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Biomedical subjects

A Belbachir

Publications and source records attributed to A Belbachir.

6 recordsLinked to original sources

[KID syndrome: a cause of pachydermatoglyphia].

INTRODUCTION: The KID syndrome is a rare ectodermal dysplasia associating erythrokeratodermia, deafness and keratitis. Other disorders such as sensitivity to infections or hypohidrosis may be associated. Pachydermatoglyphia is characterized by diffuse hyperkeratosis in which the dermatoglyphe crests are accentuated in thickness and height. CASE REPORT: We report the case of a KID syndrome in a young girl, born of non-consanguine parents and without any familial context. The classical elements of this dysplasia were present: erythrokeratoderma with dryness and roughness of the whole tegument, plicatured pachydermia of the knees, facial erythema, grooves around the mouth, hypotrichosis of the lashes and eyebrows, deafness, and ophthalmologic involvement. Involvement of the palms was characterized by the pachydermatoglyphic aspect. DISCUSSION: In this case report, the palmar keratoderma corresponded to the original description of pachydermatoglyphia and we consider that the KID syndrome should be integrated as a possible etiology of pachydermatoglyphia.

Child↗

[Preoperative hemodilution by erythrocytapheresis with homologous blood saving in total hip arthroplasty].

OBJECTIVES: To compare three techniques for decreasing homologous blood requirements in total hip arthroplasty (THA), including preoperative autologous donation (PAD), preoperative acute normovolaemic haemodilution with erythrocytapheresis (erythro) and intraoperative normovolaemic haemodilution (haemo). STUDY DESIGN: Prospective clinical trial. PATIENTS: The study included 45 patients scheduled for THA, under general anaesthesia and operated on by the same surgeon. The patients were allocated into three groups of 15 each. METHODS: Blood loss was assessed, during surgical procedure, by the weight of sponges and, the amount of blood collected in the suction bottles during and after surgery. The haemoglobin concentration was measured at the time of preoperative assessement (d-30), just prior to surgery (d-1), in the recovery room (d+3h), and 1, 3, and 8 days later (d8). The transfusion end-point in the three groups was to obtain a haemoglobin concentration of 100 g.L-1 from d+3h until d8. Every pack of red blood cells transfused was weighed and its haematocrit assessed to determine the accurate volume of red blood cells. RESULTS: In the three groups haemoglobin concentration was similar from d+3h until d8. In the PAD group, no patient required homologous blood transfusion. There was no significant difference between the two other groups in the mean volume of homologous red blood cells required (308 +/- 197 mL in erythro group and 331 +/- 202 mL in the haemo group, respectively). The intraoperative blood loss was significantly higher (P = 0.001) in the erythro group: 914 +/- 305 mL vs 665 +/- 263 in the PAD group and 512 +/- 146 mL in the haemo group, respectively. There was an inverse correlation between haematocrit at d-1 and intraoperative bleeding (r = -0.7) (P = 0.0001). The distribution of the points was fitted as an exponential curve. CONCLUSIONS: In THA, PAD is obviously the best technique to avoid homologous blood transfusion. However, when PAD is not feasible, removal of blood prior to surgery does not decrease requirements of homologous blood, as intraoperative blood loss is higher. Our results strongly question the use of major haemodilution during a surgical procedure exposing a major blood loss.

Aged↗

[Ethnic predisposition of the severity of HELLP syndrome. Retrospective study of 12 cases including 5 during post-partum].

HELLP syndrome is characterized by association of haemolysis (H), elevated liver enzymes (EL), and low platelets (LP). From 1989 to 1991, we studied retrospectively 12 cases of HELLP syndrome cases that occurred during the third trimester for 7 cases and during post-partum for 5 cases. 83% of patients (10/12) were black people (African or Creole). The most frequent sign of HELLP syndrome during pre- and post-partum was epigastric or dorsal pain, present in 91% of the cases (11/12) and in all cases of preeclampsia. Aggressive treatment was always performed, leading to 12 births: 7 of the 12 children were hypotrophic for gestational age. There were no maternal or neonatal deaths. Post-partum HELLP syndrome occurred 28.8 hours (mean) after delivery. Whether HELLP syndrome occurred during pre- or post-partum, laboratory findings returned to normal levels after equivalent delays: platelets 57 hours, ASAT 68 hours and ALAT 65 hours.

Adult↗