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Biomedical subjects

M Ould-Ahmed

Publications and source records attributed to M Ould-Ahmed.

16 recordsLinked to original sources
PubMed2006

[Nefopam by continuous intravenous injection and adverse drug reactions: which causality assessment?].

We report the case of a 77-year-old man, with nefopam postoperative analgesia, who developed subacute neurological symptoms, whereas he had profound hypoprotidemia and acute renal failure. Chronological, semiological and bibliographical criteria are in favour of causality assessment. The plasma nefopam concentration (135 ng/ml) during the neurological symptoms is another argument.

Acute Kidney Injury↗
PubMed2005

[Delayed and fortuitous diagnosis of right diaphragmatic rupture during preoperative evaluation].

Although diaphragmatic rupture occurs after violent blunt trauma, its diagnosis is often delayed. The intra-thoracic displacement of abdominal organs through diaphragmatic rupture may lead to early or delayed complications because of compression of heart and lungs or strangulation of the abdominal viscera. A 49-year-old woman was scheduled to undergo elective lumbar disc surgery in prone position. The preoperative chest radiograph revealed an abnormally elevated right hemi diaphragm with loops of colon filling the right costophrenic angle. The CT-scan confirmed right chronic diaphragmatic rupture with colon and liver herniations. Fifteen months previously, this woman had been involved in a traffic accident, with blunt right trauma resulting in right pelvic fractures. Perianaesthetic course increase the pre-existing mechanical risk of complications of chronic diaphragmatic rupture. Primary repair of right chronic diaphragmatic rupture through thoracotomy must be recommended. When another surgery must be done in emergency, the feasibility of regional anaesthesia should be considered.

Accidents, Traffic↗
PubMed2003

[Acute colonic pseudo-obstruction (Ogilvie's syndrome) in pneumococcal meningo-encephalitis treated with neostigmine].

We report the case of a 71-year-old man with acute colonic pseudo-obstruction that complicates a pneumococcal meningo-encephalitis. After 48 h of conservative management with nothing by mouth, nasogastric suction, fluid and electrolyte correction, withdrawal of any anticholinergic agents, a pharmacological approach with 2 mg of neostigmine was successful in intensive care unit. This treatment was effective in over 80% of patients of recent reports. Neostigmine might be considered as first-line therapy in patients who do not have major contraindications to its use, because of less frequent iatrogenic risk than colonoscopic decompression or surgery.

Aged↗
PubMed2002

[Convulsions induced by ropivacaine after midhumeral block].

We report a case of central nervous system toxicity induced by ropivacaine following a brachial block at the humeral canal. Forty millilitres 0.75% ropivacaine (4.28 mg.kg-1) were used uneventfully, with slow injections and negative intermittent aspirations. Fifteen minutes later, the patient presented two episodes of generalised convulsions treated by diazepam, 20 mg. The total venous ropivacaine concentration measured two hours after the block was 2.3 mg.l-1.

Amides↗
PubMed2001

[Difficult reintubation during a Fantoni's tracheostomy resolved using a laryngeal mask].

We report the failure of a reintubation under direct laryngoscopy, during a percutaneous tracheostomy by Fantoni method. After the accidental per-procedural extubation and in front of an unpredicted difficult conventional endotracheal intubation, a laryngeal mask was used as an airway intubator conduit for the blind passage of the set's ventilation tube. This ventilation tube is a 40 cm long, 4 mm internal diameter special catheter with low pressure cuff, included into the TLT kit. The end of the procedure was uneventful.

Coronary Artery Bypass↗
PubMed2000

[Chance discovery of methanol poisoning during a state of inebriation].

We report a case of wood alcohol (methylated spirits) poisoning in a 40-year-old chronic alcoholic. The initial diagnosis of state of drunkenness was supported by the increased plasma level of ethanol (4.66 g.L-1) obtained with enzymatic method. The confirmation, using gas chromatography (GC), showed an unexpected peak with a retention time at 1.19 min, characteristic of methanol (0.41 g.L-1). The GC analysis of the absorbed beverage revealed a 5% methanol content. The osmolal gap was 115 mOsm.kg-1, with 13 mOsm.kg-1 due to methanol and 90 mOsm.kg-1 to ethanol. Seven hours after the ingestion, the anion gap was at 13 mmol-1. This result reflected the inhibition of methanol oxidation by alcohol-dehydrogenase, when the plasma ethanol concentration was above 1 g.L-1. This concentration was maintained by continuous intravenous administration of (Curéthyl-A) a 95% ethanol containing solution, until methanol concentration decreased below 0.2 g.L-1. The outcome was favourable without neurological and ophthalmological sequelae.

Acid-Base Equilibrium↗
PubMed2000

[Unusual course of a pulmonary artery catheter through a persistent superior vena cava] .

We report the unusual course of a pulmonary artery catheter through a persistent left-sided superior vena cava. After left subclavian vein cannulation and downward left-sided paramediastinum course, the Swan-Ganz catheter enters the right pulmonary artery. Haemodynamic monitoring was consistent with the diagnosis of septic shock developed by this 56-year-old woman, after cephalic duodenopancreatectomy. Persistent left-sided superior vena cava occurs in 0.5% of the population and 5-10% of patients with congenital heart diseases. It drains into the right atrium through the coronary sinus in 92% of cases and is associated with an absent right superior vena cava in 20% of cases. The left-sided superior vena cava persists when the caudal part of the left anterior cardinal vein does not degenerate. A persistent left superior vena cava may be medically relevant during implantation of pacemaker leads or radiofrequency ablation, during cardiac surgery for placement of a retrograde coronary sinus cardioplegia catheter and during transjugular intrahepatic portosystemic shunt placement.

Angiography↗
PubMed1999

[Suprascapular palsy: a complication of surgical positioning?].

We report a case of persisting suprascapular nerve palsy after surgery under general anaesthesia of short duration in a conventional position. Surgical exploration, eight months later, showed a suprascapular notch narrowed by a hypertrophied and calcified superior transverse ligament. Such a lesion and the practice of volley-ball by the patient are in favour of a pre-existing infraclinical neuropathy.

Adult↗
PubMed1998

[Implanted automatic defibrillator after ventricular fibrillation treated with semi-automatic defibrillation].

We report two cases of out-of-hospital ventricular fibrillation treated without delay, with basic life support practiced by the witness, followed by a successful defibrillation by paramedics with a semi-automatic defibrillator. In the subsequent month, a cardioverter-defibrillator was implanted. In one patient, a ventricular tachycardia occurring 10 months later and a ventricular fibrillation 9 months later in the other respectively, were successfully reversed by the implanted defibrillator. These two cases illustrate the value of the "survival chain" concept (undelayed alert, basic life support by witness, early defibrillation by paramedics with a semi-automatic defibrillator, advanced life support by a physician) as well as the benefit of the implanted cardioverter-defibrillator.

Adult↗