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Biomedical subjects

M Delecroix

Publications and source records attributed to M Delecroix.

7 recordsLinked to original sources
PubMed2004

[Management of venous thromboembolic disease in ambulatory and hospital settings: an assessment of general practices in France].

OBJECTIVE: In spite of increasing use of prophylactic treatments, venous thromboembolic disease (VTD) remains an important public health problem because of its high morbidity and mortality, in particular after major orthopedic surgery. The aim of this study is to provide an assessment of current medical management of VTD and post-thrombotic disease (PTD) in France. METHOD: A random sample of 210 investigators including hospital practitioners (orthopedic surgeons and anesthesiologists), general practitioners (GP), and angiologists working in the ambulatory setting completed a standardized questionnaire about their current medical practice. RESULTS: VTD led to an additional 8.5 days of hospital stay needed for the management of deep vein thrombosis (DVT) and 15.8 days in the event of pulmonary embolism (PE). Doppler diagnosis of DVT was obtained in 97% to 100% of patients. When PE was suspected, a lung scan was performed in 62% of patients managed by hospital practitioners and in 43% of patients treated by GPs. Whereas the rate of hospitalization for distal DVT diagnosed in outpatients did not exceed 14% of patients, the rate of hospitalization for proximal DVT reached 40%-48%. Eighty-eight percent of the patients with PE were managed in a hospital setting. Two-thirds of the patients with PE were given low-molecular-weight heparin for an average duration of 9.3 days and one-third of patients were treated with non-fractioned heparin for an average duration of a 11 days. Doppler diagnosis of PTD was established in 98% of patients and 98% of the patients with PTD were treated with elastic contention stockings. CONCLUSION: Based on physicians' report of their current medical practice, this study provides useful data on diagnostic and therapeutic practices in the management of VTD and PTD.

Family Practice↗
PubMed2002

[Pneumocephalus after spinal anesthesia].

We report the case of a 76-year-old man who received a spinal anaesthesia for inguinal hernia repair surgery. A cranial CT scan which was performed because the patient complained of postoperative headache and hemiparesis showed an important pneumocephalus. Because postoperative questioning revealed that the patient had a chronic and neglected rhinorrhea, we hypothesise that this pneumocephalus was secondary to an old unknown osteodural leak with intracranial air entry secondary to the spinal anaesthesia-releated decrease in CSF pressure.

Aged↗
PubMed1998

An attempt to prevent spread of local anaesthetic to the phrenic nerve by compression above the injection site during the interscalene brachial plexus block.

The brachial plexus was identified by electrical stimulation before interscalene block with 30 mL 0.5% bupivacaine and adrenaline 1:200,000. During injection, compression was applied with a finger proximal to the injection site. Spirometric measurements were made before the block, and then at 5 min, 10 min, 20 min and 4 h after the injection. Diaphragmatic excursion was measured radiographically before the block, and at 15 min and 4 h afterwards. In 25 patients studied, spirometric measurements decreased. Twenty minutes after the injection, the forced vital capacity was 27% less, forced expiratory volume at 1 s 34% less and peak expiratory flow rate 15% less (all P < 0.05). Right diaphragmatic excursion decreased from 4.5 cm (SD 1.2 cm) to 1.8 cm (0.6 cm) at 15 mins and to 1.1 cm (0.6 cm) at 4 h (P < 0.05). Identification of the plexus by electric stimulation combined with finger compression above the injection site did not prevent diaphragmatic paresis.

Adrenergic Agonists↗
PubMed1993

[Subarachnoid hematoma after spinal anesthesia and low molecular weight heparin].

A case is reported of spinal subarachnoid haematoma occurring after spinal anaesthesia. The patient was given prophylactic pre and postoperative low molecular weight heparin. On the second postoperative day, he complained of backache and got a partial cauda equina syndrome. Magnetic resonance imaging carried out on the 6th day confirmed the presence of a spinal haematoma, which was removed surgically. One year later, the bilateral motor palsy which had involved several roots, had completely regressed. It remained a severe sensory loss associated with a loss of sphincter control. This case highlights the role of predisposing factors and the importance of early diagnosis.

Anesthesia, Spinal↗