Quelles sont les pathologies auxquelles s'exposent les alpinistes de l'extrême?
Elisabeth Revol, qui souffre de gelures, est prise en charge à lhôpital de Sallanches (Haute-Savoie), spécialisé en médecine de montagne. — P. DESMAZES.
Sauvée le week-end dernier dans lHimalaya, lalpiniste française Elisabeth Revol a été rapatriée en France mardi. Depuis, elle est soignée pour des gelures dans un hôpital spécialisé de Haute-Savoie.
Comme tout sportif de lextrême, elle encourrait des pathologies liées au froid et à laltitude pouvant être mortelles. Le Dr Frédéric Champly, qui soigne la rescapée, revient sur ces maladies et leurs traitements.
L'aventure, le drame, le sauvetage, et désormais les soins. Depuis son retour en France, mardi soir, Elisabeth Revol, la « rescapée du Nanga Parbat », dans l'Himalaya, est prise en charge par les hôpitaux du Pays du Mont-Blanc, à Sallanches (Haute-Savoie).
Dans cet établissement spécialisé en médecine de montagne, l'alpiniste drômoise de 37 ans est traitée pour de graves gelures aux deux mains et au pied gauche consécutives à son ascension du 9e plus haut sommet du monde.
Mais cette sportive de l'extrême encourait d'autres pathologies liées au froid et à l'altitude.
De l'hypothermie à l'arrêt cardiaque. Chef du pôle urgence de l'hôpital de Sallanches, le Dr Frédéric Champly évoque en premier lieu l'hypothermie, ce refroidissement du corps qui peut être plus ou moins sévère.
Trois stades la caractérisent : elle est jugée légère quand la température du corps se situe entre 35 °C et 32 °C, modérée quand elle est estimée entre 32 °C et 28 °C, et profonde lorsqu'elle descend en dessous de 28 °C.
« La disparition des frissons, qui arrive en dessous de 32 °C, sert d'indicateur aux non-spécialistes, comme aux médecins, pour déterminer le degré de gravité de l'hypothermie », souligne Frédéric Champly.
Lorsque cette dernière n'intervient pas brutalement, comme après une chute dans un lac gelé, le corps peut mettre en place des mécanismes d'acclimatation au froid.
La personne sera « comme au ralenti, aura les yeux dilatés et tiendra des propos incohérents », précise-t-il. Ce sont les symptômes de troubles neurologiques pouvant aller jusqu'au coma.
Dans tous les cas, la prise en charge devra être faite par des spécialistes : l'hypothermie, à son stade le plus sévère, peut provoquer un arrêt cardiaque.
Le problème, relève le spécialiste, c'est que « les thérapies classiques pour relancer le cœur, comme l'utilisation d'adrénaline, par exemple, ne fonctionnent pas immédiatement sur les patients hypothermes. Elles ne seront efficaces qu'une fois le sang réchauffé grâce à une circulation extra-corporelle ».
Un protocole de recherches européen.
Elisabeth Revol, elle, souffre de gelures, soit « un refroidissement progressif et segmentaire des extrémités ». Elles apparaissent sur un terrain hypotherme : « Pour préserver ses organes nobles (cœur, poumons…), le corps ferme la circulation sanguine périphérique, celle au niveau des extrémités (mains et pieds).
N'étant plus vascularisés, les tissus meurent », indique Frédéric Champly. Les médecins doivent alors privilégier le réchauffement du corps avant celui des parties gelées. Dans le traitement des gelures, dont les plus graves peuvent mener à l'amputation, différents dispositifs existent.
Depuis deux ans, les hôpitaux du Pays du Montblanc suivent avec les hôpitaux universitaires de Genève (Suisse) un protocole de recherches européen (Interreg SOS Gelures) visant à « évaluer l'intérêt de l'oxygénothérapie hyperbare dans la prise en charge des gelures sévères ».
L'alpiniste française a pu être incluse dans ce programme de 20 places. Ainsi, chaque jour, « elle est véhiculée jusqu'à Genève pour suivre une séance de trois heures en caisson hyperbare », annonce le Dr Frédéric Champly.
D'autres grands maux peuvent atteindre les alpinistes de haute montagne, comme l'hypoxie (un manque d'oxygénation lié à l'altitude), un œdème pulmonaire et/ou cérébral de haute altitude, le mal aigu des montagnes (qui se manifeste par des maux de tête, des vomissements, etc.).
« Le seul traitement qui vaille est la redescente », insiste Frédéric Champly. Pour ce qui est des hallucinations provoquées par l'altitude, Elisabeth Revol, qui y avait toujours échappé, a confié à l'Agence France Presse en avoir été victime.
Elle a en effet imaginé qu'on venait lui « apporter un thé chaud » et que, « pour remercier, il fallait donner une chaussure ». Elle passera le pied à l'air pendant cinq heures.
