References of "Ghuysen, Alexandre"
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See detail“A QUICK HIGH BEFORE IMMERSION INTO THE DEEP BLUE: THE FALL OF ICARUS REVISED.”
Lopez-Rodrigez, Alicia; BRASSEUR, Edmond ULg; GHUYSEN, Alexandre ULg et al

Poster (2014, January 18)

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See detailAN UNUSUAL CERVICALGY.
PIAZZA, Justine ULg; BRASSEUR, Edmond ULg; Ghuysen, Alexandre ULg et al

Poster (2014, January 18)

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See detailDE L’AIR DANS LA VESSIE?
TAMBWE RAMAZANI, Willy ULg; BRASSEUR, Edmond ULg; Johnson, S et al

Poster (2014, January 18)

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See detailLe cas clinique du mois. Syndrome du bebe bleu: la verite cachee au fond du puits.
PIAZZA, Justine ULg; Douin, C.; Bodson, Liliane ULg et al

in Revue medicale de Liege (2014), 69(4), 175-9

Methemoglobinemia is a rare disorder preferentially affecting children. The outcome may be dramatic when the disorder remains unidentified, however early recognition using unspecific exams allows prompt ... [more ▼]

Methemoglobinemia is a rare disorder preferentially affecting children. The outcome may be dramatic when the disorder remains unidentified, however early recognition using unspecific exams allows prompt therapy. We report the case of a 14-month-old baby who presented with a sudden access of cyanosis resulting from acute methemoglobinemia. Careful investigation identified contamination of familial food by an excess of nitrates related to the use of well water from rural location. [less ▲]

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See detailSimulation en pédagogie médicale: état des lieux.
BETZ, Romain ULg; Ghuysen, Alexandre ULg; D'Orio, Vincenzo ULg

in Revue medicale de Liege (2014), 69(3), 132-8

Training methodology having emerged primarily over the last two decades, simulation in health care has arisen from the idea that students should never practice on the patient for their "first time ... [more ▼]

Training methodology having emerged primarily over the last two decades, simulation in health care has arisen from the idea that students should never practice on the patient for their "first time". Simulation makes it possible to try out the errors and to repeat the skills over and over, in a reproducible way and in the most realistic possible environment, but with no harm to the patients, a risk socially intolerable. Simulation implies multiple methods from simple role-playing schemes to most powerful experiments on high-fidelity mannequins. In all cases, simulation implies a strictly codified structure: briefing, scenario, then debriefing. Indeed, debriefing represents the cornerstone of the teaching process allowing, both technical and non-technical skills acquisition through a work based on self-criticism. It should be noticed however that, although medical simulation has very clearly provided evidence of its effectiveness in skills acquisition, appropriate behaviours or application of algorithms, it has not demonstrated any benefit in terms of patients' care quality. Further research is therefore needed to validate this last assumption, which represents the very objective of any evolution in medicine. [less ▲]

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See detailL'algorithme ALERT. Pourquoi, qui, comment, quand?
cardos, B; STIPULANTE, Samuel ULg; DELFOSSE, Anne-sophie ULg et al

in Revue Médicale de Liège (2014), 69(synthèse 2014), 19-24

La réanimation guidée par téléphone consiste à guider le témoin d'un arrêt cardiaque, formé ou non à la réanimation cardio-pulmonaire, en lui donnant des consignes standardisées par téléphone. Ces ... [more ▼]

La réanimation guidée par téléphone consiste à guider le témoin d'un arrêt cardiaque, formé ou non à la réanimation cardio-pulmonaire, en lui donnant des consignes standardisées par téléphone. Ces instructions lui permettent de vérifier l'état de conscience de la victime, de dégager ses voies aériennes, d'apprécier la présence d'une respiration efficace et de mettre en train des compressions thoraciques en cas d'état de mort apparente. L'Algorithme Liégeois d'Encadrement à la Réanimation par Téléphone (ALERT) est un protocole original permettant aux dispatchers 112 de notre pays d'encadrer l'appelant durant la fenêtre de temps qui débute avec l'appel à l'aide pour se terminer à l'arrivée des équipes de secours spécialisés sur place. Son emploi est associé à un accroissement significatif de la fréquence et de la qualité des gestes de réanimation mis en train par le témoin permettant d'accroître les chances de survie de la victime d'un arrêt cardio-respiratoire extra-hospitalier (ACREH) [less ▲]

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See detailAge-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study.
Righini, Marc; Van Es, Josien; Den Exter, Paul L. et al

in JAMA (2014), 311(11), 1117-24

IMPORTANCE: D-dimer measurement is an important step in the diagnostic strategy of clinically suspected acute pulmonary embolism (PE), but its clinical usefulness is limited in elderly patients. OBJECTIVE ... [more ▼]

