ISSN:1015-9770    

DOI:10.1159/000108266

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:1015-9770    

DOI:10.1159/000108267

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:1015-9770    

DOI:10.1159/000108268

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:1015-9770    

DOI:10.1159/000108269

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:1015-9770    

DOI:10.1159/000108270

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:1015-9770    

DOI:10.1159/000108271

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:1015-9770    

DOI:10.1159/000108201

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We analyzed glutamate levels in cerebrospinal fluid (CSF) with respect to cerebral infarct topography in 67 patients with cortical infarcts and 78 with deep infarcts of less than 24 h duration. Infarct volume and topography were determined on repeated cerebral CT performed between 4 and 7 days after admission. Stroke severity was evaluated by the Canadian Stroke Scale (CSS) at 48 h after inclusion. Glutamate concentration in CSF was 8.4 ± 4.9 µmol/l in patients with cortical infarcts and 6.5 ± 5.2 µmol/l in patients with deep infarcts (p = 0.028). In cortical infarcts, glutamate levels correlated with the CSS score (Spearman coefficient –0.601, p < 0.001) and with the infarct volume (Spearman coefficient 0.671, p < 0.001). In the logistic regression analysis, glutamate was an independent predictor for stroke severity (high: CSS score < 5; low: CSS score ≧ 5) after controlling for age, inclusion delay, body temperature, glucose levels and fibrinogen (odds ratio = 1.3; 95% confidence interval= 1.07–1.67). Glutamate was not related significantly with the severity and size of deep cerebral infarcts. Early neurological deterioration was more frequent in cortical infarcts than in deep infarcts (43 vs. 19%, p < 0.001), and was independently related to glutamate levels in CSF. These results suggest that drugs that inhibit or antagonize glutamate may be useful particularly in cortical

ISSN:1015-9770    

DOI:10.1159/000108202

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

To assess the quality of some aspects of medical hospital care an explicit review instrument (a ''criteria map'') was developed on the basis of available evidence and consensus statements. The criteria are presented as ‘optimal care trajectories’, which depend on the patient''s clinical profile. The criteria map was applied in a study of 738 stroke patients over 45 years of age. We observed for 44% of the 738 studied patients one or more deviations from the optimal care trajectory with respect to at least one of five important aspects of medical care (CT scan, reversal of anticoagulation, treatment of hypertension, anti-platelet therapy, and evaluation of carotid arteries). The frequency of deviations from optimal care increased with patients'' age and level of disability. We conclude that the criteria map is a reliable tool for case-by-case review of the quality of c

ISSN:1015-9770    

DOI:10.1159/000108203

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Stroke accounts for a significant proportion of the expenditures in the health care and social service sectors. Health economics studies of stroke have been performed in several countries. A selection of cost-of-illness studies of stroke from Europe, the USA and New Zealand were reviewed concerning methods of costing. The methodological differences between the studies are significant and this severely limits the possibility of comparing the results. Obtaining consensus on methodology is necessary to make future studies comparable.

ISSN:1015-9770    

DOI:10.1159/000108204

出版商:S. Karger AG    

年代:1997

数据来源: Karger