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Gilbert A, Piazza J, Szecel J, Ancion A, Gensburger M, Lopez R, D'Orio V, Ghuysen A. [Management of emergency department inflows during the COVID-19 outbreak in the CHU of Liege : efficiency of an advanced triage center]. Rev Med Liege 2020; 75:11-17. [PMID: 33211417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
UNLABELLED In March 2020, the COVID-19 pandemic started to spread among the Belgian territory. Our university hospital was confronted to the very need of specific reorganizations guided by the implementation of the Hospital Emergency Plan.This article aims to describe the experience of the University Hospital of Liège (CHU Liège) during the COVID-19 outbreak and demonstrates the efficiency of advanced triage centers to regulate hospital admissions from the emergency department (ED). METHODS since the beginning of March 2020, the CHU of Liège has implemented specific advanced triage centers to manage patients with SARS-CoV-2 suspected symptoms. The first center was organized inside the hospital but the need of outside structures led to the creation of two centers by the end of March. From March 2 to May 3, data from the different visits at the COVID-19 centers were collected (numbers of admissions, rationale for coming, work up and outcome). RESULTS during the study period, 3,094 patients were admitted to the specific COVID-19 centers of the CHU Liège. This represents 3,431 visits among which 337 were classified as readmission visits. The sensitivity and specificity of the triage centers to determine the need for hospitalization were, respectively, estimated at 87,9 % and 93,4 %. CONCLUSION our experience tends to demonstrate the role of specific COVID-19 triage centers located very close to the EDs aimed at managing COVID-19 suspected patients in order to actually determine their need for subsequent hospitalization.
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Affiliation(s)
- A Gilbert
- Service des Urgences, CHU Liège, Belgique
| | - J Piazza
- Service des Urgences, CHU Liège, Belgique
| | - J Szecel
- Service des Urgences, CHU Liège, Belgique
| | - A Ancion
- Service des Urgences, CHU Liège, Belgique
| | | | - R Lopez
- Service des Urgences, CHU Liège, Belgique
| | - V D'Orio
- Service des Urgences, CHU Liège, Belgique
| | - A Ghuysen
- Service des Urgences, CHU Liège, Belgique
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Gensburger M, Ghuysen A. [Pharmacotherapy of most severe forms of alcohol withdrawal]. Rev Med Liege 2019; 74:365-372. [PMID: 31206282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Acute alcohol withdrawal is a frequent medical condition among hospitalized patients. Severe forms are associated with significant morbidity and mortality, which can be sharply reduced with proper drug therapy. A good understanding of the pathophysiology as well as the pharmacokinetic and pharmacodynamic properties of the various drug used is paramount. The medications must target the imbalance between inhibitory and excitatory neurotransmitter systems responsible for the clinical picture. Proper drug therapy allows not only rapid symptomatic relief but also limit disease progression and complications while diminishing resource use, notably invasive ventilation and stay duration in the intensive care unit. GABA agonist drugs are the first line treatment, notably benzodiazepines and barbiturates. Other class, such as alpha-2 adrenoreceptor agonists may be used to control the dysautonomic features of the disease but are at best adjunctive.
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Affiliation(s)
| | - A Ghuysen
- Service des Urgences, CHU Liège, Belgique
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Henrard G, Froidcoeur X, Schoffeniels C, Gensburger M, Joly L, Dumont V. [Echography at the point of care : stethoscope of the future for the General Practitioner ?]. Rev Med Liege 2017; 72:181-186. [PMID: 28471549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Ultrasound is presently emerging not only as a specialist-delegated diagnostic procedure, but also as a tool used by clinicians for guiding decision. If this paradigm shift has taken roots in places like emergency departments, initiatives are also set up here and there in general practice. The aim of this article is , through a literature review, to identify possible indications of ultrasound performed by the general practitioner and to initiate a discussion about the obstacles and opportunities associated with its introduction in Belgian General Practice settings.
