Revue médicale de Bruxelles
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To measure waiting time delays of patients and to evaluate if the waiting time before the first physician contact is inversely correlated to the illness severity. During the period of 26/02/2007 through 3/03/2007, we prospectively studied the waiting times before the first contact with a physician (WTP) and the length of stay (LS) in 473 patients (0.8% of the annual patient volume) evaluated in our emergency department, which has a physician triage model. The WTP was correlated to a severity score "Clinical Classification of Patients in Emergency (CCPE)". ⋯ The median LS was 119 (76-186) min. In conclusion, the waiting times are comparable to those measured in similar studies. The waiting time evaluated according to CCPE is adequate.
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Therapeutic hypothermia is an essential step for the neurological protection of comatose individuals after cardiorespiratory arrest (CA) and ventricular fibrillation (VF). The evaluation of the application of the Protocol thereto within the C.H.U. Saint-Pierre (SPH) is the subject of this study. ⋯ The results of the protocol application are superior to those of several other studies. Few errors of inclusion and exclusion are present. The implementing of a common protocol for IC--Emergency Units--EMS to accelerate obtaining the target temperature and improve performance seems beneficial. The creation and implementation of a specific register with patients who had AC and were cooled seem interesting for a better medical follow-up, an assessment of the management and an enhancement of the current knowledge related to this technique.
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Continuous sedation is an acknowledged medical practice in the management of refractory symptoms at the end of life. Guidelines and recommendations have been proposed in palliative care. This paper presents the state-of-the-art (definitions, indications, technical aspects) on continuous sedation followed by an ethical reflection essentially based on the "double effect" principle, on the impact on life expectancy and the assimilation of continuous sedation as a "natural death". Distinction between continuous sedation and legal euthanasia is clarified.
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Diabetic muscle infarction is a rare and often unrecognized complication of diabetes. It typically occurs in patients with poorly controlled and multi-complicated diabetes. Typical clinical presentation is an indurate muscle pain, mainly localized in the lower limb with an acute onset. ⋯ Elevation of muscle enzymes (CPK) is present in half of cases. Management is conservative and the clinical and imaging evolution is usually favourable. We report the case of a patient presenting a subacute hyperalgesic lomboradiculopathy.
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The objective of this paper is to review the literature published in 2011 in the field of intensive care and emergency related to oncology. Are discussed because of new original publications: prognosis, resuscitation techniques, oncologic emergencies, serious toxicities of cytotoxic chemotherapy and targeted therapies, complicated aplastic anemia, toxicity of bisphosphonates, respiratory complications, pulmonary embolism and neurological complications.