References of "Janssens, Marc"
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See detailActualites therapeutiques en anesthesie-reanimation: cap sur l'hopital de jour
Hick, Gaëtane ULg; Kirsch, Murielle ULg; Janssens, Marc ULg et al

in Revue Médicale de Liège (2007), 62(5-6, May-Jun), 272-6

The one day clinic possesses its own structure and organisation; patient management is also specific. Preoperative visit and assessment are programmed at least 48 hours before anesthesia. Preoperative ... [more ▼]

The one day clinic possesses its own structure and organisation; patient management is also specific. Preoperative visit and assessment are programmed at least 48 hours before anesthesia. Preoperative examinations and choice of anesthetic technique (sedation associated with local anesthesia or not, general anesthesia, locoregional anesthesia, or hypnosedation) are discussed and determined depending upon medical history, clinical examination, and type of procedure. General recommandations, instructions about fasting, interruption of some therapies, and introduction of new medication(s) are explained orally and also provided in a written document. New anesthetics and analgesics allow quick awakening and recovery of vital functions, and subsequently rapid hospital discharge. Prevention and aggressive treatment of postoperative nausea and vomiting are also a major concern in our anesthesic management of ambulatory patient. [less ▲]

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See detailStratégies thérapeutiques dans les adénomes somatotropes avec extension extrasellaire. Place du traitement médical. Etude consensus du Répertoire français de l'Acromégalie.
Jaquet, Ph; Cortet-Rudelli, Ch; Sassolas, G. et al

in Annales d'Endocrinologie (2003), 64(6), 434-441

From the first 198 patient files included into the French Acromegaly Registry, we analyzed 68 patients harboring a somatotroph adenoma with extrasellar extension, after exclusion of those treated by ... [more ▼]

From the first 198 patient files included into the French Acromegaly Registry, we analyzed 68 patients harboring a somatotroph adenoma with extrasellar extension, after exclusion of those treated by stereotactic or conventional radiotherapy. In these patients (including 37 women), aged 21-77 yr. (45.7 +/- 13.3), GH concentrations ranged from 2-260 microg/L (38.6 +/- 44.3), and IGF I from 86-967% of age-matched upper limit of normal (303 +/- 164). Maximal diameter of the adenoma at MRI was 11-36.5 mm (20.4 +/- 6.5), with cavernous sinus involvement in 68% of cases. Three subgroups were defined: 20 patients treated by long-acting somatostatin analogs only (group M), for a mean duration of 3 yr. (extremes 1-7 yr.), 48 patients initially treated by transsphenoidal surgery (group C), of whom 21 were secondarily treated by long-acting somatostatin analogs (group CM) for a mean duration of 1.2 yr. (extremes 0.2-2 yr.). All 3 groups were not statistically different in terms of tumor mass and initial levels of GH and IGF-1. Patients from group M were significantly older than those of the other groups (p<0.05). RESULTS: 46% of patients from group C after surgery vs. 45% of patients from group M had a mean GH below 2.5 microg/L. Biochemical remission (GH<2.5 microg/L and normal IGF1 normal) was obtained in 31% of cases in group C, vs. 25% in group M. In this group, a decrease of the largest tumor diameter was observed in 10 patients (71.5%), ranging from 10-25% in 7 (50%) and exceeded 50% in 3 (21.5%). In group CM, the biochemical remission rate (42%) and final GH or IGF1 values were not significantly different from group M. In conclusion, these data suggest that surgery or long-acting somatostatin analogs have a comparable efficacy in terms of remission rates in somatotroph macroadenomas with extrasellar extensions. [less ▲]

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See detailA comparison of the training value of two types of anesthesia simulators: Computer screen-based and mannequin-based simulators
Nyssen, Anne-Sophie ULg; Larbuisson, Robert ULg; Janssens, Marc ULg et al

in Anesthesia and Analgesia (2002), 94(6), 1560-1565

In this study, we compared two different training simulators (the computer screen-based simulator versus the full-scale simulator) with respect to training effectiveness in anesthesia residents ... [more ▼]

In this study, we compared two different training simulators (the computer screen-based simulator versus the full-scale simulator) with respect to training effectiveness in anesthesia residents. Participants were evaluated in the management of a simulated preprogrammed scenario of anaphylactic shock using two variables: treatment score and diagnosis time. Our results showed that simulators can contribute significantly to the improvement of performance but that learning in treating simulated crisis situations such as anaphylactic shock did not significantly vary between full-scale and computer screen-based simulators. Consequently, the initial decision on whether to use a full-scale or computer screen-based training simulator should be made on the basis of cost and learning objectives rather than on the basis of technical or fidelity criteria. Our results support the contention that screen-based simulators are good devices to acquire technical skills of crisis management. Mannequin-based simulators would probably provide better training for behavioral aspects of crisis management, such as communication, leadership, and interpersonal conflicts, but this was not tested in the current study. IMPLICATIONS: We compared two different training simulators (computer screen-based versus full-scale) for training anesthesia residents to better document the effectiveness of such devices as training tools. This is an important issue, given the extensive use and the high cost of mannequin-based simulators in anesthesiology. [less ▲]

