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Charra B, Hachimi A, Benslama A, Motaouakkil S. Immunological manifestations in paraphenylenediamine poisoning. Crit Care 2008. [PMCID: PMC4088733 DOI: 10.1186/cc6583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Charra B, Hachimi A, Arsalane H, Benslama A, Motaouakkil S. [Colchicum autumnale L. poisoning]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2007; 26:1081-1082. [PMID: 17959341 DOI: 10.1016/j.annfar.2007.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Guedari H, Hachimi A, Charra B, Benslama A, Motaouakkil S. [Klebsiella pneumoniae meningoencephalitis]. ACTA ACUST UNITED AC 2007; 26:1004-5. [PMID: 17935938 DOI: 10.1016/j.annfar.2007.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Hypertension is very common in standard haemodialysis patients in spite of a wide use of antihypertensive medications. Up to the last decade it was reported in dialysis nts, as in the general population, as a powerful mortality risk factor. More recently several reports have challenged this view, and hypotension rather than hypertension has been claimed as the real culprit. That a risk factor has an opposite effect on mortality in conditions such as dialysis than in the general population has been termed - reverse epidemiology ,,, and suggests that our therapeutic approach toward blood pressure control in dialysis should be reconsidered. In fact, this counter intuitive concept is explained by the effect of time. Hypertension is a long-term mortality risk factor, that in a population crippled by short-acting risk factors (e.g. diabetes, congestive heart failure, malnutrition...) has not the opportunity to express itself. The clear cut noxious effect of hypertension on mortality in the years when dialysis patients were young and fit has disappeared in the present aged and highly co-morbid population. This does not mean that hypertension becomes beneficial once dialysis has been started. Hypotension is a marker of a high risk of early mortality, hypertension is a cause of late mortality. There is no evidence that hypertension might be protective in dialysis patients. Avoiding hypertension remains a capital goal of maintenance dialysis.
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Chazot C, Charra B. Traitement non médicamenteux de l’hypertension artérielle en hémodialyse. Nephrol Ther 2007; 3 Suppl 3:S178-84. [DOI: 10.1016/s1769-7255(07)80634-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Motaouakkil S, Charra B, Hachimi A, Benhsaien I, Benslama A. [Maajoun poisoning]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2007; 26:891. [PMID: 17689044 DOI: 10.1016/j.annfar.2007.07.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Jean G, Chazot C, Charra B. 12 months cinacalcet therapy in hemodialysis patients with secondary hyperparathyroidism: effect on bone markers. Clin Nephrol 2007; 68:63-4. [PMID: 17703841 DOI: 10.5414/cnp68063] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Hachimi A, Charra B, Benslama A, Motaouakkil S. [Cardiac troponin I and paraphenylenediamine poisoning]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2007; 26:711-2. [PMID: 17572042 DOI: 10.1016/j.annfar.2007.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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Rafai MA, Boulaajaj FZ, Charra B, Benslama A, Motaouakkil S, Slassi I. Aspects électrophysiologiques du syndrome intermédiaire au cours des intoxications aux organophosphorés. Rev Neurol (Paris) 2007; 163:480-2. [PMID: 17452951 DOI: 10.1016/s0035-3787(07)90425-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Acute organophosphate poisoning, whether accidental or suicidal, is frequent in developing countries and produces significant morbidity and mortality. Organophosphates inhibit cholinesterase activity at the neuromuscular junction and cause extensive muscle paralysis, particularly for respiratory function. Poisonings evolve in three stages: cholinesterase crisis, intermediate syndrome and delayed neuropathy. Electrophysiological aspects have been poorly studied. We report the case of a 25-year-old woman admitted to intensive care unit with muscarinic signs and respiratory failure after attempted suicidal organophosphate poisoning. Cholinesterase activity was low and the electrophysiological study disclosed the characteristic aspect of intermediate syndrome. The patient died due to septic complications. This syndrome is exceptional with a poorly understood pathophysiology. The electrophysiological study is essential for diagnosis.
