ABSTRACT
INTRODUCTION: Postpartum haemorrhage is the leading cause of maternal morbidity and mortality worldwide. It requires a multidisciplinary approach. Transfusion strategy is essential, playing a key role in maternal prognosis. This study aims to determine FFP/RBC ratio (plasma frais congelé/concentrés de globules rouges; fresh frozen plasma/red blood cells) during the treatment of serious postpartum haemorrhages. METHODS: We conducted a retrospective study at a Maternity Referral Center (level III) in eastern Tunisia over a period of 4 years (2009-2012). All parturients admitted due to severe postpartum bleeding requiring transfusion of more than 4 Units of RBC during the first 3 hours or of more than 10 Units of RBC during the first 24 hours of treatment were included in the study. RESULTS: 47 parturients were enrolled in our study. The diagnosis of PPH was made on the basis of vaginal bleeding in 28 cases and following cesarean section in 19 cases. Preoperative hemoglobin level was of 6.3 g/dl. Transfusion ratio (FFP/RBC) was 1/0.7. CONCLUSION: During tratment transfusion ratio was greater than that indicated in the existing guidelines stating an early and massive administration of FFP with a FFP/RBC ratio ranging between 1/2 and 1/1. Fibrinogen (Fbg) and tranexamic acid should be administered as early as possible. The use of recombinant activated factor VII (rFVIIa) should remain the ultimate treatment option.
Subject(s)
Blood Transfusion/methods , Erythrocyte Transfusion/methods , Plasma , Postpartum Hemorrhage/therapy , Adolescent , Adult , Cesarean Section , Factor VIIa/administration & dosage , Female , Fibrinogen/administration & dosage , Humans , Pregnancy , Recombinant Proteins/administration & dosage , Retrospective Studies , Severity of Illness Index , Tranexamic Acid/administration & dosage , Tunisia , Young AdultABSTRACT
Sweet's syndrome has been reported in association with inflammatory diseases such as Crohn's disease. It has also been reported in association with several drugs. Here, we report a rare case of Sweet's syndrome induced by azathioprine in a patient with Crohn's disease.
Subject(s)
Anti-Inflammatory Agents/adverse effects , Azathioprine/adverse effects , Crohn Disease/drug therapy , Gastrointestinal Agents/adverse effects , Skin/drug effects , Sweet Syndrome/chemically induced , Biopsy , Crohn Disease/diagnosis , Humans , Male , Middle Aged , Remission Induction , Skin/pathology , Sweet Syndrome/diagnosisSubject(s)
Cystadenoma, Serous/diagnosis , Pancreatic Neoplasms/diagnosis , Adult , Cystadenoma, Serous/diagnostic imaging , Cystadenoma, Serous/pathology , Female , Humans , Male , Middle Aged , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathology , Radiography , Retrospective StudiesABSTRACT
CONTEXT: Pancreatitis is a very rare adverse effect of tamoxifen with only six cases of tamoxifen-associated pancreatitis reported in the English literature until now. In these cases, rechallenge with tamoxifen was not carried out. CASE REPORT: We report a case of recurrent severe acute pancreatitis in a 44-year-old female induced by tamoxifen therapy and review the literature with regards to tamoxifen-associated pancreatitis. CONCLUSION: Clinicians should be aware of the risks of developing severe acute pancreatitis when using tamoxifen therapy. If tamoxifen is suspected as the probable causative agent, rechallenge with this drug should be prohibited.
