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Biomedical subjects

M Hachemi

Publications and source records attributed to M Hachemi.

7 recordsLinked to original sources
PubMed2006

Delayed rupture of traumatic aneurysm after civilian craniocerebral gunshot injury in children.

BACKGROUND: There are few published large series on civilian craniocerebral gunshot injuries in children. Traumatic intracranial aneurysms (TICAs) are rare and highly unstable lesions. They represent less than 1% of all aneurysms and can either rupture within minutes after formation or remain quiescent for several weeks or years, manifesting with delayed hemorrhage and neurologic deterioration. CASE HISTORY: We report the case of a 10-year-old girl who was referred for coma after high-velocity craniocerebral gunshot wound and neurological deterioration 7 days after the initial injury. A massive right posterior occipital hematoma caused by the rupture of an unsuspected right posterior cerebral artery TICA was discovered. TICA was treated by coil embolization, with a good neurological recovery at 6-month follow-up. DISCUSSION: We discuss the pathogenesis and the management of TICA in a child after civilian craniocerebral gunshot injuries. CONCLUSIONS: TICAs should be suspected in patients with civilian craniocerebral gunshot injuries, presenting with secondary neurological deterioration, to carry out emergent CT scan and angiographic exploration before contemplating definitive endovascular treatment. Endovascular management may be a prompt safe-to-use technique and a valuable option, especially when surgery is highly risky.

Aneurysm, False↗
PubMed2006

Respiratory variations in pulse oximeter waveform amplitude are influenced by venous return in mechanically ventilated patients under general anaesthesia.

BACKGROUND AND OBJECTIVES: Respiratory variations in pulse oximetry plethysmographic waveform amplitude (DeltaPOP) are related to respiratory variations in arterial pulse pressure (DeltaPP) in the critical care setting. The aims of this study were to test the hypothesis that in mechanically ventilated patients undergoing general anaesthesia, DeltaPOP calculation is feasible and can detect changes in preload. METHODS: Twenty-five mechanically ventilated patients were studied immediately after induction of general anaesthesia. Haemodynamic data (mean arterial pressure [MAP], central venous pressure [CVP], DeltaPP and DeltaPOP) were recorded at baseline, before and after tilting the patient from anti-Trendelenburg to Trendelenburg position in order to induce preload changes. RESULTS: Change from anti-Trendelenburg to Trendelenburg position induced changes in MAP (58 +/- 9 to 67 +/- 10 mmHg, P < 0.05), CVP (4 +/- 4 to 13 +/- 5 mmHg, P < 0.05), DeltaPP (14 +/- 8 to 7 +/- 5%, P < 0.05) and DeltaPOP (17 +/- 12 to 9 +/- 5%, P < 0.05). There was a significant relationship between DeltaPOP in anti-Trendelenburg position and percent change in MAP after volume expansion (r = 0.82; P < 0.05). CONCLUSIONS: DeltaPOP can be determined in the operating room and is influenced by changes in preload. This new index has potential clinical applications for the prediction of fluid responsiveness.

Adult↗
PubMed2006

[Impact of the guidelines on clinical practice of artificial nutrition in intensive care unit after cardiovascular and thoracic surgery].

OBJECTIVE: To analyze the impact of an artificial nutrition program in post-anaesthesia intensive care unit. STUDY DESIGN: Observational study. PATIENTS AND METHODS: Patients with length of stay greater than 8 days after cardiovascular and thoracic surgery: Group 1: 34 patients (4-month period in 2000); group 2: 15 patients (2-month period in 2001); group 3: 40 patients (4-month period in 2003). Between these 3 periods, informations of physicians and written protocol in order to improve their nutritional knowledge. After analysis of variance (P<0.05). Newman-Keuls tests to compare themselves each groups. RESULTS: Anthropometric, demographic and clinical parameters were similar in the 3 groups. Energic intakes were less than 80% of basal energetic expenditures in 33%, 33 and 22% of patient, respectively (NS). Caloric and nitrogen intakes were less than recommended, respectively 19+/-6 (mean+/-SD), 21+/-7 and 21+/-8 kcal/kg/24 h and 102+/-32, 111+/-31 and 92+/-40 mg/kg/24 h (NS). However enteral nutrition was administered in 49, 40 and 100% of patients respectively (P<0.001). The glucid/lipid ratio improved from 0.47 in group 1 up to 0.68 in group 3 (P<0.0001). Vitamins, oligoelements and clinical and biological monitoring of artificial nutrition improved (P<0.001). CONCLUSION: A clinical audit demonstrated an improvement in artificial nutrition parameters but no significant change in others.

Aged↗
PubMed1986

[Experiences with the Shirodkar-McDonald cerclage in the treatment of cervix insufficiency].

A clinical-statistical study of 1040 pregnancies after cerclage between 1965 and 1982. Over the same period 28,033 births were registered. Frequency of cerclage was 3.7%. Of 1682 pregnancies in the same patients without cerclage, 47.3% of the children survived, while of the 1040 pregnancies with cerclage, 92% of the children survived. The rate of abortion sank from 44% to 5.8%, the frequency of premature birth from 17.6% to 13.1%. The mothers' course of pregnancy, delivery and puerperium were normal. The relative frequency of Caesarean sections and vacuum extractions was slightly lower than that of the whole group. An attempt is made to ascribe the high success rate of 92% to the following facts: that in 75.4% of the cases, these were prophylactic cerclages; that in all cases the bladder was displaced; that, on the day of surgery, nearly all patients received a tocolytic slow drip infusion as prophylaxis; and that the low mortality rate (10.5%) among premature infants is due to excellent collaboration with the intensive care ward for premature infants in the same hospital. As regards indication, surgical techniques, antenatal counselling and management of delivery, the homogeneity of the group observed over this 17-year period is presumably another positive factor.

Abortion, Habitual↗