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Azongmo M, Zhu L, Lorenzo-Villalba N, Cardos B, Yerna M, Ali D. [A particular state of shock: spontaneous rupture of a heterotopic pregnancy]. Rev Med Liege 2023; 78:21-23. [PMID: 36634062] [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] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Heterotopic pregnancy is a rare pathology. It is defined as the coexistence of an intrauterine pregnancy and an extrauterine pregnancy, whatever its location. The presence of an intrauterine pregnancy in a woman of childbearing age does not therefore exclude the presence of an associated ectopic pregnancy. Late diagnosis can lead to fatal consequences for the mother, subsequent fertility as well as for the intrauterine pregnancy. We report the case of a 28-year old female patient, without any notion of assisted reproduction, who was admitted to the emergency department for hemorrhagic shock. The diagnosis of ruptured tubal heterotopic pregnancy was made intraoperatively.
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Affiliation(s)
- M Azongmo
- Service des Urgences, CHU Liège, Belgique
| | - L Zhu
- Service des Urgences, Hôpital de Jolimont, La Louvière, Belgique
| | - N Lorenzo-Villalba
- Service de Médecine Interne, Diabète et Maladies métaboliques, Hôpitaux Universitaires de Strasbourg, France
| | - B Cardos
- Département des Sciences de la Santé publique, ULiège, Belgique
| | - M Yerna
- Service des Urgences, CHC MontLégia, Liège, Belgique
| | - D Ali
- Service des Urgences, CHC MontLégia, Liège, Belgique
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2
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Stilmant AC, Zhu L, Gorur Y, Cardos B, Yerna M, Ali D. [Fatal serotonin syndrome induced by ecstasy consumption]. Rev Med Liege 2022; 77:8-12. [PMID: 35029334] [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: 06/14/2023]
Abstract
The use of amphetamines and amphetamine derivatives such as ecstasy can cause serotonin toxic syndrome, an uncommon but potentially serious adverse effect. Although most of the reported cases evolve spontaneously and favourably, in rare cases, serious complications can occur leading to the death of the patient. We report the case of a 27-year-old man admitted to our emergency department for altered consciousness with hyperthermia at 42°C after illicit drug use. The patient developed severe multivisceral failure and disseminated intravascular coagulopathy despite maximalist management focused on cooling and multiorgan supportive therapy. The patient died within hours of admission. The diagnosis is essentially based on the patient history and clinical examination. The first treatment is to stop the toxic and then, to treat the symptoms and support possible organ failures.
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Affiliation(s)
- A C Stilmant
- Service des Urgences, CHC MontLégia, Liège, Belgique
| | - L Zhu
- Service des Urgences, CHU Liège, Belgique
| | - Y Gorur
- Service de Radiologie, Clinique André Renard, Herstal, Belgique
| | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
| | - M Yerna
- ) Service des Urgences, CHC MontLégia, Liège, Belgique
| | - D Ali
- Service des Urgences, CHC MontLégia, Liège, Belgique
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3
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Cagnina A, Michaux S, Ancion A, Cardos B, Damas F, Lancellotti P. [European guidelines for the diagnosis and management of acute pulmonary embolism]. Rev Med Liege 2021; 76:208-215. [PMID: 33682391] [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: 06/12/2023]
Abstract
Pulmonary embolism (PE) is the third cause of cardiovascular death in industrialized countries. The difficulty lies on the diagnosis and is linked to the clinical pre-sentation which is often non-specific. The use of diagnostic scores and paraclinical examinations help the clinician in the management and assessment of the risk of death. This article aims to optimize knowledge and management of pulmonary embolism by revising the latest recommendations from the European Society of Cardiology 2019.
