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Biomedical subjects

J P Pertek

Publications and source records attributed to J P Pertek.

27 records · Page 2Linked to original sources
PubMed1987

[Zona after spinal anesthesia: coincidence or consequence?].

A case is reported of a herpes zoster infection occurring a few days after spinal anaesthesia in a man with severe cardiac disease who had undergone transurethral endoscopic resection of a prostatic epithelioma. The question as to whether there was a relationship between the two events had to be asked, all the more so as the rash seemed to be centered on the puncture wound. Others factors involved may have been the effect of anaesthesia on the body's defence mechanisms, the use of prophylactic antibiotics and the neoplasm.

Aged↗
PubMed1986

[Potentiation of a vitamin K antagonist by a pefloxacin-rifampicin combination].

The combination of a new quinolone, pefloxacin, with rifampicin seemed of interest in the treatment of staphylococcal osteitis. Interactions of a coumarin anticoagulant (acenocoumarol) and several antibiotics were well known, mostly resulting in a decrease of the anticoagulant activity. A new interaction of this anticoagulant drug with the pefloxacin-rifampicin combination is described which gave an increase in the anticoagulant activity.

Acenocoumarol↗
PubMed1985

[Respiratory depression after intrathecal injection of morphine: value of in situ naloxone].

A case of delayed respiratory depression following an intrathecal injection of hyperbaric morphine hydrochloride is reported. This injection was made during a lumbar myelography in a 60 year old patient suffering from metastatic epiduritis unrelieved by oral or parenteral drugs. The differences in densities between the CSF, hyperbaric opiate solution and contrast medium explain the migration of the morphine hydrochloride from the lumbar thecal space to the basal cisternae, giving a fall in the responsiveness to CO2 of the brain stem respiratory centres. Parenteral naloxone did not reverse this ventilatory depression. Only the myosis and the analgesia disappeared. After 16 h of various attempts of reversal by parenteral injections, an intrathecal injection of naloxone was tried. This small dose (0.1 mg), given intrathecally, resulted in a prompt return to normal of respiratory function.

Anesthesia, Spinal↗
PubMedDate not supplied

Assessment of deep vein thrombosis prophylaxis in surgical patients: a study conducted at Nancy University Hospital, France.

OBJECTIVE: This retrospective evaluation aimed to assess the adequacy of prophylaxis against thromboembolism prescribed to surgical patients at the authors' institution, and to compare it with generally accepted published guidelines. Aspects considered were indications for prophylaxis, regimens used and monitoring. METHODS: Eleven units (nine surgical and two surgical intensive care) took part in the survey on a voluntary basis. The clinical audit system used involved developing a set of criteria based on existing guidelines, comparing observed practice with those recommendations, analysing the factors underlying any deviation and developing corrective measures. RESULTS: When the medical records of 117 patients hospitalized in October 1995 were examined, prophylaxis against deep vein thrombosis was documented in 86 (low molecular weight heparin in 85, dextran in one). No associated physical preventative measures were recorded. Indications and dosage were appropriately handled in 90.7% and 75.2% of patients, respectively. Ninety-five cases were outside the reference criteria: 74 for excluded surgical indications, 13 which involved laparoscopy, and eight in which spinal or epidural anaesthesia was administered. Platelet count was performed in 73.8% of cases before prophylactic treatment, and in 23.10% during its course. Anti-Xa activity was measured in 0.4% of cases. Analysis of causes showed that guidelines were not complied with either because of lack of organization, or because of disagreement with them. DISCUSSION: In this study, indications for prophylaxis were well established and heparin dosages used were not fundamentally flawed. The weak point in practice was a failure to carry out platelet counts, particularly during the course of treatment. Appropriate corrective action consists of disseminating guidelines and relevant information, and using a preoperative checklist to assess thromboembolic risk. CONCLUSION: Physicians agree that opportunities to improve preventative practices exist, and that the quality improvement programme should be pursued.

Adult↗