Service de biologie clinique

Suresnes, France

Service de biologie clinique

Suresnes, France
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Legrand D.-A.,Cardiologie | Minon J.-M.,Service de Biologie Clinique | Hoffer E.,Cardiologie
Revue Medicale de Liege | Year: 2012

Acquired haemophilia is a rare disease, 50% of the cases are idiopathic. We report a case admitted in cardiology for spontaneous hematoma. Observation of isolated prolonged activated partial thromboplastin time (aPPT) without anticoagulation treatment and the absence of correction with normal plasma suggested diagnosis. Confirmation of inhibitors to FVIII allowed perfusions of activated prothrombin complex concentrates.

Van Dreden P.,Diagnostica Stago | Woodhams B.,Diagnostica Stago | Rousseau A.,Diagnostica Stago | Dreyfus J.-F.,University of Versailles | And 2 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2013

Background: Multiple organ dysfunction syndrome (MODS) observed in patients with sepsis and in non-septic patients organ failure (OF) is associated with a high mortality rate. We investigated whether new coagulation assays [quantification of procoagulant phospholipids (PPL) activity, functional assays measuring the activity of thrombomodulin (TMa) or tissue factor (TFa) and thrombin generation using calibrated automated thrombography (CAT)] could constitute new tools to better understand the physiopathology of MODS and have any prognostic value. Methods: We measured TMa, TFa, PPL and CAT in 32 healthy controls, 24 patients with sepsis and 26 patients with non-septic OF. We compared these parameters with usual coagulation assays [prothrombin time, activated partial thromboplastin time, protein C (PC), protein S, D-Dimers (D-Di), soluble thrombomodulin (sTM)] and markers of inflammation (IL-6, CRP). Samples were collected within 24 h of the diagnosis. Results: TMa, TFa, PPL, the lag time and time to thrombin peak levels were increased in both groups of patients. For both groups D-Di, IL-6, CRP and endogenous thrombin potential (ETP) were higher in non-survivors than in survivors, while PC and PPL were lower in non-survivors than in survivors. TMa increase was more marked in non-survivors patients with OF, while the ratio TMa/sTM was low in non-survivors with sepsis. Received operating characteristic (ROC) curve analysis indicated that thrombin peak and ETP were the more powerful discriminating factors in patients with sepsis or non-septic OF, respectively. Conclusions: PPL, TMa and CAT assays could represent promising tools to identify patients with increased risk of mortality in MODS and could procure insights into pathogenesis of MODS. © 2013 by Walter de Gruyter Berlin Boston.

PubMed | Service de biologie clinique, Service de pharmacie, Service de medecine interne et maladies infectieuses, University Pierre and Marie Curie and 2 more.
Type: Journal Article | Journal: Medecine et maladies infectieuses | Year: 2016

The emergence of bacterial resistance and the lack of new antibiotics in the pipeline represent a public health priority. Maximizing the quality of antibiotic prescriptions is therefore of major importance in terms of adequate preparation and administration modalities. Adequate preparation prevents the inactivation of antibiotics and is a prerequisite to maximizing their efficacy (taking into account the pharmacokinetic/pharmacodynamic relationship) and to minimizing their toxicity. Many antibiotic guidelines address the choice of drugs and treatment duration but none of them exclusively address preparation and administration modalities. These guidelines are based on the available literature and offer essential data for a proper antibiotic preparation and administration by physicians and nurses. They may lead to a better efficacy and to a reduced antibiotic resistance. Such guidelines also contribute to a proper use of drugs and improve the interaction between inpatient and outpatient care for a better overall management of patients.