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Affiliation(s)
- A Cagnina
- Service de Cardiologie, CHU Liège, Belgique
| | - S Michaux
- Service de Cardiologie, Clinique André Renard, Herstal, Belgique
| | - A Ancion
- Service de Cardiologie, CHU Liège, Belgique
| | - B Cardos
- Service de Cardiologie, Clinique André Renard, Herstal, Belgique
| | - F Damas
- Service de Cardiologie, CHU Liège, Belgique
| | - P Lancellotti
- Faculté de Médecine, ULiège, Service de Cardiologie, GIGA Cardiovasculaire, CHU Liège, Belgique
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4
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Charpentier S, Cardos B. [Non traumatic pneumorrhachis]. Rev Med Liege 2021; 76:142-144. [PMID: 33682380] [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: 06/12/2023]
Abstract
Presence of air in the spinal canal, called pneumorrhachis (PR) is a rare and likely unrecognized condition often due to traumatic or iatrogenic causes. Most of PR occur after repeated epidural ponction or penetrating trauma or brutal intra-alveolar increase especially in asthma attack. Non traumatic and non iatrogenic causes are uncommon but can appear in a neoplastic context.
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Affiliation(s)
- S Charpentier
- Service des Urgences, Clinique André Renard, Herstal, Belgique
| | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
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Nebie A, Ali D, Bosquee L, Gorur Y, Cardos B. [Central nervous system tuberculosis : don't miss the diagnosis !]. Rev Med Liege 2020; 75:703-705. [PMID: 33155442] [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
We are presented a 35-year-old patient with no previous relevant medical history who was admitted to the emergency department for fever, altered mental status and diffuse abdominal pain. Initial evaluation failed to the demonstrated the presence of thoracic or abdominal deep infection. The clinical course was marked by a deterioration of the neurological condition. The cerebral MRI showed diffuse and extensive involvement of the brainstem and cerebellar hemispheres associated with hydrocephalus consistent with tuberculous meningoencephalitis. Antituberculous therapy was started with some delay but no clinical improvement was achieved and the patient died.
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Affiliation(s)
- A Nebie
- Services des Urgences, CHU Liège, Belgique
| | - D Ali
- Services des Urgences, CHU Liège, Belgique
| | - L Bosquee
- Service de Pneumologie, Clinique André Renard, Herstal, Belgique
| | - Y Gorur
- Service de Radiologie, Clinique André Renard, Herstal, Belgique
| | - B Cardos
- Services des Urgences, Clinique André Renard, Herstal, Belgique
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6
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Ali D, Gorur Y, Cardos B. [Complication of a successful cardiopulmonary resuscitation]. Rev Med Liege 2020; 75:565-568. [PMID: 32909405] [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
A case of bilateral extensive subcutaneous emphysema secondary to external cardiac massage is reported. This is a rare complication. It occurs with a pneumothorax after resuscitation maneuvers. The diagnosis is based on a bundle of anamnestic, clinical and radiological arguments. This case demonstrates the importance of performing a simple prehospital thoracostomy on the finger without chest tube placement and demonstrates the need for systematic investigation of possible complications in any patient who has undergone external cardiac massage.
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Affiliation(s)
- D Ali
- Service des Urgences, CHU Liège, Belgique
| | - Y Gorur
- Service d'Imagerie médicale, CHU Liège, Belgique
| | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
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Ali D, Gorur Y, Cardos B. [Postpartum cerebral thrombophlebitis : a diagnosis not to be missed]. Rev Med Liege 2020; 75:529-531. [PMID: 32779905] [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
Cerebral thrombophlebitis is a rare but serious complication of pregnancy and postpartum. This condition is characterized by a misleading symptomatology. It must be systematically discussed in case of the persistence of a headache in the aftermath of childbirth and the diagnosis must be confirmed early with the help of computed tomography and cerebral magnetic resonance. NMR is the reference examination. The treatment is essentially based on anticoagulants. The functional prognosis remains good if the diagnosis is made in time and the treatment is initiated early. We report the case of a young 25-year-old woman who presented postpartum cerebral thrombophlebitis with a late diagnosis. The evolution was marked by severe neurological sequelae. This is why we emphasize the interest of imaging in the early diagnosis of this pathology.
