Revue médicale de Bruxelles
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Low back pain (LBP) has become one of the greatest public health problems. The differentiation between specific and non-specific low back pain is mandatory. In the specific low back pain are classified all diseases whose etiology is well defined, quick and accurate diagnosis is required for specific treatment. ⋯ Chronicity factors are multiple, mainly psycho-social and professional. The chronic low back pain treatment goals are the reduction of pain and better activity/participation to achieve the prevention of disability and maintaining work ability. Multidisciplinary treatment programs including personalized and guided physical therapy, cognitive behavioral therapy and short-term training programs will help to improve, restore and maintain the function in chronic low back pain.
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Membranous nephropathy (MN) is the most common cause for nephrotic syndrome in adults and occurs as an idiopathic (primary) or secondary disease. Since the early 2000's, substantial advances have been made in the understanding of the molecular bases of MN. The neutral endopeptidase (NEP) and the receptor for secretory phospholipase A2 (PLA2R) have been identified as target antigens for circulating and deposited antibodies in allo-immune neonatal and adult " idiopathic " MN, respectively. ⋯ Newly developed diagnostic tests detecting circulating anti-PLA2R antibody and PLA2R antigen in glomerular deposits have induced a change in paradigm in the diagnostic approach of idiopathic MN. Measurement of circulating anti-PLA2R antibody is also very useful for the monitoring of MN activity. However, the mechanisms responsible for the formation of anti-PLA2R antibodies as well as those involved in the progression of MN to end-stage renal disease remain to be defined.
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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.