Revue médicale de Bruxelles
-
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.
-
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.
-
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.
-
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.
-
Potentially inappropriate medications are a preventable cause of negative clinical and economic consequences in older people. A range of educational interventions and the implemention of clinical tools to sensitize physicians to inappropriate prescriptions appear to have positively impacted physicians' awareness and prescribing behaviour, which led to significant reductions in inappropriate drugs exposures and likely translated to significant population health benefits among their older patients. Although the level of evidence is not high, the general practitioner has a central position and its sensitization to inappropriate prescription allow to improve health of the olders.