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Affiliation(s)
- G Henrard
- Département de Médecine générale, ULg, CHU de Liège, Site Sart Tilman, Liège, Belgique
- Maison Médicale St-Léonard, Liège, Belgique
| | - X Froidcoeur
- Département de Médecine générale, ULg, CHU de Liège, Site Sart Tilman, Liège, Belgique
| | | | - M Gensburger
- Services des Urgences, CHU de Liège, Site Sart Tilman, Liège, Belgique
| | - L Joly
- Maison Médicale l'Herma, Liège, Belgique
| | - V Dumont
- Département de Médecine générale, ULg, CHU de Liège, Site Sart Tilman, Liège, Belgique
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Cuppens B, Gensburger M, Tonglet M, Marissiaux L, Brasseur E, d'Orio V, Ghuysen A. [Diagnosis of cannabinoid hyperemesis : update on the cannabis-shower syndrome]. Rev Med Liege 2016; 71:541-545. [PMID: 28387093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Sometimes, the emergency department is confronted with cases of repetitive vomiting and abdominal pain without organic causes. These patients come back again and again for this problem. All diagnostic tests are systematically negative. A well conducted history taking reveals a chronic cannabis addiction and the disappearance of symptomatology by taking hot showers. This presentation is pathognomonic of the cannabinoid hyperemesis syndrome.
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Affiliation(s)
- B Cuppens
- Service des Urgences, CHU Liège, Site du Sart Tilman, 4000 Liège, Belgique
| | - M Gensburger
- Service des Urgences, CHU Liège, Site du Sart Tilman, 4000 Liège, Belgique
| | - M Tonglet
- Service des Urgences, CHU Liège, Site du Sart Tilman, 4000 Liège, Belgique
| | - L Marissiaux
- Service des Urgences, CHU Liège, Site du Sart Tilman, 4000 Liège, Belgique
| | - E Brasseur
- Service des Urgences, CHU Liège, Site du Sart Tilman, 4000 Liège, Belgique
| | - V d'Orio
- Service des Urgences, CHU Liège, Site du Sart Tilman, 4000 Liège, Belgique
| | - A Ghuysen
- Service des Urgences, CHU Liège, Site du Sart Tilman, 4000 Liège, Belgique
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De Voeght A, Sauvage AS, Gensburger M, Giot JB, Moutschen M. [Miliary tuberculosis in a patient under adalimumab]. Rev Med Liege 2016; 71:328-331. [PMID: 28383840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We describe a case of atypical miliary tuberculosis diagnosed by molecular testing in a patient suffering from psoriasis arthritis treated by adalimumab. Tuberculosis may have a non-classical presentation in patients under biological treatments. We briefly discuss the difficulties underlying the diagnosis and treatment of tuberculosis, especially in patients suffering from fever of unknown origin.
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Affiliation(s)
| | - A-S Sauvage
- Service d'Infectiologie et Médecine Interne, CHU de Liège, Site Sart Tilman, 4000 Liège, Belgique
| | - M Gensburger
- Service des Urgences, CHU de Liège, Site Sart Tilman, 4000 Liège, Belgique
| | - J-B Giot
- Service d'Infectiologie et Médecine Interne, CHU de Liège, Site Sart Tilman, 4000 Liège, Belgique
| | - M Moutschen
- Service d'Infectiologie et Médecine Interne, CHU de Liège, Site Sart Tilman, 4000 Liège, Belgique
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Marissiaux L, Gensburger M, Tromba A, Duysinx B, Meunier P, D'Orio V, Ghuysen A. [Point-of-care ultrasound in emergency department : a case report of acute dyspnea during pregnancy]. Rev Med Liege 2016; 71:349-355. [PMID: 28383844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
On the basis of the case report of a pregnant woman with acute pleuritis, this article describes the diagnostic modalities of dyspnea during pregnancy. The utility and effectiveness of bedside ultrasound examination by the emergency physician («POCUS») are reviewed in view of recent literature data. The ultrasound in this case is considered to be the extension of physical examination aiming at providing answers with immediate clinical relevance.
