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Alves PJ, Gryson L, Hajjar J, Lepelletier D, Reners M, Rodríguez Salazar J, Simon A. Role of antiseptics in the prevention and treatment of infections in nursing homes. J Hosp Infect 2023; 131:58-69. [PMID: 36216172 DOI: 10.1016/j.jhin.2022.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/16/2022] [Accepted: 09/26/2022] [Indexed: 11/07/2022]
Abstract
Inadequate infection control, wound care, and oral hygiene protocols in nursing homes pose challenges to residents' quality of life. Based on the outcomes from a focus group meeting and a literature search, this narrative review evaluates the current and potential roles of antiseptics within nursing home infection management procedures. We examine contemporary strategies and concerns within the management of meticillin-resistant Staphylococcus aureus (MRSA; including decolonization regimes), chronic wound care, and oral hygiene, and review the available data for the use of antiseptics, with a focus on povidone-iodine. Compared with chlorhexidine, polyhexanide, and silver, povidone-iodine has a broader spectrum of antimicrobial activity, with rapid and potent activity against MRSA and other microbes found in chronic wounds, including biofilms. As no reports of bacterial resistance or cross-resistance following exposure to povidone-iodine exist, it may be preferable for MRSA decolonization compared with mupirocin and chlorhexidine, which can lead to resistant MRSA strains. Povidone-iodine oral products have greater efficacy against oral pathogens compared with other antiseptics such as chlorhexidine mouthwash, highlighting the clinical benefit of povidone-iodine in oral care. Additionally, povidone-iodine-based products, including mouthwash, have demonstrated rapid in-vitro virucidal activity against SARS-CoV-2 and may help reduce its transmission if incorporated into nursing home coronavirus 2019 control protocols. Importantly, povidone-iodine activity is not adversely affected by organic material, such as that found in chronic wounds and the oral cavity. Povidone-iodine is a promising antiseptic agent for the management of infections in the nursing home setting, including MRSA decolonization procedures, chronic wound management, and oral care.
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Affiliation(s)
- P J Alves
- Wounds Research Laboratory, Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Portugal.
| | - L Gryson
- Belgian Defence Medical Component, Brussels, Belgium
| | - J Hajjar
- Infection Control Practitioner, Consultant, Pau, France
| | - D Lepelletier
- Hospital Hygiene Department, Nantes University Hospital, Nantes, France
| | - M Reners
- Private Dental Practice, Liège, Belgium
| | | | - A Simon
- Infection Control Team, Groupe Hospitalier Jolimont, Haine Saint-Paul, Belgium
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Balasubramanyam S, Silva-Carmona M, Hajjar J. M204 CHRONIC IDIOPATHIC EOSINOPHILIC PNEUMONIA IN A 16-YEAR-OLD CHILD. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chen X, Canon N, Hajjar J. LATE-ONSET CYSTIC FIBROSIS IN AN ELDERLY MALE. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hajjar J, Kutac C, Rider NL, Seeborg FO, Scalchunes C, Orange J. Fatigue and the wear-off effect in adult patients with common variable immunodeficiency. Clin Exp Immunol 2018; 194:327-338. [PMID: 30168848 DOI: 10.1111/cei.13210] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2018] [Indexed: 12/13/2022] Open
Abstract
Patients with common variable immunodeficiency (CVID) have increased fatigue compared with the general population. Fatigue is associated with lower quality of life (QoL), which is associated with higher mortality in CVID. This study aimed to determine the prevalence of self-reported fatigue for patients with CVID and to identify its possible drivers and burden on QoL. We analysed data from the 2013 Immune Deficiency Foundation (IDF) treatment survey. Answers were included from 873 CVID patients who responded (respondents). Of the 873 respondents included in the analysis, 671 (76·9%) reported fatigue, of whom 400 (83·7%) were receiving intravenous (i.v.) immunoglobulins (IVIG) and 271 (68·6%) were receiving subcutaneous (s.c.) immunoglobulins. This difference in fatigue between patients receiving IVIG and SCIG was statistically significant (P < 0·001). Dose and frequency of immunoglobulin replacement therapy (IgGRT) did not affect fatigue prevalence. Fatigued patients on IVIG reported greater infection rates and required more anti-microbials during the wear-off period. Fatigued patients reported worse health status than non-fatigued patients, and had lower rates of employment, education, household income and school attendance than their non-fatigued counterparts. Fatigue is increased in CVID, especially among patients receiving IVIG, compared to SCIG. Fatigue has a significant impact on QoL and productivity in patients with CVID. Further studies to identify the mechanisms of fatigue are warranted to help advance therapeutic measures to treat this disease and improve patients' QoL and wellbeing.
