La Revue de médecine interne
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Scurvy is the clinical manifestation of vitamin C deficiency. It is historically linked to the era of great maritime expeditions. But it is remerging in Western countries as in France. ⋯ Scurvy must still be prevented in at risk-populations. Indeed a pocket meal enriched with vitamin C is distributed to homeless people in Paris.
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Facial pain is a frequently encountered symptom in general medical practice and encompass a wide group of facial problems. As correct diagnosis can usually be reached by history and physical examination for well defined typical clinical entities (trigeminal neuralgia, cluster headache) atypical facial pain may have many other potential causes (sinuses infection, temporomandibular joint syndrome, dental disorders...) so that diagnosis not appear an easy task. ⋯ Better knowledge in identifying the cause of facial pain may lead to improve patient care and avoid patient frustration, medical nomadism, repetitive dental and otolaryngologic procedures, and finally non-compliance with treatment.
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Neuropsychology provides essential information to all participants (physicians, psychologists, occupational therapists) involved in the treatment of the elderly. When treating depressed elderly patients, a comprehensive neuropsychological examination is required for diagnosis, prognosis and to control the effectiveness of antidepressant treatment. ⋯ A neuropsychological examination may provide new perspectives, such as the possibility of predicting the outcome of dementia which are accompanied by affective disorders, such as Alzheimer's disease, vascular dementia and frontotemporal dementia. Neuropsychology may thus improve the treatment of these patients by providing information to a better understanding of their deficits and their impact on daily living abilities.
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The clinical efficiency of every therapeutic, medicinal or other, contains a part of not specific effect, or placebo effect, of which the frequency of appearance and the importance, in the treatment of pain, can be particularly raised. The practitioners use often, deliberately either not, this effect to modulate their therapeutic efficiency, or in a diagnostic purpose to investigate the mechanism of a pain; our objective is to analyze, in the light of a review of the recent medical literature, what the understanding of the placebo effect brings to the treatment of pain. ⋯ At term of this review, we will conclude that the use of a placebo has no value of diagnostic test as for the mechanism of the pain; it is neither necessary nor desirable to implement placebo effect in the daily practice because any therapeutics acts by associating specific and not specific effects. The quality of the relation doctor-patient will allow to mobilize not specific factors susceptible to modulate favorably any therapeutic action. For controlled clinical trials, certain methodologies can be envisaged to by-pass the administration of placebo, reducing so ethical constraints bound to their use.
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Review Case Reports
[Hemolytic uremic syndrome as a complication of gemcitabine treatment: report of six cases and review of the literature].
Hemolytic uremic syndrome is a rare condition during gemcitabine therapy. ⋯ Systematic clinical and biological screening of hemolytic uremic syndrome during gemcitabine therapy should allow to better know this complication, to recognize and treat it earlier with a potential positive impact for patients.