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E. Peter F. Jean-Baptiste B. Harbaoui I. Kone-Paut C. Dauphin E. Gomard-Mennesson B. Hervier H. De Boysson L. Varron G. Pugnet D. Gobert C. Bachmeyer S. Humbert P. Roblot P. Cathébras M. Gerfaud-Valentin E. Weber Y. Jamilloux P. Sève 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2021
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E. Meriglier M. Puyade M. Carretier F. Roblot P. Roblot 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2017,38(7):436-443
Introduction
Although most infections occur within the first 2 years after splenectomy, the relatively short follow-up reported in many studies may underestimate the frequency of infections. The objective of the study was to determine the incidence of infective outcomes and factors associated with infection after splenectomy by studying a group of patients who underwent splenectomy over a 10-year period.Methods
A retrospective and monocentric study of patients who underwent splenectomy between January 1st, 1997 and December 31st, 2004 in a French university hospital. Age, sex, indication for splenectomy, infectious events, death, vaccination and antibiotic prophylaxis were collected in January 2015.Results
One hundred and sixty-five patients were included. The most common reasons for splenectomy were therapeutic hematological indications (37.5%). Ninety-seven per cent received pneumococcal vaccine. Prophylactic antibiotics were prescribed in 78% of patients. Thirty-seven patients had 42 severe infections with a median incidence rate of 4 years after splenectomy (2 days–12 years). The rate of infection after splenectomy declined over time but 57% occurred after 2 years and 14.3% after 10 years. Respiratory infections were the most common sites of infections. The incidence of infection differed according to age was highest among the elderly (HR = 6.2; 95%CI: 1.4–27.1; after 65 years old) and underlying reason for splenectomy (P = 0.02). There is no difference with or without prophylactic antibiotics.Conclusion
After splenectomy, the incidence of severe infection declined over time but can occur after 10 years. The onset of infection is linked to age and reason for splenectomy. 相似文献5.
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《Annales de cardiologie et d'angeiologie》2019,68(4):255-259
Orthostatic hypotension is a major criterion for diabetic autonomic cardiac neuropathy. It increases overall and cardiovascular mortality.PurposeThe aim of our study was to evaluate the orthostatic hypotension frequency in type 2 diabetics and to investigate the associated factors.MethodsThis prospective cross-sectional study included adult patients with type 2 diabetes. Orthostatic hypotension was defined as a decrease in the systolic arterial pressure > 20 mm-Hg or a decrease in the diastolic arterial pressure > 10 mm-Hg, after 3 minutes of standing position. The arterial pressure was measured with a validated electronic device. Vascular risk factors and micro and macro-vascular complications were systematically investigated by the appropriate diagnostic means.ResultsWe evaluated 300 diabetic patients. Of these women represented 57%. The mean age was 58 years old. The average duration of diabetes was 8 years. The antidiabetic drugs were metformin (82%), sulfonylureas (36%) and insulin (40%). High blood pressure was present in 49% among whom 50% of patients received angiotensin II receptor blockers, 47% diuretics, 24% angiotensin converting enzyme inhibitors, 17% beta blockers, and 17% calcium channel blockers. Orthostatic hypotension has been identified in 26 patients (8.6%). In multivariate analysis, the associated factors with orthostatic hypotension were elevated systolic blood pressure and insulin treatment.ConclusionThe frequency of orthostatic hypotension is relatively low in our patients with type 2 diabetes and it was significantly associated with systolic blood pressure and insulin treatment. 相似文献
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