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Affiliation(s)
- J Hajjar
- Baylor College of Medicine, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Houston, TX, USA
| | - C Kutac
- Baylor College of Medicine, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Houston, TX, USA
| | - N L Rider
- Baylor College of Medicine, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Houston, TX, USA
| | - F O Seeborg
- Baylor College of Medicine, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Houston, TX, USA
| | - C Scalchunes
- The Immune Deficiency Foundation, Towson, MD, USA
| | - J Orange
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, NYC, NY, USA
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Stonebraker JS, Hajjar J, Orange JS. Latent therapeutic demand model for the immunoglobulin replacement therapy of primary immune deficiency disorders in the USA. Vox Sang 2018; 113:430-440. [PMID: 29675923 DOI: 10.1111/vox.12651] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 02/06/2018] [Accepted: 03/05/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND OBJECTIVES Our research aim is to model latent therapeutic demand (LTD) for the immunoglobulin replacement therapy (IgGRT) of primary immune deficiency disorders (PIDDs) in the USA. Given the high level of variability of IgGRT use and major differences among American and European practices in the management of patients with PIDDs, we develop a USA-specific LTD model for common variable immune deficiency (CVID), hyper IGM syndrome, severe combined immune deficiency, Wiskott-Aldrich syndrome and X-linked agammaglobulinemia (XLA). METHODS AND MATERIALS We use decision analysis methods to model the underlying IgGRT demand for PIDDs by assessing USA-specific epidemiology and treatment. Data for the epidemiology and treatment variables were obtained from the medical literature, USIDNET and Immune Deficiency Foundation. The uncertainty surrounding the variables was modelled using probability distributions and evaluated using Monte Carlo simulation. RESULTS The mean treatment dose from USIDNET and European Society for Immunodeficiencies (ESID) was significantly different for treating CVID, and the number of annual infusions from USIDNET and ESID was significantly different for treating CVID and XLA. The mean and standard deviation of LTD for all PIDDs is 105·1 ± 88·5 g per 1000 population, with CVID contributing the most to LTD. CONCLUSION Estimating country-specific LTD is important to ensure an adequate supply of IgGRT and an optimal treatment for patients with PIDDs and for improving national healthcare policymaking and production planning.
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Affiliation(s)
- J S Stonebraker
- Department of Business Management, Poole College of Management, North Carolina State University, Raleigh, NC, USA
| | - J Hajjar
- Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - J S Orange
- Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Bupathi M, Hajjar J, Hess K, Bean S, Karp D, Meric-Bernstam F, Naing A. 425 Evaluation of drug reactions to anti-neoplastic agents in Phase I clinical trials. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70551-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hajjar J, Sun D, Schwartz L. Gabapentin for the Treatment of Neurogenic Pruritis. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Abstract
Intravitreal injections are very commonly performed in the daily practice of Ophthalmology and become a leading procedure in the management of age-related macular degeneration, diabetic retinopathy, infectious endophthalmitis or retinitis, uveitis and retinal vein occlusions. Based on the comments of a group of experts, including ophthalmologists, pharmacists and hygienists, the French Agency for the Safety of Health Products (AFSSAPS) edited a guide to good practice of intravitreal injections, revisiting those previously published in 2006. The overall experience accumulated during time is a valuable source of information to determine the most appropriate protocol. Therefore, the simplification of the procedure is reasonably proposed even though safety remains a major issue, in order to avoid complications, especially infections.
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Affiliation(s)
- B Bodaghi
- Service d'Ophtalmologie, Assistance-Publique Hôpitaux de Paris, CHU Pitié-Salpêtrière, Université Pierre et Marie Curie, 47-83 bd de l'Hôpital, 75013, Paris, France.
