References of "D'Orio, Vincenzo"
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See detailRéanimation aux urgences pédiatriques
Battisti, Oreste ULg; Brasseur, Edmond ULg; D'Orio, Vincenzo ULg et al

Learning material (2010)

précis des principales situations aux urgences pédiatriques

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See detailLe syndrome du QT long congenital.
Garweg, C.; D'Orio, Vincenzo ULg; MELON, Pierre ULg et al

in Revue Médicale de Liège (2010), 65(11), 628-33

The congenital long QT syndrome (LQTS) is a hereditary cardiac disease characterized by a prolongation of the QT interval > 440 ms at rest ECG associated with a high risk of ventricular arrhythmias ... [more ▼]

The congenital long QT syndrome (LQTS) is a hereditary cardiac disease characterized by a prolongation of the QT interval > 440 ms at rest ECG associated with a high risk of ventricular arrhythmias (torsade de pointe). Clinical manifestations are syncope and sudden cardiac death. The implicated genes encode cardiac ion channel subunits or proteins involved in modulating ionic currents. The diagnosis of LQTS can be complex in borderline cases. Etiology, pathogenesis, diagnosis and treatment are discussed. [less ▲]

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See detailValidation of a new French-language triage algorithm : the ELISA scale.
Jobe, Jérôme ULg; Ghuysen, Alexandre ULg; GERARD, P. et al

in Critical Care (2010), 14(Suppl1), 277

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See detailHemolytic uremic syndrome with an atypical presentation.
NOGUE KAMDJE, Alain ULg; BRASSEUR, Edmond ULg; fournier et al

in Revue Médicale de Liège (2010), 65(12), 676-80

RÉ SUMÉ : Le syndrome hémolytique urémique (SHU ) est une affection assez rare chez l’adulte, mais de pronostic réservé. Il traduit une microangiopathie thrombotique essentiellement rénale. Nous ... [more ▼]

RÉ SUMÉ : Le syndrome hémolytique urémique (SHU ) est une affection assez rare chez l’adulte, mais de pronostic réservé. Il traduit une microangiopathie thrombotique essentiellement rénale. Nous rapportons l’histoire d’un jeune patient dont la présentation et l’exploration cliniques rendent le diagnostic de SHU probable. La présentation quelque peu atypique offre non seulement l’occasion de discuter des différents éléments qui plaident en faveur du diagnostic selon les hypothèses physiopathologiques les plus récentes, mais aussi de redéfinir les recommandations de la prise en charge en urgence de cette affection sévère. [less ▲]

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See detailLe couplage ventriculoartériel : du concept aux applications cliniques
Morimont, Philippe ULg; Lambermont, Bernard ULg; Ghuysen, Alexandre ULg et al

in Réanimation (2009), 18(3), 201-206

L’interaction entre le ventricule et le réseau vasculaire est un déterminant majeur de la performance cardiaque globale, particulièrement en présence d’une insuffisance ventriculaire préalable ... [more ▼]

L’interaction entre le ventricule et le réseau vasculaire est un déterminant majeur de la performance cardiaque globale, particulièrement en présence d’une insuffisance ventriculaire préalable. L’évaluation du couplage ventriculoartériel grâce à la mesure de l’élastance ventriculaire, comme reflet de la contractilité et de l’élastance artérielle, en tant qu’indice de post-charge, permet de quantifier cette interaction. Des travaux récents illustrent l’intérêt clinique de ce concept. Jusqu’à présent, son utilisation restait toutefois marginale en raison de la nécessité de recourir à des mesures invasives et complexes. Le développement des techniques d’imagerie non invasive et de traitement des signaux permet actuellement d’envisager l’utilisation de ce concept en pratique clinique courante. [less ▲]

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See detailImpact of the presence of a clinical pharmacist in university hospital wards on the elderly or polymedicated patients care
Tshibungu Diambi, Annie; D'Orio, Vincenzo ULg; Delporte, Jean-Pierre ULg et al

in Pharmakon (2009, February), 41(1), 21

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See detailL'appendagite epiploique. Un diagnostic meconnu.
Jobe, Jérôme ULg; Ghuysen, Alexandre ULg; Meunier, Paul ULg et al

in Revue Médicale de Liège (2009), 64(7-8), 382-5

Epiploic appendagitis is the term used to describe the inflammation of an epiploic appendage. These small masses of fat distributed along the colon, from the caecum to the recto-sigmoid junction can ... [more ▼]

Epiploic appendagitis is the term used to describe the inflammation of an epiploic appendage. These small masses of fat distributed along the colon, from the caecum to the recto-sigmoid junction can inflammate by torsion, spontaneously or secondarily with the inflammation of an anatomical structure in the neighbourhood. Symptomatology may mimic retro-caecal appendicitis or diverticulitis and the diagnosis by CT avoids unnecessary surgery or hospitalization. Indeed, under conservative treatment by AINS and analgesics, symptomatology regresses in about five days. In this article, we relate the case of a patient with a typical clinical presentation, to remind the elements of this pathological entity. [less ▲]

