Schweizerische Rundschau für Medizin Praxis = Revue suisse de médecine Praxis
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Tremor can present a diagnostic problem in family practise. Systematic analysis of this symptom allows rapid classification of the problem without use of rigid definitions. ⋯ Also one may assume, that a symmetric tremor that aggravates during standing or movement in most cases is essential and not of cerebellar origin. Different forms of tremor and their therapies and main tremor types are presented graphically.
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Several distinct patterns of rheumatic manifestations can be seen throughout the course of Lyme borreliosis: intermittent and migratory musculoskeletal pain without objective findings, intermittent arthritis, chronic erosive arthritis, and joint deformities under affected skin in acrodermatitis chronica atrophicans. Commonly, Lyme arthritis is a late disease manifestation. A clinical history of extra-articular disease manifestations is the most reliable key to Lyme arthritis. ⋯ Otherwise, Lyme arthritis will be frequently over-diagnosed. Lyme arthritis can be cured with antibiotics. However, treatment failures occur with any of the hitherto recommended regimens.
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Schweiz. Rundsch. Med. Prax. · Mar 1993
Review[Pain assessment and documentation in patients with tumors: theory and reality].
Each tumor patient with pain is not only entitled to a careful diagnostic workup and to effective treatment of his pain syndrome, but also to a clear and useful documentation of the course of his pain(s). This documentation ('pain evolution chart') should at least include the main location(s) of the treated pain and the varying pain intensity during the course of the day as well as at night. A respective pain documentation instrument, the St. ⋯ The 'pain evolution chart' should be a regular part of the patient's hospital chart, as it forces the patient and his care-givers to cope more constructively with the present pain syndrome. The (well instructed) patient himself is responsible for an accurate and realistic pain documentation. Such longitudinal 'pain evolution charts' are not only useful for clinical oncology practice but also for clinical pain and analgesic research.
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Mortality and physical impairment in patients undergoing cardiac surgery are to a large extent due to cerebro-vascular complications that are second in frequency only to cardiopulmonary incidents. In spite of the extracorporeal circulatory support as well as progress in cardiac surgery that have improved the perioperative conditions, neurologic complications mainly of embolic nature are still common after extracorporeal circulatory assistance.
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Schweiz. Rundsch. Med. Prax. · Nov 1992
Review[Diagnosis of neurological symptoms of psychogenic origin].
The principles of neurological examination of patients in which psychogenic disturbances are suspected are first described. After mentioning the frequency of this type of disturbances in the medical literature, some of the most characteristic and most frequent psychogenic disturbances in neurology are described: cranial nerve symptoms, sensory disturbances as well as psychogenic paralysis including paraplegia and psychogenic disturbances of gait. ⋯ Finally a description is given of those organic neurological diseases in which in our experience the erroneous diagnosis of psychogenic disturbances is most frequently made. Some recommendations, how to behave in the presence of a patient with psychogenic neurological symptoms is added.