Lancet neurology
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Between 6.5% and 15.0% of all strokes occur in patients already in hospital, many of whom are there for surgical procedures or cardiac disorders. This important group of patients could potentially be assessed more rapidly than others and could be candidates for interventional therapies. However, delays in recognition and assessment are common, possibly related to comorbidities and the complexities of hospital practice. ⋯ In the postoperative setting, intra-arterial thrombolysis is feasible and reasonably safe in carefully selected patients. Experimental agents and the manipulation of physiological variables are other treatment possibilities that could be applied early in this group of patients. Increasing the awareness by hospital physicians of such interventions may be an important factor that reduces delays in assessment of patients who have stokes while in hospital.
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Human prion diseases are devastating and incurable, but are very rare. Fears that the bovine spongiform encephalopathy epizootic would lead to a large epidemic of its presumed human counterpart, variant Creutzfeldt-Jakob disease (vCJD), have not been realised. Yet a feeling of uncertainty prevails in the general public and in the biomedical world. ⋯ In addition to this problem, Switzerland is currently faced with another issue of major public concern: a recent rise in the incidence of CJD. Here we examine the plausibility of several scenarios that may account for the increase in CJD incidence, including ascertainment bias due to improved reporting of CJD, iatrogenic transmission, and transmission of a prion zoonosis. In addition, we present the design and current status of a Swiss population-wide study of subclinical vCJD prevalence.
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In this review I examine the portrayal of epilepsy, seizures, and non-epileptic attack disorder in 62 movies produced over three-quarters of a century, across four continents, covering nine cinematic genres. While similar reviews of epilepsy in literature have suggested a progression in the understanding of epilepsy over time, this survey of the newer medium found examples of all of the ancient beliefs about epilepsy including demonic or divine possession, genius, lunacy, delinquency, and general "otherness". Nevertheless there has been a progressive trend towards more overt depictions of epilepsy. ⋯ Epilepsy in female characters tends to signify exotic vulnerability. The dramatic potential of seizures remains highly tempting to film writers and directors alike. Although it is not for the medical profession to dictate or censor cinematic content, a keen eye on these depictions will help us to understand and perhaps combat some of the stereotypes and myths that continue to surround epilepsy in the 21st century.