Oddoux O.,Nancy University Hospital Center | Oddoux O.,University of Monastir | Debourgogne A.,Nancy University Hospital Center | Debourgogne A.,University of Monastir | And 7 more authors.
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2011

Recently, Plasmodium knowlesi has been recognised as the fifth Plasmodium species causing malaria in humans. Hundreds of human cases infected with this originally simian Plasmodium species have been described in Asian countries and increasing numbers are reported in Europe from travellers. The growing impact of tourism and economic development in South and Southeast Asia are expected to subsequently lead to a further increase in cases both among locals and among travellers. P. knowlesi is easily misidentified in microscopy as P. malariae or P. falciparum. We developed new primers for the rapid and specific detection of this species by low-cost real-time polymerase chain reaction (PCR) and added this method to an already existing panel of primers used for the molecular identification of the other four species in one reaction. Reference laboratories should now be able to identify undisputably and rapidly P. knowlesi, as it is a potentially fatal pathogen. © Springer-Verlag 2010.

Mechai F.,Service des Maladies Infectieuses et Tropicales | De Barbeyrac B.,University of Bordeaux Segalen | Aoun O.,Service des Maladies Infectieuses et Tropicales | Merens A.,Service de Biologie Clinique | And 2 more authors.
Sexually Transmitted Infections | Year: 2010

Lymphogranuloma venereum (LGV) cases are currently re-emerging in the homosexual community, particularly in HIV-seropositive patients. The standard treatment for this infection, which is caused by Chlamydia trachomatis L1, L2 and L3 serotypes, is a 3-week doxycycline regimen. The case is reported of a male patient presenting with LGV, who was rapidly cured with moxifloxacin treatment after failure of extended treatment with cyclines. This fluoroquinolone is known to be highly active in vitro on the LGV pathogenic agent. Thus it may be a useful alternative when doxycycline treatment results in failure.

Couturier R.,Center Chirurgical Marie Lannelongue | Rubatti M.,Center Chirurgical Marie Lannelongue | Credico C.,Center Chirurgical Marie Lannelongue | Louvain-Quintard V.,Center Chirurgical Marie Lannelongue | And 5 more authors.
Blood Coagulation and Fibrinolysis | Year: 2014

Tranexamic acid is given continuously or discontinuously as an anti-fibrinolytic therapy during cardiac surgery, but the effects on fibrinolysis parameters remain poorly investigated. We sought to assess the effects of continuous and discontinuous tranexamic acid on fibrinolysis parameters in children undergoing cardiac surgery with cardiopulmonary bypass (CPB). Children requiring cardiac surgery or repeat surgery by sternotomy with CPB for congenital heart disease were randomized to receive either continuous or discontinuous tranexamic acid. Blood tranexamic acid, D-dimers, tissue plasminogen activator (tPA), tPA-plasminogen activator inhibitor 1 (tPA-PAI1) complexes, fibrinogen and fibrin monomers were measured and compared to values obtained from children who did not receive tranexamic acid. Tranexamic acid inhibited the CPB-induced increase in D-dimers, with a similar potency between continuous and discontinuous regimens. Time courses for tPA, fibrin monomers, and fibrinogen were also similar for both regimen, and there was a significant difference in tPA-PAI1 complex concentrations at the end of surgery, which may be related to a significantly higher tranexamic acid concentration. Continuous and discontinuous regimen are suitable for an effective inhibition of fibrinolysis in children undergoing cardiac surgery with CPB, but the continuous regimen was previously shown to be more effective to maintain stable tranexamic acid concentrations. © 2014 Wolters Kluwer Health Lippincott Williams & Wilkins.

Chani M.,Service de Reanimation Medicale | Abouzahir A.,Service de Medecine Interne B | Larreche S.,Service de Biologie Clinique | Mion G.,Groupe Hospitalier Cochin Broca Hotel Dieu
Bulletin de la Societe de Pathologie Exotique | Year: 2012

Heparin, which was widely used thirty years ago for the treatment of viper envenomations, is now contra-indicated during the acute phase, which is at risk for hemorrhage and death. We report a case of pulmonary embolism, a rare situation in the context of viper envenomation. By means of this case report, we want to discuss the pathophysiological links between envenomation and thromboembolic disease, and on the other hand, the potential heparin usefulness, not during the acute, hemorrhagic phase, but as a prophylactic treatment when hemorrhagic risk has been replaced by an inflammatory syndrome, with increased fibrinogen and platelets which are then prothrombotic factors. © 2012 Société de pathologie exotique et Springer-Verlag France.