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See detailEffective arterial elastance as an index of pulmonary vascular load.
Morimont, Philippe ULg; Lambermont, Bernard ULg; Ghuysen, Alexandre ULg et al

in American Journal of Physiology - Heart and Circulatory Physiology (2008), 294(6), 2736-42

The aim of this study was to test whether the simple ratio of right ventricular (RV) end-systolic pressure (Pes) to stroke volume (SV), known as the effective arterial elastance (Ea), provides a valid ... [more ▼]

The aim of this study was to test whether the simple ratio of right ventricular (RV) end-systolic pressure (Pes) to stroke volume (SV), known as the effective arterial elastance (Ea), provides a valid assessment of pulmonary arterial load in case of pulmonary embolism- or endotoxin-induced pulmonary hypertension. Ventricular pressure-volume (PV) data (obtained with conductance catheters) and invasive pulmonary arterial pressure and flow waveforms were simultaneously recorded in two groups of six pure Pietran pigs, submitted either to pulmonary embolism (group A) or endotoxic shock (group B). Measurements were obtained at baseline and each 30 min after injection of autologous blood clots (0.3 g/kg) in the superior vena cava in group A and after endotoxin infusion in group B. Two methods of calculation of pulmonary arterial load were compared. On one hand, Ea provided by using three-element windkessel model (WK) of the pulmonary arterial system [Ea(WK)] was referred to as standard computation. On the other hand, similar to the systemic circulation, Ea was assessed as the ratio of RV Pes to SV [Ea(PV) = Pes/SV]. In both groups, although the correlation between Ea(PV) and Ea(WK) was excellent over a broad range of altered conditions, Ea(PV) systematically overestimated Ea(WK). This offset disappeared when left atrial pressure (Pla) was incorporated into Ea [Ea * (PV) = (Pes - Pla)/SV]. Thus Ea * (PV), defined as the ratio of RV Pes minus Pla to SV, provides a convenient, useful, and simple method to assess the pulmonary arterial load and its impact on the RV function. [less ▲]

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See detailComparison of functional residual capacity and static compliance of the respiratory system during a positive end-expiratory pressure (PEEP) ramp procedure in an experimental model of acute respiratory distress syndrome.
Lambermont, Bernard ULg; Ghuysen, Alexandre ULg; Janssen, Nathalie ULg et al

in Critical Care (2008), 12(4), 91

INTRODUCTION: Functional residual capacity (FRC) measurement is now available on new ventilators as an automated procedure. We compared FRC, static thoracopulmonary compliance (Crs) and PaO2 evolution in ... [more ▼]

INTRODUCTION: Functional residual capacity (FRC) measurement is now available on new ventilators as an automated procedure. We compared FRC, static thoracopulmonary compliance (Crs) and PaO2 evolution in an experimental model of acute respiratory distress syndrome (ARDS) during a reversed, sequential ramp procedure of positive end-expiratory pressure (PEEP) changes to investigate the potential interest of combined FRC and Crs measurement in such a pathologic state. METHODS: ARDS was induced by oleic acid injection in six anesthetised pigs. FRC and Crs were measured, and arterial blood samples were taken after induction of ARDS during a sequential ramp change of PEEP from 20 cm H2O to 0 cm H2O by steps of 5 cm H2O. RESULTS: ARDS was responsible for significant decreases in FRC, Crs and PaO2 values. During ARDS, 20 cm H2O of PEEP was associated with FRC values that increased from 6.2 +/- 1.3 to 19.7 +/- 2.9 ml/kg and a significant improvement in PaO2. The maximal value of Crs was reached at a PEEP of 15 cm H2O, and the maximal value of FRC at a PEEP of 20 cm H2O. From a PEEP value of 15 to 0 cm H2O, FRC and Crs decreased progressively. CONCLUSION: Our results indicate that combined FRC and Crs measurements may help to identify the optimal level of PEEP. Indeed, by taking into account the value of both parameters during a sequential ramp change of PEEP from 20 cm H2O to 0 cm H2O by steps of 5 cm H2O, the end of overdistension may be identified by an increase in Crs and the start of derecruitment by an abrupt decrease in FRC. [less ▲]

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See detailDissection isolée de l'artère mésentérique supérieure : à propos d'un cas
Ghuysen, Alexandre ULg; Meunier, Paul ULg; Van Damme, Hendrik ULg et al

in Annales de Cardiologie et d'Angeiologie (2008), 57(4), 238-42

We report the case of a 38-year-old man admitted at the emergency department for abdominal pain of abrupt onset. Computed tomographic examination revealed a spontaneous isolated dissection of the superior ... [more ▼]

We report the case of a 38-year-old man admitted at the emergency department for abdominal pain of abrupt onset. Computed tomographic examination revealed a spontaneous isolated dissection of the superior mesenteric artery and an anevrysm of the coeliac artery caused by the arcuate ligament. Outcome was favorable under conservative medical treatment and a three months follow-up was uneventful. This observation offers the opportunity to present recent insights concerning this pathology. [less ▲]

