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Biomedical subjects

L Mahieu

Publications and source records attributed to L Mahieu.

9 recordsLinked to original sources
PubMed2006

[Surgical treatment of inferior retinal detachment: advantages of postoperative traction of the right inferior muscle].

AIM: To evaluate the advantages of keeping the right inferior muscle in traction during external surgery for inferior retinal detachment. PATIENTS AND METHODS: This was a prospective study involving ten patients consecutively operated on for rhegmatogenous retinal detachment at the Toulouse-Rangueil Teaching Hospital. Internal plugging by air or a C2F6-air mixture was systematically performed, together with external indentation and total subretinal fluid puncture. At the end of surgery, a 2.0 silk thread was set beneath the right inferior muscle and kept in traction from the forehead for a few days. The patient was maintained feet up, in a dorsal decubitus posture. RESULTS: Results proved excellent, with ten anatomical successes. However, one patient had to have gas reinjected and in another subretinal fluid persisted for 3 months. DISCUSSION: The risk of surgical failure in inferior retinal detachment is greater because dabbing is more difficult to perform. To make this dabbing easier, we propose maintaining the ocular globe rearward by maintaining traction on the right inferior muscle, which produced excellent results. CONCLUSION: The technique proposed is easy to perform, and combined with internal dabbing and adequate patient positioning, it should help improve the surgical outcome of inferior retinal detachments.

Aged↗
PubMed2006

[Specifications of retinal detachment surgery in highly myopic eyes of 10 or more dioptres and hemorrhagic complications: 79 cases].

INTRODUCTION: We report a series of 79 eyes undergoing primary surgery for rhegmatogenous retinal detachment associated with severe myopia greater than 10 diopters. Specific surgical procedures are recommended for these patients in order to minimize the high incidence of postoperative hemorrhagic complications. MATERIALS AND METHODS: Seventy-nine eyes of 76 patients treated for retinal detachment with severe myopia greater than 10 diopters were reviewed. Scleral buckling was performed in 21 eyes and pars plana vitrectomy in 58 eyes. RESULTS: After a mean follow-up period of 23.8 months, the final anatomical success rate was 93.7% (74 cases). Postoperative hemorrhagic complications (suprachoroidal hemorrhage and vitreous hemorrhage) occurred in four cases after scleral buckling and in ten cases after vitrectomy. DISCUSSION: In this study, primary scleral buckling for retinal detachment was less frequently performed than vitrectomy. Broad scleral buckling may not be associated with higher postoperative hemorrhagic complications, when the buckle does not extend over six clock hours. Postoperative hemorrhagic complications also occurred after vitrectomy; however, scleral buckling associated with vitrectomy does not seem to increase the complication rate. CONCLUSION: This retrospective study of 79 cases of rhegmatogenous retinal detachment with severe myopia higher than 10 diopters suggests that vitrectomy is often considered a primary procedure. Broad scleral buckling associated with vitrectomy is a safe and effective procedure, with an acceptable incidence of complications when not extending over six clock hours.

Choroid Hemorrhage↗
PubMed2004

[Inductively coupled plasma and clinical biology. Toxicological applications].

The multi-elementary quantitation method using inductively coupled plasma mass spectrometry has been widely developed for use with biological fluids. Many elements can be quantified simultaneously in biological fluids, including: Li, Be, B, Al, Mn, Co, Ni, Cu, Zn, Ga, Ge, As, Se, Rb, Sr, Mo, Pd, Cd, Sn, Sb, Te, Ba, W, Pt, Hg, Tl, Pb, Bi, U. The validation procedure is described by the French Society of Clinical Biology. Results for urine are corrected after creatinine determination. We report applications in clinical toxicology and forensic toxicology. Advances in inductively coupled plasma mass spectrometry in the field of clinical biology are particularly important for toxicological analysis. This powerful tool is helpful for better patient care and for the search for cause of death.

Adult↗
PubMed2004

Towards a Belgian consensus for prevention of perinatal group B streptococcal disease.

