as a curative one can be drawn up for these cases of obstetrical drama.

Adult↗
PubMed1976

[Consumption coagulopathy and acidosis in the diabetic patient (author's transl)].

Four cases of intravascular coagulation associated with a state of acidosis in diabetics were observed in 57 patients with diabetic acidosis and 19 with lactic acidosis, in a series of 112 cases of consumption coagulopathy admitted to a department of medical resuscitation. In three cases the coagulopathy was found only on investigation; in one there were clinical and anatomic signs. The coagulopathy may be found either during the phase of recovery from ketoacidosis, or during the course of severe lactic acidosis, particularly during a recurrence of this form of acidosis. In spite of the unfavorable outcome in 3 of the 4 cases, the abnormal findings of coagulopathy reverted toward normal along with successful metabolic corrections. The factors responsible for consumption coagulopathy are acidosis, collapse, generalised systemic reactions and alterations of platelet function, of coagulation, of the balance between fibrin deposition and lysis and of lipid levels, all characteristic of diabetes. The clinical effects of this coagulopathy seldom become apparent but provide a possible explanation of some of the complications of diabetic ketoacidosis, particularly certain hemorrhagic or thrombotic events, as well as certain visceral complications, especially those affecting renal, pulmonary and cerebral areas.

Adolescent↗
PubMed1976

[Suicidal behavior and meterological conditions].

Six hundred and seventy five cases of attempted suicide observed in a resuscitation department were confronted with a certain number of biometeorological factors recorded daily: atmospheric pressure, air temperature, degree of insolation, precipitation, relative humidity, water vapour pressure, wind (speed and direction), hydrometeores, index of solar eruption, density of F2 layer. The confrontation is made for the two days before the intoxication and for the day when suicide is attempted. Parameters are then studied by statistical calculation (calculation of X2 and of the number of degrees of freedom). There does not seem to be any significant relationship, in spite of disconcerting series, between most meteorological factors and the number of attempted suicides observed. However, it is noted that no suicides were recorded during periods of solar eruption, and that there seems to be a marked correlation between suicide and winds, particularly according to their direction. Thus, winds charged with ionised particles seem to coincide with a high rate of self-destruction.

Atmospheric Pressure↗
PubMed1975

Cyclical shock with hyperglobulinemia.

Two personal cases are compared with CLARKSON's case, enabling one to describe a syndrome arising in adults without a family history, and characterised by episodes of repeated shock (cyclical shock) with hemoconcentration and hypoproteinemia. The physiopathological mechanism is an acute hyperpermeability. Two cases out of three took a fatal course, with a negative autopsy. In the three cases, the presence of light kappa chain IgG type monoclonal dysglobulinemia was proven. The diagnosis of multiple myeloma can be excluded. Comparison of this syndrome with periodic disease and primary amyloidosis can be envisaged.

Adult↗