Presse Med
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PREDOMINANT FEATURES: Psoriasis is a frequent inflammatory dermatosis. All age groups are involved. The typical lesion is a well-limited erythemato-squamaous non-pruriginous lesion. All skin areas may be involved but each individual has preferential zones.
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PERIPHERAL NERVE INVOLVEMENT: Peripheral nerve involvement is better known than central nervous system involvement. The dominant features are sensoromotor polyneuropathies or pure sensorial polyneuropathies. ⋯ OTHER LOCALIZATIONS: Diffuse encephalic involvement is less common: acute aseptic meningitis, intellectual deterioration. Psychiatric manifestations are also frequently observed.
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A NEW CLASS OF NSAID: All non-steroidal antiinflammatory drugs (NSAID) inhibit cyclooxygenase (COX) and prostaglandin synthesis implicated in inflammatory processes and also participate in protecting the gastric mucosa. The discovery of two isoforms of COX, called COX-1 and COX-2 has led to further research into dissociating NSAID efficacy and intolerance. COX-1 AND COX-2: It appears that the antiinflammatory and antalgesic effects of NSAID is related to COX-2 inhibition while the undesirable effects on the gastric mucosa would be related to COX-1 inhibition. A COX-2 specific inhibitor would thus provide the same efficacy as classic NSAID but without the digestive disadvantages.
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A PRACTICAL TOOL: Screening for cognitive deficiency has been considerably improved by the use of a standardized tool, the Mini-Mental State Examination (MMSE). The MMSE only takes a few minutes and furnishes quantitative data for comparison between patients and to follow the evolution of a given patient.
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Theoretically, since 1992, 100% of socially underprivileged persons residing in France have unlimited access to health care. However, before they become fully integrated into the society, many refugees in various legal situations do not have access to health care. The mechanisms behind this exclusion unmask the difficulties the health care system has in managing the underprivileged population. ⋯ Instead of effectively applying the procedures concerning patients rights to health care, the system has developed free health care facilities which do not necessarily provide uninterrupted care. To provide the universal health care coverage promised by the legislators, the only criteria for access to care must be residence in France. Acquiring this status should be considerably simplified and requires the active participation of the entire health care community.