References of "Brichant, Jean-François"
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See detailAdherence to Continuous Positive Airway Pressure (CPAP) Therapy
Deflandre, Eric; Degey, Stéphanie; BONHOMME, Vincent ULg et al

in CHEST Journal (2014, March), 145

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See detailQUELLE EST LA PLACE DE L’HUMAIN AU SEIN DES RECOMMANDATIONS, DES CONCERTATIONS ONCOLOGIQUES
BARTHELEMY, Nicole ULg; BOGA, Deniz ULg; PRINCEN, Fabienne ULg et al

in Revue Médicale de Liège (2014), 69(Supp 1), 9-12

Le patient atteint de cancer bénéficie à l’heure actuelle d’une médecine très technique, de plus en plus ciblée et individualisée. Et l’Homme dans tout cela ? Divers outils ont été développés afin d’aider ... [more ▼]

Le patient atteint de cancer bénéficie à l’heure actuelle d’une médecine très technique, de plus en plus ciblée et individualisée. Et l’Homme dans tout cela ? Divers outils ont été développés afin d’aider les médecins et l’ensemble des soignants à concilier la médecine contemporaine et les droits fondamentaux du patient. Parmi ceux-ci, on trouve les Concertations Oncologiques Multidisciplinaires (COM) ainsi que les recommandations de traitement publiées par les socié - tés scientifiques nationales ou internationales. La prise en charge des patients doit être interdisciplinaire et basée sur une médecine factuelle. Ce processus de prise de décisions parta - gée doit, au final, être en accord avec les souhaits du patient. Cette approche doit lui permettre de conserver son autonomie et d’être l’acteur principal dans les prises de décision. [less ▲]

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See detailThalamus, Brainstem and Salience Network Connectivity Changes During Propofol-Induced Sedation and Unconsciousness
Guldenmund, Justus Pieter ULg; Demertzi, Athina ULg; BOVEROUX, Pierre ULg et al

in Brain connectivity (2013), 3

In this functional magnetic resonance imaging study, we examined the effect of mild propofol sedation and propofol-induced unconsciousness on resting state brain connectivity, using graph analysis based ... [more ▼]

In this functional magnetic resonance imaging study, we examined the effect of mild propofol sedation and propofol-induced unconsciousness on resting state brain connectivity, using graph analysis based on independent component analysis and a classical seed-based analysis. Contrary to previous propofol research, which mainly emphasized the importance of connectivity in the default mode network (DMN) and external control network (ECN), we focused on the salience network, thalamus, and brainstem. The importance of these brain regions in brain arousal and organization merits a more detailed examination of their connectivity response to propofol. We found that the salience network disintegrated during propofol-induced unconsciousness. The thalamus decreased connectivity with the DMN, ECN, and salience network, while increasing connectivity with sensorimotor and auditory/insular cortices. Brainstem regions disconnected from the DMN with unconsciousness, while the pontine tegmental area increased connectivity with the insulae during mild sedation. These findings illustrate that loss of consciousness is associated with a wide variety of decreases and increases of both cortical and subcortical connectivity. It furthermore stresses the necessity of also examining resting state connectivity in networks representing arousal, not only those associated with awareness. [less ▲]

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See detailObservance au traitement par CPAP chez les patients souffrant d’apnées du sommeil
DEFLANDRE, Eric; DEGEY, Stéphanie; BONHOMME, Vincent ULg et al

Poster (2012, September 20)

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See detailAnalgésie péridurale obstétricale et lombalgie du post-partum: un lien de cause à effet?
CHARLIER, Vanessa ULg; Brichant, Géraldine ULg; DEWANDRE, Pierre-Yves ULg et al

in Revue Médicale de Liège (2012), 67(1), 16-20

backache is a common problem in the general population. the prevalence of backpain is increased during pregnancy and after delivery. early studies have suggested that labor epidural analgesia might be ... [more ▼]

backache is a common problem in the general population. the prevalence of backpain is increased during pregnancy and after delivery. early studies have suggested that labor epidural analgesia might be associated with an increased incidence of backache in the postpartum period. However, these initial studies were retrospective and their design included several methodological deficiencies. All the prospective studies published afterwards (prospective cohort studies and 3 ran- domized controlled trials) yield the same result : there is no relationship between labor epidural analgesia and long-term postpartum backpain. pregnant women must be aware of this in order to make an informed and appropriate choice about labor epidural analgesia, the most effective technique for intra- partum pain relief. [less ▲]

