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Article: Prise en charge de l’accident ischémique transitoire.

Lamme, Jessica / Sauvin, Margot / Sztajzel, Roman

2022 Volume 18, Issue 794, Page(s) 1671–1676

Abstract: This article reviews the management of transient ischemic attack (TIA) in 2022. There is an important risk of developing a stroke within the first weeks after a TIA and this risk may be significantly reduced with appropriate management. Clinical scores ... ...

Title translation	Management of transient ischemic attack.
Abstract	This article reviews the management of transient ischemic attack (TIA) in 2022. There is an important risk of developing a stroke within the first weeks after a TIA and this risk may be significantly reduced with appropriate management. Clinical scores coupled with imaging allow risk stratification. Brain imaging (CT scan and/or MRI) is an essential part of the diagnostic approach and should be performed within 24h. Etiological investigations including vascular and cardiac workup should be scheduled. Therapeutic options include antiplatelet therapy, anticoagulant therapy in case of atrial fibrillation, recanalization in case of symptomatic carotid stenosis, and for all patients a strategy to reduce cardiovascular risk factors.
MeSH term(s)	Anticoagulants/therapeutic use ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/therapy ; Carotid Stenosis ; Humans ; Ischemic Attack, Transient/diagnosis ; Ischemic Attack, Transient/etiology ; Ischemic Attack, Transient/therapy ; Risk Factors ; Stroke/diagnosis ; Stroke/etiology ; Stroke/therapy
Chemical Substances	Anticoagulants
Language	French
Publishing date	2022-08-30
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2177010-4
ISSN	1660-9379
ISSN	1660-9379
DOI	10.53738/REVMED.2022.18.794.1671
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Article: L'insuffisance cardiaque chronique et ses conséquences sur la relation de couple.

Sztajzel, Juan

Revue medicale suisse

2015 Volume 11, Issue 498, Page(s) 2313–2315

Abstract: There are presently few data on chronic heart failure (CHF) and its consequences on the partner relationship. The aim of our study was to assess how patients with severe CHF and their female partners were affected in their relationship. First, there was ... ...

Title translation	Chronic heart failure and its consequences on the partner relationship.
Abstract	There are presently few data on chronic heart failure (CHF) and its consequences on the partner relationship. The aim of our study was to assess how patients with severe CHF and their female partners were affected in their relationship. First, there was a need to address the issue of sexuality with the doctor because of fear of the occurrence of a cardiac event or an implantable cardioverter defibrillator shock. Second, there was often a significant decrease in libido and erectile dysfunction associated with general depressive symptoms. Finally, the female partners in several couples developed an overprotective behavior leading to resentment and frustration in patients towards them.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Depression/complications ; Depression/etiology ; Erectile Dysfunction/epidemiology ; Erectile Dysfunction/etiology ; Female ; Heart Failure/complications ; Heart Failure/physiopathology ; Humans ; Male ; Middle Aged ; Severity of Illness Index ; Sexual Dysfunction, Physiological/epidemiology ; Sexual Dysfunction, Physiological/etiology ; Sexual Partners/psychology ; Sexuality
Language	French
Publishing date	2015-12-09
Publishing country	Switzerland
Document type	English Abstract ; Journal Article
ZDB-ID	2177010-4
ISSN	1660-9379
ISSN	1660-9379
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Article: Sexualité et troubles du rythme cardiaque.

Sztajzel, J

Revue medicale suisse

2013 Volume 9, Issue 378, Page(s) 616–619

Abstract: For most patients, sexual activity represents a low risk of triggering cardiac arrhythmias. However, particularly in patients with an underlying heart disease, sexual activity may cause cardiac arrhythmias which may be sometimes serious. From a ... ...

