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Biomedical subjects

P Zachee

Publications and source records attributed to P Zachee.

25 records · Page 2Linked to original sources

Thallium intoxication treated with combined hemoperfusion-hemodialysis.

A 32-year-old woman who ingested thallium sulfate was treated with combined hemoperfusion-hemodialysis. Classical therapy, including Prussian Blue, was also administered. The clearance rate of the hemoperfusion and hemodialysis were 139 and 47 mL/min, respectively. The efficiencies of these different methods were compared with each other and with the classical methods. It was concluded that hemoperfusion was the most efficient technique in extracting thallium sulfate. The combined hemoperfusion-hemodialysis procedure is proposed for the treatment of severe intoxications with thallium sulfate.

Adult↗

[The Lemierre syndrome: a complicated oropharyngeal infection].

The Lemierre syndrome or 'necrobacillosis' is a post angina sepsis caused by an acute oropharyngeal infection with a secondary thrombophlebitis of the internal jugular vein. There are often septic emboli in the lungs, although intestinal organs can also be affected. This syndrome is caused by the strictly anaerobic gram-negative pathogen Fusobacterium necrophorum, sometimes in combination with other pathogens. The patient typically presents with high fever, pain in the neck, malaise and dyspnoea one week after the start of an angina. Plain chest radiograph shows bilateral nodular infiltrates, ultrasound reveals a thrombophlebitis of the internal jugular vein. CT scan can be useful to confirm the diagnosis and possible complications. In the beginning there is often a transient hyperbilirubinemia with toxic inflammatory blood results. Under the correct antibiotic regime complete recovery can be obtained.

Adult↗

Laparoscopic splenectomy after arterial embolisation.

Laparoscopic splenectomy remains a challenging procedure, as haemorrhage causes the most complications. In order to reduce this risk, preoperative selective embolisation of the splicing artery has been performed in a series of six successful laparoscopic splenectomies in one male and five female patients with a mean age of 34.6 years (range 17-53 yrs). Indications for surgery were immune thrombocytopenic purpura (ITP)(n = 3), non-Hodgkin lymphoma with secondary haemolytic anaemia (n = 1), autoimmune haemolytic anaemia (n = 1) and congenital spherocytosis (n = 1). The mean splenic length was 12.3 cm (range 9-16 cm) and no accessory spleens were identified. Mean operative time was 96.7 min (range 90-150 min). There were no deaths nor haemorrhagic or septic complications. Recovery after surgery was excellent with a mean hospital stay of 5.2 days (range 2-10 days). We conclude that selective embolisation of the splenic artery, just prior to laparoscopic splenectomy adds to the safety, and operating time may be shortened.

Adolescent↗