Autre cause de mort subite du nourrisson: à propos d’un cas clinique de syndrome du QT long congenital

Le syndrome du QT long congénital est une maladie rythmique liée à une mutation génétique et caractérisée par un espace QT allongé sur l'électrocardiogramme, des arythmies malignes type torsade de pointe et  fibrillation ventriculaire entraînant une mort subite. Les gènes impliqués dans ces mutations codent pour des sous unités des canaux ioniques responsables de l'activité électrique cardiaque. Le diagnostic est basé sur l'électrocardiogramme, une enquête familiale et l'étude génétique. Le traitement repose sur les  bêtabloquants, la sympathectomie et le stimulateur cardiaque. Nous rapportons le cas d'un nourrisson de 2 ans retrouvé en état de mort apparente. Nous discutons de sa prise en charge initiale, de l'enquête familiale et de son suivi ultérieur.Key words: Syndrome du QT long, canalopathie rythmique, mort subit

Pre-hospital management protocols and perceived difficulty in diagnosing acute heart failure

Aim To illustrate the pre-hospital management arsenals and protocols in different EMS units, and to estimate the perceived difficulty of diagnosing suspected acute heart failure (AHF) compared with other common pre-hospital conditions. Methods and results A multinational survey included 104 emergency medical service (EMS) regions from 18 countries. Diagnostic and therapeutic arsenals related to AHF management were reported for each type of EMS unit. The prevalence and contents of management protocols for common medical conditions treated pre-hospitally was collected. The perceived difficulty of diagnosing AHF and other medical conditions by emergency medical dispatchers and EMS personnel was interrogated. Ultrasound devices and point-of-care testing were available in advanced life support and helicopter EMS units in fewer than 25% of EMS regions. AHF protocols were present in 80.8% of regions. Protocols for ST-elevation myocardial infarction, chest pain, and dyspnoea were present in 95.2, 80.8, and 76.0% of EMS regions, respectively. Protocolized diagnostic actions for AHF management included 12-lead electrocardiogram (92.1% of regions), ultrasound examination (16.0%), and point-of-care testings for troponin and BNP (6.0 and 3.5%). Therapeutic actions included supplementary oxygen (93.2%), non-invasive ventilation (80.7%), intravenous furosemide, opiates, nitroglycerine (69.0, 68.6, and 57.0%), and intubation 71.5%. Diagnosing suspected AHF was considered easy to moderate by EMS personnel and moderate to difficult by emergency medical dispatchers (without significant differences between de novo and decompensated heart failure). In both settings, diagnosis of suspected AHF was considered easier than pulmonary embolism and more difficult than ST-elevation myocardial infarction, asthma, and stroke. Conclusions The prevalence of AHF protocols is rather high but the contents seem to vary. Difficulty of diagnosing suspected AHF seems to be moderate compared with other pre-hospital conditions

Bulk micromegas detectors for large TPC applications

A large volume TPC will be used in the near future in a variety of experiments including T2K. The bulk Micromegas detector for this TPC is built using a novel production technique particularly suited for compact and robust low mass detectors. The capability to pave a large surface with a simple mounting solution and small dead space between modules is of particular interest for these applications. We have built several large bulk Micromegas detectors (27 x 26 cm2) and we have tested them in the former HARP field cage setup with a magnetic field. Cosmic ray data have been acquired in a variety of experimental conditions. Good detector performances and space point resolution have been achieved

Time projection chambers for the T2K near detectors

The T2K experiment is designed to study neutrino oscillation properties by directing a high intensity neutrino beam produced at J-PARC in Tokai, Japan, towards the large Super-Kamiokande detector located 295 km away, in Kamioka, Japan. The experiment includes a sophisticated near detector complex, 280 m downstream of the neutrino production target in order to measure the properties of the neutrino beam and to better understand neutrino interactions at the energy scale below a few GeV. A key element of the near detectors is the ND280 tracker, consisting of two active scintillator-bar target systems surrounded by three large time projection chambers (TPCs) for charged particle tracking. The data collected with the tracker is used to study charged current neutrino interaction rates and kinematics prior to oscillation, in order to reduce uncertainties in the oscillation measurements by the far detector. The tracker is surrounded by the former UA1/Nomad dipole magnet and the TPCs measure the charges, momenta, and particle types of charged particles passing through them. Novel features of the TPC design include its rectangular box layout constructed from composite panels, the use of bulk micromegas detectors for gas amplification, electronics readout based on a new ASIC, and a photoelectron calibration system. This paper describes the design and construction of the TPCs, the micromegas modules, the readout electronics, the gas handling system, and shows the performance of the TPCs as deduced from measurements with particle beams, cosmic rays, and the calibration system