IMPORTANCE: D-dimer measurement is an important step in the diagnostic strategy of clinically suspected acute pulmonary embolism (PE), but its clinical usefulness is limited in elderly patients. OBJECTIVE: To prospectively validate whether an age-adjusted D-dimer cutoff, defined as age x 10 in patients 50 years or older, is associated with an increased diagnostic yield of D-dimer in elderly patients with suspected PE. DESIGN, SETTINGS, AND PATIENTS: A multicenter, multinational, prospective management outcome study in 19 centers in Belgium, France, the Netherlands, and Switzerland between January 1, 2010, and February 28, 2013. INTERVENTIONS: All consecutive outpatients who presented to the emergency department with clinically suspected PE were assessed by a sequential diagnostic strategy based on the clinical probability assessed using either the simplified, revised Geneva score or the 2-level Wells score for PE; highly sensitive D-dimer measurement; and computed tomography pulmonary angiography (CTPA). Patients with a D-dimer value between the conventional cutoff of 500 microg/L and their age-adjusted cutoff did not undergo CTPA and were left untreated and formally followed-up for a 3-month period. MAIN OUTCOMES AND MEASURES: The primary outcome was the failure rate of the diagnostic strategy, defined as adjudicated thromboembolic events during the 3-month follow-up period among patients not treated with anticoagulants on the basis of a negative age-adjusted D-dimer cutoff result. RESULTS: Of the 3346 patients with suspected PE included, the prevalence of PE was 19%. Among the 2898 patients with a nonhigh or an unlikely clinical probability, 817 patients (28.2%) had a D-dimer level lower than 500 microg/L (95% CI, 26.6%-29.9%) and 337 patients (11.6%) had a D-dimer between 500 microg/L and their age-adjusted cutoff (95% CI, 10.5%-12.9%). The 3-month failure rate in patients with a D-dimer level higher than 500 microg/L but below the age-adjusted cutoff was 1 of 331 patients (0.3% [95% CI, 0.1%-1.7%]). Among the 766 patients 75 years or older, of whom 673 had a nonhigh clinical probability, using the age-adjusted cutoff instead of the 500 microg/L cutoff increased the proportion of patients in whom PE could be excluded on the basis of D-dimer from 43 of 673 patients (6.4% [95% CI, 4.8%-8.5%) to 200 of 673 patients (29.7% [95% CI, 26.4%-33.3%), without any additional false-negative findings. CONCLUSIONS AND RELEVANCE: Compared with a fixed D-dimer cutoff of 500 microg/L, the combination of pretest clinical probability assessment with age-adjusted D-dimer cutoff was associated with a larger number of patients in whom PE could be considered ruled out with a low likelihood of subsequent clinical venous thromboembolism. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01134068. [less ▲]

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See detailA fatal case of Perthes syndrome
JOBE, Jérôme ULg; Ghuysen, Alexandre ULg; Hartstein, Gary ULg et al

in Journal of Emergencies, Trauma and Shock (2013), 6(4), 296-297

Perthes syndrome, or traumatic asphyxia, is a clinical syndrome associating cervicofacial cyanosis with cutaneous petechial haemorrhages and subconjonctival bleeding resulting from severe sudden ... [more ▼]

Perthes syndrome, or traumatic asphyxia, is a clinical syndrome associating cervicofacial cyanosis with cutaneous petechial haemorrhages and subconjonctival bleeding resulting from severe sudden compressive chest trauma. Deep inspiration and a Valsalva maneuver just prior to rapid and severe chest compression, are responsible for the development of this syndrome. Current treatment is symptomatic: urgent relief of chest compression and cardiopulmonary resuscitation if needed. Outcome may be satisfactory depending on the duration and severity of compression. Prolonged thoracic compression may sometimes lead to cerebral anoxia, irreversible neurologic damage and death. We report a fatal case of Perthes syndrome resulting from an industrial accident. [less ▲]

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See detailEvaluating the psychological impact of practice dispatch-assisted cardiopulmonary instructions using the ALERT protocol: preliminary results in Liege dispatching centre.
Hirtz, Elodie; Ghuysen, Alexandre ULg; STIPULANTE, Samuel ULg et al

Poster (2013, July)

ABSTRACT Background. The ALERT algorithm, an effective compression-only phone cardiopulmonary resuscitation (CPR) protocol has the potential to help bystanders initiate CPR. This study evaluates the ... [more ▼]