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See detailNeural correlates of consciousness during general anesthesia using functional magnetic resonance imaging (fMRI).
BONHOMME, Vincent ULg; Boveroux, Pierre; Brichant, Jean-François ULg et al

in Archives italiennes de biologie (2012), 150(2-3), 155-63

This paper reviews the current knowledge about the mechanisms of anesthesia-induced alteration of consciousness. It is now evident that hypnotic anesthetic agents have specific brain targets whose ... [more ▼]

This paper reviews the current knowledge about the mechanisms of anesthesia-induced alteration of consciousness. It is now evident that hypnotic anesthetic agents have specific brain targets whose function is hierarchically altered in a dose-dependent manner. Higher order networks, thought to be involved in mental content generation, as well as sub-cortical networks involved in thalamic activity regulation seems to be affected first by increasing concentrations of hypnotic agents that enhance inhibitory neurotransmission. Lower order sensory networks are preserved, including thalamo-cortical connectivity into those networks, even at concentrations that suppress responsiveness, but cross-modal sensory interactions are inhibited. Thalamo-cortical connectivity into the consciousness networks decreases with increasing concentrations of those agents, and is transformed into an anti-correlated activity between the thalamus and the cortex for the deepest levels of sedation, when the subject is non responsive. Future will tell us whether these brain function alterations are also observed with hypnotic agents that mainly inhibit excitatory neurotransmission. The link between the observations made using fMRI and the identified biochemical targets of hypnotic anesthetic agents still remains to be identified. [less ▲]

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See detailConnectivity changes underlying spectral EEG changes during propofol-induced loss of consciousness.
Boly, Mélanie ULg; Moran, Rosalyn; Murphy, Michael et al

in The Journal of neuroscience : the official journal of the Society for Neuroscience (2012), 32(20), 7082-90

The mechanisms underlying anesthesia-induced loss of consciousness remain a matter of debate. Recent electrophysiological reports suggest that while initial propofol infusion provokes an increase in fast ... [more ▼]

The mechanisms underlying anesthesia-induced loss of consciousness remain a matter of debate. Recent electrophysiological reports suggest that while initial propofol infusion provokes an increase in fast rhythms (from beta to gamma range), slow activity (from delta to alpha range) rises selectively during loss of consciousness. Dynamic causal modeling was used to investigate the neural mechanisms mediating these changes in spectral power in humans. We analyzed source-reconstructed data from frontal and parietal cortices during normal wakefulness, propofol-induced mild sedation, and loss of consciousness. Bayesian model selection revealed that the best model for explaining spectral changes across the three states involved changes in corticothalamic interactions. Compared with wakefulness, mild sedation was accounted for by an increase in thalamic excitability, which did not further increase during loss of consciousness. In contrast, loss of consciousness per se was accompanied by a decrease in backward corticocortical connectivity from frontal to parietal cortices, while thalamocortical connectivity remained unchanged. These results emphasize the importance of recurrent corticocortical communication in the maintenance of consciousness and suggest a direct effect of propofol on cortical dynamics. [less ▲]

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See detailLes céphalées post-ponction durale: traitement et prévention
LENELLE, Laurence ULg; LAHAYE-GOFFART, Benoît ULg; DEWANDRE, Pierre-Yves ULg et al

in Revue Médicale de Liège (2011), 66(11), 575-580

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See detailThe volume of blood for epidural blood patch in obstetrics: a randomized, blinded clinical trial
Paech, M. J.; Doherty, D. A.; Christmas, T. et al

in Anesthesia and Analgesia (2011), 113(1), 126-33

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See detailAnesthésie pédiatrique et hôpital de jour: les grands problèmes des petits enfants
GROSJEAN, Valérie ULg; Veyckemans, F.; SEGHAYE, Marie-Christine ULg et al

in Revue Médicale de Liège (2011), 66(3), 135-139

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See detailAnesthésie et sécurité des procédures en dehors du bloc opératoire: "l'affaire de tous"
Jastrowicz, Julie ULg; Hallet, Claude ULg; Roediger, Laurence ULg et al

in Revue Médicale de Liège (2011), 66(1), 18-24

Due to important technological improvements, anesthesiological activity outside the operating theatre is increasing. Most of these procedures are performed for gastro- enterology procedures; other ... [more ▼]

