Revue médicale de Bruxelles
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Pain represents the most frequent symptom faced by general practitioners and is associated with 60% of neurological troubles. Pain consists in a conscious, subjective, unpleasant and protective sensory experience transmitted by thermoalgic pathways in the central nervous system (nociceptive pain). Lesioning of peripheral or central sensory pathways can also generate pain associated with hypoesthesia (phantom or neuropathic pain). ⋯ However, the technique, when not sufficiently selective, can generate a neuropathic pain and then a short-lating pain relief. Increasing knowledge on pathophysiological mechanisms of pain allowed surgery to interfere with the functioning of the sensory circuits without lesioning and to modulate neuronal activity in order to reduce pain (neuromodulation). Non-lesioning modulating techniques (then reversible) appeared (deep brain stimulation, epidural spinal cord or motor cortex stimulation, intrathecal infusion, radiosurgery) and are currently applied to efficiently alleviate neuropathic pain.
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Biography Historical Article
[Richard Doll. A surprising story of conflicts of interest].
Richard Doll is a very famous English physician epidemiologist. He is credited with discovering the link between smoking and lung cancer. His reputation was recently vitiated by two facts, ignorance of German studies prior to his work and the existence of major conflicts of interest with industry that led him to minimize the role of chemical products in carcinogenesis.