BACKGROUND & OBJECTIVES: In Belgium, as in many other countries, group B Streptococcus (GBS) is still the leading cause of sepsis and meningitis in neonates. In 2001, though no Belgian guidelines for their prevention were available, in some hospitals, obstetrical programmes included a GBS prevention policy. With an aim to reach a Belgian consensus for the prevention of perinatal group B streptococcal disease, a national consensum meeting was organized in 2001. We report here our experience and findings of this meeting. METHODS: In November 2001, obstetricians, neonatologists, microbiologists and infectious diseases specialists were invited to participate in a GBS symposium. International and Belgian speakers presented epidemiological aspects, argued comparative cost-effectiveness of different approaches for prevention and debated technical and practical problems. Management of neonates with risk factors for GBS disease and progress in GBS vaccines were also included in the programme. Further results about Belgian obstetricians' practice and compliance to a policy for prevention of neonatal GBS diseases, as answered in two mail surveys, were commented and discussed. In an interactive session at the end, each participant was asked to vote on the key points related to the different steps of the ideal prevention strategy to recommend. RESULTS: For the main questions, 94 per cent of participants choose a screening-based approach and 94 per cent shifted from the current use of ampicillin to penicillin as first choice for antimicrobial prophylaxis. Further, 79 per cent voted for an approach with integrated neonatal prophylaxis for selected neonates at high risk for GBS disease and 47 per cent voted for a strategy based on an intrapartum rapid screening-based approach. INTERPRETATION & CONCLUSION: The state of the question by different speakers, the data from Belgian epidemiology, and the debate about cost-effectiveness of different approaches led to a massive vote in favour of the universal screening-based approach. Based on these results, a working group has been appointed by the Ministry of Health to draft and edit Belgian recommendations for the prevention of perinatal GBS disease.

Belgium↗
PubMed2003

Twin versus singleton pregnancy and preterm prelabour rupture of the membranes.

PURPOSE: The primary purpose of this study was to compare the latency period between preterm prelabour rupture of the membranes (PPROM) and delivery in twin versus singleton pregnancies. The secondary purpose was to compare the neonatal outcome of these two groups. METHODS: A retrospective case control study was performed on 33 consecutive bichorionic twin pregnancies with gestational age 20 to 36 weeks admitted to the Antwerp University Hospital with PPROM from 1995 to 2000. These were matched with singletons experiencing PPROM at the same gestational age. Groups were compared for smoking behaviour, whether conception was spontaneous or with artificial reproductive technology, dilation at the moment of PPROM, latency period between PPROM and delivery, the use of tocolytics, antibiotics, corticosteroids, cervicovaginal culture results and neonatal morbidity and mortality. RESULTS: The latency period was significantly shorter in twins (median 19 versus median 47 hours; p = 0.01) and significantly more twins were born within 48 hours after rupture of the membranes (74.2% versus 51.5%; p = 0.01). This is due to a difference in the group with gestational age 30 or less weeks, after gestational age 30 weeks no significant difference exists. No other differences were noted between groups. CONCLUSION: No clinically relevant differences for the perinatal outcome after PPROM in twin versus singletons can be noted, but delivery is more likely to result within 48 hours after PPROM in cases of a twin pregnancy.

Apgar Score↗
PubMedDate not supplied

Scheduled relaparotomies using a zipper system for the treatment of diffuse generalized peritonitis in children.

In the treatment of diffuse peritonitis, planned relaparotomies with peritoneal lavages using a zipper system (EthiZip Ethicon) are sometimes necessary to obtain a complete eradication of the infectious focus. While most reported series are dealing with an adult population, this review focuses on the treatment of peritonitis using a zipper system in a paediatric age group. In a period of 3 years, insertion of a zipper device and peritoneal lavages were considered necessary to control intraabdominal sepsis in 7 children (age varying from 5 days to 13 years). They consequently underwent planned relaparotomies with peritoneal lavages every 24 to 48 hours. The peritonitis was caused by necrotizing enterocolitis (3 patients), postoperative complications (3 patients) and long existing perforated appendicitis (1 patient). Physical status, assessed by the Acute Physiologic Score (A.P.S.), varied from 12 to 22 (mean 17.7). Usually more than one lavage was necessary (1 to 3, mean 1.9) before the abdomen was considered clean and the zipper could be removed. Closure of the abdominal cavity could be achieved primarily in all cases. All patients survived. Although no statistically significant conclusions can be drawn from this small series and although it is unclear whether these children would not have survived without the zipper, this review shows that planned relaparotomies with peritoneal lavages using a zipper system can be performed safely even in very small children.

Adolescent↗