Presse Med
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The Mini Mental State Examination (MMSE) is the gold standard cognitive test for screening delirium in cancer patients on opioids. But the MMSE is long and requires writing, reading and drawing from patients with various degrees of physical inability. Age and educational level affect the MMSE score. The Blessed Orientation-Memory-Concentration (BOMC) test is strictly oral and brief. This six item test is not affected by age or educational level. ⋯ BOMC is more applicable than MMSE for screening delirium in cancer patients. The relationship between BOMC time and delirium deserves further investigations.
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RISING INCIDENCE AND PREVALENCE: The frequency of epilepsy after the age of 60 years is increasing, a particularly important point in light of the rise in this age group. Incidence is estimated to exceed 100 cases per 100,000 subjects over the age of 60, reaching 160 per 100,000 in subjects aged 80 to 84 years. ⋯ CLINICAL FEATURES IN THE ELDERLY: Partial complex seizures are particularly frequent. Some patients experience seizure-related confusion states or slowly regressive neurological deficits.
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ASSESSMENT OF NUTRITIONAL STATUS: Protein-calorie malnutrition is frequent and often severe in fragile hospitalized or institutionalized elderly subjects. Underdiagnosis and undertreatment is commonplace. Since under- or malnutrition is more difficult to correct in the elderly than in the young subject, a careful assessment of the nutritional status must be made in order to recognize any nutritional disorder early and initiate proper treatment early.
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FUNCTIONS OF THE ENDOTHELIUM: The endothelium plays a pivotal role in regulating vasomotor tone, vessel permeability, blood cell extravasation, and antiatherogenic, antithrombogenic and antiadhesive processes.
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MDR GENES: Overexpression of MDR genes leads to the production of glycoprotein P (PGP) that can use protease inhibitors as a substrate. This overexpression of MDR genes appears to be the cause, at least partially, of resistance to protease inhibitors by induction of very low intracellular inhibitor concentrations.