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Chami K, Gavazzi G, de Wazières B, Lejeune B, Carrat F, Piette F, Hajjar J, Rothan-Tondeur M. Guidelines for infection control in nursing homes: a Delphi consensus web-based survey. J Hosp Infect 2011; 79:75-89. [DOI: 10.1016/j.jhin.2011.04.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 04/07/2011] [Indexed: 10/18/2022]
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Berthelot P, Lucet JC, Aho S, Hajjar J. [The return of the GAS Mask. Reply of P. Berthelot, J.-C. Lucet, S. Aho, J. Hajjar to the article by O. Multon ]. Gynecol Obstet Fertil 2008; 36:354-5. [PMID: 18337143 DOI: 10.1016/j.gyobfe.2008.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Carbonne A, Veber B, Hajjar J, Zaro-Goni D, Maugat S, Seguier JC, Chalfine A, Blanckaert K, Aggoune M, Auboyer C. Évaluation des pratiques en anesthésie exposant au risque infectieux par transmission croisée. ACTA ACUST UNITED AC 2006; 25:1158-64. [DOI: 10.1016/j.annfar.2006.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hajjar J. [Assessment of guidelines adherence for peripheral venous catheters placement]. Ann Fr Anesth Reanim 2005; 24:565-6. [PMID: 15904741 DOI: 10.1016/j.annfar.2005.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Mallaret MR, Fourneret-Vivier A, Poujol I, Dutel C, Béringuier C, Berthelot P, Hajjar J, Fabry J. [Resources and organization of 124 health-care institutions in South-East France for standard precautions and isolation]. Med Mal Infect 2004; 34:477-84. [PMID: 15747473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVES The authors had aimed to evaluate resources and organization necessary for applying guidelines issued 5 years earlier in various institutions: standard precautions, septic isolation, prevention against spread of multidrug-resistant bacteria. MATERIAL AND METHODS Volunteer institutions were surveyed for hygiene product consumption, architectural requirements, inventory of protocols, description septic patients'management, and available personnel. RESULTS One hundred and twenty-four institutions (40,784 beds) were included in the study. Eleven percent had no hygiene physician or nurse; the rates of personnel specialized in hygiene practice were 0.4 physicians per 800 beds and 0.8 registered nurses per 400 beds. Eighty-eight percent of the studied institutions had a protocol for standard precautionary measures, 77% had a septic isolation protocol. A multidrug-resistant bacteria identification sheet was attached to examination reports in 87% of cases. Multidrug-resistant bacteria screening was practiced by 18.1% of the institutions. Hygiene product consumption for 1000 days of hospitalization was 7861 disposable gloves, 2.3 1 of hydroalcoholic solution, and 63 disposable gowns. 28.9% of the wards lacked water hand washing points, 32.2% had no sinks, and 48.5% had no local equipment maintenance. In addition, 40.7% of the beds were in single rooms, 4.8% of the institutions had no single rooms. Differences were observed depending on specialties and institutions. CONCLUSION Analysis of consumption shows insufficient application of standard precautions, notably for hydroalcoholic solutions. The number of single rooms is acceptable, architectural requirements were not adequate in too many wards. These results can explain some problems encountered in applying the guidelines.
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Affiliation(s)
- M R Mallaret
- Antenne CCLIN Sud-Est, unité d'hygiène hospitalière, pavillon Charmant-Som, centre hospitalier universitaire, 38043 Grenoble 09, France.
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Hajjar J, Girard R, Marc JM, Ducruet L, Béruard M, Fadel B, Forêt M, Lerda D, Roche C, Vallet M, Ayzac L, Fabry J. [Surveillance of infections in chronic hemodialysis patients]. Nephrologie 2004; 25:133-40. [PMID: 15291141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To confirm rates of infections from a previous survey in chronic hemodialysis patients; to get information about incidents and manipulations of vascular access-site, number and reasons of hospitalisation; to asses a relationship between the frequency of vascular access-site infections (VASI) and quality of care during the procedures of vascular access-site use. DESIGN Prospective, multicenter survey performed from February 2000 to January 2001, including all patients underwent chronic hemodialysis in 5 participating centers. Standardized definitions used and different clinical and biological risk factors recorded. RESULTS 429 patients for a total of 4273 dialysis months (DM) were enrolled. 245 infections in 164 infected patients were reported. The overall rate was 5.73 infections per 100 DM (18 VASI, 25 bacteraemia, 84 respiratory, 29 urinary tract, 1 endocarditis and 88 other infections). 50% of infections were microbiologically documented. 19 of 21 antibiotics resistant microorganisms were meticillin resistant Staphylococcus aureus. Compared to the incidence rate of fistula (0.05 per 1000 days of follow-up) or prosthesis related VASI (0.11), the incidence rate of catheter related VASI (0.65) was significantly higher. Poor hygiene and duration of catheter use were the significant risk factors for VASI showed by logistic analysis regression. VASI and bacteraemia occurred more frequently after incident or manipulation of the vascular access-site. The decrease of VASI between the 2 periods of survey was significantly higher in centers having reduced the catheter use and implemented written protocols. CONCLUSIONS This second period of surveillance has confirmed the frequency of infections rate in chronic hemodialysis patients and particularly bacteraemia and VASI. This study has allowed to establish risk factors for infections and showed that VASI in hemodialysis are related to factors in part preventable.
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Affiliation(s)
- J Hajjar
- EIDLIN Drôme-Ardèche, Centre hospitalier, Valence.