. « Sa psychothérapie, elle la suivra en montagne ». Aujourd'hui, l'alpiniste doit récupérer, mais, lors dans son entretien avec l'AFP, elle reconnaissait avoir « besoin » de repartir en montagne. Un discours qui peut paraître étonnant pour le commun des mortels.
La « montagne tueuse », comme est surnommé le Naga Parbat, a gardé avec elle son compagnon de cordée, le Polonais Tomek Mackiewicz.
Or, en 2009, la grimpeuse avait déjà perdu en coéquipier, le Tchèque Martin Minarik, alors qu'elle descendait le massif de l'Annapurna (Népal). « Qu'on se le dise, ces grands alpinistes ont des profils psychologiques particuliers, insiste Frédéric Champly.
Ils sont habités par une passion qui nous dépasse et n'ont pas la même approche de la mort que nous. » Le médecin, qui est en contact direct avec la rescapée, assure que « l'expérience traumatisante qu'elle a vécue l'affecte profondément ».
Mais, il en est certain, « sa psychothérapie, elle la suivra en montagne ».
For more infomation >> Quelles sont les pathologies auxquelles s'exposent les alpinistes de l'extrême? - Duration: 8:44.-------------------------------------------
【MMD】Monster【Zatsune】 - Duration: 1:15.
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What does Passive Income Really Mean? Understanding Passive Income - Duration: 3:40.
So you've been trying to figure out what is this whole thing about passive income
and why is it important for you well in this video I'm gonna answer just that
question coming up hey there it's Billy with KeePon Cashflow helping
you to grow your money and your mindset so you can get to the lifestyle that you
really want to lead faster now on this channel we're going to be sharing weekly
tips and strategy videos just like this so if it's your first time here you're
definitely going to want to consider subscribing to the channel and you also
want to make sure that you check out the links and the comments that are in the
section below that's where all of the great learning starts to happen but as
for today I want to talk to you about what is this whole concept of passive
income and why is it important for you first of all let me start off with a
definition passive income is that income that is created by people and/or
entities where they're not actively involved now let me just highlight
something there I said not actively involved it doesn't mean that they're
not involved and because it's a very big difference and it's actually passive
income is one of the three different types of income that we've talked about
before and it has some special tax treatments that we'll talk to talk to
you about especially at the at the end of the video but let me just give you a
couple of examples first of all you could think about something like a
limited partnership where you are with a number of people and you are part of
that that entity and that can create your investment can create a passive
income for you you can also think about maybe a enterprise venture that's
another type of way where you can place your capital and that is how that
capital is actually creating a residual and I guess at the end of the day one of
the ways that you can think about this is you're not you don't have to actually
exchange your time in order to create a return and one of the best examples that
I can leave you with is one that's really close to my heart and that's
rental properties and you can even think of about it a
couple of different ways because you can actually roll your sleeves up if you
want and really lead the the charge if you will and be responsible for specific
projects or you can decide that you want to just have your money go out and work
for you and that money is actually working and while you are on vacation
it's kind of the way that I like to think about it making sure that my money
is working harder then I am actually working so that's some of the different
ways around passive income and I've even talked about before there are the four
different ways that you can go out within a specific real estate deal to
create this type of passive income and you'll definitely want to make sure that
you speak with your CPA to understand how you can best leverage the the
passive income streams so I want to leave you with a question of the day and
today's question is of the different types of ways to create passive income
which is the most interesting for you and why so I want to watch what your
comments are below and help to continue to interact with you so you can get
closer to your dreams much faster so once again this is Billy with keep on
cashflow as always that's my two cents for today and hasta la próxima
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How READY are YOU - Duration: 0:43.
If you're not ready, if you don't want it bad enough , if you're just coming here
and shopping around, window shopping, yeah, forget about It, OK, you are here, because
you can see yourself where ever you want to see yourself, imagine, start thinking about
it, look it up online, draw it up for yourself, it doesn't have to be a cat-walk body or
a bikini body or whatever, those are all dangling carrots, essentially its you who's going
to have to push, who's going to have to seek out that vision, I can't do it for
you you're going to have to come up with that big vision, you have to see it in your
mind, and then you have to go for it
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Researcher identifiers - Duration: 2:03.
Author identifiers are critical to the research lifecycle. They help you
disambiguate your work and distinguish your research activity, and it helps to
automate processes where instead of you needing to manage your profile, it's done
in an automated and transparent way. Some of the main ones would include
researcher ID and Google Scholar. Those are author identifiers
that researchers tend to use but the university is certainly encouraging all
researchers at UQ to use ORCID and the ORCID ID is like an umbrella that sits
above all of those other author identifiers and helps to in an
automated way collect data from all of the wider range of author
identifiers. Registering author identifiers, ORCID in particular, is very
easy. It's quick and it's fast and it's free. But you do need to get in touch
with your liaison librarian -- they're the network of librarians that help
researchers connect with each other and connect with their own research activity.