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Affiliation(s)
| | | | - A Tromba
- Clinique Saint-Joseph, Arlon, Belgique
| | - B Duysinx
- Service de Pneumologie, CHU de Liège, Belgique
| | - P Meunier
- Service de Radiodiagnostic, CHU de Liège, Belgique
| | - V D'Orio
- Service des Urgences, CHU de Liège, Belgique
| | - A Ghuysen
- Service des Urgences, CHU de Liège, Belgique
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Taupin T, Ltaief Boudrigua A, Baggio E, Gensburger M, Pialat J. Erratum de l’article : « Comparaison de la dacryoIRM 3 T par instillation au dacryoscanner dans le cadre du larmoiement chronique » [J. Fr. Ophtalmol. 37 (2014) 526–34]. J Fr Ophtalmol 2014. [DOI: 10.1016/j.jfo.2014.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Taupin T, Ltaief Boudrigua A, Taief Boudrigua Aicha L, Baggio E, Gensburger M, Pialat JB. [Comparison of 3T dacryo-MRI by instillation with dacryo-CT scan for evaluation of epiphora]. J Fr Ophtalmol 2014; 37:526-34. [PMID: 24972894 DOI: 10.1016/j.jfo.2014.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 02/01/2014] [Accepted: 03/07/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Epiphora is frequently related to stenosis of the lacrimal drainage pathways. In the evaluation of stenosis, dacryo-CT scan remains the gold standard, despite the need for radiation and catheterization of the lacrimal passages. Evaluation by high field 3T MRI compared to the gold standard in the morphological study of the lacrimal passages and quantification of the stenosis is attractive considering the lack of radiation and non-invasive nature of the technique. METHODS Twenty-four patients were included, including 9 with bilateral epiphora, representing 33 pathological drainage systems out of 48. Twenty-three drainage systems underwent subsequent surgery (18 patients, 5 patients bilaterally). RESULTS The average diameter on CT scan images of the superior canaliculus was 0.70 mm (± 0.46), of the inferior canaliculus 0.69 (±0.42), the common canaliculus 0.68 (± 0.58), the lacrimal sac 4.32 (± 2.10), and the nasolacrimal duct 1.15 mm (±1.42). 3T dacryo-MRI overestimated the diameters by 0.35 to 1mm (up to 20 % of the lacrimal sac size), and the concordance between dacryo-CT scan and 3T dacryo-MRI was of average value (kappa 0.5, P<0.05) concerning the diagnosis of stenosis. Furthermore, dacryo-CT scan demonstrated higher sensitivity (72.7 %) than 3T dacryo-MRI (42.4 %). CONCLUSIONS The two techniques are not equivalent in the diagnosis of stenosis. An optimization of protocols and an evaluation on a larger cohort remain necessary before dacryo-CT scan can be replaced by dacryo-MRI in routine practice.
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Affiliation(s)
- T Taupin
- Service de radiologie, centre Léon-Bérard, FNCLCC, 28, promenade Léa-et-Napoléon-Bullukian, 69373 Lyon, France.
| | | | - L Taief Boudrigua Aicha
- Service de radiologie ostéo-articulaire et neurologique, pavillon B, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69437 Lyon, France
| | - E Baggio
- Centre ophtalmologique Kleber, 50, cours Franklin-Roosevelt, 69006 Lyon, France
| | - M Gensburger
- Service d'ophtalmologie, centre hospitalier Lyon-Sud, 130, rue Jules-Guesde, 69495 Pierre-Bénite cedex, France
| | - J B Pialat
- Service de radiologie ostéo-articulaire et neurologique, pavillon B, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69437 Lyon, France
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Bertrand X, Gensburger M, Steckx E. [Mephedrone]. Rev Med Liege 2011; 66:540-544. [PMID: 22141261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Mephedrone is a designer drug recently appeared on the belgian market of the drugs of misuse. The aim of this journal paper is to provide a review on the available data about mephedrone and to call the attention of the first line practitioners who will have to face this emerging problem.
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Affiliation(s)
- X Bertrand
- Service des Urgences, CHR Liège, Belgique.
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Germay C, Brasseur E, Gensburger M, Lewin M, D'Orio V. [Image of the month. Thoracic variant of the Chance fracture]. Rev Med Liege 2011; 66:409-410. [PMID: 21942073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- C Germay
- Chef de Clinique, Service des Urgences CHU de Liège
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Perignon S, Cornut P, Janin H, Gensburger M, Denis P, Burillon C. 292 Œdipisme (auto-énucléation) bilatéral non concomitant : à propos d’un cas. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80104-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
We report the case of a patient with a unilateral chorioretinal lesion that evolved over 35 years before enucleation provided the diagnosis of amelanotic choroidal melanoma. This case is quite unusual in regards the long-term follow-up of this tumor before treatments were initiated. The patient showed no evidence of locoregional failure or distant metastasis at 30 months of follow-up.
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Affiliation(s)
- M Gensburger
- Clinique Ophtalmologique Universitaire, Hôpital de la Croix Rousse, Lyon, France
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