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Charra B, Sodqi M, Sandali O, Nejmi H, Hachimi A, Ezzouine H, Benslama A, Himmich H, Motaouakkil S. Paludisme grave d'importation chez l'adulte: étude rétrospective de dix cas admis en réanimation à Casablanca. Med Mal Infect 2007; 37:162-5. [PMID: 17197142 DOI: 10.1016/j.medmal.2006.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2006] [Accepted: 09/06/2006] [Indexed: 10/23/2022]
Abstract
INTRODUCTION We report a retrospective study in the medical intensive care unit of the Casablanca Ibn-Rochd University hospital. MATERIAL AND METHODS All patients over 14 years of age with falciparum malaria, who were admitted to ICUs between 1996 and 2001, were included. The main epidemiological features, criteria of admission, treatment, and outcome were investigated. RESULTS Ten patients were included for severe imported malaria. The mean age was 32+/-4 years. All patients had acquired falciparum malaria in sub-Saharan Africa. Chemoprophylaxis was inadequate in all patients. The mean time from symptom onset to treatment initiation was 9+/-2 days. Criteria of admission were impaired consciousness (7), acute renal failure (4), and respiratory distress (3). The most worrying factors were the severity of consciousness disorders, the acute respiratory distress syndrome, the metabolic acidosis, and the refractory shock. All patients presented with nosocomial respiratory infection related to Gram-negative bacilli, in the evolution. All patients received quinine therapy with loading dose and symptomatic treatment. Five patients died. CONCLUSION The lethality of severe imported malaria is still high despite optimal management in ICUs. Improving chemoprophylaxis and an earlier diagnosis may reduce significantly the mortality rate.
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Ezzouine H, Charra B, Benslama A, Motaouakkil S. [Acute cupric sulfate intoxication]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2007; 26:94. [PMID: 17158022 DOI: 10.1016/j.annfar.2006.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Rafai MA, Boulaajaj FZ, Bourezgui M, Charra B, Otmani HE, Benslama A, Motaouakkil S, Slassi I. Aspects cliniques et électrophysiologiques de l’intoxication aiguë aux organophosphorés. Neurophysiol Clin 2007; 37:35-9. [PMID: 17418356 DOI: 10.1016/j.neucli.2007.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Acute organophosphate (OP) intoxications, accidental or voluntary, are responsible for a high mortality. They cause extensive muscular paralysis by acetyl cholinesterase activity inhibition at the neuromuscular junction level. AIM To underline the rarity and the characteristic electrophysiological pattern during cholinergic crisis. OBSERVATION A 28-year-old woman was admitted to the medical intensive care unit for Malathion acute intoxication with signs of glandular hypersecretion, complicated tetraparesis, and respiratory distress. The cholinesterase activity was 17%. The electroneuromyography showed multiple motor responses to the same stimulation, which is characteristic of the cholinergic crisis. Other electrophysiological parameters, in particular low-frequency repetitive stimulations, were normal. The evolution was favourable after symptomatic treatment and respiratory assistance. DISCUSSION AND CONCLUSIONS Organophosphate intoxications evolve in three phases: acute cholinergic crisis, intermediate syndrome, and delayed neuropathy. While the electrophysiological aspects of delayed neuropathy are best characterized, those of crisis and intermediate syndrome remain very little studied. The persistence of acetylcholine in the synaptic slit would explain the multiple motor responses to single stimulation during the crisis.
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Charra B, Chazot C. Analyse critique des méthodes de mesures du volume extra-cellulaire en dialyse. Nephrol Ther 2007; 3 Suppl 2:S112-20. [DOI: 10.1016/s1769-7255(07)80018-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Charra B, Hares N, Hachimi A, Ezzouine H, Benslama A, Motaouakkil S. [Haemodynamic profile in paraphenylene-diamine poisoning]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2006; 25:1167-8. [PMID: 17010560 DOI: 10.1016/j.annfar.2006.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Fekhkhar K, Charra B, Benslama A, Motaouakkil S. [Noninvasive ventilation and acute severe asthma]. ACTA ACUST UNITED AC 2006; 25:784-5. [PMID: 16815666 DOI: 10.1016/j.annfar.2006.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Motaouakkil S, Charra B, Hachimi A, Ezzouine H, Guedari H, Nejmi H, Benslama A. Rhabdomyolyse et intoxication à la paraphénylène-diamine. ACTA ACUST UNITED AC 2006; 25:708-13. [PMID: 16698226 DOI: 10.1016/j.annfar.2006.03.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2005] [Accepted: 03/29/2006] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this study is to describe clinical description, biological findings, outcome and prognostic factors of paraphenylene-diamine poisoning. PATIENTS AND METHODS We report a cohort study spreaded over 6 years (1999-2004), realized in Medical Intensive Care Unit in Ibn-Rochd University Hospital at Casablanca (Morocco). This study included 315 patients admitted for paraphenylene-diamine (PPD) poisoning. Diagnosis was based on: poisoning reported by the patient or his family, clinical data, biological findings and qualitative determination of PPD. Epidemiological parameters was obtained at admission. Every day, clinical and biological data, therapy and gravity scores were collected and a mean was calculated. RESULTS 315 patients were admitted over this period. The mean age was 23+/-9 years. We noticed a clear female predominance (sex-ratio=9.86). The intoxication was voluntarily aiming at autolysis in 93.3% of the cases. The patients were admitted at about 5+/-5.3 hours after the intoxication. The clinical chart was at first dominated by the respiratory and renal symptoms. The mean of CPK was 132,351.8+/-164,978 UI/l. The treatment was especially symptomatic. The mortality was 47%. The multivariate analysis concluded that acid urinary pH, hyperglycaemia, hard muscles, betamimetic drugs and MPM II>0.14 were associated with a poor prognosis. CONCLUSION The PPD poisoning represents the first cause of toxic rhabdomyolysis in our context and responsible of high mortality. For that, it's necessary to control PPD trade, to inform the medical persons and a rapid management.