De Backer B.,Service de Biologie Clinique | Goffin F.,University of Liège | Nisolle M.,University of Liège | Minon J.-M.,Service de Biologie Clinique
Annales de Biologie Clinique | Year: 2013

Unexpected finding or persistence of low human chorionic gonadotropin (hCG) levels is not a rare situation. It requires a clinico-biological approach in order to avoid misunderstandings that could lead to inappropriate diagnostic or therapeutic attitudes. Beyond pregnancy, persistent low levels of hCG may be associated with various benign and malignant conditions, i.e. quiescent gestational trophoblastic disease (QTD), raised pituitary hCG or false positive elevation caused by circulating heterophile antibodies. We report the cases of two non-pregnant patients with low serum hCG. In the first case, hCG levels raised during several years following a spontaneous abortion. The likelihood of heterophilic antibodies interference was ruled out and extensive clinical investigation excluded the presence of a tumour. The diagnosis was QTD. In the second case, elevated hCG came to light as an incidental finding in a women with chronic renal failure and led the clinicians to question the laboratory. The cause was probably an increase in pituitary hCG consecutive to terminal renal failure. These cases illustrate the importance of understanding the biology of the hCG and the causes of its persistent low elevation, which are reviewed in this article. It is essential to demonstrate clinically the presence of a tumour in order to avoid unnecessary and ineffective chemotherapy and/or hysterectomy.

Senterre T.,University of Liège | Minon J.-M.,Service de biologie clinique | Rigo J.,University of Liège
Archives de Pediatrie | Year: 2011

ABO allo-immunization is the most frequent hemolytic disease of the newborn and ABO incompatibility is present in 15-25 % of pregnancies. True ABO alloimmunization occurs in approximately one out of 150 births. Intensity is generally lower than in RhD allo-immunization. We report on three cases showing that ABO allo-immunization can lead to severe hemolytic disease of the newborn with potentially threatening hyperbilirubinemia and complications. Early diagnosis and adequate care are necessary to prevent complications in ABO incompatibility. A direct antiglobulin test is the cornerstone of diagnosis and should be performed at birth on cord blood sampling in all group infants born to O mothers, especially if of African origin. Risk factor analysis and attentive clinical monitoring during the first days of life are essential. Vigilance is even more important for infants discharged before the age of 72. h. Every newborn should be assessed for the risk of developing severe hyperbilirubinemia and should be examined by a qualified healthcare professional in the first days of life. Treatment depends on the total serum bilirubin level, which may increase very rapidly in the first 48. h of life in cases of hemolytic disease of the newborn. Phototherapy and, in severe cases, exchange transfusion are used to prevent hyperbilirubinemia encephalopathy. Intravenous immunoglobulins are used to reduce exchange transfusion. Treatments of severe hemolytic disease of the newborn should be provided and performed by trained personnel in neonatal intensive care units. © 2010 Elsevier Masson SAS.

Roche C.,Service de biologie clinique | Thefenne H.,Service de biologie clinique | Hance P.,Service de biologie clinique | Garnotel E.,Service de biologie clinique
Transfusion Clinique et Biologique | Year: 2013

Blood transfusion safety covers all stages from prescription of immuno-haematological examinations until the completion of the transfusion. According to the 05/11/2006 Afssaps' decision on good transfusion practices, transfusions should not be given at night unless the patient is actively bleeding or has some other urgent clinical need. A retrospective study was used to assess the proportion of transfusions at night. Through this professional practice evaluation, we analyze the reasons leading to perform transfusions at late hours, in order to reduce errors and improve safety for patients. © 2013 Elsevier Masson SAS.

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