Due to important technological improvements, anesthesiological activity outside the operating theatre is increasing. Most of these procedures are performed for gastro- enterology procedures; other procedures include medical ima- ging, electroconvulsive therapy or cardioversion. The practice of anesthesia at alternative sites is associated with logistical dif- ficulties with many constraints. Anesthesia will be requested if the procedure is likely to be unpleasant or painful, if the patient is not cooperative, or if the patient’s hemodynamic condition is unstable. The pre-anesthesia assessment, an adequate monito- ring and an appropriate choice of the anesthetic technique and drugs will be helpful in managing an anesthetic procedure too frequently neglected despite it is associated with risks similar to procedures performed in the operating theatre. [less ▲]

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See detailPropofol anesthesia and sleep: a high-density EEG study.
Murphy, Michael; Bruno, Marie-Aurélie ULg; Riedner, Brady A et al

in Sleep (2011), 34(3), 283-91

STUDY OBJECTIVES: The electrophysiological correlates of anesthetic sedation remain poorly understood. We used high-density electroencephalography (hd-EEG) and source modeling to investigate the cortical ... [more ▼]

STUDY OBJECTIVES: The electrophysiological correlates of anesthetic sedation remain poorly understood. We used high-density electroencephalography (hd-EEG) and source modeling to investigate the cortical processes underlying propofol anesthesia and compare them to sleep. DESIGN: 256-channel EEG recordings in humans during propofol anesthesia. SETTING: Hospital operating room. PATIENTS OR PARTICIPANTS: 8 healthy subjects (4 males) INTERVENTIONS: N/A MEASUREMENTS AND RESULTS: Initially, propofol induced increases in EEG power from 12-25 Hz. Loss of consciousness (LOC) was accompanied by the appearance of EEG slow waves that resembled the slow waves of NREM sleep. We compared slow waves in propofol to slow waves recorded during natural sleep and found that both populations of waves share similar cortical origins and preferentially propagate along the mesial components of the default network. However, propofol slow waves were spatially blurred compared to sleep slow waves and failed to effectively entrain spindle activity. Propofol also caused an increase in gamma (25-40 Hz) power that persisted throughout LOC. Source modeling analysis showed that this increase in gamma power originated from the anterior and posterior cingulate cortices. During LOC, we found increased gamma functional connectivity between these regions compared to the wakefulness. CONCLUSIONS: Propofol anesthesia is a sleep-like state and slow waves are associated with diminished consciousness even in the presence of high gamma activity. CITATION: Murphy M; Bruno MA; Riedner BA; Boveroux P; Noirhomme Q; Landsness EC; Brichant JF; Phillips C; Massimini M; Laureys S; Tononi G; Boly M. Propofol anesthesia and sleep: a high-density EEG study. SLEEP 2011;34(3):283-291. [less ▲]

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See detailComparison of the Surgical Pleth Index (TM) with haemodynamic variables to assess nociception-anti-nociception balance during general anaesthesia
Bonhomme, Vincent ULg; Uutela, K.; Hans, Grégory ULg et al

in British Journal of Anaesthesia (2011), 106(1), 101-11

BACKGROUND: The Surgical Pleth Index (SPI) is proposed as a means to assess the balance between noxious stimulation and the anti-nociceptive effects of anaesthesia. In this study, we compared SPI, mean ... [more ▼]

BACKGROUND: The Surgical Pleth Index (SPI) is proposed as a means to assess the balance between noxious stimulation and the anti-nociceptive effects of anaesthesia. In this study, we compared SPI, mean arterial pressure (MAP), and heart rate (HR) as a means of assessing this balance. METHODS: We studied a standard stimulus [head-holder insertion (HHI)] and varying remifentanil concentrations (CeREMI) in a group of patients undergoing neurosurgery. Patients receiving target-controlled infusions were randomly assigned to one of the three CeREMI (2, 4, or 6 ng m(1)), whereas propofol target was fixed at 3 microg ml(1). Steady state for both targets was achieved before HHI. Intravascular volume status (IVS) was evaluated using respiratory variations in arterial pressure. Prediction probability (Pk) and ordinal regression were used to assess SPI, MAP, and HR performance at indicating CeREMI, and the influence of IVS and chronic treatment for high arterial pressure, as possible confounding factors. RESULTS: The maximum SPI, MAP, or HR observed after HHI correctly indicated CeREMI in one of the two patients [accurate prediction rate (APR)=0.5]. When IVS and chronic treatment for high arterial pressure were taken into account, the APR was 0.6 for each individual variable and 0.8 when all of them predicted the same CeREMI. That increase in APR paralleled an increase in Pk from 0.63 to 0.89. CONCLUSIONS: SPI, HR, and MAP are of comparable value at gauging noxious stimulation-CeREMI balance. Their interpretation is improved by taking account of IVS, treatment for chronic high arterial pressure, and concordance between their predictions. [less ▲]