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Affiliation(s)
- D Ali
- Service des Urgences, CHC Saint-Joseph, Liège, Belgique
| | - Y Gorur
- Service de Radiologie, Clinique André Renard, Herstal, Belgique
| | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
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Ali D, Gorur Y, Cardos B. [Mediastinal hydatid cyst]. Rev Med Liege 2019; 74:561-562. [PMID: 31729842] [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: 06/10/2023]
Abstract
Mediastinal hydatid cyst is an exceptional pathology that poses a problem of diagnosis with the other cystic lesions of the mediastinum. Diagnosis is suspected on ultrasound and CT exams and confirmed by surgical findings and histopathological characteristics.
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Affiliation(s)
- D Ali
- Service des Urgences, CHU Liège, Belgique
| | - Y Gorur
- Service de Radiologie, Clinique André Renard, Herstal, Belgique
| | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
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Ali D, Gorur Y, Bosquée L, Cardos B, Lorenzo Villalba N. [Hypoxemic measles pneumonitis in an immunocompetent adult]. Rev Med Liege 2019; 74:499-502. [PMID: 31609551] [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: 06/10/2023]
Abstract
Measles is a highly contagious viral disease and one of the biggest causes of morbidity and mortality in the world. Transmission occurs from person to person through direct contact or by aerosolization of pharyngeal secretions. It can be responsible for severe respiratory and neurological complications. The diagnosis is clinical, confirmed by serology, PCR or culture of the measles virus. Treatment is symptomatic and prevention is based on a well conducted vaccination. In severe cases, the use of vitamin A is recommended by the World Health Organization, at least in chidren. Antivirals (ribavirin) have not been shown to be effective in clinical practice. We present a severe respiratory form of measles, affecting a young immunocompetent adult.
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Affiliation(s)
- D Ali
- Service des Urgences, CHC Saint-Joseph, Liège, Belgique
| | - Y Gorur
- Service d'Imagerie médicale, CHU Liège, Belgique
| | | | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
| | - N Lorenzo Villalba
- Service de Médecine interne, Diabète et Maladies métaboliques, Hôpitaux Universitaires de Strasbourg, France
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Ali D, Cardos B. [Upper extremity deep venous effort thrombosis : management of the Paget-Schroetter syndrome in the emergency department]. Rev Med Liege 2017; 72:432-435. [PMID: 29058833] [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 report a case of upper extremity deep venous effort thrombosis complicating a thoracic outlet syndrome in a 44-year-old patient. The appearance of this complication was sudden. A clinical examination followed by imaging with phlebography leads to a quick diagnosis. Effort thrombosis is a classic example of an entity which, if treated correctly, has minimal long-term sequelae but, if ignored, is associated with significant long-term morbidity. An appropriate medical and interventional care has been implemented as soon as possible. Once primary thrombosis is recognized, catheter-directed thrombolytic therapy is usually successful if initiated early, but often unmasks an underlying problem.
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Affiliation(s)
- D Ali
- Service des Urgences, CHU de liège, site Sart Tilman, 4000 Liège, Belgique
| | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
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11
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Cardos B, Stipulante S, Delfosse AS, D'Orio V, Ghuysen A. [The alert algorithm: why, for whom, how, and when?]. Rev Med Liege 2014; 69 Spec No:19-24. [PMID: 25796793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Phone cardiopulmonary resuscitation (CPR) assists any cardiac arrest witness, previously trained or not, through standardized instructions given by phone. These instructions are intended to guide the bystander in checking for responsiveness, opening the airway and checking for adequate breathing, and to initiate chest compressions in case of apparent death. The "Algorithme Liégeois d'Encadrement à la Réanimation par Té1éphone" (ALERT) is an original phone CPR protocol helping the dispatchers to guide callers during the dispatcher's time window, between the beginning of the call and the Emergency Medical Services (EMS) arrival on scene. Its use has been demonstrated to increase the frequency and performance of bystanders' initial CPR efforts. Such improvement might increase the survival chances of out-of-hospital cardiac arrest victims (OOHCA).
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Cardos B. [Transferrin receptors in immunological response]. Rev Med Liege 1991; 46:216-24. [PMID: 2052816] [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: 12/30/2022]
Affiliation(s)
- B Cardos
- Service d'Histologie, Institut A. Swaen, Université de Liège
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