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M C Laurain

Publications and source records attributed to M C Laurain.

12 recordsLinked to original sources
PubMed1998

[Prevention of venous thromboembolism. Survey of in-hospital medical practice].

OBJECTIVES: In an effort to improve the prevention of venous thromboembolism, the Nancy University Hospitals conducted a survey of medical practice concerning indications for preventive therapy and surveillance of platelet counts and anti Xa activity. METHODS: The survey involved 163 medical files. Questionnaires were filled out in 6 units (3 medical wards and 3 intensive care units). RESULTS: Indications for preventive therapy were found to be quite variable with the exception of very low risk of thromboembolism where the treat/do not treat ratio was 0.1/1, indicating a clear tendency for abstention. This ratio was 0.77/1 and 0.38/1 respectively for low and moderate risk and 2/1 for high risk. There was undoubtedly a ward effect. The attitudes in practice tended toward non-prevention in patients without limited mobility. For platelet counts, an initial count was performed in 95% of the cases and during treatment in 38% although the specific rates were not the same for different types of units. Anti-Xa activity, which according to prevention recommendations need not to be determined, was not monitored in 88% of the cases. In accordance with prevention recommendations, anti-Xa activity was not determined in 88% of the cases. CONCLUSION: Further progress is needed in the prevention of venous thromboembolism and should be based on wider use of existing methods.

France↗
PubMed1996

[Infectious diarrhea in the aged].

Infectious diarrhoea in the elderly is associated with high morbidity and mortality and need early diagnosis and treatment. Polypathology, malnutrition, polytherapy, length of stay in the hospital and residence in nursing-home contribute to the increasing incidence and gravity of these diseases with aging. Viral gastroenteritis is responsible for epidemic in nursing-home residents. Bacterial gastrointestinal infections are primarily caused by enterotoxigenic agents inducing sporadic or epidemic infections food poisoning. Older adults are more particularly exposed to antibiotic-associated diarrhoea. Clostridium difficle has been increasingly recognized as a cause of pseudomembranous colitis in elderly and is associated with increased mortality. The approach to an old patient with suspected infectious diarrhoea should be to eliminate the likely noninfectious causes, to detect immediate complications due to hydroelectrolytic loss, to initiate early appropriated oral rehydration therapy so as to prevent dehydratation, to avoid the use of antimotility drugs, and to evaluate and to take over nutritional consequences of diarrhoea.

Aged↗
PubMed1994

[Central pontine myelinolysis: apropos of an oligosymptomatic form].

The authors report a case of paucisymptomatic central pontine myelinolysis (CMP). A 66 years old female had severe hypochloronatremia and hypokaliemia due to diuretic. Despite a slow hydroelectrolytic correction, she presented with dumbness and seizure. CT scan showed hypodensity of protuberance and magnetic resonance imaging (MRI) shown hypersignal of protuberance and undercortex, compatible with central and extra pontine myelinolysis. The long term clinical outcome was good, as MRI's data. Rapid and important correction of severe hyponatremia should be the most important factors of demyelination, secondary to interference with cerebral adaptation mechanisms to hypoosmolality. These factors were not present in this case.

Aged↗
PubMed1994

Thymoma with immunodeficiency (Good's syndrome) associated with selective cobalamin malabsorption and benign IgM-kappa gammopathy.

We have described the first case, to our knowledge, in which recurrent respiratory tract infections were the primary manifestation of thymoma with immunodeficiency (Good's syndrome) associated with cobalamin malabsorption and immunoglobulin M-kappa (IgM-kappa) M component. The intrinsic factor receptor activity was dramatically decreased in a mucosal homogenate prepared from ileal biopsies. This decreased activity could be the principal cause of the malabsorption of labelled cobalamin which was observed in the presence of intrinsic factor. However, it could be the consequence of the cobalamin deficiency, as it is known that a cobalamin deficiency can affect the assimilation of cobalamin, even in presence of exogenous intrinsic factor.

Aged↗
PubMed1993

[Heparin-induced thrombocytopenia and vena cava filter. Difficulties of treatment].

The authors report two cases of thrombosis occurring after partial interruption of the inferior vena cava. They presented as collapse and anuria with fatal outcome. Heparin induced thrombocytopenia was present in two cases and distal migration of filter in one case. Thrombo-embolic complications can follow heparin induced thrombocytopenia and justify first treatment with low molecular weight heparin and/or early treatment with oral anti-coagulant. Thrombosis, recurrent embolism or thrombosis of renal vena may occur after vena cava filter. Renal vena thrombosis especially follow filter movement and present as collapse and cardiac failure often with fatal outcome.

Aged↗