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See detailManagement of Difficult Intubation
Janssens, Marc ULg; Hartstein, Gary ULg

in European Journal of Anaesthesiology (2001), 18(1), 3-12

Appropriate airway management is an essential part of the anaesthetist's role. Difficult intubation, which can now be quantified using the 'Intubation Difficulty Scale', should be anticipated whenever ... [more ▼]

Appropriate airway management is an essential part of the anaesthetist's role. Difficult intubation, which can now be quantified using the 'Intubation Difficulty Scale', should be anticipated whenever possible. A strategy needs to be developed in order to anticipate problems. The first part of this paper reviews the different factors that contribute to make intubation and/or ventilation difficult. Problems with intubation (or ventilation of the lungs) can be caused by abnormal laryngeal structures (e.g. tumour, stenosis), or by difficulty in seeing the glottis. The clinical history will usually help identify the former problem, while physical examination of the airway is required to reveal either disproportion between the various structures of the airway (e.g. tongue, larynx), and/or difficulties in aligning the oral, pharyngeal, and laryngeal axes. The different techniques used to diagnose these problems are described. The second part of this paper summarizes the algorithms used by the anaesthetist when management of the airway is found difficult. Three situations are considered: (a) anticipated difficult intubation, for which awake fibreoptic intubation would appear to be the technique of choice in the majority of cases, (b) unforeseen difficult intubation in a patient whose lungs can be ventilated; here, various techniques for control of the airway will be briefly described, and (c) both tracheal intubation and lung ventilation are impossible; this is a life-threatening emergency, for which three solutions are proposed. These include use of the laryngeal mask airway, the Combitube, or transtracheal ventilation. These situations will be analysed with the aim of proposing management strategies that always guarantee the safety of the patient. [less ▲]

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See detailPrincipes et intérêts du simulateur en anesthésie-réanimation
Larbuisson, Robert ULg; Nyssen, Anne-Sophie ULg; Janssens, Marc ULg et al

in Praticien en Anesthésie Réanimation (Le) (2001), 5(4), 225

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See detailUse of Anaesthesia Simulator: Initial Impressions of Its Use in Two Belgian University Centers
Larbuisson, Robert ULg; Pendeville, P.; Nyssen, Anne-Sophie ULg et al

in Acta Anaesthesiologica Belgica (1999), 50(2), 87-93

459 trainees in Anesthesia and Intensive Care Medicine, accompanied by fully certified specialists from several Belgian University Hospital Centers, spend at least a 3 hour session at the Anaesthesia ... [more ▼]

459 trainees in Anesthesia and Intensive Care Medicine, accompanied by fully certified specialists from several Belgian University Hospital Centers, spend at least a 3 hour session at the Anaesthesia Simulator. Each session comprises three segments: the briefing, the simulation session and the debriefing. The use of simulations allows significant individualization of the learning experience. The simulator helps to develop the capacity to understand, explain a phenomenon and to resolve problems. Another important aspect of the use of the simulator involves the trainee's "right to make mistakes". This allows to widen the spectrum of executional situations, and decreases the number of dangerous situations. Two University Centers (ULg and UCL) have each organized simulator sessions despite some differences in their approaches. The simulator is a teaching tool worthy of an obligatory role in the most up-to-date training possible of modern anesthesiologist. This is all the more important given that the current practice of anesthesiology is so complex that any error could cost a human life. [less ▲]

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See detailTreatment of Excessive Mediastinal Bleeding after Cardiopulmonary Bypass
Hartstein, Gary ULg; Janssens, Marc ULg

in Annals of Thoracic Surgery (1996), 62(6), 1951-4

BACKGROUND: Excessive mediastinal bleeding after cardiopulmonary bypass is one of the most frequently reported complications of cardiac operations. Appropriate treatment requires a rapid and effective ... [more ▼]

