Revue médicale de Bruxelles
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Pain is a frequent problem in aged population and often undertreated despite undesirable effects such as depression, malnutrition, sleep disturbance, decreased socialization, impaired ambulation with increased risk of falls problems, adverse effects from multiple inadequate drugs prescriptions, cognitive and behaviour impairments. Detection, diagnosis of the causes, evaluation with specific scales and adapted therapy of pain are essential to preserve quality of life and autonomy. Pharmacological therapy using the three-step analgesic ladder of W. ⋯ O. is appropriate owing to individual age-related sensitivity which requires to follow the rule of "start low and go slow" with regular pain and side effects assessments, particularly for opioids. For chronic pain, non pharmacological strategies optimise pain management in addition to medications. Comprehensive geriatric assessment is recommended to complete the global view of the frailed patient with the help of a multidisciplinary team.
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Any general practitioner can be confronted with bleeding complication, the most frequent complication after a dental extraction. As with all complications prevention of bleeding is the best way to manage this problem. ⋯ The goal of this paper is to review the different steps of hemostasis as well as the most frequent anomalies associated to each step. The treatment will be discussed but it's more specific to specialists in odontostomatology.
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Acute infections of the upper respiratory tract are reviewed from an ENT point of view. Only the most frequent pathologies are taken into account. Clinical presentation and an update of current treatment are presented.
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Infections of the lower respiratory tract usually occurs during winter and are responsible for a high mortality and morbidity rate. The major clinical syndromes that are observed ranges from acute bronchitis to fatal pneumonia. In order to give optimal treatment and to avoid inappropriate use of antibiotics a careful diagnosis is necessary when signs and symptoms of lower respiratory tract infection are presents. Different clinical lower respiratory tract infections are presented with diagnostic and therapeutic approach considering actual belgium epidemiology.