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Biomedical subjects

Y Hemon

Publications and source records attributed to Y Hemon.

6 recordsLinked to original sources

[Transfusion strategy in programmed hemorrhagic orthopedic surgery].

OBJECTIVES: Prospectively assess autologous blood transfusion for programmed orthopedic procedures. METHODS: From January 1 to December 31 1993, 307 patients underwent programmed orthopedic procedures: total hip replacement (n = 191), total knee replacement (n = 83) and osteotomy (n = 33). General (94%) or spinal anesthesia (6%) was used. The anesthesist explained transfusion techniques and patients gave informed consent for inclusion in an autologous transfusion protocol including differed autologous transfusion, intentional normovolemic hemodilution and intraoperative transfusion of shed blood. RESULTS: A total of 269 autologous transfusion were performed among the 307 patients (87.6%). This was sufficient in 242 cases (78.8%) and in 65 (21.2%) homologous transfusion was required. Among the 269 patients given autologous transfusion, differed transfusion was used in 145 (53.9%), intentional normovolemic hemodilution in 124 (46%) and intraoperative transfusion of shed blood in 222 (82.5%). Among the patients given a differed autologous transfusion, 9 (6.2%) required a homologous transfusion and among the 40 patients in which all 3 techniques were used, only 2 (5%) received homologous blood, both due to secondary complications. CONCLUSION: These findings show that when differed autologous transfusion is included in the transfusion strategy, less than 10% of the patients require homologous blood. In addition, when the 3 autologous transfusion techniques are used, the rate of homologous blood transfusion approaches zero.

Adolescent↗

Relationship between skin reactions to common allergens and non-specific bronchial reactivity in young healthy subjects.

In patients with respiratory symptoms, several studies have provided data supporting the hypothesis that there is a casual relationship between allergen exposure and variations in bronchial reactivity. In order to determine if this relationship holds when atopy is defined only on the basis of positive skin tests to common allergens, we compared bronchial reactivity in a group of twelve healthy subjects with positive skin tests and twenty-eight healthy subjects with negative tests. The two groups were comparable in terms of gender, age, smoking habits and family history of atopic diseases. The slopes of the dose-response curves, using airway conductance as an index of response, were similar in the two groups. Thus, in this healthy group of subjects, there was no relationship between skin and bronchial reactivity. It can be hypothesized that, if genetic factors determine bronchial reactivity, such reactivity might not be revealed until skin-test positive subjects have received repeated bronchial stimulation through inhalant allergens.

Adult↗

[Hepatic rupture. Wrapping with absorbable mesh].

Considerable progress in conservative surgery of the spleen and kidney has been achieved in recent years by wrapping the organ in absorbable mesh. Following an experimental study, this technique has been used in 5 cases of rupture of the liver. Each injured lobe can be wrapped in an absorbable prosthetic sheet which is sutured in such a way as to form a purse applied onto the tissue, to control bleeding and bile leakage. The purse is then sutured to the falciform ligament detached from the diaphragm. Under drainage and provided the liver is watched for cavitation by scanning methods, this technique is simple and consistently effective. It avoids sutures, which are imperfect, and resections, which are fraught with dangers when performed in an emergency.

Humans↗

Subcutaneous low-dose epoetin beta for the avoidance of transfusion in patients scheduled for elective surgery not eligible for autologous blood donation.

This randomized, multicentre, parallel-group study assessed the efficacy of epoetin beta in reducing the transfusion frequency in patients ineligible for autologous blood donation prior to surgery. The patients (n = 194) received either epoetin beta (125 or 250 IU/kg, once weekly) or no therapy for 3-4 weeks before surgery. The pre-operation haemoglobin levels were markedly increased in the epoetin beta groups (125 IU/kg: +1.1 g/dl; 250 IU/kg: +1.6 g/dl), but not in the control group. The transfusion frequency was significantly reduced in both epoetin groups as compared with the control group (p = 0.046). Epoetin beta was well tolerated, and no serious adverse events were observed. Low-dose administration of epoetin beta before elective surgery reduces the transfusion frequencies in patients not eligible for autologous blood donation.

Blood Transfusion↗