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See detailLinking sleep and general anesthesia mechanisms: this is no walkover
BONHOMME, Vincent ULg; BOVEROUX, Pierre ULg; Vanhaudenhuyse, Audrey ULg et al

in Acta Anaesthesiologica Belgica (2011), 62(3), 161-171

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See detailAnalgésie épidurale obstétricale et pseudoxanthome élastique : à propos d’un cas
Clanet, Matthieu; CHANTRAINE, Frédéric ULg; DEWANDRE, Pierre-Yves ULg et al

in Annales Françaises d'Anesthésie et de Réanimation (2011), 30(9), 685-7

Pseudoxanthoma elasticum is a rare inherited disorder of the elastic tissue characterised by multisystem manifestations. Skin, eyes, gastro-intestinal system and cardiovascular system are the major ... [more ▼]

Pseudoxanthoma elasticum is a rare inherited disorder of the elastic tissue characterised by multisystem manifestations. Skin, eyes, gastro-intestinal system and cardiovascular system are the major affected systems. We describe the anaesthetic management of a parturient affected by this disease. [less ▲]

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See detailEnd of life care in the operating room for non-heart-beating donors: organization at the University Hospital of Liege.
JORIS, Jean ULg; KABA, Abdourahmane ULg; LAUWICK, Séverine ULg et al

in Transplantation Proceedings (2011), 43(9), 3441-4

Non-heart-beating (NHB) organ donation has become an alternative source to increase organ supply for transplantation. A NHB donation program was implemented in our institution in 2002. As in many ... [more ▼]

Non-heart-beating (NHB) organ donation has become an alternative source to increase organ supply for transplantation. A NHB donation program was implemented in our institution in 2002. As in many institutions the end of life care of the NHB donor (NHBD) is terminated in the operating room (OR) to reduce warm ischemia time. Herein we have described the organization of end of life care for these patients in our institution, including the problems addressed, the solution proposed, and the remaining issues. Emphasis is given to our protocol elaborated with the different contributors of the chain of the NHB donation program. This protocol specifies the information mandatory in the medical records, the end of life care procedure, the determination of death, and the issue of organ preservation measures before NHBD death. The persisting malaise associated with NHB donation reported by OR nurses is finally documented using an anonymous questionnaire. [less ▲]

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See detailInfluence of anesthesia on cerebral blood flow, cerebral metabolic rate, and brain functional connectivity.
BONHOMME, Vincent ULg; BOVEROUX, Pierre ULg; HANS, Pol ULg et al

in Current Opinion in Anaesthesiology (2011), 24(5), 474-9

PURPOSE OF REVIEW: To describe recent studies exploring brain function under the influence of hypnotic anesthetic agents, and their implications on the understanding of consciousness physiology and ... [more ▼]

PURPOSE OF REVIEW: To describe recent studies exploring brain function under the influence of hypnotic anesthetic agents, and their implications on the understanding of consciousness physiology and anesthesia-induced alteration of consciousness. RECENT FINDINGS: Cerebral cortex is the primary target of the hypnotic effect of anesthetic agents, and higher-order association areas are more sensitive to this effect than lower-order processing regions. Increasing concentration of anesthetic agents progressively attenuates connectivity in the consciousness networks, while connectivity in lower-order sensory and motor networks is preserved. Alteration of thalamic sub-cortical regulation could compromise the cortical integration of information despite preserved thalamic activation by external stimuli. At concentrations producing unresponsiveness, the activity of consciousness networks becomes anticorrelated with thalamic activity, while connectivity in lower-order sensory networks persists, although with cross-modal interaction alterations. SUMMARY: Accumulating evidence suggests that hypnotic anesthetic agents disrupt large-scale cerebral connectivity. This would result in an inability of the brain to generate and integrate information, while external sensory information is still processed at a lower order of complexity. [less ▲]

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