Title translation	Sexuality and cardiac arrhythmias.
Abstract	For most patients, sexual activity represents a low risk of triggering cardiac arrhythmias. However, particularly in patients with an underlying heart disease, sexual activity may cause cardiac arrhythmias which may be sometimes serious. From a physiological point of view, sexual activity produces increased sympathetic activity and thereby probably reduced vagal tone which at different degrees may induce cardiac arrythmias. Several presently available autopsy-studies have shown that this happens very rarely and that it mostly affects men. Finally, recently published recommendations allow us to better advise patients with cardiac arrhytmias to engage in sexual activity or to defer it until the condition is stabilized and optimally controlled.
MeSH term(s)	Arrhythmias, Cardiac/physiopathology ; Female ; Heart Diseases/physiopathology ; Humans ; Male ; Risk ; Sex Factors ; Sexual Behavior/physiology ; Sympathetic Nervous System/physiology ; Vagus Nerve/physiology
Language	French
Publishing date	2013-03-20
Publishing country	Switzerland
Document type	English Abstract ; Journal Article
ZDB-ID	2177010-4
ISSN	1660-9379
ISSN	1660-9379
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Article: Sexualité et cardiopathie.

Sztajzel, J

Revue medicale suisse

2012 Volume 8, Issue 333, Page(s) 631–634

Abstract: Sexual activity represents a light physical effort in most subjects with or without heart disease. In a small number of patients with heart disease sexual activity may trigger cardiac symptoms and even induce serious cardiac problems, such as myocardial ... ...

Title translation	Sexuality and heart disease.
Abstract	Sexual activity represents a light physical effort in most subjects with or without heart disease. In a small number of patients with heart disease sexual activity may trigger cardiac symptoms and even induce serious cardiac problems, such as myocardial infarction or sudden cardiac death due to malignant ventricular arrhythmias. However, the global risk remains very low. Thus, it is important to stratify patients with heart disease into risk groups which may help to counsel them to resume sexual activity, to identify those patients at higher risk for cardiac events and to treat those with sexual dysfunction, particularly when using 5-phosphodiesterase inhibitors for erectile dysfunction.
MeSH term(s)	Heart Diseases/physiopathology ; Humans ; Risk Assessment ; Sexual Behavior/physiology
Language	French
Publishing date	2012-03-21
Publishing country	Switzerland
Document type	English Abstract ; Journal Article
ZDB-ID	2177010-4
ISSN	1660-9379
ISSN	1660-9379
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Article: BPCO: recommandations pour les médecins de premiers recours.

Razban, Mohammad / Sztajzel, Manuel Diego / Lador, Frédéric / Sommer, Johanna / Haller, Dagmar M / Favrod-Coune, Thierry

Revue medicale suisse

2021 Volume 18, Issue 797, Page(s) 1792–1797

Abstract: Chronic obstructive pulmonary disease (COPD) is common and should be suspected in any patient with chronic dyspnea, cough, or sputum with a history of exposure to tobacco or harmful particles. Spirometry is used for diagnosis. Full evaluation includes ... ...

Title translation	COPD: Guidelines for primary care physicians.
Abstract	Chronic obstructive pulmonary disease (COPD) is common and should be suspected in any patient with chronic dyspnea, cough, or sputum with a history of exposure to tobacco or harmful particles. Spirometry is used for diagnosis. Full evaluation includes the severity of obstruction and clinical data, following the Global Initiative for Chronic Obstructive Lung Disease guidelines. Although the only treatments that have an impact on mortality are tobacco cessation, pulmonary rehabilitation and, for advanced disease, oxygen therapy, new symptomatic treatment have recently been made available. The duration of antibiotic and corticosteroid treatment for exacerbations has been shortened. The new diagnostic and management recommendations are summarized in this article.
MeSH term(s)	Adrenal Cortex Hormones/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Humans ; Oxygen ; Physicians, Primary Care ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Pulmonary Disease, Chronic Obstructive/therapy
Chemical Substances	Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Oxygen (S88TT14065)
Language	French
Publishing date	2021-07-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2177010-4
ISSN	1660-9379
ISSN	1660-9379
DOI	10.53738/REVMED.2022.18.797.1792
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Article: Heart rate variability: a noninvasive electrocardiographic method to measure the autonomic nervous system.

Sztajzel, Juan

Swiss medical weekly

2004 Volume 134, Issue 35-36, Page(s) 514–522

Abstract: The autonomic nervous system (ANS) plays an important role not only in physiological situations, but also in various pathological settings such as diabetic neuropathy, myocardial infarction (MI) and congestive heart failure (CHF). Autonomic imbalance ... ...