Linking your ORCID to the eSpace repository is critical because it helps
the university and you to update your data -- your publications -- in eSpace
in an automated way so when you're claiming in publications if when you
submit to the publisher at time of submission, using your ORCID, that stays
in the metadata and then as the publication comes through and it's
published, you'll find that you won't be asked questions over and over about
whether this is your publication or not. So it streamlines the process for you as the
author, and that will help you to make your work more discoverable to the
research community and for the university to report on your work
after your conferral.
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Peer review - Duration: 2:24.
The question comes out, "How good is your work?" You can't judge, your supervisor
can't judge. So when I heard of the peer review process, I was very scared
and intimidated. But then, to actually participate in it, I have a totally
different experience. So basically the editor will choose a reviewer -- two or
three reviewers for the publication -- and send that manuscript to them. So there
will be a deadline that they will have to meet. They will come up with their
questions and recommendations on how the paper can be improved and after that
there will be three decisions and maybe it will be rejected if there are some serious flaws with
methodology or some misconceptions within the paper. So it
can be rejected, or it can be revised and resubmitted. So after that -- after several
revisions -- hopefully all the criteria will be
met, everything will be addressed, and the paper will be accepted for publication.
My published research will be better, my future research will be better, my thesis
will be better because I've had a whole heap of people absolutely rip my work to
shreds and that really hurts but I know that it makes me a better researcher and
makes my research better underneath. Peer reviewing, according to me, it's like
watching your research through different eyes. I would say it's time-consuming, but
if you follow the comments from the reviewers, I think you will be in good
stead. But again it was just more explanation and ensuring that we
had information that could stand the scrutiny of a reader in terms of the
validity of this research and the rigour that went into it. Peer review is
really important because it is a way of just maintaining quality in the
publications in scholarly publishing.
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Børnenes Udstilling 2018 - Processen - Duration: 5:14.
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Masters of the Universe Grayscale 4 Figure Set | Super7 | Spin-A-jSALEj #1 - Duration: 0:51.
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[ Skeletor, Beast-Man, Mer-Man and He-Man ]
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Film: "Io ho scelto voi..."(Gv.15.16). Soundtrack by Rooves - Duration: 58:24.
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Early Man FULL'MOVIE'2018'HD - Duration: 1:40:28.
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扣扣妹妹搖搖 - Duration: 1:01.
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EJ Carter is Up Next
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Red Wheels On The Bus | Song for kids | Kindergarten Nursery Rhymes for Children by Little Treehouse - Duration: 1:01:16.
The wheels on the bus go round and round..
Round and round,round and round
The wheels on the bus go round and round,
All through the town.
The wipers on the bus go Swish,Swish,swish..
Swish, swish, Swish, swish, .Swish, swish, Swish,
The wipers on the bus go Swish, swish,swish..
All through the town.
The horn on the bus goes Beep, beep beep...
Beep, beep, beep, beep, beep, beep
The horn on the bus goes Beep, beep, beep,
All through the town.
The windows on the bus go up and down,
Up and down,up and down
The windows of the bus go up and down..
All through the town.
The seat on the bus goes squeak, squeak, squeak..
Squeak, squeak, squeak squeak, squeak, squeak
The seat on the bus goes squeak, squeak, squeak
All through the town.
The monkey on the bus goes giggle, giggle, giggle
Giggle, giggle, giggle, giggle, giggle, giggle
The monkey on the bus goes giggle, giggle, giggle
All through the town.
The wheels on the bus go round and round
Round and round round and round
The wheels on the bus go round and round
All through the town.
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Five Little Shapes | Kindergarten Nursery Rhymes For Toddlers | Song For Babies by Kids Baby Club - Duration: 1:03:09.
Five little shapes jumping on the bed
Square fell off and bumped his head
Triangle called the doctor, and the doctor said
No more shapes jumping on the bed
Four little shapes jumping on the bed
Triangle fell off and bumped his head
Star called the doctor, and the doctor said
No more shapes jumping on the bed
Three little Shapes jumping on the bed
Star fell off and bumped his head
Oval called the doctor, and the doctor said
No more Shapes jumping on the bed
Two little Shapes jumping on the bed
Oval fell off and bumped his head
Circle called the doctor, and the doctor said
No more Shapes jumping on the bed
One little Shape jumping on the bed
Circle fell off and bumped his head
Square called the doctor, and the doctor said
Put those Shapes right to bed!!
"And all the shapes went right to bed! Goodbye!"
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Film: "Io ho scelto voi..."(Gv.15.16). Soundtrack by Rooves - Duration: 58:24. For more infomation >> Film: "Io ho scelto voi..."(Gv.15.16). Soundtrack by Rooves - Duration: 58:24. -------------------------------------------
Rig A Jig Jig | Bao Panda | Song For Kids | Kindergrten Nursery Rhymes For Children by Kids Tv - Duration: 1:04:29.
Rig A Jig Jig BaO Panda
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Tractor Unboxing | Surprise Gift Box For Toddlers | Tractor For Kids | Rhymes For Babies - Duration: 21:55.
Tractor Unboxing
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