Presse Med
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The frequency of chronic postsurgical pain is high, ranging from 10 to 80%. Among the factors promoting it are the existence of preoperative pain, the intensity and duration of postoperative pain, and the type of surgery. It frequently has a neuropathic aspect. ⋯ Few studies have thus far evaluated methods for preventing chronic postsurgical pain, and their results are conflicting. Recent studies indicate, however, that the use of perioperative regional analgesia is associated with a reduced incidence of chronic postsurgical pain, compared with patient-controlled intravenous morphine. Antihyperalgesic drugs, such as NMDA antagonists, may also decrease chronic postsurgical pain by reducing its perioperative hyperalgesic component.
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Web 2.0: interactive, collaborative tools (wikis, social networks, blogs, virtual worlds) make Internet users active participants rather than simple consumers. Medicine 2.0: mentalities, approaches, and medical practices are changing, thanks to greater access to information, communal exchanges, and the comparison of personal experiences. ⋯ The risks reside in the reliability of information and the privacy of patient data. The challenges are to use these new resources to improve the quality of care and participate in the profound change they are bringing to the healthcare system.
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Review
[Diagnosing the cause of acute dyspnea in elderly patients: role of biomarkers in emergencies].
Acute dyspnea is one of the leading causes of emergency hospitalization of elderly patients. Clinical diagnostic procedures are difficult in this geriatric population. Acute heart failure is the most frequent cause of acute dyspnea in geriatric patients. ⋯ There has also been progress recently for other frequent causes of dyspnea in the elderly, including infection and venous thromboembolic disease. Procalcitonin assays may be useful as a prognostic factor for infectious disease. Nevertheless, the real value of BNP assays in geriatric populations must be clarified by interventional studies.
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A digital campus is a distance learning site that uses the potential of information and communication technologies to disseminate and improve educational services. This website, with open and free access, is built from free software with Web 2.0 technology. It is hosted at the University of Limoges. ⋯ All areas of neurosurgery are concerned. All the courses, including tests for self-evaluation and scientific meetings (organized with information and communication technologies) are digitally recorded for the site. The principles that make it possible for a medical discipline to organize around an online project are: a pedagogical conception of projects built in the form of models reusable by other health specialties; a stronghold within professional societies of the relevant specialties able to create high-quality intellectual and scientific resources; an organization by educational levels that can be extended transversally to other health disciplines; and free access to the digital campus, the durability of which depends on the dissemination and dynamism of its consortium.