Abstract	The autonomic nervous system (ANS) plays an important role not only in physiological situations, but also in various pathological settings such as diabetic neuropathy, myocardial infarction (MI) and congestive heart failure (CHF). Autonomic imbalance associating increased sympathetic activity and reduced vagal tone has been been strongly implicated in the pathophysiology of arrhythmogenesis and sudden cardiac death. Among the different available noninvasive techniques for assessing the autonomic status heart rate variability (HRV) has emerged as a simple, noninvasive method to evaluate the sympathovagal balance at the sinoatrial level. It has been used in a variety of clinical situations including diabetic neuropathy, MI, sudden death and CHF. The standard measurements intervening in the analysis of HRV comprise time domain indices, geometric methods and components of the frequency domain. Measurements of HRV are generally performed on the basis of 24 hour Holter recordings (long-term recordings) or on shorter periods ranging from 0.5 to 5 minutes (short-term recordings). The use of long or short-term recordings depends on the type of study that has to be realised. Established clinical data based on numerous studies published during the last decade consider decreased global HRV as a strong predictor of increased all-cause cardiac and/or arrhythmic mortality, particularly in patients at risk after MI or with CHF. This article reviews the mechanism, the parameters and the use of HRV as a marker reflecting the activity of the sympathetic and vagal components of the ANS on the sinus node, and as a clinical tool for screening and identifying patients particularly at risk for cardiac mortality.
MeSH term(s)	Arrhythmias, Cardiac/physiopathology ; Autonomic Nervous System/physiology ; Autonomic Nervous System/physiopathology ; Electrocardiography/methods ; Heart Failure/physiopathology ; Heart Rate/physiology ; Humans ; Monitoring, Physiologic/methods ; Myocardial Infarction/physiopathology
Language	English
Publishing date	2004-09-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2036179-8
ISSN	1424-3997 ; 1424-7860
ISSN (online)	1424-3997
ISSN	1424-7860
DOI	10.4414/smw.2004.10321
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Article ; Online: Letter by Kamtchum-Tatuene et al Regarding Article, "Mechanical Thrombectomy Improves Functional Outcomes Independent of Pretreatment With Intravenous Thrombolysis".

Kamtchum-Tatuene, Joseph / Sztajzel, Roman / Mendes Pereira, Vitor

Stroke

2016 Volume 47, Issue 7, Page(s) e197

Language	English
Publishing date	2016-07
Publishing country	United States
Document type	Letter
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.116.013896
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Article: Hemorrhagic Plaques in Mild Carotid Stenosis: The Risk of Stroke.

Scheffler, Max / Pellaton, Alain / Boto, José / Barnaure, Isabelle / Delattre, Bénédicte M / Remuinan, Jorge / Sztajzel, Roman / Lövblad, Karl-Olof / Vargas, Maria Isabel

The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques

2020 Volume 48, Issue 2, Page(s) 218–225

Abstract: Objectives: Embolic ischemic strokes cause significant mortality and morbidity worldwide. It has been proposed that some of these strokes are due to unstable carotid plaques with intraplaque hemorrhage (IPH) but a low overall degree of stenosis. Our aim ...

Abstract	Objectives: Embolic ischemic strokes cause significant mortality and morbidity worldwide. It has been proposed that some of these strokes are due to unstable carotid plaques with intraplaque hemorrhage (IPH) but a low overall degree of stenosis. Our aim was to test a fat-saturated T1-weighted (T1WI) black-blood sequence on MRI for the detection of IPH in symptomatic individuals and to quantify the relation between IPH, severity of stenoses, and ischemic brain lesions. Materials and methods: Sixty-two patients were examined by 3T MRI. Sequences included brain diffusion-weighted imaging (DWI) as well as 3D turbo spin echo (TSE) fat-saturated black-blood T1 of the carotid bifurcations, to detect IPH as a focal intraplaque hyperintensity. Both carotid arteries were analyzed in each patient. The North American Symptomatic Carotid Endarterectomy Trial scale was used for quantification of stenosis degree. Results: Thirty-six out of 62 patients (mean age, 74) showed brain ischemia on DWI. Fifteen of these 36 patients (42%) had associated ipsilateral IPH at the carotid bifurcation or the proximal internal carotid artery. Mean degree of stenosis in this group was 50%. In 21 patients with ischemia without IPH, the mean degree of stenosis was 44%. Conclusions: MRI with 3D TSE fat-saturated black-blood T1 technique is a safe, reliable, and noninvasive tool for the detection of IPH. A high percentage (42%) of ischemic events in patients with low- to moderate-degree stenosis were associated with IPH, an easily detectable imaging biomarker of plaque vulnerability. The ability to confirm IPH by MRI may help stratify patients into different risk and treatment groups in the future.
MeSH term(s)	Aged ; Carotid Arteries ; Carotid Stenosis/complications ; Carotid Stenosis/diagnostic imaging ; Endarterectomy, Carotid ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Plaque, Atherosclerotic/complications ; Plaque, Atherosclerotic/diagnostic imaging ; Stroke/complications ; Stroke/diagnostic imaging
Language	English
Publishing date	2020-08-17
Publishing country	England
Document type	Journal Article
ZDB-ID	197622-9
ISSN	0317-1671
ISSN	0317-1671
DOI	10.1017/cjn.2020.177
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Zs.A 1203: Show issues