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See detailL'image du mois. Une ingestion indigeste"."
Jobe, Jérôme ULg; Brasseur, Edmond ULg; Ghuysen, Alexandre ULg et al

in Revue Médicale de Liège (2008), 63(2), 57-8

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See detailAlteration of Right Ventricular-Pulmonary Vascular Coupling in a Porcine Model of Progressive Pressure Overloading
Ghuysen, Alexandre ULg; Lambermont, Bernard ULg; Kolh, Philippe ULg et al

in Shock (Augusta, Ga.) (2008), 29(2), 197-204

In acute pulmonary embolism, right ventricular (RV) failure may result from exceeding myocardial contractile resources with respect to the state of vascular afterload. We investigated the adaptation of RV ... [more ▼]

In acute pulmonary embolism, right ventricular (RV) failure may result from exceeding myocardial contractile resources with respect to the state of vascular afterload. We investigated the adaptation of RV performance in a porcine model of progressive pulmonary embolism. Twelve anesthetized pigs were randomly divided into two groups: gradual pulmonary arterial pressure increases by three injections of autologous blood clot (n = 6) or sham-operated controls (n = 6). Right ventricular pressure-volume (PV) loops were recorded using a conductance catheter. Right ventricular contractility was estimated by the slope of the end-systolic PV relationship (Ees). Afterload was referred to as pulmonary arterial elastance (Ea) and assessed using a four-element Windkessel model. Right ventricular-arterial coupling (Ees/Ea) and efficiency of energy transfer (from PV area to external mechanical work [stroke work]) were assessed at baseline and every 30 min for 4 h. Eaincreased progressively after embolization, from 0.26 +/- 0.04 to 2.2 +/- 0.7 mmHg mL (P < 0.05). Ees increased from 1.01 +/-0.07 to 2.35 +/- 0.27 mmHg mL (P < 0.05) after the first two injections but failed to increase any further. As a result, Ees/Ea initially decreased to values associated with optimal SW, but the last injection was responsible for Ees/Ea values less than 1, decreased stroke volume, and RV dilation. Stroke work/PV area consistently decreased with each injection from 79% +/- 3% to 39% +/- 11% (P < 0.05). In response to gradual increases in afterload, RV contractility reserve was recruited to a point of optimal coupling but submaximal efficiency. Further afterload increases led to RV-vascular uncoupling and failure. [less ▲]

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See detailComment je traite... une intoxication au paracetamol.
Bertrand, Xavier ULg; Brasseur, Edmond ULg; Ghuysen, Alexandre ULg et al

in Revue Médicale de Liège (2008), 63(7-8), 465-8

Drug self-poisoning is a common cause of admission in ED. Among various incriminated substances, paracetamol is often implicated and presents a severe toxicity. We briefly describe the epidemiology and ... [more ▼]

Drug self-poisoning is a common cause of admission in ED. Among various incriminated substances, paracetamol is often implicated and presents a severe toxicity. We briefly describe the epidemiology and physiopathology of paracetamol self-poisoning. We then clarify the diagnostic elements, thresholds of toxicity, indications for treatment and different available therapeutic guidelines. [less ▲]

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See detailL'image du mois. Larva migrans cutanee.
Hick, Sybilla ULg; Brasseur, Edmond ULg; Ghuysen, Alexandre ULg et al

in Revue Médicale de Liège (2008), 63(9), 521-2

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See detailL'image du mois. Dissection aortique avec hemopéricarde
Secco, Daniel ULg; Brasseur, Edmond ULg; Ghuysen, Alexandre ULg et al

in Revue Médicale de Liège (2007), 62(9), 534-5

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See detailLevosimendan: Right for the right ventricle?
Lambermont, Bernard ULg; Ghuysen, Alexandre ULg; Harstein, Gary et al

in Critical Care Medicine (2007), 35(8), 1995-1996

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See detailAre Belgian hospitals prepared for an H5NI1-pandemic?
De Cauwer, H. G.; Mortelmans, L. J. M.; D'Orio, Vincenzo ULg

in European Journal of Emergency Medicine (2007), 14(4), 204-206

Objective Virulent airborne diseases can be a real burden to a nation's health system. The most recent threat is the fear of a mutation-induced H5N1-influenza pandemic. We studied whether Belgian ... [more ▼]

Objective Virulent airborne diseases can be a real burden to a nation's health system. The most recent threat is the fear of a mutation-induced H5N1-influenza pandemic. We studied whether Belgian hospitals are able to deal with H5N1-influenza infected patients in the case of a pandemic. Many patients, including children, may require artificial ventilation within 48h after admission. Methods A survey aimed at determining 'availability and preparedness' was sent by e-mail to the different Belgian Emergency Departments. Results and discussion Sixty-five hospitals were finally included. The amount of patients being potentially admitted is limited, owing to the reduced number of intensive care beds equipped with automatic ventilators. Furthermore, the number of available intensive care beds for children is still lower than for adult patients. The number of mortuary places, in the case of a catastrophe, is also insufficient. Although most hospitals set up a disaster plan on H5N1, there are only limited stocks of antiviral medication to protect the hospital staff in the acute phase. A separate triage area is only available in a limited number of hospitals. We conclude that Belgian hospitals and emergency departments are not equipped to deal with potential pandemic situations. [less ▲]

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