Swiss medical weekly
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Swiss medical weekly · Apr 1997
Review Case Reports[Sentinel headache: a premonitory symptom too often unrecognized in intracranial ruptured aneurysm].
Headache is a common complaint in emergency departments, but only a small percentage of patients have a serious disease. Nevertheless, some forms of headache, such as "warning headaches", need special attention. By far the most common symptom associated with aneurysmal minor bleed (warning leak) is a sudden headache that is considered to be a warning symptom of impending aneurysmal rupture. ⋯ Recognition of these warning headaches probably offers the best opportunity of reducing the otherwise serious mortality and morbidity of aneurysmal subarachnoid hemorrhage. This report describes 7 non-consecutive patients presenting warning headaches before major aneurysm rupture. Based on our experience and a review of the literature, we recommend a management algorithm for patients presenting with sudden severe headache.
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Swiss medical weekly · Apr 1997
Review[Sudden death in hypertrophic obstructive and non-obstructive cardiomyopathy: can it be prevented?].
Sudden cardiac death constitutes the most devastating aspect of obstructive and non-obstructive hypertrophic cardiomyopathy. Loss of consciousness and family history of sudden cardiac death should alert the physician to the risk of sudden death. ⋯ Loss of consciousness associated with nonsustained ventricular tachycardia and inducible sustained ventricular arrhythmia identify patients at very high risk of sudden cardiac death. Nevertheless, many variable factors are involved in the pathophysiology of sudden cardiac death, and hence risk stratification of sudden cardiac death in patients with hypertrophic cardiomyopathy remains a very difficult clinical challenge.
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Swiss medical weekly · Apr 1997
Review Case Reports[Compulsory psychiatric drug therapy in Switzerland--legislation and reality exemplified by a few clinical cases].
We discuss the existing or desired legal basis for forced medical treatment in psychiatry, in the light of supranational, international and Swiss law. Four situations in which forced medical treatment may occur are described and illustrated with case reports. A distinction is drawn between treatment against a destructive will, treatment against lack of will, treatment against an antisocial will, and long-term treatment against a chronic destructive will. Finally, proposals for improved Swiss legislation on forced psychopharmacological treatment are discussed.