Sudden cardiac death in forensic medicine – Swiss recommendations for a multidisciplinary approach

Sudden cardiac death (SCD) is by definition unexpected and cardiac in nature. The investigation is almost invariably performed by a forensic pathologist. Under these circumstances the role of the forensic pathologist is twofold: (1.) to determine rapidly and efficiently the cause and manner of death and (2.) to initiate a multidisciplinary process in order to prevent further deaths in existing family members. If the death is determined to be due to "natural" causes the district attorney in charge often refuses further examinations. However, additional examinations, i.e. extensive histopathological investigations and/or molecular genetic analyses, are necessary in many cases to clarify the cause of death. The Swiss Society of Legal Medicine created a multidisciplinary working group together with clinical and molecular geneticists and cardiologists in the hope of harmonising the approach to investigate SCD. The aim of this paper is to close the gap between the Swiss recommendations for routine forensic post-mortem cardiac examination and clinical recommendations for genetic testing of inherited cardiac diseases; this is in order to optimise the diagnostic procedures and preventive measures for living family members. The key points of the recommendations are (1.) the forensic autopsy procedure for all SCD victims under 40 years of age, (2.) the collection and storage of adequate samples for genetic testing, (3.) communication with the families, and (4.) a multidisciplinary approach including cardiogenetic counselling.

Overview of imlementation of some ESAPP funded projects in the HoA

Evaluation by the regional coordinator of ESAPP projects implemented in 2004.

Proposals for Specific Activities of the Basic Mandate and Priority Action Projects, 2nd round 2005: Documentation for the ESAPP Advisory Board Meeting of June 15th, 2005

Budget frame-figures for 2nd half 2005; priority listing of proposals for PAP 2nd round 2005; evaluation sheets of approved, revised and rejected proposals for Specific Activities of the BM and PAP.

Annual Planning for the Basic Mandate and Proposals for Priority Action Projects, 1st round 2005

Budget frame-figures for 2005; annual planning for the BM 2005; priority listing of proposals for PAP 2005; evaluation sheets of approved, postponed and rejected proposals for the BM and PAP.

Proposals for Priority Action Projects, second round 2004

Budget frame-figures for 2nd half of 2004; priority listing of proposals for PAP 2nd round 2004; evaluation sheets of approved, revised and rejected proposals for PAP.

ERS statement on the multidisciplinary respiratory management of ataxia telangiectasia.

Ataxia telangiectasia (A-T) is a rare, progressive, multisystem disease that has a large number of complex and diverse manifestations which vary with age. Patients with A-T die prematurely with the leading causes of death being respiratory diseases and cancer. Respiratory manifestations include immune dysfunction leading to recurrent upper and lower respiratory infections; aspiration resulting from dysfunctional swallowing due to neurodegenerative deficits; inefficient cough; and interstitial lung disease/pulmonary fibrosis. Malnutrition is a significant comorbidity. The increased radiosensitivity and increased risk of cancer should be borne in mind when requesting radiological investigations. Aggressive proactive monitoring and treatment of these various aspects of lung disease under multidisciplinary expertise in the experience of national multidisciplinary clinics internationally forms the basis of this statement on the management of lung disease in A-T. Neurological management is outwith the scope of this document.

Justification of Data Warehousing Projects

Project justification is regarded as one of the major methodological deficits in Data Warehousing practice. As reasons for applying inappropriate methods, performing incomplete evaluations, or even entirely omitting justifications, the special nature of Data Warehousing benefits and the large portion of infrastructure-related activities are stated. In this paper, the economic justification of Data Warehousing projects is analyzed, and first results from a large academiaindustry collaboration project in the field of non-technical issues of Data Warehousing are presented. As conceptual foundations, the role of the Data Warehouse system in corporate application architectures is analyzed, and the specific properties of Data Warehousing projects are discussed. Based on an applicability analysis of traditional approaches to economic IT project justification, basic steps and responsibilities for the justification of Data Warehousing projects are derived.