Revue médicale de Bruxelles
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Delirium in the elderly is common but unfortunately underdiagnosed. The consequences could be significant such as an increase of the mortality in the hospital, loss of autonomy and increased risk to be institutionalized. ⋯ The physiopathology is not yet well defined but the inflammation and the neuromediators are involved. It is important to develop primary and secondary prevention, but also to propose a follow in memory clinics for all elderly people who having suffered from delirium during hospitalization because a confusional state could be the first step towards future dementia.
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The objective of this paper is to review the literature published in 2012 in the field of intensive care and emergency related to oncology. Are discussed because of new original publications: prognosis, resuscitation techniques, oncologic emergencies, haemodynamic, respiratory and metabolic complications, microangiopathic anemia, serious toxicities of anticancer treatment and limitations to life-support techniques.
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Since a few years, the number of cases of fraud reported in the scientific and medical literature and retraction of articles has increased exponentially. Such fraud is due to fabrication, falsification, theft, embellishment or retention of data, plagiarism, incorrect list of authors or undisclosed conflicts of interest. ⋯ This crisis can be controlled by measures at different levels: society, universities, scientific institutions, study promoters, scientific and medical journals. A legal framework at EU level would allow to combat such fraud more efficiently.
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Munchausen's syndrome is classified as a chronic factitious disorder with predominant physical signs and symptoms. Several symptoms are specific to this disorder, such as travelling and pseudologia fantastica. ⋯ We discuss also the opportunity to classify such a syndrome as a factitious disorder. Indeed, several authors suggest classifying Munchausen syndrome as a subtype of somatoform disorders, as those two disorders share a lot of characteristics.
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To measure waiting time delays of patients and to evaluate if the waiting time before the first physician contact is inversely correlated to the illness severity. During the period of 26/02/2007 through 3/03/2007, we prospectively studied the waiting times before the first contact with a physician (WTP) and the length of stay (LS) in 473 patients (0.8% of the annual patient volume) evaluated in our emergency department, which has a physician triage model. The WTP was correlated to a severity score "Clinical Classification of Patients in Emergency (CCPE)". ⋯ The median LS was 119 (76-186) min. In conclusion, the waiting times are comparable to those measured in similar studies. The waiting time evaluated according to CCPE is adequate.