ABSTRACT Background. The ALERT algorithm, an effective compression-only phone cardiopulmonary resuscitation (CPR) protocol has the potential to help bystanders initiate CPR. This study evaluates the psychological impact of the CPR’s practice on untrained persons (UP). Methods. This is a quasi experimental longitudinal study (n = 153). We used: demographics data, CPR’ emotional characteristics; the Peritraumatic Dissociative Experiences Questionnaire ; the Way of Coping Check List and the Impact of Event Scale. Findings. Two psychological profiles: UP at high risk to develop a post traumatic disorder (higher average scores ; high emotional distress during the CPR) versus UP at low risk. Discussion. These preliminary results highlight the importance of identifying the psychological profile of the UP. For a CPR, UP at high risk should be treated differently: first, take the time to reduce emotional distress and then only talk about the CPR. This step could reduce the risk for PTSD [less ▲]

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See detailEvaluation of a Model-Based Hemodynamic Monitoring Method in a Porcine Study of Septic Shock
Revie, James; Stevenson, David; Chase, J. Geoffrey et al

in Computational and Mathematical Methods in Medicine (2013)

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See detailALGORITHMES DE RÉGULATION DES APPELS DE MÉDECINE GÉNÉRALE
BRASSEUR, Edmond ULg; PAQUES, Florence ULg; GHUYSEN, Alexandre ULg et al

in Acta Clinica Belgica (2013), 68(6), 487

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See detailAssessment of ventricular contractility and ventricular-arterial coupling with a model-based sensor.
Desaive, Thomas ULg; LAMBERMONT, Bernard ULg; JANSSEN, Nathalie ULg et al

in Computer Methods & Programs in Biomedicine (2013), 109(2),

Estimation of ventricular contractility and ventricular arterial coupling is clinically important in diagnosing and treating cardiac dysfunction in the critically ill. However, experimental assessment of ... [more ▼]

Estimation of ventricular contractility and ventricular arterial coupling is clinically important in diagnosing and treating cardiac dysfunction in the critically ill. However, experimental assessment of indexes of ventricular contractility, such as the end-systolic pressure-volume relationship, requires a highly invasive maneuver and measurements that are not typical in an intensive care unit (ICU). This research describes the use of a previously validated cardiovascular system model and parameter identification process to evaluate the right ventricular arterial coupling in septic shock. Model-based ventricular arterial coupling is defined by the ratio of the end systolic right ventricular elastance (E(esrvf)) over the pulmonary artery elastance (E(pa)) or the mean pulmonary inflow resistance (R(pulin)). Results are compared to the clinical gold-standard assessment (conductance catheter method). Six anesthetized healthy pigs weighing 20-30kg received a 0.5mgkg(-1) endotoxin infusion over a period of 30min from T0 to T30, to induce septic shock and veno-venous hemofiltration was used from T60 onward. The results show good agreement with the gold-standard experimental assessment. In particular, the model-based right ventricular elastance (E(esrvf)) correlates well with the clinical gold standard (R(2)=0.69) and the model-based non-invasive coupling (E(esrvf)/R(pulin)) follow the same trends and dynamics (R(2)=0.37). The overall results show the potential to develop a model-based sensor to monitor ventricular-arterial coupling in clinical real-time. [less ▲]

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See detailValidation of subject-specific cardiovascular system models from porcine measurements.
Revie, J. A.; Stevenson, D. J.; Chase, J. G. et al

in Computer Methods & Programs in Biomedicine (2013), 109(2),

A previously validated mathematical model of the cardiovascular system (CVS) is made subject-specific using an iterative, proportional gain-based identification method. Prior works utilised a complete set ... [more ▼]

A previously validated mathematical model of the cardiovascular system (CVS) is made subject-specific using an iterative, proportional gain-based identification method. Prior works utilised a complete set of experimentally measured data that is not clinically typical or applicable. In this paper, parameters are identified using proportional gain-based control and a minimal, clinically available set of measurements. The new method makes use of several intermediary steps through identification of smaller compartmental models of CVS to reduce the number of parameters identified simultaneously and increase the convergence stability of the method. This new, clinically relevant, minimal measurement approach is validated using a porcine model of acute pulmonary embolism (APE). Trials were performed on five pigs, each inserted with three autologous blood clots of decreasing size over a period of four to five hours. All experiments were reviewed and approved by the Ethics Committee of the Medical Faculty at the University of Liege, Belgium. Continuous aortic and pulmonary artery pressures (P(ao), P(pa)) were measured along with left and right ventricle pressure and volume waveforms. Subject-specific CVS models were identified from global end diastolic volume (GEDV), stroke volume (SV), P(ao), and P(pa) measurements, with the mean volumes and maximum pressures of the left and right ventricles used to verify the accuracy of the fitted models. The inputs (GEDV, SV, P(ao), P(pa)) used in the identification process were matched by the CVS model to errors <0.5%. Prediction of the mean ventricular volumes and maximum ventricular pressures not used to fit the model compared experimental measurements to median absolute errors of 4.3% and 4.4%, which are equivalent to the measurement errors of currently used monitoring devices in the ICU ( approximately 5-10%). These results validate the potential for implementing this approach in the intensive care unit. [less ▲]

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