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Article: Heart rate variability: a noninvasive electrocardiographic method to measure the autonomic nervous System

Sztajzel, Juan

Swiss medical weekly

2004 Volume 134, Issue 35/36, Page(s) 514

Language	German
Document type	Article
ZDB-ID	2036179-8
ISSN	1424-7860
Database	Current Contents Medicine

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Article ; Online: Carotid plaque surface echogenicity predicts cerebrovascular events: An Echographic Multicentric Swiss Study.

Journal of neuroimaging : official journal of the American Society of Neuroimaging

2022 Volume 32, Issue 6, Page(s) 1142–1152

Abstract: Background and purpose: To determine the prognostic value for ischemic stroke or transitory ischemic attack (TIA) of plaque surface echogenicity alone or combined to degree of stenosis in a Swiss multicenter cohort METHODS: Patients with ≥60% ... ...

Abstract	Background and purpose: To determine the prognostic value for ischemic stroke or transitory ischemic attack (TIA) of plaque surface echogenicity alone or combined to degree of stenosis in a Swiss multicenter cohort METHODS: Patients with ≥60% asymptomatic or ≥50% symptomatic carotid stenosis were included. Grey-scale based colour mapping was obtained of the whole plaque and of its surface defined as the regions between the lumen and respectively 0-0.5, 0-1, 0-1.5, and 0-2 mm of the outer border of the plaque. Red, yellow and green colour represented low, intermediate or high echogenicity. Proportion of red color on surface (PRCS) reflecting low echogenictiy was considered alone or combined to degree of stenosis (Risk index, RI). Results: We included 205 asymptomatic and 54 symptomatic patients. During follow-up (median/mean 24/27.7 months) 27 patients experienced stroke or TIA. In the asymptomatic group, RI ≥0.25 and PRCS ≥79% predicted stroke or TIA with a hazard ratio (HR) of respectively 8.7 p = 0.0001 and 10.2 p < 0.0001. In the symptomatic group RI ≥0.25 and PRCS ≥81% predicted stroke or TIA occurrence with a HR of respectively 6.1 p = 0.006 and 8.9 p = 0.001. The best surface parameter was located at 0-0.5mm. Among variables including age, sex, degree of stenosis, stenosis progression, RI, PRCS, grey median scale values and clinical baseline status, only PRCS independently prognosticated stroke (p = 0.005). Conclusion: In this pilot study including patients with at least moderate degree of carotid stenosis, PRCS (0-0.5mm) alone or combined to degree of stenosis strongly predicted occurrence of subsequent cerebrovascular events.
MeSH term(s)	Humans ; Carotid Stenosis/diagnostic imaging ; Ischemic Attack, Transient/diagnostic imaging ; Constriction, Pathologic ; Pilot Projects ; Switzerland/epidemiology ; Risk Factors ; Plaque, Atherosclerotic/diagnostic imaging ; Stroke/diagnostic imaging ; Ultrasonography
Language	English
Publishing date	2022-07-18
Publishing country	United States
Document type	Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1071724-9
ISSN	1552-6569 ; 1051-2284
ISSN (online)	1552-6569
ISSN	1051-2284
DOI	10.1111/jon.13026
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