Revue medicale suisse最新文献

Stroke represents a leading cause of mortality and hospitalization in Switzerland, with an estimated 20,000 cases annually. Timely and effective management is critical to minimizing severe neurological deficits. Optimal care relies on seamless coordination among healthcare professionals-including general practitioners, emergency medical services (EMS), paramedics, emergency department personnel, neurologists, and radiologists-and on the prompt transfer of patients to specialized stroke units. Recent therapeutic advances, particularly the extension of the endovascular treatment window to up to 24 hours after symptom onset, underscore the vital importance of rapid medical intervention to significantly improve both prognosis and post-stroke quality of life.

In recent decades, significant progress has been made in understanding the influence of sex hormones on women's mental health. The perimenopausal and menopausal periods are characterized by increased vulnerability to depression. This article provides an overview of current knowledge on the clinical specificities of perimenopausal and menopausal depression, the neurobiological mechanisms involved, and management recommendations. Integrating this knowledge into our clinical practice is essential for improving the quality of women's mental healthcare.

A patient initially presents with an abnormal sensation on the tip of her nose, followed by the appearance of a localized redness and oedematous macule progressively evolving into a necrotic lesion at follow-up. This dermatological finding is known as the Hutchinson's Sign, a reactivation of the varicella-zoster virus along the nasociliary branch of the fifth cranial nerve. Hutchinson's sign can be associated with a risk of ocular involvement, and requires immediate systemic treatment. Ophthalmologic referral is recommended in cases of clinical suspicion of ocular globe involvement.

In neurology and liaison psychiatry, it is common to encounter patients with functional neurological disorders (FND), whose clinical presentation requires joint management. The somatic, neurological, and psychiatric comorbidities associated with FNDs add significant complexity to care (symptom overlap, stress-related modulation of symptoms, and multiple barriers to treatment engagement) and necessitate early detection and intervention to prevent a poorer prognosis. Drawing on an illustrative clinical case, this article presents an integrated, early intervention care model for hospitalized FND patients, involving coordinated input from neurology, liaison psychiatry, physiotherapy, and occupational therapy teams.

Menopause is a major hormonal transition associated with a significant increase in cardiovascular risk. The decline in estrogen levels negatively affects the lipid profile. Early and individualized management of risk factors is essential. Hormone replacement therapy (HRT) is not recommended for primary or secondary cardiovascular prevention. Late initiation, especially in oral form, substantially increases the cardiovascular risk, particularly the occurrence of ischemic stroke. A window of opportunity exists for initiating HRT in women under 60 years old or within 10 years of menopause onset, who experience severe vasomotor symptoms, preferably using transdermal estrogen combined with micronized progesterone. HRT should be initiated at the lowest effective dose and reassessed annually.

Renin-angiotensin system blockers have been a cornerstone of hypertension management since the late 1980s. Angiotensin converting enzyme inhibitors, particularly lisinopril, are prescribed more frequently than angiotensin receptor blockers for several reasons. However, current data show similar efficacy between the two classes, with notable differences in terms of action duration, side effects, and costs. This article reviews the factors that may influence the choice between these treatments.