EuReCa ONE—27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe

AbstractIntroductionThe aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.MethodsThis was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries.ResultsData on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge.ConclusionThe results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe.EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events

Médecine aiguë

SYL-8208 = Volume 1 ;SYL-8207 = Volume 2 ;SYL-8206 = Volume 3 ;SYL-8205 = Volume 4 ;SYL-8204 = Volume 5 ;SYL-8203 = Volume 6 ;SYL-8202 = Volume 7Volume 1 :Polytrauma -- Volume 2 :L'arrêt cardiaque chez l'adulte, l'arrêt cardiaque chez l'enfant, le bébé et le nouveau né -- Volume 3 :Prise en charge d'un patient dyspnéique -- Volume 4 :Prise en charge des douleurs thoraciques -- Volume 5 :Fièvre aux urgences -- Volume 6 :Pédiatrie aiguë - Volume 7 :Vertiges, lipothymies, syncopes, autres urgences cardio-vasculairesSAMUL, SAMUM (formation de deux ans) - EXTE000info:eu-repo/semantics/published

Thérapies non médicamenteuses, détresse psychologique et situations d'exception

SCOPUS: ed.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Contribution à l'étude de la fonction cardiaque droite dans la bronchopneumopathie chronique obstructive sévère

Doctorat en sciences médicalesinfo:eu-repo/semantics/nonPublishe

Médecine aiguë

SYL-002817 = Volume 1 ;SYL-002869 = Volume 2 ;SYL-002870 = Volume 3 ;SYL-002871 = Volume 4 ;SYL-002872 = Volume 5 ;SYL-002873 :Volume 6 ;SYL-002874 = Volume 7Volume 1 :Ethique et économie de la santé - Toxicologie -- Volume 2 :Pédiatrie. Arrêt cardiorespiratoire. Médecine de catastrophe -- Volume 3 :Urgences cardiovasculaires. Polytrauma. Petite chirurgie -- Volume 4 :Urgences neurologiques, pneumologiques, métaboliques -- Volume 5 :Infectiologie. Urgences spécialités -- Volume 6 :Pédiatrie aiguë -- Volume 7 :Vertiges, lipothymies, syncopes. Autres urgences cardio-vasculairesv.1-5 :2e édition 2000-01/1 ;v.6-7 :2e édition 2002-03/1SAMUL, SAMUMEXTE000info:eu-repo/semantics/published

Médecine aiguë

SYL-8475 = Volume 7 ;SYL-8473 = Volume 8 ;SYL-8476 = Volume 9 ;SYL-8474 = Volume 10 ;SYL-8428 = Volumes 12 et 13 ;SYL-8426 = Volume 14 ;SYL-8427 = Volume 15 ;SYL-8850 = Volume 17Volume 7 :Vertiges, lipothymies, syncopes, Autres urgences cardio-vasculaires -- Volume 8 :Neurologie aiguë ;Volume 9 :Etat confusionnels aigus. Urgences psychiatriques autres. Toxicologie -- Volume 10 :Abdomen aigu -- Volume 12 et 13 :les chocs, Urgences ophtalmologiques, Urgences obstétricales et gynécologiques -- Volume 14 :Pathologies ostéo-articulaires aiguës -- Volume 15 :Pathologies de l'environnement, Gestion de la douleur -- Volume 17 :Certificat de compétence en médecine aiguë pédiatriqueSAMUL, SAMUM (formation de deux ans) - EXTE000info:eu-repo/semantics/published