Revue médicale suisse
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Revue médicale suisse · Nov 2008
Historical Article[From the mad cow to the scrapie of the European sheep].
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Revue médicale suisse · Nov 2008
[Access to thrombolysis in stroke: place of the rescue system and of the primary care physician].
Thrombolysis is the most effective treatment improving the outcome of patients suffering from acute stroke. Moreover, its effectiveness increases when administrated as quick as possible after the onset of the first symptoms. Prehospital selection of patients and their immediate transfer to stroke center are the principal factors allowing the practice of thrombolysis within the authorized time frame. On the basis of regional Swiss French data, it seems that patients evaluated by emergency physician and their direct transfer in an acute stroke unit reduces delays and allows for a higher thrombolysis rate.
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Confusion is a frequent psychiatric and behavioural manifestation of diffuse cerebral injury found in elderly patients that are severely ill or stressed. The hyperactive form is often recognised because of the psychomotor agitation. However, the hypoactive form is most frequent and has a worse prognosis. ⋯ Among contributing factors, anticholinergic agents and drug interactions are significant. Identification and treatment of the underlying cause of delirium is essential with a focus on non pharmacological approach. Antipsychotic agents are reserved for severe forms and where non pharmacological intervention fracases.