Läkartidningen
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Early repolarization defined as antero-lateral ST-segment elevation exists in 1-2 % of the general population and has been considered a benign ECG finding for decades. However, early repolarization, defined as infero-lateral J-waves, has in recent studies been associated with an increased - albeit low - risk of sudden and cardiovascular death. This ECG pattern is present in 3-13% of the general population. ⋯ In athletes, early repolarization, regardless of type, is considered benign. In asymptomatic non-athletes, the absolute risk is too low to use this ECG finding in clinical practice. In individuals with J-wave syndrome, on the other hand, ICD implantation should be strongly considered to prevent sudden cardiac death.
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A thorough investigation is warranted when a person presents to health care services with signs and symptoms of schizophrenia. Positive (hallucinations and delusions) as well as negative symptoms (blunted affect, avolition, and loss of speech content) should be assessed in order to confirm the diagnosis. Further, psychosocial functioning must be evaluated. ⋯ Case management in a multiprofessional »Assertive Community Treatment« (ACT) setting should be used as an organizational model for psychiatric teams caring for persons with first onset psychoses as well as those with long-term psychotic illness. Collaboration between psychiatric and social services is central and mandatory by law. Models for collaboration need to be examined further.