Revue médicale de Bruxelles
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Kyphoplasty, the newest of the tools treating vertebral osteoporotic compression fractures (VOCF) is the evolution of vertebroplasty, allowing not only pain control and strengthening of the fractured vertebra, but also offering the possibility to restore vertebral height with a lower risk of complications. We present our series of 41 consecutive VOCF treated by kyphoplasty in 30 patients between October 2003 and March 2006. Systematic spinal X rays and CT scan have be performed, occasionally followed by bone scintigraphy or spinal MRI. ⋯ The mean postoperative stay was 2.5 days. We found kyphoplasty to be a safe technique allowing immediate pain control after VOCF, with minimal risks of cement leakage or pulmonary embolism. Vertebral height and deformity correction are best achieved with early surgery, but pain control is always excellent even with a delayed procedure.
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Fear of falling and poor physical performance are prominent symptoms in many older people. The prevalence of fear of falling in community-living elderly ranges between 12 % and 65 %, and is higher in women than men. It commonly occurs after falls, but it also occurs without a previous fall history. ⋯ The consequences of this pattern may, however, be debilitating and devastating. Excessive fear and avoidance may compromise the quality of life, and may result in a decline of physical capabilities and, ultimately, in an increased risk of falls, which may further fuel fear and avoidance. Future research should investigate whether individualised intervention strategies are efficient in preventing falls and activity-related fear of falling within this population in order to improve her quality of life.
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Pregabalin is a novel central nervous system (CNS) drug with no interaction at benzodiazepine or GABA receptor. Its mechanism of action is correlated with its high affinity for the alpha/delta submit of the voltage-dependant CNS calcium channel. Pregabalin is rapidly absorbed with at least 90% bioavailable irrespective of dose, does not bind to plasma proteins and is excreted virtually unchanged by the kidneys. ⋯ Pregabalin is indicated, like gabapentin, in the treatment of neuropathic pain syndromes like post-herpetic neuralgia (PHN) and diabetic polyneuropathy (DPN). Efficacy in other neuropathic pain syndromes need further investigations. This paper emphasizes advantages and disadvantages on a clinical point of view.
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We report the embolization of a pulmonary artery pseudoaneurysm consecutive to Swan-Ganz catheterization. Embolization was successful despite an iatrogenic rupture and a massive hemoptysis.