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Benslama A, Charra B, Hachimi A, Youklif A, Motaouakkil S. [Hepatic infarction and protein C deficiency]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2006; 25:666-7. [PMID: 16600565 DOI: 10.1016/j.annfar.2006.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Motaouakkil S, Charra B, Hachimi A, Benslama A. Pneumonies nosocomiales à Acinetobacter baumaniimultirésistant traitées par colistine et rifampicine. ACTA ACUST UNITED AC 2006; 25:543-4. [PMID: 16488103 DOI: 10.1016/j.annfar.2006.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Charra B, Guedari H, Bassir S, Maski G, Rayed L, Benslama A, Motaouakkil S. [Flash pulmonary oedema]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2006; 25:539-40. [PMID: 16469476 DOI: 10.1016/j.annfar.2005.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Rabbai O, Hachimi A, Charra B, Benslama A, Motaouakkil S. [Vertex extradural haematoma by superior sagittal sinus rupture]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2006; 25:469-70. [PMID: 16524689 DOI: 10.1016/j.annfar.2005.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
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Charra B, Nejmi H, Hachimi A, Benslama A, Motaouakkil S. [Neuroleptic malignant syndrome]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2006; 25:542-3. [PMID: 16488105 DOI: 10.1016/j.annfar.2006.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Motaouakkil S, Charra B, Hachimi A, Nejmi H, Benslama A, Elmdaghri N, Belabbes H, Benbachir M. Colistin and rifampicin in the treatment of nosocomial infections from multiresistant Acinetobacter baumannii. J Infect 2006; 53:274-8. [PMID: 16442632 DOI: 10.1016/j.jinf.2005.11.019] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2005] [Revised: 11/09/2005] [Accepted: 11/18/2005] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The increased incidence of nosocomial infections by multi-drug resistant Acinetobacter baumannii creates demand on the application of some combinations of older antimicrobials on that species. We conducted the present observational study to evaluate the efficacy of intravenous and aerosolized colistin combined with rifampicin in the treatment of critically patients with nosocomial infections caused by multiresistant A. baumannii. PATIENTS AND METHODS Critically ill patients with nosocomial infections caused by A. baumannii resistant to all antibiotics except colistin in a medical intensive care unit. Diagnosis of infection was based on clinical data and isolation of bacteria. The bacterial susceptibilities to colistin were tested. Clinical response to colistin+rifampicin was evaluated. RESULTS Twenty-six patients (43.58+/-18.29 years, Acute Physiology and Chronic Health Evaluation II Score (APACHE II): 6.35+/-2.99), of whom 16 cases of nosocomial pneumonia treated by aerosolized colistin (1x10(6) IU three times/day) associated with intravenous rifampicin (10 mg/kg every 12h), nine cases of bacteraemia treated by intravenous colistin (2x10(6)IU three times/day) associated with intravenous rifampicin (10 mg/kg every 12h) in which three cases associated with ventilator associated pneumonia and one case of nosocomial meningitis treated by intrathecal use of colistin associated with intravenous rifampicin. The clinical evolution was favourable for all ill patients. Concerning side effects, we have noticed a moderate hepatic cytolysis in three patients. CONCLUSION This is the first clinical report of colistin combined with rifampicin for treatment of A. baumannii infection. Despite the lack of a control group and the limited number of patients, the results seem to be encouraging.
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Charra B, Hachimi A, Guedari H, Benslama A, Motaouakkil S. Myélinolyse extrapontine après correction d'une hyponatrémie. ACTA ACUST UNITED AC 2006; 25:76-7. [PMID: 16263235 DOI: 10.1016/j.annfar.2005.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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