RESUMO
Sickle cell disease is the genetic disease most frequently detected at birth in France. The comprehension and knowledge of its pathophysiology allow to establish the principles of management for the drepanocytic patient, especially in the perioperative phase. In the light of recent recommendations published for anesthesia of a drepanocytic adult, this clinical case revealed allows to reexamine that subject, with a focus on biological aspects, which are transfusional strategy and antibioprophylaxy. The presented observation is a concrete feature of daily collaboration between clinician and biologist, which is an essential point of the ISO standard EN 15189 concerning laboratories' accreditation.
Assuntos
Anemia Falciforme/genética , Anemia Falciforme/terapia , Prática Profissional , Anemia Falciforme/diagnóstico , Anemia Falciforme/patologia , Atitude do Pessoal de Saúde , Biologia Celular , Feminino , Humanos , Modelos Biológicos , Médicos , Adulto JovemRESUMO
Baclofen is an agonist of peripheral and central B gamma-aminobutyric acid receptors, whose activation causes a myorelaxation and a powerfull depression of the central nervous system. Moreover, it has an action against addiction, in reducing craving. Commercialized since 1975 in France, to control muscle spasticity due to medullar affection or multiple sclerosis, it receives a temporary recommendation of use in march 2014, as a last-line adjuvant treatment in alcohol withdrawal. Beyond its therapeutic use, baclofen is involved in many self-induced intoxications. We report the case of a patient who develops, after a massive ingestion of baclofen (supposed dose ingested: 1 200 mg), a hypotonic and calm coma, requiring her admission in our intensive care unit, and then a status epilepticus.
Assuntos
Baclofeno/intoxicação , Coma/induzido quimicamente , Overdose de Drogas/diagnóstico , Comportamento Autodestrutivo , Estado Epiléptico/induzido quimicamente , Coma/complicações , Feminino , França , Humanos , Pessoa de Meia-Idade , Hipotonia Muscular/induzido quimicamente , Hipotonia Muscular/complicações , Comportamento Autodestrutivo/complicações , Comportamento Autodestrutivo/diagnóstico , Estado Epiléptico/complicações , Síndrome de Abstinência a Substâncias/complicaçõesRESUMO
Acute arsenic poisoning is a rare cause of suicide attempt. It causes a multiple organs failure caused by cardiogenic shock. We report the case of a patient admitted twelve hours after an ingestion of trioxide arsenic having survived thanks to a premature treatment.
Assuntos
Intoxicação por Arsênico , Óxidos/intoxicação , Doença Aguda , Adulto , Intoxicação por Arsênico/complicações , Intoxicação por Arsênico/diagnóstico , Trióxido de Arsênio , Arsenicais , Humanos , Masculino , Insuficiência de Múltiplos Órgãos/etiologia , Tentativa de SuicídioRESUMO
Falciparum malaria is a potentially deadly infectious disease, imposing a sure and fast biologic diagnosis, an early and efficient treatment. We report a case of severe imported Falciparium malaria who received artesunate, and we rewiew the different diagnostic methods of malaria as well as the clinico-biological characteristics of severe malaria. Recent data concerning malaria treatment are presented, as a pharmacokinetic study leaded during this case.