BACKGROUND: Excessive mediastinal bleeding after cardiopulmonary bypass is one of the most frequently reported complications of cardiac operations. Appropriate treatment requires a rapid and effective diagnostic work-up, based on the knowledge of the pathophysiology induced by cardiopulmonary bypass. METHODS: Possible causes, diagnostic methods available, and therapeutic approaches are reviewed in the light of the literature published on excessive bleeding after cardiac operations. RESULTS: When bleeding is massive (> 250 to 300 mL/h for the first 2 hours, > 150 mL/h thereafter), immediate surgical reexploration is mandatory. When bleeding is less important (50 to 150 mL/h), the decision to reoperate should be based on the presence of hemodynamic compromise or a suspected surgical cause. Otherwise, coagulation testing should allow the correction of hemostatic defects as appropriate with protamine, platelet concentrates, fresh frozen plasma, desmopressin, or antifibrinolytics. Hypothermia and hypotension should be corrected and a trial of positive end-expiratory pressure may be considered if diffuse mediastinal oozing (especially from the bed of the mammary artery) is suspected. CONCLUSIONS: A protocol is suggested to guide treatment, taking into account the rapidity of blood loss and the suspected underlying cause. [less ▲]

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See detailReduction in Requirements for Allogeneic Blood Products: Pharmacologic Methods
Janssens, Marc ULg; Hartstein, Gary ULg; David, Jean-Louis ULg

in Annals of Thoracic Surgery (1996), 62(6), 1944-50

BACKGROUND: Numerous articles describe the reduction of perioperative bleeding by the therapeutic or prophylactic administration of drugs such as prostacyclin, desmopressin, and natural or synthetic ... [more ▼]

BACKGROUND: Numerous articles describe the reduction of perioperative bleeding by the therapeutic or prophylactic administration of drugs such as prostacyclin, desmopressin, and natural or synthetic antifibrinolytics. METHODS: A review of the literature was carried out to help the reader define the indications of these drugs during cardiopulmonary bypass operations, highlight the questions that remain concerning their indications and modes of action, and suggest future studies to answer these remaining questions. RESULTS: Prostacyclin reduces platelet trauma induced by extracorporeal circulation but does not effectively reduce postoperative bleeding and transfusion requirements. Desmopressin acts as a "glue," improving platelet adhesion, and may be effective when postoperative bleeding is excessive, but its routine use in cardiac operations cannot be recommended. Natural and synthetic antifibrinolytics inhibit plasmin and plasmin-induced platelet dysfunction. These agents have been shown to decrease bleeding and the need for allogeneic transfusions after open heart operations. However, with antifibrinolytic drugs, the risk of thromboembolic phenomena cannot be neglected. With aprotinin, this risk appears to be minimal when the drug is used at concentrations high enough to inhibit plasma kallikrein also. CONCLUSIONS: Prophylactic antifibrinolytics are efficacious, but their routine use remains controversial, both for economic reasons and for fear of thromboembolic complications. [less ▲]

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See detailPlace de l'érythropoiétine recombinante en période périopératoire
Janssens, Marc ULg; Lamy, Maurice ULg

in Annales Françaises d'Anesthésie et de Réanimation (1995), 14(Suppl 1), 98-106

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See detailHigh-dose aprotinin reduces blood loss in patients undergoing total hip replacement surgery
Janssens, Marc ULg; Joris, Jean ULg; David, Jean-Louis et al

in Anesthesiology (1994), 80

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See detailIs aprotinin worth the risk in total hip replacement?
Janssens, Marc ULg; Joris, Jean ULg

in Anesthesiology (1994), 81(2), 518-519

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See detailLaryngeal Mask
Janssens, Marc ULg; Lamy, Maurice ULg

in Intensive Care World (1993), 10(2), 99-102

The laryngeal mask, provides a totally patent airway when positioned in the hypopharynx with remarkable patient tolerance, even at very light planes of sedation. The major advantages of the laryngeal mask ... [more ▼]

The laryngeal mask, provides a totally patent airway when positioned in the hypopharynx with remarkable patient tolerance, even at very light planes of sedation. The major advantages of the laryngeal mask are its ease of insertion, the absence of contact with the vocal cards, and the fact that it frees the hands of the anesthesiologist. Contraindications to its use result from its failure to seal the airway against regurgitation of gastric content. Laryngeal masks can be used easily instead of facial masks during anesthesia with spontaneous ventilation and, with experience, can be used for longer procedures using controlled ventilation. Suspected difficult intubation and establishment of a patent airway in emergency conditions are good indications for the use of this device. The laryngeal mask does not replace endotracheal intubation. It can, however, permit better management of the airway while waiting for personnel trained in endotracheal intubation. The nature of the pulmonary pathology seen in intensive care patients limits use of the laryngeal mask during intensive care. In the operating room few complications have been described, and postoperative discomfort is minimal. The laryngeal mask is a device positioned in the hypopharynx which allows separation of the digestive tract from the airway, without violation of either the larynx or the upper oesophageal sphincter. An endotracheal tube, because of its positioning, hinders normal glottic movement and narrows the airway.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]

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