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Hajjar J, Loctin H, Goullet D. [Technical requirements for buying a heat and humidity exchanger for ventilation during anesthesia. French Society of Anesthesia and Intensive Care]. Ann Fr Anesth Reanim 2000; 19:556-60. [PMID: 10976373 DOI: 10.1016/s0750-7658(00)00256-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To prevent cross infection and to improve the management of anaesthetic circuits, the French society of anesthesia and intensive care recommended the use of heat and moisture exchange filter (HMEF). Buying a HMEF needs a procedure with different steps and a product request form must delineate precise needed requirements of the device. In the absence of standardized methods to assess filtration performance, required specifications are established from both manufacturer data and scientific published studies. Proposed purchasing method and criteria help the health care workers at the time of final decision for objective comparison between the different devices on the market.
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Affiliation(s)
- J Hajjar
- Equipe interdépartementale de lutte contre l'infection nosocomiale CHU, Valence, France
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Abstract
OBJECTIVES To determine incidence rate, main characteristics and risk factors of nosocomial infections associated with anesthesia (NIAA). STUDY DESIGN Prospective, descriptive multicentre survey. PATIENTS All patients aged more than 15 years and undergoing surgery (except cardio-thoracic, ENT or ambulatory surgery) under general or regional anaesthesia. METHODS Voluntary participation of surgical units from public or private hospitals. Use of pre-established definitions of infections and a 72 hours postanesthetic follow-up. Anaesthesia and operation related risk factors collected. End point based on occurrence, or not, of clinical infection. Record, control, treatment and analysis of the data by Epi Info--5.0 software. Statistics used: Fischer's exact test, Mantel-Haenszel test, Anova method, Kruskall-Wallis test. RESULTS Among 7,300 patients belonging to 13 hospitals, 25 developed an infection (nine vascular catheter related infections, 12 respiratory tract infections, two infections of the eye and two of the mouth). Only two infections have been bacteriologically documented. The overall incidence of NIAA was 3.4 per 1,000 patients. It was significantly higher after an anaesthetic of more than 2 hours and after transfusion. CONCLUSIONS This first prospective survey of NIAA confirmed that nosocomial infections are a real problem in the practice of anaesthesia and the necessity to use preventive measures. A survey with a larger sample size would allow to specify the respective part of the various risk factors and to develop a risk index.
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Affiliation(s)
- J Hajjar
- Equipe interdépartementale de lutte contre l'infection nosocomiale, Centre hospitalier général, Valence, France
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Hajjar J, Hernigou E, Gouin F. [Maintenance and disinfection of equipment necessary for airway control and mechanical ventilation]. Ann Fr Anesth Reanim 1998; 17:403-7. [PMID: 9750771 DOI: 10.1016/s0750-7658(98)80089-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- J Hajjar
- Equipe interdépartemantale de lutte contre l'infection nosocomiale, centre hospitalier général, Valence, France
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Abstract
Cervical epidural anaesthesia (CEA) results in an effective sensory blockade of the superficial cervical (C1/C4) and brachial plexus (C5/T1-T2). It is used both intraoperatively and in the treatment of postoperative or chronic pain. The approach to the epidural space at the C7-T1 interspace is not technically difficult. Patients are placed in the sitting position, increasing the negative pressure in the epidural space, with the head flexed on the thorax, in order to open the lowest cervical interspace. A 18-gauge Tuohy needle is inserted by a midline approach into the C6-C7 or C7-T1 interspace. A catheter may be inserted and left in place for postoperative analgesia. Local anaesthetics are administered either alone, or in combination with opiates. The CEA blocks the cardiac sympathetic fibers and consequently decreases heart rate, cardiac output and contractility. The mean blood pressure is unchanged or decreased, depending on peripheral systemic vascular resistance changes. The baroreflex activity is also partly impaired. Sympathetic blockade also decreases myocardial ischaemia. The cardiovascular changes induced by CEA are also partly due to the systemic effect of the local anaesthetic. The respiratory effects are minimal and depend on the extent of the blockade and the concentration of the local anaesthetic. A moderate restrictive syndrome occurs. Since the phrenic nerves originate from C3 to C5, ventilation may be impaired by CEA. Extension of the block may also impair intercostal muscle function, with a risk of respiratory failure when a CEA is used in patients with compromised respiratory function. The potential specific complications, mainly cardiovascular and respiratory, are the exacerbation of the effects of CEA. Side effects such as bradycardia, hypotension and acute ventilatory failure in relation to respiratory muscle paralysis, may be observed. Close monitoring of haemodynamics, respiratory rate and level blockade is required. Cervical epidural anaesthesia may be used either alone, or in combination with general anaesthesia depending on the surgical procedure. This technique seems to be effective in carotid artery surgery since sensitive and reliable information on cerebral function may be obtained. It is also for shoulder and upper limb surgery as well as for pharyngolaryngeal surgery, providing efficient operative anaesthesia and postoperative analgesia. CEA is used for relief of chronic pain in the head and neck or cancer pain due to Pancoast-Tobias syndrome. It seems to be effective for treating pain in patients with unstable angina pectoris or acute myocardial infarction.
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Affiliation(s)
- D Baylot
- Département d'Anesthésie-Réanimation, CHU, Hôpital Bellevue, Saint-Etienne
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Abstract
A case is reported of endotracheal tube obstruction due to impaction of a turbinate. This complication occurred during a first attempt of nasotracheal intubation in an ASA 1 18-year-old patient. Once the tube had been inserted into the trachea, manual ventilation was impossible. The diagnosis was made on removal of the completely obstructed tube. Differential diagnosis was sudden severe bronchospasm or a herniated cuff. Anaesthesiologists should be aware of this rare complication when carrying out nasotracheal intubation. Means of prevention are proposed.
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Affiliation(s)
- J Hajjar
- Département d'Anesthésie-Réanimation, CHU Bellevue, Saint-Etienne
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Hajjar J, Baylot D. [Antibiotic prophylaxis in cervicofacial cancer surgery]. Ann Fr Anesth Reanim 1993; 12:522-3. [PMID: 8311365 DOI: 10.1016/s0750-7658(05)81007-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Baylot D, el Khouri Z, Aarab A, Navez ML, Hajjar J, Auboyer C. [Cerebral pneumocephalus after epidural anesthesia: a rare complication?]. Ann Fr Anesth Reanim 1993; 12:431-3. [PMID: 8273933 DOI: 10.1016/s0750-7658(05)80112-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A case is reported of pneumoencephalus occurring after an accidental dural puncture during a cervical epidural puncture using the loss of resistance technique. Six ml of air were injected intrathecally. The patient recovered spontaneously within five days. This complication may occur more frequently than commonly admitted. It may be difficult to differentiate between headache due to pneumoencephalus and that by stretching of the meninges due to cerebrospinal fluid leakage. Only a CT scan can help to answer this question.
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Affiliation(s)
- D Baylot
- Département d'Anesthésie-Réanimation, Hôpital de Bellevue, Saint-Etienne
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Leventhal AM, Camuto P, Hajjar J, Wolman SR, Plawner J. Flow cytometric and genetic study of familial gonadal tumors. Urology 1992; 39:558-62. [PMID: 1615609 DOI: 10.1016/0090-4295(92)90018-r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Three cases of familial gonadal tumors are reported. Genetic studies were conducted in 2 cases: a brother and sister with embryonal carcinoma and a benign cystic teratoma, respectively, and a father and son with embryonal carcinoma. DNA flow cytometry of paraffin-embedded tumors and constitutional karyotyping were performed. Further genetic studies are emphasized.
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Affiliation(s)
- A M Leventhal
- Department of Urology, New York University Medical Center, New York
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Gromolard P, Massardier N, Hajjar J, Aubert, Huppert J. Essai de traitement par les quinolones des infections osseuses sur materiel etranger. Med Mal Infect 1987. [DOI: 10.1016/s0399-077x(87)80295-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Cieplinski W, Tomicic T, Schwink A, Hajjar J. Kinetics of amino acid transport by human-mouse myeloma hybrids--difference between human immunoglobulin producers and nonproducers. Cancer Biochem Biophys 1985; 7:309-16. [PMID: 3978588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Somatic cell hybridization techniques have allowed the preparation of interspecies hybrids that express the features of both parental cell lines. We have studied hybrids made with human myeloma cells fused to a continuous mouse myeloma cell line. In the present study we analyzed the kinetics of leucine influx and efflux in Ig producer and nonproducer hybrids. We found no statistical difference in amino acid influx; however, the rates of efflux were markedly increased in nonproducer hybrids as compared to the producers. The producer cells were tested further in puromycin known to inhibit protein synthesis. Under these conditions amino acid influx was not altered, but efflux was markedly increased resembling the findings in nonproducers. We conclude that hybrids that synthesize human immunoglobulins show decreased efflux of labeled leucine and this effect can be abolished by inhibition of protein synthesis. This difference in the efflux rate appears to be a consequence of immunoglobulin synthesis, rather than a component of a control mechanism of Ig synthesis.
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